American Journal of Preventive Medicine最新文献

{"title":"Cannabis use & food insecurity risk among U.S. adults with & without children.","authors":"Rishika Chakraborty, Gabby Headrick, Katelyn F Romm, Yan Wang, Darcey McCready, Patricia A Cavazos-Rehg, Laura C Schubel, Morgan Speer, Y Tony Yang, Carla J Berg","doi":"10.1016/j.amepre.2025.107740","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107740","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of cannabis use and food insecurity (FI) have increased in the United States, yet how cannabis use and FI interact, particularly among young parents, remains understudied. This study assessed associations between cannabis use and FI among young adults and differences based on parental status.</p><p><strong>Methods: </strong>The study analyzed two waves (W1-W2) of survey data from 2023-2024 among 3437 US young adults (ages 18-34; M_age=26.4, 61.6% female, 30.4% parents, 27.5% sexual minority, 12.5% Black). Logistic regressions examined W1 past-month cannabis use and W2 past-year FI, and W2 FI and W2 past-month cannabis use, cannabis expenditures, and impact of cannabis cost on amount used, separately, adjusting for sociodemographics and state non-medical cannabis laws. The moderating effect of parental status on each of the above associations was assessed.</p><p><strong>Results: </strong>At W1, 46.6% of participants reported cannabis use. At W2, 39.5% reported cannabis use, 48.2% FI, and 22.9% cannabis use and FI. W1 cannabis use was associated with greater odds of W2 FI (adjusted odds ratio [aOR]=1.62, 95%CI=1.39, 1.88). W2 FI was associated with greater odds of W2 cannabis use (aOR=1.44, 95%CI=1.24, 1.68), greater cannabis expenditures (aOR=1.44, 95%CI=1.17, 1.78), and greater impact of cannabis cost on use (aOR=1.92, 95%CI=1.57, 2.35). The associations between W2 FI and W2 cannabis use were stronger among parents compared to adults without children.</p><p><strong>Conclusions: </strong>Socio-structural, economic, and individual interventions are needed to mitigate FI and address the dynamics between FI and cannabis use that could perpetuate disparities related to FI and cannabis use.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107740"},"PeriodicalIF":4.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235843","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":"Neighborhood firearm violence, psychosocial risks and youth firearm perception.","authors":"Jungwon Min, Vicky Tam, Stephanie Mayne, Polina Krass, Joel Fein","doi":"10.1016/j.amepre.2025.107741","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107741","url":null,"abstract":"<p><strong>Introduction: </strong>Youth firearm access is associated with psychosocial behaviors, violence and injury. Some youth without firearms at home perceive they could obtain one, indicating higher risk than those with securely stored firearms. We examined youth and neighborhood factors associated with perceived firearm availability.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 23,334 Emergency Department (ED) visits by 14-18-year-olds completing Behavioral Health Screening (2013-2024) for firearm availability and psychosocial risks. Neighborhood firearm violence and Child Opportunity Index (COI) scores were linked to patients' census tracts. Patient and neighborhood characteristics were compared across groups: no firearm availability, at-home availability, and perceived availability. Mixed-effects models and mediation analyses further examined the associations.</p><p><strong>Results: </strong>Among 16,174 patients (65% Medicaid insured, 75% in very low COI neighborhoods), perceived firearm availability was associated with racial/ethnic minority status, reported fighting, retaliation, at-risk substance use, school bullying, intimate partner violence, lower COI and higher neighborhood firearm violence. At-home firearm availability was linked to non-Hispanic White status, non-Medicaid insurance, ED visits for mental health, higher COI, and lower firearm violence (all p < 0.001). Among those without firearms at home, fighting (OR=3.6 [3.1-4.3]) and high neighborhood firearm violence (OR=1.8 [1.5-2.3]) were associated with perceived availability after covariate adjustment. Fighting behaviors mediated 32% of the total effect of neighborhood firearm violence on perceived firearm availability.</p><p><strong>Conclusions: </strong>Youth fighting and high neighborhood firearm violence were associated with perceived firearm availability, highlighting the connection between violence exposure and firearm perceptions. ED-based screening for perceived firearm availability may help intervene youth firearm carriage and future violence.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107741"},"PeriodicalIF":4.