American Journal of Preventive Medicine最新文献

{"title":"Electronic Adolescent Substance Use Screening: Focus on Implementation is Needed","authors":"Amy M. Yule MD , Alyssa Levin-Scherz MD , Julianna Brody-Fialkin LICSW, MPH , Dana S. Rubin MD, MSW , Caroline J. Kistin MD, MPH","doi":"10.1016/j.amepre.2024.10.018","DOIUrl":"10.1016/j.amepre.2024.10.018","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 418-421"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559319","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":"Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth","authors":"Katrina A. Vickerman PhD ,&nbsp;Kelly M. Carpenter PhD ,&nbsp;Kristina Mullis PhD ,&nbsp;Abigail B. Shoben PhD ,&nbsp;Julianna Nemeth PhD ,&nbsp;Elizabeth Mayers MS ,&nbsp;Elizabeth G. Klein PhD, MPH","doi":"10.1016/j.amepre.2024.10.019","DOIUrl":"10.1016/j.amepre.2024.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Broad-reaching, effective e-cigarette cessation interventions are needed.</div></div><div><h3>Study Design</h3><div>This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.</div></div><div><h3>Setting/Participants</h3><div>Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18–24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.</div></div><div><h3>Intervention</h3><div>All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).</div></div><div><h3>Main Outcome Measures</h3><div>Self-reported 7-day point prevalence vaping abstinence at 3 months.</div></div><div><h3>Results</h3><div>A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; <em>p</em>=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; <em>p</em>=0.84).</div></div><div><h3>Conclusions</h3><div>This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.</div></div><div><h3>Trial Registration</h3><div>clinicaltrials.gov NCT04974580.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 366-376"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814975","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":"Response to Letter to the Editor in Response to “Psychedelic Use by Sexual Minority Adults in the United States, 2022”","authors":"Juhan Lee PhD,&nbsp;Maria A. Parker PhD, MS, MPH","doi":"10.1016/j.amepre.2024.09.015","DOIUrl":"10.1016/j.amepre.2024.09.015","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Page 422"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029745","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":"Cardiovascular Disease Mortality Trends, 2010–2022: An Update with Final Data","authors":"Rebecca C. Woodruff PhD ,&nbsp;Xin Tong MPH ,&nbsp;Fleetwood V. Loustalot PhD ,&nbsp;Sadiya S. Khan MD, MSc ,&nbsp;Nilay S. Shah MD ,&nbsp;Sandra L. Jackson PhD ,&nbsp;Adam S. Vaughan PhD, MPH","doi":"10.1016/j.amepre.2024.09.014","DOIUrl":"10.1016/j.amepre.2024.09.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Age-adjusted mortality rates (AAMR) for cardiovascular diseases (CVD) increased in 2020 and 2021, and provisional data indicated an increase in 2022, resulting in substantial excess CVD deaths during the COVID-19 pandemic. Updated estimates using final data for 2022 are needed.</div></div><div><h3>Methods</h3><div>The National Vital Statistics System's final Multiple Cause of Death files were analyzed in 2024 to calculate AAMR from 2010 to 2022 and excess deaths from 2020 to 2022 for U.S. adults aged ≥35 years, with CVD as the underlying cause of death.</div></div><div><h3>Results</h3><div>The CVD AAMR among adults aged ≥35 years in 2022 was 434.6 deaths per 100,000 (95% CI=433.8, 435.5), which was lower than in 2021 (451.8 deaths per 100,000; 95% CI=450.9, 452.7). The most recent year with a similarly high CVD AAMR as in 2022 was 2012 (434.7 deaths per 100,000 population, 95% CI=433.8, 435.7). The CVD AAMR for 2022 calculated using provisional data overestimated the AAMR calculated using final data by 4.6% (95% CI=4.3%, 4.9%) or 19.9 (95% CI=18.6, 21.2) deaths per 100,000 population. From 2020 to 2022, an estimated 190,661 (95% CI=158,139, 223,325) excess CVD deaths occurred.</div></div><div><h3>Conclusions</h3><div>In 2022, the CVD AAMR among adults aged ≥35 years did not increase, but rather declined from a peak in 2021, signaling improvements in adverse mortality trends that began in 2020, amid the COVID-19 pandemic. However, the 2022 CVD AAMR remains higher than observed before the COVID-19 pandemic, indicating an ongoing need for CVD prevention, detection, and management.