American Journal of Preventive Medicine最新文献

{"title":"Message Evaluation Equivalence in Pre Versus Postproduction Tobacco Education Ads","authors":"Emily B. Peterson PhD ,&nbsp;Matthew E. Eggers PhD ,&nbsp;Emily C. Sanders MPH ,&nbsp;Anh Nguyen Zarndt PhD, MPH ,&nbsp;Emily McDonald MPH ,&nbsp;Xiaoquan Zhao PhD ,&nbsp;James M. Nonnemaker PhD ,&nbsp;Nicole B. Swires BA ,&nbsp;Margaret G. Moakley MPH","doi":"10.1016/j.amepre.2025.108044","DOIUrl":"10.1016/j.amepre.2025.108044","url":null,"abstract":"<div><h3>Introduction</h3><div>The U.S. Food and Drug Administration’s The Real Cost campaigns inform the public about the harms of tobacco use. The U.S. Food and Drug Administration has followed a 2-part approach to advertise formative testing to ensure sufficient audience receptivity: preproduction qualitative testing and postproduction quantitative testing. This process provides safeguards for ad performance but course corrections to message selection or development after the ads are already fully produced can be time and resource intensive. This study assesses equivalence in message evaluations between pre and postproduction campaign ads.</div></div><div><h3>Methods</h3><div>Data were collected in 2023 from an online panel survey of 804 youth aged 13–17 years, who currently use or are susceptible to use E-cigarettes or cigarettes. Participants were randomly assigned to a set of 4 preproduction or postproduction The Real Cost campaign ads. Participants completed a series of message evaluation measures after each ad. Authors tested for equivalence of mean message evaluation scores between the pre and postproduction versions of each ad using 2 one-sided <em>t</em>-tests and estimated concordance correlation coefficients. Data were analyzed in 2024.</div></div><div><h3>Results</h3><div>Aggregate ad performance scores between pre and postproduction versions were equivalent. Patterns varied for individual ads, with most demonstrating equivalence on some but not all message evaluation measures. Concordance correlation coefficients for pre and postproduction ads were positive and moderate in size.</div></div><div><h3>Conclusions</h3><div>Results suggest that message evaluation assessments of preproduction ads are likely a good indicator of message evaluation assessments for postproduction ads. Public health practitioners may consider incorporating quantitative copy testing earlier in the formative testing process to identify the most promising ad concepts.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108044"},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042072","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":"Cost-effectiveness and health equity improvements from excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program.","authors":"Aviva A Musicus, Jessica L Barrett, Stephanie McCulloch, Michael W Long, Zachary J Ward, Angie L Cradock, Sara N Bleich, Steven L Gortmaker","doi":"10.1016/j.amepre.2025.108082","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108082","url":null,"abstract":"<p><strong>Introduction: </strong>Excluding sugar-sweetened beverages (SSBs) from eligible purchases in the Supplemental Nutrition Assistance Program (SNAP) has been proposed as a strategy to improve diet quality and health. This study estimates the cost-effectiveness of this policy and its potential impact on health equity.</p><p><strong>Methods: </strong>The Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation and systematic review process was used in 2024 to estimate the potential impact of excluding SSBs from SNAP-eligible purchases over a ten-year period (2023-2032) for the U.S.</p><p><strong>Population: </strong>Health outcomes related to excess weight, costs, and relative changes in obesity prevalence by income, race, and ethnicity group in 2032 were estimated.</p><p><strong>Results: </strong>The policy is projected to be cost-saving, prevent 279,000 cases of obesity (95% UI: 149,000-446,000), and contribute 115,000 (95% UI: 60,100-187,000) quality-adjusted life years gained over ten years among SNAP participants. The policy could save an estimated $2.75 billion in healthcare costs related to excess weight over ten years, resulting in $3.35 in healthcare cost savings per dollar spent on implementation. Reductions in obesity prevalence were estimated to be 3.5 times greater among individuals with income ≤130% of the federal poverty level compared to the overall mean, and 3-3.5 times greater among non-Hispanic Black and Hispanic individuals compared to non-Hispanic white individuals.</p><p><strong>Conclusions: </strong>Excluding SSBs from SNAP-eligible purchases could be a cost-saving strategy to improve health and health equity between income, racial, and ethnic groups. The U.S. Department of Agriculture could use pilot studies to test the real-world effects of excluding SSBs from SNAP.