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235844","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 Between Caring for a Disabled Adult and Spousal Caregiver's Chronic Disease: Evidence from a National Study in China.","authors":"Rixiang Xu, Guiyue Ma, Lijiangshan Hua, Yulian Liu, Tingyu Mu, Dandan Chen","doi":"10.1016/j.amepre.2025.107734","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107734","url":null,"abstract":"<p><strong>Objective: </strong>Spousal caregiving for disabled adults poses health risks, yet few studies address chronic diseases among caregivers of middle-aged and older spouses. This study explores the impact of caregiving on caregivers' chronic disease.</p><p><strong>Methods: </strong>Using data from the China Health and Retirement Longitudinal Study, we included 10,090 spousal caregivers of disabled individuals aged ≥45, categorized into current, previous and no-caregiving groups across 2015-2020 waves, and recorded caregiving duration. Chronic diseases (e.g., hypertension, dyslipidemia, diabetes), their counts, and covariates (including sex, age, education level, location, number of children, internet use, drinking and smoking status, physical activity and social activities) were obtained from the 2020 wave. Binary logistic regression assessed the relationship between caregiving status and chronic diseases, while zero-inflated negative binomial regression analyzed caregiving status and duration on disease counts. Analyses were conducted in October 2024.</p><p><strong>Results: </strong>54.55% of the participants were men, and the mean age was 59.35 ± 8.60 years. The current and previous caregiving groups were more likely to have chronic diseases, particularly arthritis and heart disease, compared to the no-caregiving group. Chronic disease counts were also higher in these groups. Longer caregiving duration also was associated with increased disease counts in both the current and previous caregiving groups.</p><p><strong>Conclusion: </strong>Caregiving for disabled middle-aged and older adults is associated with a higher prevalence and greater number of chronic diseases among caregivers. Caregiving duration is also positively associated with chronic disease counts. Tailored health policies and support systems are crucial for improving caregivers' health and care quality for disabled individuals in China.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107734"},"PeriodicalIF":4.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200750","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 long-term blood pressure with frailty progression in older adults: a prospective cohort study.","authors":"Yinfen Xu, Qiyuan Lv, Yi Liu, Yimo Li, Fenfen Gao, Dan Zhou, Huilin Ji, Ruoting Ge, Jiahe Tian, Yun Lai, Linhui Zhu, Yuxin Chen, Rui Liu, Xiaodong Liu, Shumei Ma, Fang Shi","doi":"10.1016/j.amepre.2025.107735","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107735","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is associated with an increased risk of frailty; however, the role of cumulative blood pressure (CBP) and blood pressure variability (BPV) in frailty remains underexplored. This study aims to investigate the association between long-term blood pressure and the progression of frailty in older adults.</p><p><strong>Methods: </strong>This study analyzed data from the Chinese Longitudinal Healthy Longevity Survey. Cox regression and linear mixed-effects model were used to assess the association between long-term blood pressure and frailty.</p><p><strong>Results: </strong>The longitudinal study included 3,758 participants. The highest quartiles of cumulative systolic blood pressure (CSBP), cumulative diastolic blood pressure (CDBP), systolic blood pressure variability (SBPV), diastolic blood pressure variability (DBPV), and pulse pressure variability (PPV) were associated with an increased risk of frailty. Specifically, the HR (95% CI) for the highest quartiles compared to the lowest were 1.228 (1.067-1.413) for CSBP, 1.201 (1.044-1.382) for CDBP, 1.220 (1.066-1.396) for SBPV, 1.224 (1.099-1.440) for DBPV, and 1.250 (1.090-1.432) for PPV. CBP and BPV exhibited significant interactions with time in frailty index (FI) progression. The highest quartile of CSBP showed an annual FI increase of 0.018 compared to the lowest quartile, while CDBP (β: 0.012), SBPV (β: 0.012), and PPV (β: 0.014) were also associated with the FI progression.</p><p><strong>Conclusions: </strong>Higher CBP and BPV are associated with an increased FI over time. In adults aged ≥65 years, CBP and BPV may serve as early indicators of frailty. These findings highlight the need for a stratified approach to frailty management that considers long-term blood pressure patterns in older adults.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107735"},"PeriodicalIF":4.