Preventing Chronic Disease最新文献

{"title":"Dance Instructors and Early Recognition of Adolescent Idiopathic Scoliosis.","authors":"Amy Liu","doi":"10.5888/pcd23.260460","DOIUrl":"https://doi.org/10.5888/pcd23.260460","url":null,"abstract":"","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E58"},"PeriodicalIF":5.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable Machine Learning for Predicting Early Onset Hypertension in the US.","authors":"Li-Wei Wu, Kiyoung Kim, Peter Washington, Chanhyun Park","doi":"10.5888/pcd23.260109","DOIUrl":"https://doi.org/10.5888/pcd23.260109","url":null,"abstract":"<p><strong>Introduction: </strong>Early onset hypertension is often overlooked despite its association with lifelong cardiovascular disease risk. We developed an interpretable machine learning model to predict early onset hypertension in US adults using the 2022 Medical Expenditure Panel Survey, incorporating demographic, socioeconomic, health care utilization, and comorbidity features.</p><p><strong>Methods: </strong>We analyzed data on adults aged 55 years or younger. Hypertension was defined by International Classification of Diseases, 10th Revision, Clinical Modification code number I10 or self-reported physician diagnosis at or before age 55 years. Eighty-four variables were screened; Least Absolute Shrinkage and Selection Operator reduced the set to 45 variables. Extreme gradient boosting was trained with stratified 5-fold cross-validation. Performance metrics included accuracy, precision, recall, F2 score, area under the receiver operating characteristic curve (ROC AUC), and area under the precision-recall curve (PR AUC). We assessed fairness across subgroups and used Shapley Additive Explanations to quantify feature influence.</p><p><strong>Results: </strong>Among 9,850 adults, 1,647 (weighted prevalence, 15.2%) had hypertension. Discrimination was strong, with a ROC AUC of 0.807 (95% CI, 0.787-0.827), PR AUC of 0.486 (95% CI, 0.439-0.530), recall of 0.848 (95% CI, 0.816-0.878), and F2 score of 0.606 (95% CI, 0.578-0.634). Key predictors included older age, high body mass index, and a diagnosis of high cholesterol. Fairness analyses showed slightly higher true positive rates for Hispanic (+0.11) and Asian (+0.08) people, with performance for African American people modestly lower than that for White people.</p><p><strong>Conclusion: </strong>Both medical and nonmedical predictors contributed meaningfully, with high cholesterol particularly influential among adults older than 40 years and race and ethnicity especially important among African American adults. Prospective validation and routine fairness audits are warranted to ensure equitable benefit across populations. This interpretable model supports recall-oriented screening to identify younger adults at risk of hypertension for further evaluation and early intervention.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E56"},"PeriodicalIF":5.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity and Perceptions of the Community Walking Environment Among Cancer Survivors, National Health Interview Survey, 2024.","authors":"Jonathan Bryant-Genevier, Michael Boring, Elizabeth A Rohan, Dawn M Holman, Anne K Julian, Yamisha Bermudez, Mary Puckett, Shixiu Ricardo, Jasmine Y Nakayama","doi":"10.5888/pcd23.260220","DOIUrl":"https://doi.org/10.5888/pcd23.260220","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer survivors are a growing population in the US. Physical activity can reduce cancer-specific and all-cause mortality and decrease cancer recurrence risk among survivors. However, estimates of physical activity among cancer survivors by sociodemographic and health factors are not up to date.</p><p><strong>Methods: </strong>We used data from the 2024 National Health Interview Survey of civilian, noninstitutionalized US adults to calculate the proportions of cancer survivors who were inactive, insufficiently active, and sufficiently active through meeting leisure-time aerobic physical activity guidelines (0, 1-149, and ≥150 minutes/week of moderate-intensity equivalent physical activity, respectively) by sociodemographic and health factors and examined associations between physical activity and perceptions of the local walking environment.</p><p><strong>Results: </strong>In 2024, based on our sample (N = 3,486), an estimated 21.1 million US adults reported a history of cancer. Among cancer survivors, 33.9% (95% CI, 31.9%-35.9%) were inactive, 28.1% (95% CI, 26.3%-30.1%) were insufficiently active, and 38.0% (95% CI, 36.0%-40.0%) were sufficiently active. Cancer survivors living in communities with features that support walking reported lower levels of inactivity compared with survivors living in communities without such supports. Physical inactivity was higher among those with multiple comorbid chronic conditions and those reporting fair or poor overall health.