American Journal of Preventive Medicine最新文献

{"title":"Natural Transitions of Non–High-Density Lipoprotein Cholesterol Levels in Children Aged 9–11 Years","authors":"Yaxing Meng PhD ,&nbsp;Tetsuhiro Kidokoro PhD ,&nbsp;Natsuko Imai PhD ,&nbsp;Russell J. Thomson PhD ,&nbsp;Grant R. Tomkinson PhD ,&nbsp;Costan G. Magnussen PhD","doi":"10.1016/j.amepre.2025.108243","DOIUrl":"10.1016/j.amepre.2025.108243","url":null,"abstract":"<div><h3>Introduction</h3><div>U.S. guidelines recommend universal lipid screening in children aged between 9 and 11 years, with follow-up screening at ages 17–21 years. Non–high-density lipoprotein cholesterol is the preferred marker. However, the stability of non–high-density lipoprotein cholesterol within the screening window remains unclear. This study aimed to estimate the probabilities of non–high-density lipoprotein cholesterol transitioning between its classifications (acceptable, borderline high, and high) during the 9–11-year age period and the average duration that it remains stable within each classification.</div></div><div><h3>Methods</h3><div>This study included 496 Japanese children with non–high-density lipoprotein cholesterol measured between ages 9 and 11 years. Data were collected from 2015 to 2019, and analyses were conducted in 2024. A time-homogeneous continuous-time Markov model was used to estimate the probabilities of transitioning among non–high-density lipoprotein cholesterol classifications—acceptable (&lt;120 mg/dL), borderline high (120-144 mg/dL), and high (≥145 mg/dL)—and the average duration children remained in a given non–high-density lipoprotein cholesterol classification before transitioning.</div></div><div><h3>Results</h3><div>At the population level, all non–high-density lipoprotein cholesterol classifications identified at age 9 years were estimated to remain stable for more than 2 years. Children with acceptable non–high-density lipoprotein cholesterol had a mean duration of 10.6 years (95% CI=7.8, 14.5) before transitioning to another classification, with an estimated 0.90 probability of maintaining in the acceptable classification during the 9–11-year window.</div></div><div><h3>Conclusions</h3><div>Non–high-density lipoprotein cholesterol classifications identified at age 9 years remained stable for over 2 years, supporting the appropriateness of screening at any point within the 9–11-year window. These findings offer insights into optimal lipid-screening practices, thereby enhancing early cardiovascular disease prevention.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108243"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835165","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":"Subpopulation Differences in Connecting to Resources to Address Social Needs","authors":"Deborah A. Gurewich PhD ,&nbsp;Hannah Friedman PhD ,&nbsp;Mingfei Li PhD ,&nbsp;Kelly J. Hunt PhD ,&nbsp;Melissa E. Dichter PhD ,&nbsp;Lauren R. Fanning MPH ,&nbsp;Barbara Niles PhD","doi":"10.1016/j.amepre.2025.108205","DOIUrl":"10.1016/j.amepre.2025.108205","url":null,"abstract":"<div><h3>Introduction</h3><div>Evaluations of healthcare-based interventions to address social needs are flourishing, but few assess for which subpopulations such interventions are comparatively more effective than others. Yet, this is an additional lens for understanding what works and where improvements are needed.</div></div><div><h3>Methods</h3><div>Ad hoc subgroup analyses were conducted in 2024–2025 using data from a 3-arm intent-to-treat RCT (2021–2023). The control arm (Arm 1) received a postcard listing generic Veteran Health Administration resources (e.g., National Call Center for Homeless Veterans). Intervention arms received the same plus tailored resource sheets (Arm 2) and tailored resource sheets plus navigation assistance from a social worker (Arm 3). The primary outcome was social need resource connection. Generalized linear models were used with random effects to account for intervention sites to conduct subgroup analyses on the basis of veteran sociodemographic and clinical characteristics (e.g., age, comorbidity, income). As-treated analysis was also conducted.</div></div><div><h3>Results</h3><div>Among veterans who were low income but ineligible for Veteran Health Administration disability benefits and veterans with ≥4 Elixhauser comorbidities, those randomized to Arm 3 were more likely to connect to ≥1 resource than those randomized to Arm 1 (OR=6.47, 95% CI=1.87, 22.37 and OR=2.18, 95% CI=1.16, 4.10, respectively). Intervention Arm 3 was also associated with higher odds of resource connection in the as-treated analysis than Arm 1 (OR=1.77, 95% CI=1.04, 2.99).