American Journal of Preventive Medicine最新文献

{"title":"Racial and Ethnic Disparities in Prehospital Restraint Use and Sedation","authors":"Thomas J. McAdam MPH ,&nbsp;Seth J. Prins PhD, MPH ,&nbsp;John R. Pamplin II PhD, MPH ,&nbsp;Pia M. Mauro PhD, MPH ,&nbsp;Sarah Gutkind PhD, MSPH ,&nbsp;Megan E. Marziali MPH ,&nbsp;Zachary L. Mannes PhD, MPH","doi":"10.1016/j.amepre.2025.108066","DOIUrl":"10.1016/j.amepre.2025.108066","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency medical service clinicians routinely encounter patients experiencing behavioral health emergencies, yet limited data describe the prehospital use of physical restraints or sedatives. Systemic racism and challenges in access to behavioral health care may contribute to disparities in restraint and sedation use among minoritized groups. This study examined whether race and ethnicity were associated with prehospital use of physical restraints and/or sedation among patients with behavioral health emergencies.</div></div><div><h3>Methods</h3><div>Using the 2022 ESO Data Collaborative consisting of ∼12,000,000 emergency medical service healthcare encounters, this study estimated the associations between race and ethnicity (non-Hispanic White, Black/African American, Hispanic any race, Asian, or American Indian/Alaskan Native) and physical restraint and/or sedation use (yes, no) among patients aged ≥15 years who had an emergency medical service encounter for a behavioral health emergency. AOR estimates with 95% CIs are presented.</div></div><div><h3>Results</h3><div>Approximately 7.1% (<em>n</em>=3,799) of behavioral health encounters involved any restraint or sedation use. All racial and ethnic minoritized groups were more likely to receive physical restraints (AOR range=1.62–2.72, <em>p</em>&lt;0.05) than non-Hispanic White patients, whereas Black/African American, Hispanic, and American Indian/Alaskan Native patients were more likely to be sedated with antipsychotics or benzodiazepines (AOR range=1.27–3.21, <em>p</em>&lt;0.05). Black/African American patients were also more likely than non-Hispanic White patients to be concurrently restrained and sedated (AOR=1.30, 95% CI=1.09, 1.55).</div></div><div><h3>Conclusions</h3><div>Disparities in restraint and sedation use may perpetuate poor psychiatric outcomes for racially and ethnically minoritized groups, particularly Black/African American patients, in a system that already hinders their access to mental health treatment.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108066"},"PeriodicalIF":4.5,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977440","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":"Public Support for Warning Label Policies on Social Media Among U.S. Adults in 2024","authors":"Jennifer Cornacchione Ross PhD ,&nbsp;Lynsie R. Ranker PhD ,&nbsp;Jessica L. Fetterman PhD ,&nbsp;Emelia J. Benjamin MD, ScM ,&nbsp;Traci Hong PhD","doi":"10.1016/j.amepre.2025.108067","DOIUrl":"10.1016/j.amepre.2025.108067","url":null,"abstract":"<div><h3>Introduction</h3><div>Health warning labels are used across several regulatory spaces to warn consumers about potentially harmful products. The study goal was to assess U.S. adults’ public opinions about health warning label policies on social media in general and for commercial tobacco/nicotine products specifically in response to a call from the U.S. Surgeon General on health warning label policies on social media. This study examined support by political party affiliation.</div></div><div><h3>Methods</h3><div>A nationally representative online survey was conducted in September 2024 among U.S. adults. Respondents indicated how much they strongly agreed (5) or strongly disagreed (1) with 5 statements about social media health warning labels, including mental health, influencer promotions, and tobacco/nicotine products. Log binomial regression models were constructed to estimate relative support prevalence by political affiliation. Analyses were conducted in 2024–2025.</div></div><div><h3>Results</h3><div>U.S. adults, regardless of political affiliation, generally supported social media health warning label policies, including agreeing/strongly agreeing that social media platforms should be required to have warning labels on posts promoting any tobacco product (81.2% of Democrats, 74.8% of Republicans). Democrats and Republicans were also closely aligned in support of influencer disclosures generally (82.9% and 80.5%, respectively) and in their support that social media platforms should do more to warn youth about the harms of vaping (82.4% and 77.2%, respectively). Democrats generally expressed the highest levels of support, whereas those who identified as independent or with no affiliation generally expressed the lowest levels of support.