</p><p><strong>Conclusion: </strong>Levels of physical activity among cancer survivors are low, especially for survivors with additional comorbid chronic conditions or who report fair or poor overall health. Evidence-based physical activity interventions that address land use and environmental design alongside community engagement to promote walking may increase physical activity among cancer survivors.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E55"},"PeriodicalIF":5.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Structural Equation Analysis of Body Image, Stigma, Depression, and Resilience Among Active-Duty Female Military Service Members.","authors":"Reneé Z Banks","doi":"10.5888/pcd23.260225","DOIUrl":"https://doi.org/10.5888/pcd23.260225","url":null,"abstract":"<p><p>Body image dissatisfaction and weight stigma may affect psychological readiness for duty among female service members, but evidence for active-duty populations is limited. Cross-sectional data were collected via validated self-report instruments from 193 active-duty female US service members in 2025. Partial least squares structural equation modeling was used to analyze data. Body image dissatisfaction was associated with lower resilience (β = -0.388) and greater weight stigma (β = -0.587). Weight stigma was not associated with resilience or depression and did not mediate outcomes. Emotional regulation moderated the relationship between weight stigma and resilience, suggesting that the military's approach to health promotion may be strengthened by incorporating evidence-based strategies for enhancing body image satisfaction, such as emotional regulation and resilience-building techniques.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E57"},"PeriodicalIF":5.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Discussion of Family Cancer Risk and Use of Genetic Testing Among US Adults With a Family History of Cancer.","authors":"Abe E Sahmoun","doi":"10.5888/pcd23.260179","DOIUrl":"10.5888/pcd23.260179","url":null,"abstract":"<p><strong>Introduction: </strong>Family history plays a key role in assessing inherited cancer risk, but genetic testing is still underused at the population level. The role of clinician-patient discussion in this gap is not well characterized. This study aimed to evaluate the association between clinician discussion of family cancer risk and use of genetic testing among US adults with a first-degree family history of cancer.</p><p><strong>Methods: </strong>This cross-sectional study used data from the 2023 National Health Interview Survey. The exposure was self-reported clinician discussion of family cancer risk, and the outcome was self-reported receipt of genetic testing for cancer risk. Survey weights were applied to generate nationally representative estimates. Propensity scores were used to match respondents with and without clinician discussion. Survey-weighted logistic regression models estimated associations.</p><p><strong>Results: </strong>Among 9,476 respondents (representing approximately 72.6 million US adults), 50% reported clinician discussion, and 7.8% reported genetic testing. Testing was more common among those reporting discussion (12.9%) than those who did not (2.7%) (P < .001). In fully adjusted analyses, clinician discussion was associated with higher odds of testing (adjusted odds ratio, 5.35; 95% CI, 4.23-6.76). Older age, female sex, higher education, and personal cancer history were also associated with testing.</p><p><strong>Conclusion: </strong>Clinician discussion of family cancer risk was strongly associated with use of genetic testing; however, overall testing rates were low. Improving routine clinician engagement may increase use of genetic services and support cancer prevention.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E52"},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Access to Primary Care and Racial and Ethnic Disparities in the Prevalence of Maternal Chronic Conditions 2020-2024.","authors":"Sheree Boulet, Lauren Costley, Kaitlyn Stanhope","doi":"10.5888/pcd23.260235","DOIUrl":"10.5888/pcd23.260235","url":null,"abstract":"<p><strong>Introduction: </strong>Unequal access to preventive health care before and between pregnancies contributes to risk for adverse perinatal outcomes. Few studies have examined access to primary care as a contributor to racial and ethnic disparities in chronic disease prevalence among women having a live birth.