</div></div><div><h3>Conclusions</h3><div>Specific veteran subgroups may benefit most from interventions designed to connect patients to social need resources. Given limitations of adhoc analyses, it will be important for future study to explore the generalizability of these findings.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108205"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670671","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":"Polypharmacy as a Simple Measure for Assessing the Risk of Fall-Related Hospitalization in Older Adults","authors":"Marie-Eve Gagnon RN, MSN ,&nbsp;Denis Talbot PhD ,&nbsp;Marc Simard PhD ,&nbsp;Véronique Boiteau MSc ,&nbsp;Caroline Sirois PhD","doi":"10.1016/j.amepre.2025.108206","DOIUrl":"10.1016/j.amepre.2025.108206","url":null,"abstract":"<div><h3>Introduction</h3><div>Medication is a modifiable risk factor for falls. Evaluating medication use may aid in identifying individuals at increased risk of a first fall and in preventing associated outcomes. The aim of this study was to identify the best medication-based measure to evaluate fall-related hospitalization risk among older adults.</div></div><div><h3>Methods</h3><div>A population-based cohort was created using the Quebec Integrated Chronic Disease Surveillance System. Individuals aged &gt;66 on April 1, 2019 (index date) insured by the public drug plan and without fall-related hospitalization the prior year were included. Five medication-based measures were developed, derived from the average number of medications claimed in the previous year (≥5, ≥10 medications, ≥5 third-level Anatomical Therapeutic Chemical classes, ≥1 fall-risk increasing drugs, ≥1 potentially inappropriate medications). Hazard ratios were estimated with sex-stratified Cox models to predict fall-related hospitalization in the year after index date. Predictive performances were compared between each medication-based measure.</div></div><div><h3>Results</h3><div>The cohort included 647,795 women and 529,725 men. Hazard ratios ranged from 1.43 (95% CI=1.37, 1.49) for ≥1 potentially inappropriate medication (women) to 2.17 (95% CI=2.05, 2.31) for ≥10 medications (men). Lowest predictive performance was for ≥1 potentially inappropriate medication (c-statistic=0.724 [women]; 0.722 [men]), and highest predictive performance was for ≥1 fall-risk increasing drug (c-statistic=0.735 [women], 0.736 [men]).</div></div><div><h3>Conclusions</h3><div>All medication-based measures have similar performance in assessing fall-related hospitalization. From a public health standpoint, measures that have the added benefits of being simple and accessible, such as polypharmacy, can support surveillance efforts and inform public health actions.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108206"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679374","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":"Revising the Sustainability Plan for the National Diabetes Prevention Program","authors":"Natalie D. Ritchie PhD ,&nbsp;Melanie T. Turk PhD, RN","doi":"10.1016/j.amepre.2025.108182","DOIUrl":"10.1016/j.amepre.2025.108182","url":null,"abstract":"<div><div>The National Diabetes Prevention Program is a yearlong lifestyle intervention for adults at high risk of developing type 2 diabetes. The program is based on the highly efficacious yet resource-intensive intervention from the landmark Diabetes Prevention Program trial. This <em>Current Issues</em> article examines the successes and challenges in achieving financial sustainability for the NDPP, focusing on strengthening Medicare coverage, which is a key indicator of the program’s long-term potential success. A major barrier is that Medicare reimbursement rates were initially based on incomplete cost estimates that excluded critical components such as participant recruitment and administrative support. Combined with performance-based payment models and frequent claim denials, these low rates have resulted in average payments of only $225 dollars per Medicare participant, leaving a considerable financial shortfall to program suppliers. Low payments have discouraged suppliers from offering the NDPP and may explain its limited uptake, with approximately 0.03% of eligible Medicare beneficiaries participating to date. In this research letter, we identify four strategies to improve sustainability. First, define the minimum cost of effective delivery using rigorous and comprehensive costing studies. Second, systematically reduce administrative burdens to lower indirect costs. Third, set reimbursement rates that reflect actual costs and consider hybrid payment models that both support access and reward outcomes. Fourth, plan for future scale-up by setting delivery targets that are aligned with available resources, while prioritizing the highest-risk populations. Firmly establishing a sustainable delivery model for the NDPP may be key to ensuring widespread uptake and preventing diabetes across the US.