</div></div><div><h3>Conclusions</h3><div>Adding sponsored content disclosures and health warning labels to social media platforms and related posts is generally supported by U.S. adults, showing promise for policy adoption and implementation.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108067"},"PeriodicalIF":4.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977368","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 All-Cause Mortality in a Western State Prison System, 1999-2020.","authors":"Jillian J Turanovic, Nancy Rodriguez, Julie L Kuper","doi":"10.1016/j.amepre.2025.108063","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108063","url":null,"abstract":"<p><strong>Introduction: </strong>Incarceration is linked to mortality, yet specific factors associated with death during imprisonment remain poorly understood, limiting efforts to identify vulnerable populations and develop effective prevention strategies in carceral settings.</p><p><strong>Methods: </strong>Administrative records were analyzed from 91,979 adults who served any portion of their sentence in a Western US state prison system between 1999 and 2020. Complementary log-log regression was used to identify demographic, criminal history, institutional, and behavioral health-related factors associated with all-cause mortality in prison.</p><p><strong>Results: </strong>Of incarcerated individuals (mean age 35.83 years at admission; 86.3% male), 839 (0.91%) died in prison. Self-harm incidents (HR 15.19; 95% CI 10.50-21.98) and sentences of 21+ years (HR 16.84; 95% CI 10.49-27.03 vs. ≤1 year) were most strongly associated with mortality. Variety of correctional programs completed was a protective factor (HR 0.78; 95% CI 0.74-0.82), and foreign-born status (HR 0.41; 95% CI 0.26-0.65), Black race (HR 0.73; 95% CI 0.59-0.91 vs. White), and violent infractions (HR 0.91; 95% CI 0.88-0.95) had inverse associations with mortality. Mortality risk increased substantially with age, with individuals aged 55+ years at admission having over 11 times the risk of death compared to those aged 24 and under (HR 11.79; 95% CI 8.75-15.88). Male sex, prior incarcerations, higher custody levels, drug infractions, mental health needs, academic needs, and criminogenic needs were also associated with increased mortality risk.</p><p><strong>Conclusions: </strong>This study identified new risk factors for mortality during imprisonment. The findings highlight directions for future research and actionable intervention points for reducing mortality in incarcerated populations.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108063"},"PeriodicalIF":4.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977391","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":"Precarious Employment Typologies and Psychotropic Medication Use and Misuse","authors":"Seong-Uk Baek MD ,&nbsp;Jin-Ha Yoon MD, PhD","doi":"10.1016/j.amepre.2025.108064","DOIUrl":"10.1016/j.amepre.2025.108064","url":null,"abstract":"<div><h3>Introduction</h3><div>Precarious employment has emerged as a significant social determinant of worker health. This cross-sectional study examined the association between precarious employment and psychotropic medication use and misuse using a typological approach.</div></div><div><h3>Methods</h3><div>A nationally representative sample of 8,993 young workers in Korea was analyzed. Data collection was conducted in 2022, and the analyses for this study were performed in 2025. Eight precarious employment indicators related to employment security, income adequacy, worker rights, and protection were included. Latent class analysis was employed to classify employment typologies. The associations between employment typologies, psychotropic medication use, and misuse were determined using ORs and 95% CIs.</div></div><div><h3>Results</h3><div>Three latent employment typologies were identified: standard employment relationship–like type (n=4,864; 59.7%), instrumental type (<em>n</em>=1,973; 20.3%), and precarious type (<em>n</em>=2,156; 19.9%). Psychotropic medication use was reported by 2.6%, 4.7%, and 6.5% of individuals in the standard employment relationship–like, instrumental, and precarious types, respectively. Psychotropic medication misuse was reported by 0.4%, 1.1%, and 1.4% of individuals in the standard employment relationship–like, instrumental, and precarious types, respectively. After adjusting for the sociodemographic factors, individuals in the precarious type had 6.16 times higher odds of psychotropic medication use (95% CI=3.10, 12.25) and 10.34 times higher odds of psychotropic medication misuse (95% CI=1.64, 65.39) than those in the standard employment relationship–like type.