American Journal of Preventive Medicine最新文献

{"title":"Online RCT of added-sugar warning labels and Spanish-English label education.","authors":"Ethan C Wolf, Marissa G Hall, Dean Schillinger, Jim Krieger, Jennifer A Woo Baidal, Sarah Solar, Christina Lin, Jennifer Falbe","doi":"10.1016/j.amepre.2025.107966","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107966","url":null,"abstract":"<p><strong>Introduction: </strong>A policy requiring front-of-package added-sugar warning labels has the potential to improve dietary patterns in the U.S. However, because such a policy would require English labels, the labels may not be equally effective among individuals with varying English proficiency. One potential way to increase the broad efficacy of warning labels is to use a multilingual campaign to explain the labels. This study's objective was to determine whether combining an added-sugar warning label with a Spanish and English educational message reduces intention to select sugar-sweetened beverages (SSBs) to a greater extent than either the label or educational message alone among Hispanic adults.</p><p><strong>Study design: </strong>Online RCT.</p><p><strong>Setting/participants: </strong>2,000 U.S. Hispanic adults with varying acculturation participated between October-December 2022.</p><p><strong>Intervention: </strong>Participants were randomized to 1 of 4 conditions: (1) control, (2) language-matched message about added-sugar warning labels (in English or Spanish), (3) warning label (English, yellow, icon) on SSBs, and (4) message-plus-warning.</p><p><strong>Main outcome measures: </strong>Intention to select an SSB, measured by hypothetical SSB selection in an online shopping task, analyzed May 2023-April 2024.</p><p><strong>Results: </strong>In the control condition, 58% selected an SSB for themselves. In comparison, a significantly lower percentage of participants selected an SSB in the message (43%), warning label (38%), and message-plus-warning (27%) conditions (p-values<0.001). The message-plus-warning condition had a lower risk of SSB selection than both the message and warning conditions (p-values<0.001). Efficacy was larger for the message among those with lower acculturation and for the warning among those navigating the study in Spanish and certain income categories. Results were similar for the secondary outcome of selecting an SSB for one's child.</p><p><strong>Conclusions: </strong>Using educational messages in more than one language to accompany rollout of a new warning label may further improve outcomes in populations with varying levels of acculturation.</p><p><strong>Trial registration: </strong>Trial registered on Clinicaltrials.gov (NCT: NCT05563181).</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107966"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use among pregnant and non-pregnant women of childbearing age: Findings from the 2021-2023 National Survey of Drug Use and Health.","authors":"Timothy J Grigsby, Bertille Assoumou, Stephanie M Koning, Jeffrey T Howard, Krista Howard","doi":"10.1016/j.amepre.2025.107967","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107967","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis use during pregnancy poses potential risks to maternal and neonatal health. This study examines cannabis use prevalence, methods of use (e.g., smoking, vaping, edibles), and associated factors among pregnant and non-pregnant women of reproductive age (12-44 years old) using data from the 2021-2023 National Survey on Drug Use and Health (NSDUH).</p><p><strong>Methods: </strong>Secondary analyses of data from the 2021-2023 NSDUH assessed prevalence of cannabis use and method of use (e.g., smoking, vaping, edibles) along with sociodemographic factors, other substance use, and past year major depressive episode. Multivariable logistic regression models assessed correlates of cannabis use, adjusting for survey design.</p><p><strong>Results: </strong>Cannabis use prevalence was 12.6% among non-pregnant and 6.8% among pregnant women (unweighted N=94,225 women of reproductive age with 2,051 pregnant women). First-trimester use was highest at 10.1%, peaking at 14.2% in 2022. Smoking was the predominant method (non-pregnant: 72.7%; pregnant: 65.4%), followed by vaping and edibles. Covariates of cannabis use included past 30-day alcohol (AOR=7.51; 95% CI=2.71-20.82), tobacco (AOR=3.04; 95% CI=1.50-6.19), and illicit drug use (AOR=4.70; 95% CI=1.37-16.11), and past-year major depressive episode (AOR=2.52; 95% CI=1.35-5.03). Younger age, lower income, and having no children was associated with increased odds of cannabis use.