Preventing Chronic Disease最新文献

{"title":"Evaluation Resources for Asthma Programs and Beyond.","authors":"Samuel Dunklin, Sarah Gill, Maureen Wilce","doi":"10.5888/pcd21.240035","DOIUrl":"10.5888/pcd21.240035","url":null,"abstract":"<p><p>Evaluation can ensure the quality of public health programs. Systematic efforts to identify and fully engage everyone involved with or affected by a program can provide critical information about asthma programs and the broader environment in which they operate. To assist evaluators working at programs funded by the Centers for Disease Control and Prevention (CDC's) National Asthma Control Program (NACP), we developed a package of tools that build on the CDC's 1999 Framework for Program Evaluation in Public Health. The resulting suite of evaluation tools guides evaluators through a structured but flexible process, engaging a diverse array of interest holders and actively involving them in evaluation planning and implementation, all while strengthening their capacity to meaningfully contribute to the evaluation process. For our newest tool, our team reviewed the recent evaluation literature to create an enhanced version of the 1999 framework that describes important elements of professional evaluation practice. Although the original framework describes the steps to take in conducting an evaluation and the standards for a high-quality evaluation, our enhanced framework includes an explanation of how evaluators should approach their work: by incorporating critical reflection, interpersonal competence, situational awareness, and cultural responsiveness. In this article, we highlight many of the evaluation resources our team has created since the NACP's inception, culminating in a free e-text called Planting the Seeds of High-Quality Program Evaluation in Public Health. Public health professionals working in many types of programs - not just asthma - may find these resources useful.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E57"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876612","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":"Sociodemographic Factors of Asthma Prevalence and Costs Among Children and Adolescents in the United States, 2016-2021.","authors":"Nianyang Wang, Tursynbek Nurmagambetov","doi":"10.5888/pcd21.230449","DOIUrl":"10.5888/pcd21.230449","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma is a chronic condition with a high prevalence and cost of care among children and adolescents. While previous research described the association of sociodemographic factors with childhood asthma prevalence, there is limited knowledge of these factors' association with medical expenditures. In this study, we examined disparities in treated asthma prevalence and medical expenditures among US children and adolescents.</p><p><strong>Methods: </strong>Using nationally representative data from the 2016-2021 Medical Expenditures Panel Survey, we conducted a cross-sectional study of 2,365 children and adolescents (aged 0-17 y) with treated asthma compared with 40,497 children and adolescents without treated asthma. Treated asthma was defined as whether the child or adolescent had a medical event (emergency department visit, hospital inpatient stay, hospital outpatient visit, office-based medical visit, home health, and/or prescribed medicines) due to asthma. We controlled for sociodemographic factors of race and ethnicity, age, sex, health insurance coverage, family poverty status, and census region. We used 2-part models and generalized linear models to estimate annual per-person incremental medical expenditures associated with asthma.</p><p><strong>Results: </strong>Children and adolescents with treated asthma were more likely than those without treated asthma to be non-Hispanic Black or Hispanic, male, and publicly insured. Children and adolescents with treated asthma had $3,362.56 in additional annual medical expenditures, of which $174.06 was out-of-pocket, compared with children and adolescents without treated asthma. The additional expenditures included $955.96 for prescribed medicines, $151.52 for emergency department visits, and $858.17 for office-based medical visits. Non-Hispanic Black children with treated asthma had significantly lower total ($2,721.28) and office-based visit expenditures ($803.19) than non-Hispanic White children with treated asthma.</p><p><strong>Conclusion: </strong>Disparities among children and adolescents in the US persist in treated asthma prevalence and associated medical expenditures by sociodemographic factors.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E54"},"PeriodicalIF":4.