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108082"},"PeriodicalIF":4.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034704","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":"Family History-Guided Physical Activity for Cardiovascular Disease Prevention.","authors":"Ana Polo-López, Joaquín Calatayud, Laura López-Bueno, Rodrigo Núñez-Cortés, Lars Louis Andersen, Rubén López-Bueno","doi":"10.1016/j.amepre.2025.108080","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108080","url":null,"abstract":"<p><strong>Introduction: </strong>It remains unclear if individuals with a family history of cardiovascular disease (CVD) can achieve similar CVD incidence reductions through moderate-to-vigorous physical activity (MVPA) as those without a family history. The aim of the study was to investigate the importance of familial CVD history on the association of MVPA with CVD risk.</p><p><strong>Methods: </strong>A prospective cohort from the UK Biobank who completed one week of accelerometer-based MVPA measurements from June 1, 2013, to December 23, 2015 was analyzed. The exposures were the different doses of MVPA derived from accelerometry. The main outcomes and measures were the dose-response associations between moderate-to-vigorous MVPA and incident CVD in individuals with and without a family history of CVD.</p><p><strong>Results: </strong>74,715 individuals (mean age 55.2 years) were examined. The median follow-up time was 7.9 years. The dose-response association between MVPA and incident CVD among individuals with family history of CVD showed significant risk reductions within the range of 10-1,555 weekly minutes (reference: 0 MVPA minutes). The optimal risk reduction (i.e., nadir of the curve) was identified at 555 weekly minutes of MVPA (HR, 0.72 [95% CI, 0.64-0.81]). The dose-response associations between MVPA and incident CVD among individuals with no family history of CVD showed significant risk reductions within the range of 220-555 weekly minutes. The optimal risk reduction was identified at 445 weekly minutes of MVPA (HR, 0.80 [95% CI, 0.65-0.99]).</p><p><strong>Conclusions: </strong>Physical activity guidelines should account for familial CVD history, as those with a family history may achieve greater risk reductions.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108080"},"PeriodicalIF":4.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034689","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":"Mediating Pathways between Neighborhood Structural Investment and Cardiometabolic Health Across U.S. Cities.","authors":"Marcus R Andrews, Dana Sandler, Shirley Lopez De Leon, Seann Regan, Wayne R Lawrence, James F Troendle, Tiffany M Powell-Wiley","doi":"10.1016/j.amepre.2025.108087","DOIUrl":"10.1016/j.amepre.2025.108087","url":null,"abstract":"<p><strong>Background: </strong>Epidemiologic studies have linked neighborhood socioeconomic conditions to health. However, few have examined neighborhood structural investment (NSI) influences on cardiometabolic risk markers across urban environments. This study investigated whether NSI varies by historic redlining, associations between NSI and the prevalence of obesity, diabetes, and coronary heart disease (CHD) and whether redlining's effect on obesity, diabetes, and CHD prevalence are mediated by neighborhood structural investment.</p><p><strong>Methods: </strong>NSI was measured using a composite score based on census tract data from MapUSA, which included home value, rent, vacant houses, and structures older than 30 years (higher scores representing greater investment). Obesity, diabetes, and CHD prevalence estimates were from the 2024 CDC's 500 Cities 2024 data. Redlining data from the Home Owners' Loan Corporation (HOLC) scores from the University of Richmond's Mapping Inequality Project were analyzed for seventeen U.S. cities. NSI was tested as a mediator of these associations. Models were adjusted for % Black, % of people 60 and older, % of families in poverty, % of people with a college degree, % unemployed, median household income, and length of residency.</p><p><strong>Results: </strong>Living in a formerly redlined neighborhood was associated with lower NSI longitudinally. NSI was associated with decreased obesity, diabetes, and CHD prevalence, but these associations varied by city. NSI mediated associations between redlining and health outcomes varying by city.</p><p><strong>Conclusions: </strong>This study suggests that historic redlining is associated with contemporary health outcomes via neighborhood structural investment. Such findings could be used to inform cardiometabolic health intervention designs.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108087"},"PeriodicalIF":4.