American Journal of Preventive Medicine最新文献

{"title":"Healthcare Utilization Around the Time of Pregnancy by Extent of Disability in the U.S., 2018–2020","authors":"Andrea L. Deierlein PhD ,&nbsp;Hedda L. Boege MS ,&nbsp;Lauren T. Berube PhD ,&nbsp;Rachel Ryan PhD ,&nbsp;Cheryl R. Stein PhD","doi":"10.1016/j.amepre.2025.108211","DOIUrl":"10.1016/j.amepre.2025.108211","url":null,"abstract":"<div><h3>Introduction</h3><div>Females with disabilities have greater preconception health risks and adverse perinatal outcomes than those without disabilities. Characterization of reproductive healthcare utilization among females with disabilities in the U.S. is limited. We examined healthcare receipt before, during, and after pregnancy by extent of disability among U.S. females with recent live births.</div></div><div><h3>Methods</h3><div>This cross-sectional study used Pregnancy Risk Assessment Monitoring System data (collected in 2018–2020 and analyzed in 2025) from 24 states that included the Washington Group Short Set of Questions on Disability. Participants self-reported healthcare visits in the year prior to pregnancy, receipt and timing of prenatal care, and receipt of a postpartum checkup. Disability was assessed as extent of difficulty (none, some, and a lot of difficulty). Associations between extent of disability and healthcare utilization were estimated using multivariable modified Poisson regression (adjusted prevalence ratios and 95% CI).</div></div><div><h3>Results</h3><div>Of 41,210 participants, 34.2% and 6.7% reported some and a lot of difficulty, respectively. Females with some difficulty had higher prevalence (adjusted prevalence ratio range=1.10–1.24) of not having a prepregnancy reproductive healthcare visit, any prenatal care, first trimester prenatal care initiation, and a postpartum checkup than those with no difficulty. Among females with a lot of difficulty, there was similarly elevated prevalence of not having a prepregnancy reproductive healthcare visit or first trimester initiation of prenatal care, but they had a 171% (adjusted prevalence ratio=2.71, 95% CI=1.49, 4.94) and 63% (adjusted prevalence ratio=1.63, 95% CI=1.40, 1.91) higher prevalence of not having any prenatal care and not having a postpartum checkup, respectively, than females with no difficulty.</div></div><div><h3>Conclusions</h3><div>Females with some and a lot of difficulty reported lower receipt of reproductive, prenatal, and postpartum care than those with no difficulty. Strategies are needed to establish and coordinate comprehensive reproductive health care among females with disabilities.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108211"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696449","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 Expanding Home Cook Interventions for Salt Reduction in China","authors":"Xuanjing Li PhD ,&nbsp;Yipeng Lv PhD ,&nbsp;Xiang Gao PhD ,&nbsp;Bonan Fan MS ,&nbsp;Yibei He BS ,&nbsp;Shan Zhao PhD ,&nbsp;Fangchao Liu PhD ,&nbsp;Na Li PhD ,&nbsp;Qi Wu MBA ,&nbsp;Weixin Li PhD ,&nbsp;Donglan Zhang PhD ,&nbsp;Matti Marklund PhD ,&nbsp;José A. Pagán PhD ,&nbsp;Lijing L. Yan PhD ,&nbsp;Andrew E. Moran MD, MPH ,&nbsp;Jing Wu PhD ,&nbsp;Yan Li PhD","doi":"10.1016/j.amepre.2025.108203","DOIUrl":"10.1016/j.amepre.2025.108203","url":null,"abstract":"<div><h3>Introduction</h3><div>Excessive salt intake is a major risk factor for cardiovascular disease and premature mortality in China and globally. A recent cluster RCT demonstrated the effectiveness of home cook interventions in reducing salt intake and blood pressure among participants from 6 provinces in China. Yet, it remains unclear whether expanding these interventions across China would be cost-effective.</div></div><div><h3>Methods</h3><div>The China Cardiovascular Disease Prevention Model, a validated microsimulation model that captures the development and consequences of cardiovascular disease among adults aged ≥35 years in China, was used to estimate lifetime averted cardiovascular disease events and deaths, direct medical costs (2022 international dollar), quality-adjusted life years gained, and the incremental cost-effectiveness ratio of home cook interventions versus the status quo. Costs and quality-adjusted life years were discounted at 3%.</div></div><div><h3>Results</h3><div>Compared with the status quo, home cook interventions were projected to avert 1.97 million coronary heart disease events, 3.69 million stroke events, 0.77 million deaths due to coronary heart disease, and 1.29 million deaths due to stroke in women. The interventions would also avert 1.62 million coronary heart disease events, 3.8 million stroke events, 0.6 million deaths due to coronary heart disease, and 1.15 million deaths due to stroke in men. The interventions resulted in an incremental cost-effectiveness ratio of 3,552 international dollar per quality-adjusted life year in women and 5,445 international dollar per quality-adjusted life year in men and, thus, were cost-effective considering a willingness-to-pay threshold of 21,318 international dollar (1-time gross domestic product per capita).