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762493","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":"State and Regional Trends in Incidence and Early Detection of Lung Cancer Among US Adults, 2010-2020.","authors":"Jonathan Bryant-Genevier, Christine M Kava, Stephanie C Melkonian, David A Siegel","doi":"10.5888/pcd21.240016","DOIUrl":"10.5888/pcd21.240016","url":null,"abstract":"","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E55"},"PeriodicalIF":4.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762494","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 Status of Asthma in the United States.","authors":"Cynthia A Pate, Hatice S Zahran","doi":"10.5888/pcd21.240005","DOIUrl":"10.5888/pcd21.240005","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma imposes a substantial health and economic burden on patients and their families and on the health care system. An assessment of the status of asthma in the US may lead to effective strategies to improve health and quality of life among people with asthma. The objective of our study was to assess the historical trends and current state of asthma illness and death among children and adults in the US.</p><p><strong>Methods: </strong>We assessed asthma-related emergency department visits and hospitalizations among children and adults by using data from the 2010-2021 National Health Interview Survey (NHIS), the 2010-2020 Nationwide Emergency Department Sample (NEDS), the National (Nationwide) Inpatient Sample (NIS), the Healthcare Cost and Utilization Project (HCUP), and the Agency for Healthcare Research and Quality (AHRQ). Asthma death rates were calculated by using 2010-2021 National Vital Statistics System data.</p><p><strong>Results: </strong>Asthma prevalence increased significantly among adults from 2013 through 2021 (P = .04 for the annual percentage change [APC] slope) and decreased among children from 2010 through 2021 (P values for slopes: 2010-2017, P = .03; 2017-2021, P = .03). Prevalence of current asthma was higher among non-Hispanic Black people (children, 12.5%; adjusted prevalence ratio [APR] = 2.19; 95% CI, 1.68-2.84 and adults, 10.6%; APR = 1.25; 95% CI, 1.09-1.43) compared with non-Hispanic White people (children, 5.7%; adults, 8.2%). Prevalence of asthma attacks and use of asthma-related health care declined among adults and children. Asthma prevalence and asthma-related emergency department visits, hospitalization, and death rates differed by select characteristics.</p><p><strong>Conclusions: </strong>Although asthma attacks, ED visits, hospitalizations, and deaths have declined since 2010 among all ages, current asthma prevalence declined only among children, and significant disparities in health and health care use still exist.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E53"},"PeriodicalIF":4.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725005","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":"Interactive Maps to Improve Stroke Systems of Care in Wisconsin.","authors":"Ka Z Xiong, Lena Swander, Dot Bluma, Joshua Tootoo, Marie Lynn Miranda, Melissa Fiffer","doi":"10.5888/pcd21.230166","DOIUrl":"10.5888/pcd21.230166","url":null,"abstract":"","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E52"},"PeriodicalIF":4.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724989","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":"Implementing Policy and Practice Changes to Support Breastfeeding Duration in New York State Communities.","authors":"Ann Lowenfels, Megan Murphy, Abbie Archibald, Sarah Avellino, Katie Potestio","doi":"10.5888/pcd21.240003","DOIUrl":"10.5888/pcd21.240003","url":null,"abstract":"<p><p>The health benefits of breastfeeding are well-documented, but rates of breastfeeding duration in the US fall below national targets - especially when mothers have less education, have lower incomes, are non-Hispanic Black, or live in nonmetropolitan areas. The Creating Breastfeeding Friendly Communities program was designed to promote breastfeeding and reduce disparities by implementing policy and practice changes in worksites from 2017 through 2023. The purpose of this evaluation was to determine whether the program was effective in increasing breastfeeding supports and addressing disparities. We used a 14-item tool to assess breastfeeding policies and practices at baseline and follow-up at each worksite. We used number of employees to determine worksite size, and we used worksite address to calculate social vulnerability of the community where each site was located and to classify rurality of the county where sites were located. We found significant improvements in the number and quality of breastfeeding supports available at participating worksites (N = 292 at baseline and follow-up). The program successfully reached worksites in socially vulnerable communities. Supports for breastfeeding increased in all worksite subgroups, but they increased less at worksites that were small or rural. The evaluation supports the effectiveness of worksite lactation programs and protective labor laws. Findings suggest that special attention must be given to worksites that are small, located in socially vulnerable communities, or rural counties, to support implementation and reduce disparities.