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200751","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 to Benefit for Lung Cancer Screening: A Systematic Review and Survival Meta-Analysis.","authors":"Eliana E Kim, Irena Cenzer, Francis J Graham, Jasmine Kang, Sei J Lee, Alison S Rustagi","doi":"10.1016/j.amepre.2025.107736","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107736","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer screening with low-dose computed tomography (LDCT) reduces lung cancer mortality in the long term but carries immediate risks. Guidelines recommend screening persons whose life expectancy exceeds the screening test's time to benefit (TTB), defined as the time from screening initiation to first observed benefit. This study aimed to estimate the TTB for lung cancer screening to prevent lung cancer mortality.</p><p><strong>Methods: </strong>Randomized controlled trials of lung cancer screening with LDCT were identified from two prior systematic reviews and an updated search to December 3, 2023. Studies that reported lung cancer mortality were included. For each study, independent Weibull survival curves were fitted and Markov chain Monte Carlo simulations were generated to estimate the absolute risk reduction at different time points. Time to benefit was determined as the time at which absolute risk reduction thresholds (ARR=0.0005, 0.001, 0.002) were crossed. These estimates were pooled using a random-effects meta-analysis model.</p><p><strong>Results: </strong>A total of eight randomized controlled trials comprising 88,526 participants were included. Enrollment age ranged from 50 to 70 years of age; follow-up duration ranged from 7.3 to 12.3 years. For every 1000 persons screened, 3.4 years (95% CI 2.2-5.1) passed before one death from lung cancer was prevented (ARR=0.001). The time to prevent one lung cancer death per 2000 persons screened (ARR=0.0005) was 2.2 years (95% CI 1.4-3.4); per 500 persons screened (ARR=0.002), it was 5.2 years (95% CI 3.7-7.3).</p><p><strong>Discussion: </strong>Lung cancer screening is most appropriate for older adults at high risk of lung cancer with a life expectancy greater than 3.4 years.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107736"},"PeriodicalIF":4.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188454","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":"Healthcare Access among Pregnant Women in States with and without Abortion Restrictions.","authors":"Adam Gaffney, David U Himmelstein, Samuel L Dickman, Lenore Azaroff, Danny McCormick, Steffie Woolhandler","doi":"10.1016/j.amepre.2025.107671","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107671","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107671"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250596","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":"A cohort study of statin prescribing among the uninitiated pre and post the 2013 ACC/AHA guideline change by race, ethnicity and language.","authors":"John D Heintzman, Jorge Kaufmann, Jennifer A Lucas, Brian Chan, Carlos Rodriguez, Dave Boston, Miguel Marino","doi":"10.1016/j.amepre.2025.107659","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107659","url":null,"abstract":"<p><strong>Introduction: </strong>The 2013 American College of Cardiology (ACC)/ American Heart Association (AHA) guidelines to manage atherosclerotic cardiovascular disease (ASCVD) expanded eligibility for medication. To better understand the guidelines' impact on those who should have been on a statin all along, we performed a cohort study of patients eligible-for-but-never-prescribed statins before the guideline change, evaluating statin eligibility or prescription after the guideline change by race, ethnicity, and preferred language.</p><p><strong>Methods: </strong>We used 2012-2020 electronic health record data from low-income patients in community health centers (CHCs) in 14 states to evaluate statin eligibility and prescriptions in patients aged 40-75 years, using multivariable generalized estimating equation logistic regression, accounting for clustering of patients within clinics, adjusted for patient demographics, overall healthcare utilization, and comorbidities.</p><p><strong>Results: </strong>In our sample (N=13,669), Black and most Latino patients were more likely eligible for statins post-guideline change than non-Hispanic whites. All minority groups in our study (except English-preferring Latino patients ≤ 65) were more likely than white adults to receive a statin post-guideline change if eligible. Spanish-preferring Latino patients had the highest prevalence of statin prescriptions. Patients age ≥65 had high eligibility (85% overall), but a statin prescription prevalence of 50% overall.</p><p><strong>Conclusion: </strong>In CHCs, racial and ethnic minority patients, especially Spanish-preferring Latinos, may receive statin prescriptions more than white patients. Further work can help elucidate these trends to aid physicians in effectively and equitably managing ASCVD risk across minority populations as they age.