</div></div><div><h3>Conclusions</h3><div>Public health policymakers in China should consider widely adopting home cook interventions to better prevent cardiovascular disease and reduce healthcare costs.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108203"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670525","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":"Modeling Tradeoffs in Reminder Intensity and Navigation for Large-Scale Mailed Stool Testing Programs","authors":"Jennifer C. Spencer PhD ,&nbsp;Nicole Kluz MPH ,&nbsp;Virginia E. Mitchell MS ,&nbsp;F. Benjamin Zhan PhD ,&nbsp;Navkiran K. Shokar MD, MPH ,&nbsp;Michael P. Pignone MD, MPH","doi":"10.1016/j.amepre.2025.108187","DOIUrl":"10.1016/j.amepre.2025.108187","url":null,"abstract":"<div><h3>Introduction</h3><div>Mailed stool testing is effective for increasing colorectal cancer screening, which reduces colorectal cancer incidence and mortality. To scale up mailed programs efficiently, this study examines tradeoffs between total reach, program intensity, and budget impact.</div></div><div><h3>Methods</h3><div>A population-based simulation model was adapted to reflect 215,000 underscreened individuals in Federally Qualified Health Centers across a large U.S. state (Texas) over 5 years. Base case parameters and uncertainty ranges for impact and costs across alternative strategies were derived from local program data and literature review conducted in 2025. Comparisons included reminder intensity—(1) no reminders (initial mailing only), (2) low intensity (reminders by letters, texts, or automated calls), and (3) high intensity (staff outreach by phone)—as well as adding patient navigator outreach for participants with positive stool tests. Program designs were compared across 200 probabilistic scenarios under traditional and budget-constrained frameworks.</div></div><div><h3>Results</h3><div>Scenarios incorporating navigation were always preferred over those without navigation. Relative to no reminders, low-intensity reminders cost an incremental $108,000 per colorectal cancer case prevented. Adding high-intensity reminders costs a further $193,000 per case prevented. At a fixed budget lower than $13 million over 5 years, a combination of navigation and low-intensity reminders would generally maximize total program impact, although this inflection point varies with the size of the target unscreened population.</div></div><div><h3>Conclusions</h3><div>Policymakers facing economic tradeoffs in program design should prioritize patient navigation after positive primary tests, which is cost-efficient, and should consider patient reminders, with the optimal reminder strategy dependent on the target population size and budget.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108187"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530883","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 Intensity of Adolescent Substance Use Before and After the COVID-19 Pandemic","authors":"Richard A. Miech MPH, PhD","doi":"10.1016/j.amepre.2025.108166","DOIUrl":"10.1016/j.amepre.2025.108166","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescent cannabis and alcohol use declined substantially after the COVID-19 pandemic onset in 2020. This study tests whether substance use hardened, defined as an increased proportion of heavy users resulting from overall prevalence declines driven mainly by reductions in light and moderate use.</div></div><div><h3>Methods</h3><div>Data come from Monitoring the Future, which annually surveys nationally representative, cross-sectional samples of U.S. adolescents in 8th, 10th, and 12th grades. The analysis includes 252,810 respondents surveyed between 2017 and 2024, with response rates of 86% in 8th grade, 85% in 10th grade, and 76% in 12th grade. The main outcome is lifetime intensity of cannabis and alcohol use, measured as light (1–5), moderate (6–19), and heavier (≥20) occasions of lifetime use.</div></div><div><h3>Results</h3><div>After the pandemic onset, adolescent alcohol use softened notably, whereas cannabis use softened slightly. For alcohol, light use increased significantly across all 3 grades by 3–7 percentage points, moderate use decreased in all 3 grades by 2–4 points, and heavy use decreased by 4 points in 12th grade and 3 points in 10th grade. For cannabis, changes were limited to 10th grade, where light use increased by 3 points, and moderate use decreased by 2 points.