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks for adverse events by sex and age after prescription opioid dose reduction.","authors":"Verena E Metz, Vanessa Palzes, Ingrid A Binswanger, Andrea Altschuler, Melissa N Poulsen, Brian K Ahmedani, Susan E Andrade, Robin E Clark, Rulin C Hechter, Michael Horberg, Katherine Sanchez, Steffani R Bailey, Kari A Stephens, Andrea L Rubinstein, Cynthia I Campbell","doi":"10.1016/j.amepre.2025.108085","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108085","url":null,"abstract":"<p><strong>Introduction: </strong>Prescription opioid dose reductions can raise the risk of adverse events for patients on long-term opioid therapy for non-cancer pain. Evidence on whether risks differ by age or sex is needed to support tailored clinical decision-making.</p><p><strong>Methods: </strong>In 2024, a secondary analysis of an observational cohort study was conducted across 8 U.S. healthcare systems analyzing electronic health record and claims data from a prescription opioid registry (excluding buprenorphine prescriptions) between 1/1/2012 and 12/31/2018, including adults with stable prescription opioid use and a subsequent ≥2-month dose reduction period (n=60,040), yielding 600,234 dose reduction periods as the analytic sample. Differences in the association between dose reduction level (1-<15%, 15-<30%, 30-<100%, 100% from baseline) and potential adverse events (emergency department visits, opioid overdose, all-cause mortality, benzodiazepine prescription fills) in the month after dose reduction by sex and age group were examined by including interaction terms in logistic regression models.</p><p><strong>Results: </strong>Of the 600,234 dose reduction periods, 346,733 were among women, with a mean age of 57.5 [SD=13.2] years for women and 56.7 [SD=12.1] years for men. Associations between dose reduction levels and potential adverse events did not differ significantly by sex, but differed by age for emergency department visits: patients 40-64 and ≥65 years with dose reductions of 30-<100% had lower odds compared to those aged 19-39 (adjusted ratio of odds ratios [aROR]=0.87, CI 0.80, 0.96; aROR=0.82, CI 0.74, 0.91; respectively).</p><p><strong>Conclusions: </strong>Patients under 40 may benefit from closer monitoring in the month after dose reduction, given their higher odds of an emergency department visit.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108085"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024689","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":"Identifying physical health concerns of people with a mental health condition: an RCT.","authors":"Caitlin Fehily, Ama Ampofo, Jade Ryall, Joanna Latter, Belinda Jackson, Emily Hielscher, Sumathi Govindasamy, Tara Clinton-McHarg, Julia Dray, Lucy Leigh, Jenny Bowman","doi":"10.1016/j.amepre.2025.108083","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108083","url":null,"abstract":"<p><strong>Introduction: </strong>PhysiCards© have been co-designed to support an interactive, person-led approach to help people with mental health conditions identify and respond to cardiovascular disease (CVD) and other physical health concerns. This study aimed to test the efficacy of the PhysiCards© in assisting people accessing support from a mental health community managed organisation to identify and take action to address CVD and other physical health concerns.</p><p><strong>Study design: </strong>Parallel-group randomised controlled trial.</p><p><strong>Setting/participants: </strong>Participants (>=18 years; N=154) were accessing Flourish Australia services in New South Wales.</p><p><strong>Intervention: </strong>Participants were randomly allocated to a control condition (physical health concerns discussed in line with usual support) or intervention condition (usual care and offered PhysiCards©) delivered in a single session.</p><p><strong>Main outcome measures: </strong>assessed through support worker records of allocation delivery, and participant self-report telephone surveys at baseline, and 1-week and 4-month follow-ups (September 2022 to January 2024). Analysis was conducted in 2025. Primary outcomes were identifying at least one concern participants wanted support for that was a: physical health concern, CVD prevention concern, 'new' (not previously raised with a health professional) physical health concern, and new CVD prevention concern.</p><p><strong>Secondary outcomes: </strong>discussing a concern with a health professional, confidence to raise concerns and acceptability of PhysiCards©.</p><p><strong>Results: </strong>Intervention group participants were significantly more likely to identify a: physical health concern they wanted support for (OR 16.7, 95% CI 5.14-54.24, p<.001), CVD-related concern (OR 7.89, 95% CI 2.91-21.39, p<.001), and new health concern (OR 7.40, 95% CI 2.28-24.05, p<.001). PhysiCards© were rated as highly acceptable. There was no significant difference in discussing concerns with a health professional or confidence in raising concerns.