</p><p><strong>Conclusions: </strong>Cannabis use among non-pregnant women increased over the observed period, reflecting increasingly normalized use of cannabis, while pregnant women demonstrated stable rates, with higher first-trimester use. Concurrent substance use and mental health conditions highlight the need for integrated interventions during prenatal care to mitigate risks. These findings underscore the importance of targeted prevention strategies and early interventions, particularly for high-risk groups, to improve maternal and child health outcomes.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107967"},"PeriodicalIF":4.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Preconception and Prenatal Cannabis Use with Breastfeeding.","authors":"Kelly C Young-Wolff, Sara R Adams, Kenya J Homsley, Stacey E Alexeeff, Erica P Gunderson, Monique B Does, Deborah Ansley, Carley Castellanos, Erica Haley, Lyndsay A Avalos","doi":"10.1016/j.amepre.2025.107964","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107964","url":null,"abstract":"<p><strong>Introduction: </strong>Breastfeeding is recommended. It is unknown whether preconception or prenatal cannabis use are related to breastfeeding behaviors.</p><p><strong>Methods: </strong>This population-based retrospective cohort study included 200,207 pregnancies in Northern California (2016-2022) with live births screened in early pregnancy for cannabis use. Exposures included prenatal cannabis use, preconception cannabis use only, or no cannabis use. Additional analyses considered frequency of prenatal cannabis use. Longitudinal breastfeeding outcomes assessed at each well-child visit during the first year included any breastfeeding, and full breastfeeding (breastmilk without formula). Adjusted prevalence ratios (aPRs) were calculated using modified Poisson regression for longitudinal binary outcomes in 2024 and 2025. The risk of stopping breastfeeding among those who started was modeled using Cox proportional hazard regression.</p><p><strong>Results: </strong>Overall, 7.6% of pregnancies had preconception cannabis use only and 7.2% had prenatal use. Most people (94.6% overall) initiated breastfeeding, with only modest differences by cannabis use (94.9% no cannabis use, 95.7% preconception cannabis use only, 90.5% prenatal cannabis use). However, over time, prenatal cannabis use was associated with earlier discontinuation of breastfeeding (aHR 1.12, 95% CI: 1.09-1.15) and lower prevalence of breastfeeding (aPR 0.84, 95% CI: 0.82-0.85 at 6 months, aPR 0.81, 95%CI: 0.78-0.83 at 12 months). Associations were stronger for higher frequency use. There were small differences in breastfeeding among those with preconception cannabis use only verses none. Full breastfeeding results were similar.</p><p><strong>Conclusions: </strong>Despite high prevalence of breastfeeding initiation, prenatal cannabis use was associated with earlier breastfeeding discontinuation and lower prevalence at 6 and 12 months.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107964"},"PeriodicalIF":4.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Trends in Child Cannabis Exposures During Legalization in California.","authors":"Laura A Schmidt, Laurie M Jacobs, Ellicott C Matthay, James Roake, Justin Lewis, Raymond Ho, Dorie E Apollonio","doi":"10.1016/j.amepre.2025.107963","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107963","url":null,"abstract":"<p><strong>Introduction: </strong>In 2016, California legalized cannabis for adult recreational use; after recreational sales began in 2018, it became the largest retail market worldwide. This study profiled specific risks and prevention opportunities across age groups and examined changes in medically significant child cannabis exposures before and after legalization.</p><p><strong>Methods: </strong>Researchers conducted analyses, including interrupted time-series, to examine 1695 California Poison Control System (CPCS) reports of cannabis exposure in children 0-17 years of age, from 2010-2020. Analyses were confined to moderate and severe exposures, identified by CPCS toxicologists as requiring medical attention.</p><p><strong>Results: </strong>Monthly rates of moderate/severe cannabis exposure per million children increased following legalization (β=0.06, CI [0.05, 0.08]), especially in children under 5. Fourteen percent required critical care admission. Exposures were primarily unintentional in younger children (87.7-99.2%) and intentional in adolescents (85.5%). Across all ages, most exposures occurred in the home (94.0%) and involved edible products (83.5%). An analysis of packaging on edible brands frequently cited in health records found that most could be easily mistaken for popular candies and snack foods.