</div></div><div><h3>Conclusions</h3><div>These results point to a continued need for prevention policies and programs to achieve further reductions in adolescent cannabis and alcohol use. Current patterns of use are not yet at a hardened stage dominated by heavy users who struggle to quit, where further reductions in prevalence would be achieved primarily through cessation programs.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 4","pages":"Article 108166"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369022","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":"Suicide by Cop Following an Emergency Dispatch From the Veterans Crisis Line","authors":"Peter C. Britton PhD ,&nbsp;Kipling M. Bohnert PhD ,&nbsp;Lauren M. Denneson PhD ,&nbsp;Dara Ganoczy MPH ,&nbsp;Mark A. Ilgen PhD","doi":"10.1016/j.amepre.2025.107743","DOIUrl":"10.1016/j.amepre.2025.107743","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 107743"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235845","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 Combined Impact of Campus and State Alcohol Policies on College Drinking and Harms","authors":"Pamela J. Trangenstein PhD, MPH ,&nbsp;Timothy S. Naimi MD, MPH ,&nbsp;Ziming Xuan ScD, SM, MA ,&nbsp;Raimee H. Eck PhD, MPH, MPA ,&nbsp;Thomas K. Greenfield PhD ,&nbsp;Sally Casswell PhD ,&nbsp;David H. Jernigan PhD, MA","doi":"10.1016/j.amepre.2025.108143","DOIUrl":"10.1016/j.amepre.2025.108143","url":null,"abstract":"<div><h3>Introduction</h3><div>Little is known about what policies and practices may prevent alcohol-related harms to others. This study tested whether campus alcohol policies were associated with alcohol use and alcohol-related harms to others among college students and whether these associations differ in states with weak versus strong alcohol policies.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from a 2021 probability-based survey of U.S. college students. The main predictor was a campus alcohol policy score that combined 33 policies. Alcohol use outcomes included past 30-day volume and binge drinking frequency, and analyses with alcohol use outcomes included 968 students who drink. In 2024, models with alcohol-related harms to other outcomes used data from 1,737 students (comprising abstainers and those who drink alcohol) and 3 alcohol-related harms to others: verbal, physical, and sexual. Models also assessed interactions between campus and state alcohol policy scores.</div></div><div><h3>Results</h3><div>Stronger campus alcohol policy scores were associated with lower alcohol volumes (incidence rate ratio=0.91; 95% CI=0.86, 0.97; <em>p</em>=0.003) and lower odds of verbal alcohol-related harms to others (AOR=0.86; 95% CI=0.75, 0.98; <em>p</em>=0.022). Associations between campus alcohol policy scores and binge frequency, verbal alcohol-related harms to others, and sexual alcohol-related harms to other were only significant in states with weak policies, whereas the association between campus alcohol policy scores and alcohol volumes held across state policy environments.</div></div><div><h3>Conclusions</h3><div>Student drinking and rates of alcohol-related harms to others were lower on campuses with stronger alcohol policies. Campus alcohol policy scores were associated with lower volume overall and with reduced binge drinking and verbal and sexual alcohol-related harms to others in states with weaker policies. Findings highlight the importance of campus alcohol policies in such states.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 108143"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276499","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 Evolving Impact of Medicaid Expansion on Suicide Mortality: Demographic and Method-Specific Effects","authors":"Stephen N. Oliphant PhD, MPP ,&nbsp;Zainab Hans PhD ,&nbsp;Anna E. Austin PhD ,&nbsp;Rebeccah L. Sokol PhD","doi":"10.1016/j.amepre.2025.108130","DOIUrl":"10.1016/j.amepre.2025.108130","url":null,"abstract":"<div><h3>Introduction</h3><div>Research suggests that Medicaid expansion may lead to population-level reductions in suicide. However, the time-varying impact on suicide rates has not been well characterized, and it is unknown whether potential suicide reductions are limited to specific injury mechanisms. This study examined the evolving effects of Medicaid expansion on state-level suicide rates disaggregated by injury mechanism and across demographic groups.</div></div><div><h3>Methods</h3><div>Restricted mortality data for 2005–2021 were obtained from the National Center for Health Statistics. Difference-in-differences approaches with event-study specifications were used to estimate the effects of Medicaid expansion on firearm, nonfirearm, and overall suicide rates among nonelderly adults and demographic subgroups. Analyses were conducted in 2024.