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108182"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453843","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":"Beyond Anthropometry: The Clinical Role of Epigenetics in Prenatal Programming of Obesity","authors":"Concetta Schiano PhD,&nbsp;Filomena de Nigris PhD,&nbsp;Claudio Napoli PhD","doi":"10.1016/j.amepre.2025.108213","DOIUrl":"10.1016/j.amepre.2025.108213","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108213"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752330","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 PhD ,&nbsp;Dana Sandler BA ,&nbsp;Shirley J. Lopez De Leon BA ,&nbsp;Seann D. Regan MA ,&nbsp;Wayne R. Lawrence DrPH ,&nbsp;James F. Troendle PhD ,&nbsp;Tiffany M. Powell-Wiley MD, MPH","doi":"10.1016/j.amepre.2025.108087","DOIUrl":"10.1016/j.amepre.2025.108087","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidemiologic studies have linked neighborhood socioeconomic conditions to health. However, few have examined neighborhood structural investment influences on cardiometabolic risk markers across urban environments. This study investigated whether neighborhood structural investment varies by historic redlining, associations between neighborhood structural investment and the prevalence of obesity, diabetes, and coronary heart disease and whether the effect of redlining on obesity, diabetes, and coronary heart disease prevalence is mediated by neighborhood structural investment.</div></div><div><h3>Methods</h3><div>Neighborhood structural investment was measured using a composite score based on census tract data from the MapUSA project, which included home value, rent, vacant houses, and structures older than 30 years (with higher scores representing greater investment). Obesity, diabetes, and coronary heart disease prevalence estimates were from the 2024 Centers for Disease Control and Prevention’s 500 Cities Project 2024 data. Redlining data from the Home Owners’ Loan Corporation scores from the University of Richmond’s Mapping Inequality project were analyzed for 16 U.S. cities. Neighborhood structural investment was tested as a mediator of these associations. Models were adjusted for % Black individuals, % of people aged ≥60 years, % of families in poverty, % of people with a college degree, % unemployed, median household income, and length of residency.</div></div><div><h3>Results</h3><div>Living in a formerly redlined neighborhood was associated with lower neighborhood structural investment longitudinally. Neighborhood structural investment was associated with decreased obesity, diabetes, and coronary heart disease prevalence, but these associations varied by city. Neighborhood structural investment mediated associations between redlining and health outcomes varying by city.</div></div><div><h3>Conclusions</h3><div>This study suggests that historic redlining is associated with contemporary health outcomes via neighborhood structural investment. These findings can be used to inform cardiometabolic health intervention designs.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108087"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Health Plan Design and the Demand for Naloxone: Evidence From a Natural Experiment in New York","authors":"Christopher Dunphy PhD ,&nbsp;Gaius Ahamide PhD ,&nbsp;Kun Zhang PhD ,&nbsp;Gery P. Guy Jr. PhD, MPH","doi":"10.1016/j.amepre.2025.108208","DOIUrl":"10.1016/j.amepre.2025.108208","url":null,"abstract":"<div><h3>Introduction</h3><div>Although supply-side barriers to naloxone have been reduced, receipt remains low in the U.S. Demand-side barriers, such as out-of-pocket costs, may contribute to low receipt. This study evaluated the association between health plan design and receipt of naloxone, leveraging a natural experiment arising from the passage of a naloxone coprescribing law in New York state.</div></div><div><h3>Methods</h3><div>This study used administrative claims data on naloxone and opioid dispensing for the commercially insured population in New York from the Merative MarketScan Database from January 2021 to March 2023. Difference-in-difference models were estimated, comparing codispensed naloxone between individuals enrolled in high-deductible healthcare plans and those enrolled in non–high-deductible healthcare plans before and after New York's passage of the law on December 30, 2021. Data were collected and analyzed in 2025.