</p><p><strong>Conclusions: </strong>PhysiCards© were efficacious in supporting people to identify CVD and other physical health concerns. Future research is needed to consider additional strategies to enhance their impact on care-seeking.</p><p><strong>Trial registration: </strong>prospectively registered: https://osf.io/r8m97.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108083"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024675","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":"Trends in prenatal opioid use disorder in California, 2010-2022.","authors":"Sidra Goldman-Mellor, Jyotishman Pathak, Claire Margerison","doi":"10.1016/j.amepre.2025.108086","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108086","url":null,"abstract":"<p><strong>Introduction: </strong>Opioid-related deaths among perinatal populations have increased sharply in the United States. Whether the recent ascendence of illicit fentanyl and other synthetic opioids in the drug supply translates to increasing prenatal opioid use disorder (OUD) remains unknown. This study tested whether California's comparatively late fentanyl influx, in 2019, was associated with a subsequent increase in OUD among pregnant people.</p><p><strong>Methods: </strong>This ecologic, repeated retrospective cohort study examined annual cohorts of individuals with an index live-birth delivery in California, 2010-2022. Analyses used statewide, all-payer linked hospitalization and emergency department (ED) records. Overall and subgroup-specific trends in prevalence of prenatal OUD, assessed using ICD-9/10-CM diagnoses recorded at delivery hospitalization and during prenatal ED visits, were examined using joinpoint and logistic regression analyses. Data analysis was conducted in 2025.</p><p><strong>Results: </strong>The study included 4,381,064 index deliveries. Between 2010 and 2022, prevalence of prenatal OUD doubled (as assessed at delivery: 0.15% to 0.30%; as assessed via prenatal OUD ED visits: 0.04% to 0.08%). Joinpoint analysis indicated that most of this increase occurred prior to 2018; annual percentage changes (APC) after 2018 were largely flat (at-delivery prevalence APC: 2.4%, 95% CI, -2.2% to 7.3%; ED prevalence APC: 1.4%, 95% CI, -7.0% to 3.8%). Differences in 2019-2022 vs. 2010-2018 prevalence of prenatal OUD were larger among non-Hispanic White and other/multiple-race individuals, and those covered by Medicaid.</p><p><strong>Conclusions: </strong>The recent introduction of fentanyl to California was associated with only incremental increases in prevalence of prenatal OUD. Continued tracking of these trends is important for perinatal health.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108086"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024714","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":"Factors Associated with Patients Wanting Assistance with their Social Risks.","authors":"Emma L Tucher, Margae J Knox, Richard W Grant, Meagan C Brown","doi":"10.1016/j.amepre.2025.108084","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108084","url":null,"abstract":"<p><strong>Introduction: </strong>Screening and addressing social risks (e.g., finances, food, housing, transportation) has increasingly been used to evaluate health care system performance and to set payment rates. The ability for health systems to intervene is limited by patients who endorse social risks but do not want help from their health care provider.</p><p><strong>Methods: </strong>Data were from Kaiser Permanente's 2022 Social Needs Survey, a representative sample from all eight regional markets. The primary exposures were respondents' demographics. The outcome was whether a patient wanted assistance with social risks assessed using weighted logistic regression modeling conducted in 2025.</p><p><strong>Results: </strong>This cross-sectional study sample included 5,905 respondents. 56.3% were women, mean age was 50.7 (+/- 17.3), 9.0% were Black, 26.3% Hispanic, 43.6% White, and 26.8% had an income below $50,000. 34.8% had at least one social risk, 9.9% had three or more, and 31.7% wanted assistance. In fully adjusted models among respondents with social risks, those with multiple social risks versus one (two: OR 2.5, 95% CI 1.9-3.4; three or more: OR 11.3 95% CI, 6.9-18.4), self-identifying as Black versus White (OR 2.7, 95% CI 1.7-4.3), or had an income <$50,000 (OR 1.9, 95% CI 1.4-2.6) had higher odds of wanting assistance. Being less than 65 was associated with lower odds of wanting assistance (OR 0.3, 95% CI 0.2-0.6).</p><p><strong>Conclusions: </strong>Less than half of respondents with social risks wanted assistance from their health care team. These findings can help health plans and policymakers to target outreach and interventions for individuals who experience social risks.