</div></div><div><h3>Results</h3><div>Medicaid expansion was associated with 1.01 fewer suicides (95% CI= −1.93, −0.10) and 0.47 fewer firearm suicides (95% CI= −1.05, 0.11) per 100,000 nonelderly adults. The protective effects of expanding Medicaid eligibility grew over time. Among demographic subgroups, reductions were largest for the population aged 18–29 years, including 2.70 fewer suicides (95% CI= −4.55, −0.86) and 1.47 fewer firearm suicides per 100,000 (95% CI= −2.67, −0.27). Expansion was also associated with fewer firearm suicides among adolescents aged 10–17 years (−0.47; 95% CI= −1.05, 0.12). There were no significant reductions in overall suicide among Black individuals (−2.05; 95% CI= −8.22, 4.11), whereas expansion was associated with 0.79 fewer suicides per 100,000 White individuals (95% CI= −1.74, 0.16).</div></div><div><h3>Conclusions</h3><div>Medicaid expansion resulted in fewer suicide deaths, including those involving firearms. These findings suggest that Medicaid expansion was particularly impactful in preventing suicide among young adults.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 108130"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151881","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 RCT of Front-Of-Package Nutrition Labels in Latino Populations in the U.S.","authors":"Marissa G. Hall PhD ,&nbsp;Cristina J.Y. Lee MPH ,&nbsp;Aline D’Angelo Campos PhD ,&nbsp;Natalicio Serrano PhD ,&nbsp;Lindsey Smith Taillie PhD ,&nbsp;Jennifer Falbe ScD, MPH ,&nbsp;Aviva A. Musicus ScD ,&nbsp;Callie Whitesell MPH ,&nbsp;Angela Viviana Martinez MPH, MCRP ,&nbsp;Anna H. Grummon PhD","doi":"10.1016/j.amepre.2025.108122","DOIUrl":"10.1016/j.amepre.2025.108122","url":null,"abstract":"<div><h3>Introduction</h3><div>The effects of front-of-package nutrition labels among Latino adults in the U.S., including those with limited English proficiency, remains largely unknown. The Food and Drug Administration has considered a high-in label stating when foods are high in nutrients of concern, but the design differs from Latin American high-in labels in several ways. This study examined the impact of Food and Drug Administration–style high-in labels among Latino consumers.</div></div><div><h3>Study design</h3><div>This was an online randomized trial conducted in 2024.</div></div><div><h3>Setting/participants</h3><div>A total of 3,053 Latino U.S. adults (49% with limited English proficiency).</div></div><div><h3>Intervention</h3><div>Participants viewed 1 of 3 labels: numerical labels displaying numerical information about added sugar, saturated fat, and sodium; text high-in labels; and icon high-in labels identical to the text labels plus a magnifying glass icon.</div></div><div><h3>Main outcome measures</h3><div>Participants viewed 3 frozen pies, 3 frozen pizzas, and 3 frozen meals displaying randomly assigned labels and identified the healthiest and least healthy product within each group (on the basis of nutrient content). Analyses were conducted in 2025.</div></div><div><h3>Results</h3><div>Text high-in labels (49% correct) led to higher correct identification of the least healthy foods than the numerical labels (44%, <em>p</em>&lt;0.001), but the icon high-in labels did not (47%, <em>p</em>=0.07). Neither the text high-in labels (46% correct) nor the icon high-in labels (46%) led to better identification of the healthiest food than the numerical labels (45%, all <em>p</em>≥0.71). Neither high-in label led to more correct identification of foods high in nutrients of concern or higher selection of the healthiest food for purchase than the numerical labels (all <em>p</em>≥0.09). English proficiency moderated the impact of label type on correct identification of the least healthy food (<em>p</em>-interaction=0.003), such that the benefit of high-in labels was only present for participants with high English proficiency.</div></div><div><h3>Conclusions</h3><div>High-in labels helped Latino consumers to identify unhealthy foods more than numerical labels but only among those with high English proficiency.</div></div><div><h3>Trial registration</h3><div>NCT06293963.