</p><p><strong>Methods: </strong>We linked 2020-2024 natality data with Health Resources and Services Administration's Area Health Resource Files and used spatial Bayesian conditional autoregressive models to estimate county-level associations between geographic access to primary care and prevalence of chronic conditions (obesity, hypertension, and diabetes) in 1,374 counties in the contiguous US. We defined geographic access to primary care using the Health Resources and Services Administration's primary care Health Professional Shortage Area (HPSA) designation and the number of primary care providers per 100,000 persons in quartiles. We assessed racial disparities in outcomes by modeling the difference in rate differences and 95% CIs among non-Hispanic Black and non-Hispanic White women having a live birth, controlling for county characteristics.</p><p><strong>Results: </strong>Residing in a county designated as a primary care HSPA or with lower rates of density of primary care providers was associated with modestly increased prevalence of obesity and hypertension but not diabetes. However, across the chronic conditions, the disparity between non-Hispanic Black and non-Hispanic White women was generally consistent regardless of geographic access to primary care. For example, the rate difference between the 2 groups for obesity was 11.3 (95% CI, 10.5-12.0) per 100 births for primary care HPSAs and 9.9 (95% CI, 9.5-10.4) per 100 births for non-primary care HPSAs, while the adjusted β for the difference in rate differences was 0.005 (95% CI, -0.005 to 0.014).</p><p><strong>Conclusion: </strong>Geographic access to primary care did not attenuate racial disparities in the prevalence of chronic conditions among women who had a live birth.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E54"},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Screen Time and Obesity in Children, Adolescents, and Young Adults: Sex-Specific Pathways and Implications for Public Health Interventions.","authors":"Jinsoo Min, Yoomi Chae, Yoolwon Jeong","doi":"10.5888/pcd23.260212","DOIUrl":"10.5888/pcd23.260212","url":null,"abstract":"<p><strong>Introduction: </strong>Screen time is associated with multiple adverse health outcomes, including obesity. However, evidence for children and adolescents is limited and inconsistent, and potential sex-specific differences have not been characterized. This systematic review aimed to synthesize evidence on the association between screen time and obesity-related outcomes among children, adolescents, and young adults, with a focus on sex-specific pathways and implications for public health interventions.</p><p><strong>Methods: </strong>This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was based on an a priori protocol. Two reviewers independently selected studies, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale. Data were synthesized based on the direction of associations and patterns of sex differences.</p><p><strong>Results: </strong>Of the 22 studies included, 18 reported a significant positive association between screen time and obesity-related outcomes. Sex-specific patterns were also observed, with some studies reporting associations only among females (n = 6) or males (n = 4). Among females, observed associations more frequently involved adiposity, metabolically unhealthy obesity, and psychologic factors such as body image concerns and weight dissatisfaction, whereas among males, associations were more often linked to behavioral factors such as increased caloric intake, late-night screen use, and reduced sleep.</p><p><strong>Conclusion: </strong>Our findings indicate that screen time is associated with obesity among children, adolescents, and young adults, with evidence suggesting potential sex differences in the behavioral, physiologic, and psychologic mechanisms. These findings highlight the need for interventions that move beyond simple screen time reduction and consider the mechanisms that may underlie sex-related differences in obesity risk. Potential strategies may include promoting physical activity among girls and addressing problematic screen use, screen-related eating, and sleep disruption among boys, as well as integrating screen-related psychosocial factors into obesity prevention and management. Given the limited number of studies formally assessing sex-screen time interactions, further research is needed to better characterize these observed patterns.