</p><p><strong>Conclusions: </strong>Following cannabis legalization in California, reports of child cannabis exposures requiring medical attention increased significantly. Most reported cannabis exposures occurred in the home through the ingestion of edible products, often packaged to look like popular candy and snack food brands. To prevent these harms, cannabis legalization should be accompanied by robust marketing and packaging regulations (e.g., plain labels, larger warning labels). Secondary prevention should focus on educating parents and caregivers on safe cannabis storage in the home.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107963"},"PeriodicalIF":4.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-based health centers and the utilization of primary care in rural communities.","authors":"Xue Zhang, Sharon Tennyson, Chris Kjolhede, Wendy M Brunner","doi":"10.1016/j.amepre.2025.107962","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107962","url":null,"abstract":"<p><strong>Introduction: </strong>School-based health centers (SBHCs) in rural communities improve students' access to primary care, but evidence on service utilization patterns is limited.</p><p><strong>Methods: </strong>2011-2017 healthcare encounter data for students (ages 5-18) who used primary care were analyzed to compare utilization patterns (total number of office visits, well-child, immunization, chronic-condition visits) in a four-county rural region of New York. Students were categorized into no-SBHC-access (living in school districts without SBHCs) and SBHC-access (living in districts with SBHCs). Students with SBHC access were further categorized into SBHC-non-users (with SBHC access but not using SBHCs), SBHC-only-users (only using SBHCs), and hybrid-users (using SBHCs and other primary care providers).Treatment effects of SBHC-access and usage categories were estimated, adjusting for age, sex, year, community-level socioeconomic factors, and student/school district random effects. Hybrid-users' visits were stratified by site (SBHC versus non-SBHC clinic). Analyses were performed in 2025.</p><p><strong>Results: </strong>Students with SBHC access included 24% SBHC-non-users, 52% SBHC-only-users, and 24% hybrid-users. Compared to the no-SBHC-access category, SBHC-access was associated with greater primary care utilization. Results differed within SBHC-access: hybrid-users had the highest utilization, while SBHC-non-users had the lowest. SBHC-only-users had more office visits and were more likely to have immunization visits than students without SBHC access. Hybrid-users had more office visits and immunizations at SBHCs than other primary care clinics.</p><p><strong>Conclusions: </strong>SBHCs increased overall office visits and immunization visits among students using primary care in this rural region. Promoting SBHC enrollment and use is important as effects were seen only among students who utilized the SBHC.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107962"},"PeriodicalIF":4.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Provider Communication among U.S. Adults with Food Insecurity.","authors":"Sungchul Park, Seth A Berkowitz","doi":"10.1016/j.amepre.2025.107958","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107958","url":null,"abstract":"<p><strong>Introduction: </strong>Food-insecure adults may experience poor patient-provider communication, potentially compromising care delivery, but this remains unclear. This study examined whether food-insecure adults face poorer patient-provider communication than food-secure adults and how this interplay affects access to care, health care utilization, and financial burden of care.</p><p><strong>Methods: </strong>This study used data from the 2016, 2017, and 2021 Medical Expenditure Panel Survey. Outcomes included patient-provider communication, access to care, health care utilization, and financial burden of care. Key independent variables were patient-provider communication and food insecurity. Analysis was conducted in September 2024.</p><p><strong>Results: </strong>Food-insecure adults reported poorer patient-provider communication than food-secure adults, with 9.0% (95% CI: 7.7-10.3) and 56.0% (53.9-58.2) in reporting low and moderate communication among food-insecure adults vs. 4.3% (4.1-4.6) and 50.7% (50.0-51.4) in reporting low and moderate communication among food-secure adults. Furthermore, food insecurity was associated with lower access to care, higher emergency departments visits, and greater financial burdens, particularly among adults with low communication. Among adults with low communication, the likelihood of having a usual source of care was lower for food-insecure adults than food-secure adults: 69.9% (61.3-78.6) vs. 84.2% (79.8-88.6). Among adults with low communication, food-insecure adults had higher rates of emergency department visits (40.2% [34.5-45.8] vs. 20.1% [17.6-22.6]) and reported experiencing problems paying medical bills (43.7% [37.6-49.8] vs. 20.1% [17.6-22.6]) than food-secure adults.