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 108122"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126494","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":"Predicted Cardiovascular and Economic Impacts of the Measure Accurately, Act Rapidly, and Partner With Patients Program to Improve Hypertension Control","authors":"Steven P. Dehmer PhD ,&nbsp;Brent M. Egan MD ,&nbsp;Blaine Hardy BS ,&nbsp;Michael V. Maciosek PhD ,&nbsp;Susan E. Sutherland PhD ,&nbsp;Stavros Tsipas MA ,&nbsp;Gregory Wozniak PhD","doi":"10.1016/j.amepre.2025.108132","DOIUrl":"10.1016/j.amepre.2025.108132","url":null,"abstract":"<div><h3>Introduction</h3><div>This study uses microsimulation to estimate 10-year health and economic outcomes that may be achieved by widely adopting the American Medical Association’s Measure Accurately, Act Rapidly, and Partner with Patients Hypertension quality improvement program.</div></div><div><h3>Methods</h3><div>A microsimulation model was adapted to conduct what-if analyses for adopting the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension program nationwide and in care delivery systems of varying size. The analysis was conducted in 2020–2024, and the microsimulation model was constructed using various data sources from 1948 to 2019. Modeled outcomes over 10 years included prevalence of systolic blood pressure ≥140 mmHg, incidence of cardiovascular disease events and cardiovascular disease–related mortality, averted medical costs by payer in 2021 U.S. dollars, and net costs.</div></div><div><h3>Results</h3><div>For patients with hypertension over 10 years, nationwide adoption of the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension program was predicted to improve mean blood pressure control by 4.3% and prevent 601 thousand cardiovascular disease events and 120 thousand cardiovascular disease deaths. Most of the estimated $17.9 billion in averted disease costs were observed in patients with Medicare. Total costs associated with implementing the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension program totaled $12.6 billion, resulting in a predicted $5.3 billion in net savings to the healthcare sector over 10 years. Small and large care delivery organizations could economically benefit from implementing the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension program at varying levels (5%–50%) of shared cost savings from payers.</div></div><div><h3>Conclusions</h3><div>There is promise for quality improvement programs targeting blood pressure management, but more research is needed to affirm the assumptions and findings of this analysis.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 108132"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139238","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":"Prevalence of Loneliness States Among the U.S. Adult Population: Findings From the 2022 HINTS-6","authors":"Juan R. Albertorio-Diaz MA ,&nbsp;Christopher W. Wheldon PhD","doi":"10.1016/j.amepre.2025.107935","DOIUrl":"10.1016/j.amepre.2025.107935","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2023, the U.S. Surgeon General declared loneliness and social isolation as significant public health issues, linked to adverse outcomes such as chronic disease, mental health disorders, and mortality. This study aimed to provide population-based estimates of loneliness states among U.S. adults and identify differences across sociodemographic, contextual, and health-related factors.</div></div><div><h3>Methods</h3><div>The authors conducted a secondary analysis of the 2022 Health Information National Trends Survey. Loneliness was measured using the PROMIS Social Isolation Short form. Weighted percentages and 95% CIs were generated using the Korn–Graubard method for complex surveys for each variable. Logistic regression was used to examine correlates of moderate–severe loneliness.</div></div><div><h3>Results</h3><div>Approximately 37.4% of the U.S. adult population experienced moderate-to-severe loneliness (i.e., 23.5% moderate and 14.0% severe loneliness). There were several disparities across sociodemographic groups (e.g., lesbian and gay individuals), those with social isolation proxies (e.g., never married), those with poor health, and those with general and chronic health conditions. In a fully adjusted model, younger age, lower income, gay or lesbian identity, being divorced or widowed, short sleep duration, and depression were consistently associated with higher odds of moderate–severe loneliness states.</div></div><div><h3>Conclusions</h3><div>Loneliness is a critical public health challenge in the U.S., with pronounced disparities across sociodemographic and health-related factors. These findings compel the necessity for preventive targeted interventions aimed at addressing loneliness within public health initiatives. Enhancing public health surveillance to capture loneliness more effectively is imperative to mitigate its impact.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 3","pages":"Article 107935"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295276","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}