</div></div><div><h3>Results</h3><div>The policy change was associated with a 4.6 percentage point (95% CI=4.1, 5.0) and 1.3 percentage point (95% CI=0.3, 2.1) increase in the probability of being codispensed naloxone for non–high-deductible healthcare plan and high-deductible healthcare plan groups, respectively, equating to a 131% and 39% increase from their respective baselines. This change in probability among high-deductible healthcare plan enrollees was 3.4 percentage point (95% CI= −4.4, −2.4) lower than that among non–high-deductible healthcare plans enrollees.</div></div><div><h3>Conclusions</h3><div>Individuals facing higher out-of-pocket costs were less likely to fill naloxone prescriptions than those facing lower out-of-pocket costs after the naloxone coprescribing mandate. Supply-side naloxone access policies may be unevenly distributed across patient populations owing to variations in insurance design and associated financial barriers. Addressing demand-side barriers to naloxone uptake may be an important overdose prevention strategy.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108208"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670594","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":"Primary Care–Based Alcohol Screening and Alcohol Use Among Transgender and Cisgender Adults in an Integrated Health System","authors":"Shannon He MD ,&nbsp;Riley Darby-McClure MD ,&nbsp;Matthew E. Hirschtritt MD, MPH ,&nbsp;Stacy A. Sterling DrPH, MSW, MPH ,&nbsp;Michael J. Silverberg PhD, MPH ,&nbsp;Wendy A. Leyden MPH ,&nbsp;Alan H. Shu MD ,&nbsp;Toren S. Andrewson MS ,&nbsp;Vanessa A. Palzes MPH","doi":"10.1016/j.amepre.2025.108240","DOIUrl":"10.1016/j.amepre.2025.108240","url":null,"abstract":"<div><h3>Introduction</h3><div>Alcohol screenings and excessive alcohol use among transgender adults remain understudied. Prior research is limited by small samples, poor generalizability, and lack of validated gender identity data. This study examined alcohol screening rates and excessive use among transgender and cisgender adult members of a large, integrated health system.</div></div><div><h3>Methods</h3><div>Electronic health record data from Kaiser Permanente Northern California (2013–2021) were analyzed. Gender identity was previously verified. Primary outcomes included completion of a standardized alcohol screening over a 2-year follow-up and alcohol use exceeding national sex- and age-based limits. Concordance between screening parameters and sex assigned at birth versus gender identity was explored.</div></div><div><h3>Results</h3><div>Of the 7,933 transgender and 128,577 cisgender adults studied, 76% and 66% received alcohol screening, respectively. Transgender individuals had higher alcohol screening rates (adjusted hazard ratio=1.08; 95% CI=1.05, 1.11), and 68.3% were screened using drinking limits based on sex assigned at birth. Among those screened, excessive alcohol use was lower among transgender individuals (8.2% vs 10.6%; adjusted prevalence ratio=0.85; 95% CI=0.78, 0.93). Prevalence of excessive alcohol use was similar regardless of whether screening parameters aligned with sex assigned at birth or gender identity.</div></div><div><h3>Conclusions</h3><div>Transgender individuals were more likely to receive alcohol screening, and those screened had lower prevalence of excessive alcohol use than cisgender comparators. This study adds to the limited literature on how transgender populations are screened in a real-world clinical setting and may inform future alcohol screening practices and guideline development.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108240"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835157","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 Association Between Recreational Cannabis Legalization and Substance Use Treatment Admissions for Cannabis Misuse, 2010–2021","authors":"Ruoyan Sun PhD,&nbsp;Hao Zhang PhD","doi":"10.1016/j.amepre.2025.108186","DOIUrl":"10.1016/j.amepre.2025.108186","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing legalization of recreational cannabis use in the U.S. has raised concerns about its potential impact on public health, including frequent cannabis use and treatment-seeking behavior. Although previous studies have examined cannabis use prevalence, less is known about its association with utilization of substance use treatment.