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E53"},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Community Pharmacies in Creating Harm Reduction Infrastructure to Address the US Opioid Crisis.","authors":"Isaiah Ratz, Landon Woinarowicz, Heidi Eukel","doi":"10.5888/pcd23.260181","DOIUrl":"10.5888/pcd23.260181","url":null,"abstract":"","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E51"},"PeriodicalIF":5.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of Behavioral Health by Community Health Workers Into a Lifestyle Intervention That Addresses Reduction of Risk for Cardiovascular Disease in Rural Communities.","authors":"Stephanie Coronel-Mockler, Nick Flattery, Ashley Ambrose, Samuel Hubley, Kristin Kilbourn, Carter Sevick, Emily Bilenduke, Bryan Contreras Zamora, Jacqueline Howard, Raymond O Estacio","doi":"10.5888/pcd23.260142","DOIUrl":"10.5888/pcd23.260142","url":null,"abstract":"<p><strong>Purpose and objectives: </strong>Cardiovascular disease (CVD) is the leading cause of death and disability in the US, with higher rates in rural areas. Although community health workers (CHWs) are effective in improving CVD outcomes, limited evidence exists on their role in addressing behavioral health needs within lifestyle change interventions. This evaluation assessed the feasibility of integrating behavioral health components focusing on psychologic distress, anxiety, and depression into the Colorado Heart Healthy Solutions program (CHHS) in rural communities by using 3 domains of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework.</p><p><strong>Intervention approach: </strong>Beginning in 2018, behavioral health components were added to CHHS: assessments for stress, anxiety, and depression; connections with community-based behavioral health resources; and a health coaching intervention linking physical and mental health. Program adaptations that provided additional CHW training, lowered screening thresholds, and expanded intervention materials were implemented to address local determinants.</p><p><strong>Evaluation methods: </strong>Reach, implementation, and maintenance were assessed by using completion rates of each behavioral health component from 2019 to 2023. Logistic regression within an interrupted time-series framework evaluated the effects of program adaptations on CHW delivery.</p><p><strong>Results: </strong>CHWs completed 8,077 visits with 5,559 participants in 7 rural communities. Completion rates during the first 10 months ranged from 78.6% to 87.5% for the behavioral health assessments; 51.9% completed the connections to care and 8.2% completed the coaching intervention. Program adaptations in 2019 significantly improved completion of the brief assessments and coaching intervention use (P < .001). Adaptations in 2022 increased intervention use (P < .001) but initially reduced completion of longer assessments. By the final year, assessment completion rates were above 89%, with intervention delivery reaching 42.8%.</p><p><strong>Implications for public health: </strong>Integrating behavioral health into a CHW-led program in rural communities was feasible and sustainable. High completion rates suggest that CHWs can effectively deliver behavioral health assessments and support in underserved settings, highlighting the value of flexible, community-informed implementation strategies.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E50"},"PeriodicalIF":5.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant-Based Medically Tailored Groceries From a Food Pantry and Adult Cardiometabolic Outcomes.","authors":"Jacob B Mirsky, Allison J Wu, Mandy Luo, Meghan E Perkins, Joseph J Locascio, Marie-France Hivert, Rachel Burgun, Michele Fronk Schuckel, Elsie M Taveras, Lauren Fiechtner","doi":"10.5888/pcd23.260023","DOIUrl":"10.5888/pcd23.260023","url":null,"abstract":"<p><p>This study examined the association of weekly plant-based medically tailored groceries (MTGs) with cardiovascular-kidney-metabolic outcomes among patients with food insecurity. The intervention began on December 20, 2019, and ended on April 1, 2025 (275 weeks). Linear mixed-effects models estimated the dose-dependent association of MTGs received and the rates of changes in blood pressure, glycated hemoglobin A_1c, weight, and body mass index from baseline to follow-up periods. Among 68 adults, during an average of 2.7 years, each 100 MTGs received was associated with a greater improvement from baseline to follow-up periods in the rates of changes in diastolic blood pressure (-3.21 mm Hg; 95% CI, -4.89 to -1.52), weight (-2.63 kg; 95% CI, -3.73 to -1.53), and body mass index (-1.04 kg/m²; 95% CI, -1.50 to -0.58).</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"23 ","pages":"E47"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}