</div></div><div><h3>Conclusions</h3><div>Precarious employment experience is closely linked with psychotropic medication use and misuse among young Korean wage workers. Policy interventions are required to improve the employment quality and ensure appropriate psychotropic medication use in this population.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108064"},"PeriodicalIF":4.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977347","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 and Prevalence of Modifiable Risk Factors for Birth Defects Among U.S. Women of Reproductive Age: National Health and Nutrition Examination Survey 2007 to March 2020.","authors":"Arick Wang, Lauren H Zauche, Krista S Crider, Cara T Mai, Yan Ping Qi, Lorraine F Yeung, Jennifer L Williams","doi":"10.1016/j.amepre.2025.107947","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107947","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital heart defects, orofacial clefts, and neural tube defects share similar modifiable risk factors. The prevalence and trends of risk factors for these selected birth defects were assessed among nonpregnant, nonlactating women of reproductive age (aged 12-49 years) in the U.S.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey 2007-March 2020 were analyzed in fall 2024. Demographics, BMI, household food security, folic acid supplement use, usual intake of dietary folate and vitamin B12, concentrations for serum and red blood cell folate, serum vitamin B12, serum cotinine (smoking exposure), and diabetes status were reported. Weighted percentages of prevalence of risk factors with 95% CIs were calculated using the survey package in R to account for clustered sampling.</p><p><strong>Results: </strong>Among 5,374 women of reproductive age, approximately 66.4% (95% CI=64.3, 68.4) had at least 1 known modifiable risk factor: 6.7% (95% CI=5.7, 7.6) reported very low food security, 33.8% (95% CI=32.2, 35.4) had obesity, 4.8% (95% CI=4.0, 5.5) had diabetes, 18.8% (95% CI=17.2, 20.4) had smoking exposure, and 19.5% (95% CI=17.8, 21.1) had red blood cell folate concentrations below the threshold (748 nmol/L) for optimal neural tube defect prevention. Over the time studied, the percentage of women of reproductive age with at least 1 risk factor rose from 65.3% (95% CI=62.1, 68.4) to 69.5% (95% CI=65.4, 73.9; p=0.08).</p><p><strong>Conclusions: </strong>Approximately 2 of 3 women of reproductive age in the U.S. have pre-existing modifiable risk factors for birth defects. Implementation of preconception health care could help reduce the prevalence of known risk factors and improve birth outcomes.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107947"},"PeriodicalIF":4.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977380","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 Stress and Cardiovascular Health: The MESA and MASALA Studies.","authors":"Saaniya Farhan, Laura A Colangelo, Abigail Marie Gauen, Nilay S Shah, Alka M Kanaya, Kiarri N Kershaw, Michael P Bancks, Sameera Talegawkar, Luis A Rodriguez, Donald M Lloyd-Jones, Norrina B Allen, Rachel Zmora","doi":"10.1016/j.amepre.2025.108045","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108045","url":null,"abstract":"<p><strong>Introduction: </strong>Research suggests chronic stress is associated with individual cardiovascular health (CVH) metrics (e.g., physical activity and diet quality); however, the association between chronic stress and overall CVH is less well understood. Further, minoritized racial and ethnic groups experience a disproportionate stress burden. Therefore, this study assessed the association between chronic stress and CVH within two racially and ethnically diverse cohorts.</p><p><strong>Methods: </strong>This study utilized pooled data from 7978 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) studies collected between 2000-2011 and 2010-2018, respectively. The associations between chronic stress and the cross-sectional and annualized change in Life's Essential Eight CVH score, excluding sleep, (range 0-100), were assessed using linear regression to adjust for sociodemographic factors. Anxiety, depression, and social support were assessed as potential moderators of this association. Analyses were repeated using individual CVH metrics as the outcome. Analyses were conducted in 2025.