</div></div><div><h3>Methods</h3><div>This study utilized data from the Treatment Episode Data Set – Admissions from 2010 to 2021. The study sample included all treatment admissions during the study period. Difference-in-differences models were built to examine the association between recreational cannabis law and cannabis-related treatment admissions. Stratified analyses were conducted by age, sex, and race/ethnicity to identify subgroup variations. Statistical analysis was conducted in 2024–2025.</div></div><div><h3>Results</h3><div>Among the 19,873,143 admissions included in this study, 54.7% were aged between 21 and 39 years, 65.8% were males, 62.8% were non-Hispanic White, 75.4% were unemployed or not in the labor force, and 13.5% were married. The proportion of cannabis-related treatment admissions decreased continuously throughout the study period from 18.7% in 2010 to 8.9% in 2021. Although recreational cannabis law was not associated with significant immediate changes in cannabis-related treatment admissions, we identified a delayed effect beginning in the fourth year after policy implementation. Stratified analyses revealed that recreational cannabis law had a significant impact on individuals classified as other (i.e., those not identifying as White, Black, or Hispanic).</div></div><div><h3>Conclusions</h3><div>Recreational cannabis law was associated with a long-term increase in the treatment-seeking behavior among individuals with cannabis use. The impact was particularly large among racial and ethnic minority populations.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108186"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530951","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":"An Investigation of Young Adults' Psychophysiological and Self-Report Responses to Paid Partnership Disclosures in Pro-Oral Nicotine Pouch Videos","authors":"Russell B. Clayton PhD ,&nbsp;Junho Park MA ,&nbsp;Darren Mays PhD, MPH ,&nbsp;Elise M. Stevens PhD","doi":"10.1016/j.amepre.2025.108196","DOIUrl":"10.1016/j.amepre.2025.108196","url":null,"abstract":"<div><h3>Introduction</h3><div>Oral nicotine pouches have surged in popularity on social media, in part owing to promotions by influencers. This study examined how the presence or absence of a paid partnership disclosure in an influencer’s oral nicotine pouch TikTok video impacted psychophysiological and self-report responses of young adults who use oral nicotine pouches.</div></div><div><h3>Study Design</h3><div>Using a between-participant design, participants viewed 1 of 2, 2-minute TikTok simulations that either did or did not have a paid partnership disclosure in an influencer video promoting oral nicotine pouches during the fall of 2024.</div></div><div><h3>Setting/Participants</h3><div>The study was conducted in a media psychophysiology research laboratory and included 96 young adults (aged 18–23 years) who had used oral nicotine pouches within the past 30 days.</div></div><div><h3>Intervention</h3><div>Participants’ heart rates were measured during the TikTok simulation, and they answered self-report questions about oral nicotine pouches before and after viewing the simulation.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcomes included self-reported craving, perceived harm reduction, behavioral intentions, and heart rate as a psychophysiological indicator of cognitive resource allocation.</div></div><div><h3>Results</h3><div>Data were analyzed in the spring of 2025. Psychophysiological data indicated greater cognitive resource allocation among participants who viewed the video with the paid partnership disclosure than among those who viewed the video without the disclosure (<em>p</em>=0.03). Self-report measures revealed significant increases from baseline between message conditions, with craving, perceived harm reduction, and behavioral intentions to use oral nicotine pouches increasing more among participants who viewed the video with the disclosure than among those who viewed the video without the disclosure (all <em>p</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Paid partnership disclosures in an influencer-generated message promoting oral nicotine pouches facilitate attention to the message, heighten craving and intentions to use, and reduce perceived harm of oral nicotine pouches. These findings can be applied in counter-messaging efforts including testing if leveraging influencers to create user-generated content with paid partnership disclosures can effectively inform young adults about the potential risks of oral nicotine pouch use.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108196"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566242","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}