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E50"},"PeriodicalIF":4.4,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592051","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":"Public Health Surveillance in Electronic Health Records: Lessons From PCORnet.","authors":"Nidhi Ghildayal, Kshema Nagavedu, Jennifer L Wiltz, Soowoo Back, Tegan K Boehmer, Christine Draper, Adi V Gundlapalli, Casie Horgan, Keith A Marsolo, Nik R Mazumder, Juliane Reynolds, Matthew Ritchey, Sharon Saydah, Yacob G Tedla, Thomas W Carton, Jason P Block","doi":"10.5888/pcd21.230417","DOIUrl":"10.5888/pcd21.230417","url":null,"abstract":"<p><strong>Introduction: </strong>PCORnet, the National Patient-Centered Clinical Research Network, is a large research network of health systems that map clinical data to a standardized data model. In 2018, we expanded existing infrastructure to facilitate use for public health surveillance. We describe benefits and challenges of using PCORnet for surveillance and describe case studies.</p><p><strong>Methods: </strong>In 2018, infrastructure enhancements included addition of a table to store patients' residential zip codes and expansion of a modular program to generate population health statistics across conditions. Chronic disease surveillance case studies conducted in 2019 assessed atrial fibrillation (AF) and cirrhosis. In April 2020, PCORnet established an infrastructure to support COVID-19 surveillance with institutions frequently updating their electronic health record data.</p><p><strong>Results: </strong>By August 2023, 53 PCORnet sites (84%) had a 5-digit zip code available on at least 95% of their patient populations. Among 148,223 newly diagnosed AF patients eligible for oral anticoagulant (OAC) therapy, 43.3% were on any OAC (17.8% warfarin, 28.5% any novel oral anticoagulant) within a year of the AF diagnosis. Among 60,268 patients with cirrhosis (2015-2019), common documented etiologies included unknown (48%), hepatitis C infection (23%), and alcohol use (22%). During October 2022 through December 2023, across 34 institutions, the proportion of COVID-19 patients who were cared for in the inpatient setting was 9.1% among 887,051 adults aged 20 years or older and 6.0% among 139,148 children younger than 20 years.</p><p><strong>Conclusions: </strong>PCORnet provides important data that may augment traditional public health surveillance programs across diverse conditions. PCORnet affords longitudinal population health assessments among large catchments of the population with clinical, treatment, and geographic information, with capabilities to deliver rapid information needed during public health emergencies.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E51"},"PeriodicalIF":4.4,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592052","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":"Preventive Service Usage and New Chronic Disease Diagnoses: Using PCORnet Data to Identify Emerging Trends, United States, 2018-2022.","authors":"Sandra L Jackson, Akaki Lekiachvili, Jason P Block, Thomas B Richards, Kshema Nagavedu, Christine C Draper, Alain K Koyama, Lindsay S Womack, Thomas W Carton, Kenneth H Mayer, Sonja A Rasmussen, William E Trick, Elizabeth A Chrischilles, Mark G Weiner, Pradeep S B Podila, Tegan K Boehmer, Jennifer L Wiltz","doi":"10.5888/pcd21.230415","DOIUrl":"10.5888/pcd21.230415","url":null,"abstract":"<p><strong>Background: </strong>Data modernization efforts to strengthen surveillance capacity could help assess trends in use of preventive services and diagnoses of new chronic disease during the COVID-19 pandemic, which broadly disrupted health care access.</p><p><strong>Methods: </strong>This cross-sectional study examined electronic health record data from US adults aged 21 to 79 years in a large national research network (PCORnet), to describe use of 8 preventive health services (N = 30,783,825 patients) and new diagnoses of 9 chronic diseases (N = 31,588,222 patients) during 2018 through 2022. Joinpoint regression assessed significant trends, and health debt was calculated comparing 2020 through 2022 volume to prepandemic (2018 and 2019) levels.