</p><p><strong>Results: </strong>In cross-sectional analyses, individuals with high chronic stress had a 2.7-point lower (-2.71, 95% CI = -3.46, -1.95) CVH score compared to individuals with no chronic stress after adjustment. No association between chronic stress and annualized change in CVH score was observed. Additionally, there was no moderation by anxiety, depression, or social support.</p><p><strong>Conclusions: </strong>Elevated chronic stress is adversely associated with concurrent CVH. These results highlight the important relationship between chronic stress and health.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108045"},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856911","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":"Understanding the Opioid Epidemic as an Environmental Injustice","authors":"Jerel M. Ezell PhD, MPH","doi":"10.1016/j.amepre.2025.108047","DOIUrl":"10.1016/j.amepre.2025.108047","url":null,"abstract":"<div><div>The conceptual link between racial disparities in opioid use–related deaths and environmental justice, a valuable socioecologic paradigm for contextualizing how racial vulnerabilities are ecologically forged, has not been duly explored. Exploring and filling this gap, this article highlights four primary ways through which racial disparities in opioid use manifest as a matter of environmental (in)justice, namely in terms of (1) distributive justice (elevated availability and criminalization of opioids in racially minoritized communities), (2) capability justice (limited access to or uptake of mental health treatment, buprenorphine providers, and harm reduction resources in said communities), (3) recognitional justice (disproportionate placement of eyesore treatment and harm reduction sites in said communities), and (4) procedural justice (biocolonial exploitation and commodification of Indigenous plants and Chinese/Asian opium). In delineating the various modes of community and individual-level deprivation that are implicated, this article arrives at a socioecologic model focused on characterizing and addressing the environmental injustice perpetrated through opioid distribution, use, and management in racially minoritized spaces.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108047"},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856914","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 and non-healthcare costs: youth with diabetes and food insecurity.","authors":"Alice M Ellyson, Jason A Mendoza, Angela D Liese, Ashley Tabah, Traci A Bekelman, A Caroline Rudisill, Dana Dabelea, Edward A Frongillo, Catherine Pihoker, Faisal S Malik, Davene R Wright","doi":"10.1016/j.amepre.2025.108028","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108028","url":null,"abstract":"<p><strong>Introduction: </strong>This study prospectively evaluated the association of household food insecurity and acute care costs and productivity loss in youth and young adults (YYA) with type 1 and type 2 diabetes.</p><p><strong>Methods: </strong>This observational cohort study included 1,256 YYA with type 1 and type 2 diabetes from the SEARCH for Diabetes in Youth Food Security Study with data collected at three time points between 2015-2022. Both household food insecurity (HFI, measured using the US Household Food Security Survey Module) and costs (measured using survey responses on utilization and productivity losses) were self-reported by young adult participants or caregivers of adolescents. The relationship between HFI and costs was analyzed using generalized adjusted linear regression. We also analyzed the moderating role of continuous health insurance coverage.</p><p><strong>Results: </strong>Each additional 1-point increase in the HFI score was associated with a $1,077 (95%CI= [663, 1,491]) increase in measured 12-month costs. Costs were $4,384 (95%CI=[2,635, 6,133]) higher in households that were experiencing HFI versus those who were not. Youth and young adults with continuous health insurance coverage saw smaller increases in costs ($864, 95%CI=[461, 1,267]) compared to those without continuous coverage ($1,820, 95%CI=[379, 3,261]).</p><p><strong>Conclusions: </strong>This study found a positive association between HFI and costs for YYA with diabetes, and this relationship was modified by continuous health insurance coverage. Future work should use linked claims and electronic health record data to better inform efforts aiming to reduce HFI burden and improve the continuity of insurance coverage for this population.