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 391-395"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331832","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":"Chronic Opioid Use After Implementation of Oregon's Medicaid Back Pain Policy","authors":"Daniel M. Hartung PharmD, MPH ,&nbsp;Sanae El Ibrahimi PhD ,&nbsp;Catherine J. Livingston MD, MPH ,&nbsp;Christina J. Charlesworth MPH ,&nbsp;K. John McConnell PhD ,&nbsp;Esther K. Choo MD, MPH","doi":"10.1016/j.amepre.2024.10.004","DOIUrl":"10.1016/j.amepre.2024.10.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify the factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy after implementation of this policy.</div></div><div><h3>Methods</h3><div>Using Medicaid administrative claims data, this was a retrospective cohort of patients on chronic stable opioid therapy between July and December 2016. Outcomes assessed were (1) 30% reduction in opioid dose and (2) an absolute discontinuation between January and December 2017. Multivariable logistic regressions evaluated the association between dose reduction outcomes and clinical and demographic factors.</div></div><div><h3>Results</h3><div>Of 4,643 Medicaid patients on chronic opioid therapy, 3,853 (83%) had a dose reduction, and 651 (14%) discontinued opioids; patients with back pain were more likely to have a dose reduction (AOR=1.19; 95% CI=1.01, 1.41). Factors associated with discontinuation included having a mental health diagnosis (AOR=1.30; 95% CI=1.08, 1.56), substance use disorder (AOR=1.90; 95% CI=1.41, 2.56), opioid use disorder (AOR=1.55; 95% CI=1.21, 1.99), and receipt of buprenorphine (AOR=2.82; 95% CI=1.30, 6.15). Discontinuation was less likely in Black patients (AOR=0.50; 95% CI=0.29, 0.85), in older age groups, and in those with a higher opioid dose at baseline.</div></div><div><h3>Conclusions</h3><div>Most Medicaid beneficiaries had a dose reduction after implementation of Oregon's back pain policy. Opioid discontinuation was associated with factors that suggest that providers pursue this strategy for patients at higher overdose risk.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 272-280"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479917","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 of Mandating Calorie Labels on Prepared Foods in Supermarkets","authors":"Anna H. Grummon PhD ,&nbsp;Jessica L. Barrett MPH ,&nbsp;Jason P. Block MD ,&nbsp;Stephanie McCulloch MPH ,&nbsp;Amy Bolton BA ,&nbsp;Roxanne Dupuis PhD ,&nbsp;Joshua Petimar ScD ,&nbsp;Steven L. Gortmaker PhD","doi":"10.1016/j.amepre.2024.10.007","DOIUrl":"10.1016/j.amepre.2024.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The U.S. has required chain food establishments—including supermarkets—to display calorie labels on prepared (i.e., ready-to-eat) foods since 2018. Implementation of this supermarket calorie labeling policy reduced purchases of prepared foods from supermarkets, but it remains unknown whether the policy is cost-effective.</div></div><div><h3>Methods</h3><div>In 2023–2024, this study applied the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) microsimulation model to estimate the effects of the supermarket calorie labeling policy on health, costs, and cost-effectiveness over 10 years (2018–2027) for the U.S. population. The model projected benefits overall and among racial, ethnic, and income subgroups. Sensitivity analyses varied assumptions about the extent to which consumers replace calorie reductions from prepared foods with calories from other sources (i.e., caloric compensation).</div></div><div><h3>Results</h3><div>From 2018–2027, the supermarket calorie labeling policy was projected to save $348 million in healthcare costs (95% Uncertainty Interval [UI]=$263, $426 million), prevent 21,700 cases of obesity (95% UI: 18,200–25,400), including 3,890 cases of childhood obesity (95% UI=2,680, 5,120), and lead to 15,100 quality-adjusted life years (QALYs) gained across the U.S. population (95% UI=10,900, 20,500). The policy was projected to prevent cases of obesity and childhood obesity across all racial, ethnic, and income groups. The policy was projected to be cost-saving when assuming low and moderate caloric compensation and cost-effective when assuming very high caloric compensation.</div></div><div><h3>Conclusions</h3><div>A policy requiring calorie labels on prepared foods in supermarkets was projected to be cost-saving or cost-effective and lead to reductions in obesity across all racial, ethnic, and income groups.