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108084"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024681","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":"Frailty and Risks of Dementia among Middle-aged and Older Adults: Evidence from Three Prospective Cohort Studies.","authors":"Xin Ye, Xinfeng Wang, Mingzheng Hu, Yingying Ouyang","doi":"10.1016/j.amepre.2025.108088","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108088","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty and dementia are prevalent, interrelated conditions in aging populations; yet the temporal relationship between frailty progression and dementia risk remains underexplored. This study aimed to investigate how both baseline frailty and its subsequent changes over time are associated with the risk of incident dementia in three large prospective cohorts.</p><p><strong>Methods: </strong>This study analyzed data from 25,357 participants in three prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) 2011-2020, U.S. Health and Retirement Study (HRS) 2006-2020, and English Longitudinal Study of Ageing (ELSA) 2004-2023. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) between frailty and risks of dementia after adjusting for potential confounders. Analyses were conducted in 2025.</p><p><strong>Results: </strong>Across all three cohorts, participants who were pre-frail (HRs ranging from 1.13 to 1.17) or frail (HRs ranging from 1.37 to 1.54) at baseline had a significantly increased risk of dementia compared to their robust peers. This risk was most pronounced for those whose frailty status worsened over time; robust participants who transitioned to a frail state had increased risks of dementia (HRs ranging from 2.09 to 2.77). Participants who transitioned from pre-frail to frail showed significantly elevated risks of dementia (HR = 1.32). Participants with the upper and middle tertiles of total frailty index, and those in the upper tertile of change in frailty index, exhibited significantly increased risks of dementia.</p><p><strong>Conclusions: </strong>The findings from three large, multi-national cohorts consistently demonstrate a strong link between frailty progression and an increased risk of dementia particularly for those shifting from robust to frail state. This highlights that frailty is a globally relevant, modifiable target for dementia prevention, accentuating the necessity for proactive healthcare approaches to manage its onset and progression.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108088"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024670","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":"The Cost Effectiveness of a Free Summer Day Camp Voucher Program to Prevent Summer Weight Gain among Children from Disadvantaged Households.","authors":"Brian K Chen, Michael W Beets, Sarah Burkart, Christopher D Pfledderer, Elizabeth Adams, R Glenn Weaver, Bridget Armstrong, Keith Brazendale, Xuanxuan Zhu, Alexander McLain","doi":"10.1016/j.amepre.2025.108081","DOIUrl":"10.1016/j.amepre.2025.108081","url":null,"abstract":"<p><strong>Introduction: </strong>Summer day camps (SDC) can mitigate summer weight gain by providing a structured daily environment that promotes healthy behaviors, but SDCs are often cost prohibitive to families with low-income. This study evaluated the cost effectiveness of providing free SDC to disadvantaged children to prevent summer weight gain.</p><p><strong>Methods: </strong>422 children from a low-income school district in South Carolina were recruited and randomly assigned to receive 8-10 weeks of free SDC or to experience summer as usual in 2021-2023. The incremental cost-effectiveness ratio (ICER) was calculated by dividing SDC cost by the difference between the intervention and control groups in changes in Body Mass Index Z-scores (zBMI) from the start to end of summer. ICERs at different doses of SDC participation were also calculated. Sensitivity analyses were conducted using nonparametric bootstrapping of trial-based zBMI outcomes, matched with SDC costs from across the country. The probability of cost-effectiveness was assessed over a range of potential costs at which policymakers may be willing to support.</p><p><strong>Results: </strong>The SDC voucher program averted 0.0917 zBMI gain relative to control at a cost of $1,307, yielding an ICER of $1,463 per 0.1 zBMI averted per child. Attending SDC 5 days per week, the highest dose, yielded the highest cost-effectiveness. Sensitivity analyses showed the bootstrapped ICERs averaged $2,187 per 0.1 zBMI averted, with 80% being less than $3,500 per 0.1 zBMI averted.</p><p><strong>Conclusion: </strong>The voucher program is likely cost effective, with 80% probability of cost-effectiveness if policymakers are willing to pay $3,500 per 0.1 zBMI averted.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108081"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024701","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}