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107659"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133274","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":"Expanding the Concept of Adverse Childhood Experiences: A Decade of Insights.","authors":"Roy Wade, Carolyn Smith-Brown, Leslie Lieberman, Mary Clare Reidy, Peter F Cronholm, Joel A Fein, Lee M Pachter, Christine M Forke","doi":"10.1016/j.amepre.2025.107660","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107660","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107660"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132150","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":"Augmented Doses of Nicotine Replacement Therapy: Feasibility for Dual Cigarette and E-cigarette Cessation.","authors":"Amanda M Palmer, Reid DeMass, Alana M Rojewski, Evan M Bagley, Matthew J Carpenter, Tracy T Smith, Benjamin A Toll","doi":"10.1016/j.amepre.2025.107664","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107664","url":null,"abstract":"<p><strong>Introduction: </strong>Dual use of combustible cigarettes (CC) and e-cigarettes (EC) is common and has harmful health effects. Many who dual use want to quit, but there are no empirically supported dual cessation interventions. High dose nicotine replacement therapy (NRT) is effective for treating heavy smoking and may be applied to treating dual use of CC and EC.</p><p><strong>Methods: </strong>In this pilot feasibility trial, individuals using both CC and EC who wanted to quit were randomly assigned to a 28-day supply of NRT in one of three doses: Standard (21mg patch, qd + 4mg lozenge prn [minimum of 5, up to 20/day]); Mid (21mg patch + 14mg patch + 4mg lozenge [5-30/day]), or High (2 × 21mg patches + 4mg lozenges [5-40/day]). Participants reported CC and EC use daily throughout treatment and 1-month follow-up.</p><p><strong>Results: </strong>Participants enrolled in the study (N=46 from 2023-2024, analyzed 2025) had high nicotine dependence and most completed study procedures. Participants in the Mid group reported using NRT on more days relative to the other groups. Participants in Mid and High reported numerically higher 7-day point-prevalence dual abstinence at end of treatment (13% for both groups vs 6% Standard) and follow-up (33% for both groups vs 0% Standard). GEE models showed a significantly higher likelihood of abstinence on a given day for the Mid and High groups relative to Standard (ps<.05).</p><p><strong>Conclusions: </strong>Augmented doses of NRT are a feasible, promising treatment for dual cessation of CC and EC. Future research should evaluate this approach in a more rigorous, fully powered trial.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107664"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132025","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":"Tobacco spending among low-income older adults in the United States, 2021-2023.","authors":"Erin S Rogers, Christina N Wysota, Scott E Sherman","doi":"10.1016/j.amepre.2025.107661","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107661","url":null,"abstract":"<p><strong>Introduction: </strong>Spending on tobacco products may exacerbate health-related financial hardship experienced by low-income older adults. This study examined tobacco spending and the relationship between tobacco use and non-tobacco spending among low-income older adults in the U.S.</p><p><strong>Methods: </strong>Using pooled 2021-2023 Consumer Expenditure Survey data, 1,983 single-person households (aged ≥65, with income <200% of the federal poverty level) were analyzed. Descriptive statistics summarized quarterly expenditures and budget shares for tobacco and non-tobacco goods. Generalized linear and fractional logit models compared non-tobacco expenditures and budget shares between people who use (versus do not use) tobacco, controlling for sociodemographic covariates.</p><p><strong>Results: </strong>Overall, 10.6% of respondents reported tobacco spending. Respondents who used tobacco spent an average of $305.0 (SD = 303.4) per quarter on tobacco (7.8% of their total budget). Compared to respondents that did not use tobacco, respondents that used tobacco spent significantly more per quarter on alcohol ($54.8 vs. $22.0, P<0.001) and significantly less per quarter on food ($783.9 vs. $837.0, P<0.01), housing ($1,754.5 vs. $2,189.7, P<0.05), health care ($564.0 vs. $720.2, P<0.05), and clothing ($47.8 vs. $64.7, P<0.05). Similarly, respondents that used tobacco spent a significantly greater portion of their budget on alcohol (1.3% vs. 0.4%, P<0.001) and a significantly lower portion on food (19.6% vs. 19.7%, P<0.05), housing (38.8% vs. 43.4%, P<0.01), health care (14.7% vs. 16.8%, P<0.01), and other expenses (2.0% vs. 3.9%, P<0.01).</p><p><strong>Conclusions: </strong>Tobacco spending and its complementary alcohol spending may reduce low-income older adults' expenditures on food, housing and health care.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107661"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132542","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}