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 300-310"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479930","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":"Sex Differences in Methamphetamine Mortality in the United States: Heroin and Fentanyl Coinvolvement, 1999–2021","authors":"Tonazzina H. Sauda MBBS ,&nbsp;R. Andrew Yockey PhD ,&nbsp;Sofia B. Marin ,&nbsp;Rachel A. Hoopsick PhD, MS, MPH, MCHES","doi":"10.1016/j.amepre.2024.10.012","DOIUrl":"10.1016/j.amepre.2024.10.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Prepandemic data suggests that methamphetamine-related mortality and opioid coinvolvement have been increasing in the U.S. However, there was a staggering number of U.S. drug overdose deaths in 2020 and 2021, particularly among males. An updated examination of sex-specific trends in methamphetamine-related mortality, the extent to which these deaths may be driven by the heroin and fentanyl coinvolvement, and whether this coinvolvement might explain the disproportionate number of male methamphetamine deaths is warranted.</div></div><div><h3>Methods</h3><div>The authors leveraged final and provisional data from the CDC WONDER multiple causes of death database to examine deaths involving methamphetamine (i.e., psychostimulants with abuse potential, ICD-10 code T43.6) and methamphetamine-related deaths that coinvolved heroin and/or synthetic opioids excluding methadone (ICD-10 code T40.4; e.g., fentanyl) among U.S. residents aged 15–74 years. The authors plotted age-adjusted methamphetamine mortality rates by sex and year and quantified the proportion of deaths with heroin/synthetic opioid coinvolvement. Finally, they used Joinpoint regression models to quantify sex-specific trends in methamphetamine mortality and the proportion of deaths with heroin and/or synthetic opioid coinvolvement.</div></div><div><h3>Results</h3><div>From 1999 to 2021, the methamphetamine-related mortality rate increased 58.8-fold among males (0.33 per 100,000 to 19.74 per 100,000) and 65.3-fold among females (0.12 per 100,000 to 7.96 per 100,000), with the greatest increases occurring between 2019 and 2021. The proportion of these deaths that coinvolved heroin and/or synthetic opioids increased among both males (13.1% to 61.5%) and females (7.7% to 63.1%) from 1999 to 2021.</div></div><div><h3>Conclusions</h3><div>Increasing methamphetamine-related mortality among males and females has been accompanied by a dramatic increase in the proportion of heroin and/or synthetic opioid coinvolvement among both sexes. Robust harm reduction efforts are needed to mitigate these increases, particularly for people who couse stimulants and opioids.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 320-326"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568608","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":"The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation","authors":"Lisa G. Rosas PhD, MPH ,&nbsp;Steven Chen MD ,&nbsp;Lan Xiao PhD ,&nbsp;Mike Baiocchi PhD ,&nbsp;Elliot Ng BS ,&nbsp;Benjamin O. Emmert-Aronson PhD ,&nbsp;Wei-Ting Chen PhD ,&nbsp;Ariana Thompson-Lastad PhD ,&nbsp;Erica Martinez BS ,&nbsp;Josselyn Perez BA ,&nbsp;Eric Melendez AA ,&nbsp;Elizabeth Markle PhD ,&nbsp;Marcela D. Radtke PhD ,&nbsp;June Tester MD","doi":"10.1016/j.amepre.2024.10.020","DOIUrl":"10.1016/j.amepre.2024.10.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Food as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine.</div></div><div><h3>Methods</h3><div>Recipe4Health (R4H), a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a “Food Farmacy” (16 weekly produce home deliveries) alone or in combination with a “Behavioral Pharmacy” (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record outcomes over 12 months was conducted. Participants were 2,643 R4H patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023 to 2024.</div></div><div><h3>Results</h3><div>There was a significant increase in produce consumption from baseline to 4 months (0.41 servings/day [0.11, 0.72], <em>p</em>=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (–17.1 mg/dL [–26.9, –7.2], <em>p</em>&lt;0.001) and in combination with Behavioral Pharmacy (–17 mg/dL [–28.3, –5.8], <em>p</em>=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (–0.37%, 95% CI [–0.65, –0.08]; <em>p</em>=0.01), but not the Food Farmacy with Behavioral Pharmacy.