AJPM focus最新文献

{"title":"Associations Between Reductions in Depressive Symptoms and Reductions in Pain and Anxiety Symptoms and Substance Use: Emulation of a Randomized Trial","authors":"Maria R. Khan PhD, MPH ,&nbsp;Mary Acri PhD ,&nbsp;Kaoon (Francois) Ban MPH ,&nbsp;Joy D. Scheidell PhD, MPH ,&nbsp;Elizabeth R. Stevens PhD, MPH ,&nbsp;Prima Manandhar-Sasaki MSc ,&nbsp;Dyanna Charles MPH ,&nbsp;Natalie E. Chichetto PhD, MSW ,&nbsp;Stephen Crystal PhD ,&nbsp;Adam J. Gordon MD, MPH ,&nbsp;Brandon D.L. Marshall PhD ,&nbsp;E. Jennifer Edelman MD, MHS ,&nbsp;Amy C. Justice MD, PhD ,&nbsp;Scott R. Braithwaite MD, MS ,&nbsp;Ellen C. Caniglia ScD","doi":"10.1016/j.focus.2024.100258","DOIUrl":"10.1016/j.focus.2024.100258","url":null,"abstract":"<div><h3>Introduction</h3><p>Depressive symptoms are linked with pain, anxiety, and substance use. Research estimating whether a reduction in depressive symptoms is linked to subsequent reductions in pain and anxiety symptoms and substance use is limited.</p></div><div><h3>Methods</h3><p>Using data from the Veterans Aging Cohort Study, a multisite observational study of U.S. veterans, the authors used a target trial emulation framework to compare individuals with elevated depressive symptoms (Patient Health Questionnaire-9 score ≥ 10) who experienced reductions in depressive symptoms (Patient Health Questionnaire-9 score &lt; 10) with those whose symptoms persisted (Patient Health Questionnaire-9 score ≥ 10) at the next follow-up visit (on average, 1 year later). Using inverse probability of treatment weighting, the authors estimated ORs and 95% CIs for associations between depressive symptom reduction status and improvement on the following: anxiety symptoms, pain symptoms, unhealthy alcohol use, and use of tobacco, cannabis, cocaine, and/or illicit opioids.</p></div><div><h3>Results</h3><p>Reductions in depressive symptoms were associated with reductions in pain symptoms (OR=1.43, 95% CI=1.01, 2.02), anxiety symptoms (OR=2.50, 95% CI=1.63, 3.83), and illicit opioid use (OR=2.07, 95% CI=1.13, 3.81). Depressive symptom reductions were not associated with reductions in unhealthy alcohol use (OR=0.85, 95% CI=0.48, 1.52) or use of tobacco (OR=1.49, 95% CI=0.89, 2.48), cannabis (OR=1.07, 95% CI=0.63, 1.83), or cocaine (OR=1.28, 95% CI=0.73, 2.24).</p></div><div><h3>Conclusions</h3><p>Reducing depressive symptoms may potentially reduce pain and anxiety symptoms and illicit opioid use. Future work should determine whether reductions achieved through antidepressant medications, behavioral therapy, or other means have comparable impact.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000762/pdfft?md5=5e660ce28a99f42a792f17e81a34b97f&pid=1-s2.0-S2773065424000762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Control Policies and Sociodemographic Disparities in Cigarette Smoking Behaviors in the U.S.: A Systematic Review Protocol","authors":"Catherine A. Vander Woude MPH ,&nbsp;James H. Buszkiewicz PhD ,&nbsp;Nargiz Travis MScPH ,&nbsp;LaTeesa N. James MLIS ,&nbsp;Nancy L. Fleischer PhD","doi":"10.1016/j.focus.2024.100256","DOIUrl":"10.1016/j.focus.2024.100256","url":null,"abstract":"<div><p>Since the 1998 Master Settlement Agreement in the U.S., many studies have examined the associations between tobacco control policies and smoking; however, there is a need to comprehensively examine the impact of these policies on sociodemographic disparities in cigarette smoking. This protocol outlines a systematic review that seeks to fill this gap. Quantitative observational, experimental, and quasi-experimental studies are eligible for inclusion. Policies include cigarette taxes, smoke-free air laws, anti-tobacco media campaigns, and Tobacco 21 laws implemented in the U.S. Outcomes include cigarette smoking initiation, prevalence, and cessation among youth and adults. Sources to be searched include Clarivate BIOSIS, EBSCO CINAHL Plus, Cochrane Library, Ovid MEDLINE, PsycINFO, Sociological Abstracts, Clarivate Web of Science Core Collection, and the National Bureau of Economic Research. Included studies must be written in English. Two independent reviewers will screen and analyze relevant articles and then extract data on participants, context, methods, and key findings. Studies will be assessed using the Joanna Briggs Institute critical appraisal checklists and presented in 2 reviews: 1 youth focused (aged &lt;18 years) and 1 adult focused (aged ≥18 years). The findings are intended to inform the creation of new and potentially more targeted tobacco control policies to improve health equity.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000749/pdfft?md5=39110c5d6ca087f30a1d7761452db34e&pid=1-s2.0-S2773065424000749-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Veteran to Veteran, There's Automatically a Trust”: A Qualitative Study of Veterans’ Experiences in a Peer Health-Coaching Program for Hypertension","authors":"C. Bradley Kramer PhD, MPA ,&nbsp;Karin M. Nelson MD, MSHS ,&nbsp;George Sayre PsyD ,&nbsp;Jennifer L. Williams BA ,&nbsp;Leon Spruill ,&nbsp;Tiffanie Fennell PhD, ABPP ,&nbsp;Kristen E. Gray PhD, MS ,&nbsp;Bryan J. Weiner PhD ,&nbsp;Vincent Fan MD, MPH ,&nbsp;Jessica Jones-Smith PhD, MPH ,&nbsp;Mayuree Rao MD, MS","doi":"10.1016/j.focus.2024.100257","DOIUrl":"10.1016/j.focus.2024.100257","url":null,"abstract":"<div><h3>Introduction</h3><div>Veteran peer Coaches Optimizing and Advancing Cardiac Health was an randomized controlled trial (RCT) to test the effectiveness of a peer support intervention to reduce blood pressure among veterans with hypertension and 1 or more cardiovascular risks. The authors studied participant perceptions of the intervention, including barriers and facilitators to participation, factors promoting behavior change, and disease self-management practices.