</p><p><strong>Conclusions: </strong>These results underscore the complex health care needs of food-insecure populations and highlight the need to enhance communication strategies to effectively address these challenges.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107958"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic Discrimination's Role on Increased Substance Susceptibility and Use Among US Youth.","authors":"Robert Rosales, Philip Veliz, John Jardine, Alexander S Weigard, Sean Esteban McCabe","doi":"10.1016/j.amepre.2025.107956","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107956","url":null,"abstract":"<p><strong>Introduction: </strong>. Recently, US youth of color reported greater use of alcohol, tobacco, and cannabis than White youth. Increased levels of discrimination in recent years may have added to the chronic burden associated with increased use among youth of color. Little is known about this relationship, especially among youth who initiate substance use earlier in adolescence. This study assessed the prevalence of substance susceptibility (willingness and curiosity) and use (alcohol, tobacco and cannabis) among youth by race/ethnicity and ethnic discrimination's role on this relationship.</p><p><strong>Methods: </strong>. Data come from the national panel of 11,868 US youth in the Adolescent Brain Cognitive Development study (baseline through 4^th year follow-up), which assessed these relationships beginning at 9-10 years old. Prevalence of lifetime substance susceptibility and use were quantified by race/ethnicity. Multivariable longitudinal analyses tested whether 1) discrimination was connected to substance susceptibility and lifetime use, and 2) whether that relationship differed by race/ethnicity.</p><p><strong>Results: </strong>. When compared to White youth, Black youth reported lower lifetime alcohol and tobacco use, lower curiosity towards alcohol and tobacco, and higher willingness to try alcohol. Hispanic youth reported higher willingness to try alcohol. Asian youth reported lower lifetime tobacco use. Higher levels of ethnic discrimination were consistently associated with greater odds of susceptibility and use among all racial/ethnic groups in this study.</p><p><strong>Conclusions: </strong>. Results show youth of color report lower substance use, however ethnic discrimination may account for some of the recent increased national trends in substance use among youth of color through its impact on their increased susceptibility to use substances.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107956"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Series Analysis of Infant Mortality Disaggregated by Race, Ethnicity and Specific Causes After 6-Week Abortion Ban.","authors":"Kelly DeBie, Kayleigh P Keller, Margaret J Gutilla, David Rojas-Rueda, Jennifer L Peel, Andreas M Neophytou","doi":"10.1016/j.amepre.2025.107960","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107960","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, Texas Senate Bill 8 banned abortion after six weeks gestation. Prior research has shown persistent differences in infant mortality by race/ethnicity and an overall increase in infant mortality in association with SB8. It is unclear whether recent changes may be differential by race, ethnicity, and causes of death.</p><p><strong>Methods: </strong>Using a population-based cohort of all infants under the age of one-year in Texas and 26 abortion rights protective states, a controlled interrupted time series analysis used Poisson regression to assess the association between changes in the law and monthly counts of infant deaths, adjusting for both long-term trends and seasonality. Monthly data was obtained from the Centers for Disease Control and Prevention Wonder dataset from January 2018 through December 2024.</p><p><strong>Results: </strong>Overall mortality in Texas was 17% higher after the six-week ban when compared to before (95% Confidence Interval (CI): 9%, 25%) and 10% higher than in comparison states. In disaggregated race and ethnicity data, Non-Hispanic Black mortality in Texas was 21% higher (95%CI: 5%, 38%) and 17% higher than in comparison states. Cause-specific mortality in Texas was also found to be 21% higher for congenital anomalies (95% CI: 6%, 39%), 19% higher than in comparison states.</p><p><strong>Conclusions: </strong>This study found evidence of increased infant mortality in Texas after the implementation of a six-week abortion ban with differential impact identified for Non-Hispanic Black infants in a comparison analysis. These results build on growing evidence and should guide and inform policy and public health interventions addressing increased infant mortality.