</p><p><strong>Results: </strong>From 2018 to 2022, use of some preventive services increased (hemoglobin A_1c and lung computed tomography, both P < .05), others remained consistent (lipid testing, wellness visits, mammograms, Papanicolaou tests or human papillomavirus tests, stool-based screening), and colonoscopies or sigmoidoscopies declined (P < .01). Annual new chronic disease diagnoses were mostly stable (6% hypertension; 4% to 5% cholesterol; 4% diabetes; 1% colonic adenoma; 0.1% colorectal cancer; among women, 0.5% breast cancer), although some declined (lung cancer, cervical intraepithelial neoplasia or carcinoma in situ, cervical cancer, all P < .05). The pandemic resulted in health debt, because use of most preventive services and new diagnoses of chronic disease were less than expected during 2020; these partially rebounded in subsequent years. Colorectal screening and colonic adenoma detection by age group aligned with screening recommendation age changes during this period.</p><p><strong>Conclusion: </strong>Among over 30 million patients receiving care during 2018 through 2022, use of preventive services and new diagnoses of chronic disease declined in 2020 and then rebounded, with some remaining health debt. These data highlight opportunities to augment traditional surveillance with EHR-based data.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E49"},"PeriodicalIF":4.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499630","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":"Congruence Between County Dental Health Provider Shortage Area Designations and the Social Vulnerability Index.","authors":"Gabriel A Benavidez, Elizabeth Crouch, Joni Nelson, Amy Martin","doi":"10.5888/pcd21.230315","DOIUrl":"10.5888/pcd21.230315","url":null,"abstract":"","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E48"},"PeriodicalIF":4.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472455","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":"Estimating the Burden and Distribution of Post-COVID-19 Condition in Washington State, March 2020-October 2023.","authors":"Arran Hamlet, Daniel Hoffman, Sharon Saydah, Ian Painter","doi":"10.5888/pcd21.230433","DOIUrl":"10.5888/pcd21.230433","url":null,"abstract":"<p><strong>Introduction: </strong>After SARS-CoV-2 infection, some people will experience long-term sequelae known as post-COVID-19 condition (PCC). Although PCC is recognized as a public health problem, estimates of the prevalence of PCC are sparse. We described a framework for estimating the incidence and prevalence of PCC by population subgroups and geography over time in Washington State.</p><p><strong>Methods: </strong>We collected data on reported COVID-19 cases and hospitalizations and estimated SARS-CoV-2 infections in Washington State from March 2020 through October 2023. The reported case data were incorporated with parameter estimates from published articles and prevalence estimates from the Household Pulse Survey into a mathematical compartmental model of PCC progression. The model used differential equations to describe how the population of people with PCC moved through the model's various stages. This framework allowed us to integrate data on age group, sex, race and ethnicity, vaccination status, and county to estimate incidence and prevalence of PCC for each subgroup.</p><p><strong>Results: </strong>Our model indicated that 6.4% (95% CI, 5.9%-6.8%) of all adults in Washington State were experiencing PCC as of October 2023. In addition to temporal differences in PCC prevalence and incidence, we found substantial differences across age groups, race and ethnicity, and sex. Geographic heterogeneity was pronounced, with the highest rates of PCC in central and eastern Washington.</p><p><strong>Conclusion: </strong>Estimation of PCC prevalence is essential for addressing PCC as a public health problem. Responding to PCC will require continued surveillance, research, and dedicated financial and public health action. This analysis, accounting for heterogeneities, highlights disparities in the prevalence, incidence, and distribution of PCC in Washington State and can better guide awareness and response efforts.</p>","PeriodicalId":51273,"journal":{"name":"Preventing Chronic Disease","volume":"21 ","pages":"E47"},"PeriodicalIF":4.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472456","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}