</div></div><div><h3>Conclusions</h3><div>R4H resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 377-390"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568725","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":"Racial Differences in Adverse Childhood Experiences: Timing and Patterns.","authors":"Xiafei Wang, Qingyang Liu, Ying Xu, Wenna Xi, Brooks B Gump, Sara A Vasilenko","doi":"10.1016/j.amepre.2025.01.021","DOIUrl":"10.1016/j.amepre.2025.01.021","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional research on adverse childhood experiences (ACEs) often retrospectively assesses ACEs and treats ACEs as a composite score, potentially overlooking the distinct effects of specific ACE patterns and their critical timing, which may influence health outcomes differently. It is crucial to explore variations in the patterns and timing of ACE exposure across racial/ethnic groups to improve ACE screening and intervention strategies.</p><p><strong>Methods: </strong>In 2023, this study analyzed data of the Future of Families and Child Wellbeing Study (FFCWS) initially conducted in 1998. FFCWS sampled children from three racial/ethnic groups (N_Black=2,587; N_Latine=1,577; N_White=770). ACEs were assessed through 7 indicators from ages 3 to 15 years, including physical and psychological abuse, neglect, witnessing maternal intimate partner violence, parental depression, separation, and material hardship. Using Longitudinal Latent Class Analysis, this research aimed to identify distinctive patterns and timing of ACEs among White, Black, and Latine youth.</p><p><strong>Results: </strong>The analysis revealed a 9-class model applicable to these 3 racial/ethnic youth groups. Classes combining material hardship with other ACEs and those featuring adolescent abuse were more prevalent among Black and Latine youth. This study also identified a class displaying a temporal pattern, such as early maternal intimate partner violence followed by late parental separation.</p><p><strong>Conclusions: </strong>This study highlights the necessity of analyzing diverse class structures and the timing of ACEs across different racial/ethnic groups. Understanding these nuances is vital for developing culturally tailored interventions to reduce health disparities.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076291","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 for Lonely, Socially Isolated Adults in Medicare.","authors":"Sungchul Park, Ann M Nguyen, Zoe Lindenfeld, Ji Eun Chang","doi":"10.1016/j.amepre.2025.01.018","DOIUrl":"10.1016/j.amepre.2025.01.018","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults experiencing loneliness or social isolation may experience poor patient-provider communication, potentially contributing to suboptimal healthcare utilization, particularly in mental healthcare. However, empirical evidence is limited. Thus, this study examined whether there were differences in patient-provider communication and healthcare utilization between Medicare beneficiaries with and without loneliness and social isolation.</p><p><strong>Methods: </strong>This study conducted a cross-sectional study using data from the 2021 Medical Expenditure Panel Survey. Outcomes were patient-provider communication and healthcare utilization. The primary independent variables were loneliness and social isolation. Regression analysis was conducted to estimate adjusted differences in outcomes between Medicare beneficiaries with and without loneliness and social isolation. The analysis was conducted in September 2024.</p><p><strong>Results: </strong>The sample included 4,433 Medicare beneficiaries. Medicare beneficiaries experiencing loneliness were 4.0 percentage points (95% CI=1.0, 7.1) more likely to report poor patient-provider communication compared to those without loneliness. Similarly, those with social isolation were 2.0 percentage points (1.1, 2.9) more likely to report poor communication than those without social isolation. The rates of mental healthcare utilization were higher among those with loneliness (1.8 [1.0, 2.6], 1.5 [0.8, 2.2], and 3.1 [1.1, 5.1] for social workers, psychologists, and psychiatrists) or social isolation (2.3 [0.6, 4.0] for psychiatrists), but the overall level of mental healthcare utilization remained relatively low.</p><p><strong>Conclusions: </strong>These findings highlight significant disparities in patient-provider communication among Medicare beneficiaries experiencing loneliness and social isolation. These disparities may partly result from limited engagement with mental health services, which could help address their specific healthcare needs.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076286","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}