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108028"},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856912","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":"Productivity Losses From Nonfatal Injuries in the U.S.","authors":"Ramesh Ghimire PhD,&nbsp;Cora Peterson PhD,&nbsp;Curtis Florence PhD","doi":"10.1016/j.amepre.2025.108056","DOIUrl":"10.1016/j.amepre.2025.108056","url":null,"abstract":"<div><h3>Introduction</h3><div>Information on productivity losses due to nonfatal injuries is limited. This study estimated annual productivity losses attributable to nonfatal injuries among U.S. adults aged ≥18 years in 2023.</div></div><div><h3>Methods</h3><div>Productivity losses attributable to nonfatal injuries were estimated using the human capital approach. Various data sources, including the 2021 and 2023 National Health Interview Surveys and published literature, were used to estimate the cost of absenteeism, presenteeism, inability to work, and household productivity loss attributable to these injuries. All costs were estimated for 2023, and all analyses were conducted in 2025.</div></div><div><h3>Results</h3><div>In 2023, the total annual cost of productivity losses attributable to nonfatal injuries among U.S. adults was $25.15 billion (prediction interval=$10.29–$43.95 billion). Of this amount, absenteeism accounted for $8.95 billion (prediction interval=$4.92–$14.21 billion), representing 36% of the total; presenteeism contributed $6.33 billion (prediction interval=$2.74–$11.10 billion) or 25%; inability to work resulted in costs of $9.67 billion (prediction interval=$2.54–$18.32 billion) or 38%; and household productivity loss totaled $0.20 billion (prediction interval=$0.10–$0.32 billion), which is nearly 1% of the overall cost.</div></div><div><h3>Conclusions</h3><div>The annual cost of productivity losses from nonfatal injuries among U.S. adults is substantial as of 2023. Public health strategies that reduce nonfatal injuries can create cost-savings for the U.S. economy by avoiding preventable work and personal time losses.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108056"},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856913","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":"Buprenorphine Dispensation After X-Waiver Elimination by Clinician Specialty","authors":"Elizabeth M. Stone PhD ,&nbsp;Fangzhou Xie MA ,&nbsp;Jennifer Miles PhD ,&nbsp;Hillary Samples PhD ,&nbsp;Mark Olfson MD, MPH ,&nbsp;Stephen Crystal PhD","doi":"10.1016/j.amepre.2025.108055","DOIUrl":"10.1016/j.amepre.2025.108055","url":null,"abstract":"<div><h3>Introduction</h3><div>Elimination of the X-waiver, which required clinicians to complete additional registration to prescribe buprenorphine for opioid use disorder, removed one barrier to treatment. This study examined the association of the X-waiver elimination with buprenorphine dispensations by clinician specialty.</div></div><div><h3>Methods</h3><div>Using IQVIA Longitudinal Prescription data, patients with 15 or more days of dispensed buprenorphine supply each month from May 2021 to December 2024 were identified. Interrupted time series analyses (conducted in 2025) examined changes in monthly counts of clinicians associated with dispensations and patients, overall and stratified by clinician specialty.</div></div><div><h3>Results</h3><div>During the study period, 189,771 clinicians dispensed buprenorphine to 2,699,441 patients. X-waiver elimination was associated with significant increases in the number of clinicians associated with dispensed buprenorphine prescriptions overall (change in level= 1,626 clinicians; 95% CI=577, 2,674; <em>p</em>&lt;0.01; change in slope: 15 clinicians per month, 95% CI=13, 18, <em>p</em>&lt;0.001) and across all specialties. X-waiver elimination was associated with a decrease in the number of patients with buprenorphine dispensations in January 2023 overall (change in level= −24,104 patients; 95% CI= −40,010, −8,198; <em>p</em>&lt;0.01) and from all clinician groups except behavioral health physicians. Decreasing monthly rates of patients with buprenorphine dispensed by behavioral health physicians slowed after X-waiver elimination; monthly rates of buprenorphine patients with dispensations from primary care providers increased after (versus before) the policy change.</div></div><div><h3>Conclusions</h3><div>Although the number of clinicians associated with dispensed buprenorphine prescriptions after X-waiver elimination increased across all clinician types, patient-level gains associated with X-waiver elimination were limited.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108055"},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856910","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}