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107960"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Preventive Health Services Between Transgender and Cisgender Adults by State-Level Policy Environments.","authors":"Irina Degtiar, Junqyeon Kim, Eli Michaels, Ian Huff, Mike Rudacille, Nancy Clusen, Aaron Ferguson, Esther Smith-Howell, Gilbert Gonzales","doi":"10.1016/j.amepre.2025.107954","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107954","url":null,"abstract":"<p><strong>Introduction: </strong>Transgender and gender diverse populations account for more than 1.3 million adults in the United States and experience substantial health disparities and barriers to care. This study compared preventive health services utilization between transgender and cisgender adults by state-level policy environments in 10 US states.</p><p><strong>Methods: </strong>Data on adults aged 18 years and older were extracted from two different sources: self-identified transgender (n=748) and cisgender (n=204,973) adults from the 2017-2019 Behavioral Risk Factor Surveillance System, as well as adults receiving a gender identity disorder diagnosis (i.e., transgender; n=38,037) or not receiving a gender identity disorder diagnosis (i.e., cisgender; n=34,645,129) in Medicaid based on provider reimbursement claims between 2017-2019. This study used hierarchical Bayesian models that borrowed information across states, time, and covariate groups to improve precision.</p><p><strong>Results: </strong>We identified five gender non-affirming states (Tennessee, Louisiana, Texas, Idaho, and Indiana) and five gender-affirming states (Illinois, California, Washington, Maryland, and New York). Results based on the BRFSS indicated that the disparities between transgender and cisgender adults in receiving an annual wellness visit, having a primary care provider, and receiving a flu vaccine or screenings for HIV, diabetes, and cervical cancer were wider in gender non-affirming states than in gender-affirming states. Results based on Medicaid claims data were mixed.</p><p><strong>Conclusions: </strong>State-level policy environments may affect disparities in preventive medicine for transgender individuals. Moving towards public policies and best clinical practices that are gender-affirming may improve health care access and advance health equity for transgender and gender diverse populations across the United States.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107954"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in Care Among Adolescents and Young Adults in The United States.","authors":"Samhita M Ilango, Robert Hest, Annie Schmidt, Margaret A McManus, Kathleen Call, Patience H White","doi":"10.1016/j.amepre.2025.107957","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107957","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults (AYAs) face several challenges to their wellbeing as they move into adulthood and assume a larger role in navigating their health, health care, and health insurance. This study examines gaps in care that may result in missed opportunities for health promotion and maintenance, early intervention, and acute and chronic care management.</p><p><strong>Methods: </strong>This study used the 2022-2023 National Health Interview Survey data of individuals 10-25 years old to understand which AYA age groups (10-14, 15-18, and 19-25 years) experience gaps in care and which sociodemographic, health status, and health care access variables are associated with increased odds of care gaps. The analysis was conducted in 2025.</p><p><strong>Results: </strong>More than 1 in 4 young adults (YAs) experienced a gap in care of 1 or more years, a rate twice that of adolescents. Measures of health care access-namely, being uninsured and without a usual source of care-were predictive of gaps in care across all 3 age groups. The sociodemographic factors of citizenship, region, and poverty level were also associated with care gaps across all 3 age groups.</p><p><strong>Conclusions: </strong>Policymakers, payers, public agencies, and health care providers can play an important role in AYA health. There should be increased attention to identifying and assisting AYAs with (and at risk for) lapses in coverage and care, prioritizing those without a medical home, transitioning from pediatric to adult care, losing childhood Medicaid or CHIP eligibility status, and residing in states not expanding Medicaid.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107957"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}