</div></div><div><h3>Methods</h3><div>The authors enrolled participants at their exit visit for the Veteran peer Coaches Optimizing and Advancing Cardiac Health study. Participants received primary care at the Veterans Administration healthcare system and had multiple cardiovascular disease risks, including a diagnosis of hypertension. The authors conducted a qualitative content analysis of semistructured interviews about their experience with the Veteran peer Coaches Optimizing and Advancing Cardiac Health intervention.</div></div><div><h3>Results</h3><div>Interview participants (N=29) were aged 60 years on average (SD=8.6), were 71% male, and were 55% White. They had mean systolic blood pressure of 138 mmHg (SD=18) at baseline. Authors identified themes across 3 major categories, which follow the general progression of the intervention: participation, relationship building, and behavior change. Scheduling flexibility, shared identity and experiences with the coach, acquisition of new knowledge and skills, and goal setting were important determinants of participants’ experiences in the program. In the participation category, the themes were scheduling, visit modality, life circumstances, and staffing. In the relationship category, the themes were the coach's professional role, shared identity and experiences, and social support. In the behavior change category, the themes were memory, attention, and decision processes; goal setting; skills and knowledge; and environmental context and resources. Authors report differences across patients varying by blood pressure reduction after the intervention and number of coaching visits.</div></div><div><h3>Conclusions</h3><div>Participants generally reported positive experiences in a peer support intervention for veterans with hypertension. Participant perceptions provide important insights into the intervention design and implementation. These findings may inform future implementation of peer support among veterans in hypertension and chronic disease self-management more generally.</div></div><div><h3>Trial registration</h3><div>This study was registered at Clinicaltrial.gov with the identifier NCT02697422</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100257"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of State Firearm Laws With Firearm Ownership and Mortality","authors":"Roni Barak Ventura PhD ,&nbsp;James Macinko PhD ,&nbsp;Manuel Ruiz Marín PhD ,&nbsp;Maurizio Porfiri PhD","doi":"10.1016/j.focus.2024.100250","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100250","url":null,"abstract":"<div><h3>Introduction</h3><p>Firearm injury is a leading cause of death among Americans. Because the right to bear arms is protected by the Second Amendment, policymakers must consider the impact of legislation on both firearm ownership and firearm harms. The current state of knowledge in firearm research majorly examines the impact of firearm legislation on firearm injuries and fatalities alone, and it relies on correlational analyses. The few studies that consider causal effects employ counterfactual-based inference. This study introduces information-theoretic tools to explore the role of firearm laws in mitigating firearm harms while maintaining citizens’ right to bear arms.</p></div><div><h3>Methods</h3><p>The authors study monthly time series from January 2000 to October 2019 for the implementation of firearm laws from RAND's State Firearm Law Database, firearm deaths by intent from the Centers for Disease Control and Prevention databases, and firearm ownership from an econometric model. The authors employ transfer entropy, an information-theoretic method that relies on Granger causality, to infer relationships from time series. Specifically, the authors examine transfer entropy from firearm restrictiveness to deaths per firearm owner, firearm ownership, and firearm deaths, independently.</p></div><div><h3>Results</h3><p>On a national level, the authors uncover a negative association from firearm restrictiveness to deaths per firearm owner and a positive association from firearm restrictiveness to firearm ownership. On a regional level, the authors identify a negative association from firearm restrictiveness to deaths per firearm owner in the Northeast, a negative association from firearm restrictiveness to firearm ownership in the Midwest, and a negative association from firearm restrictiveness to firearm suicides in the South.</p></div><div><h3>Conclusions</h3><p>The authors present an information-theoretic approach to study relationships in firearm research. This method provides preliminary evidence for the role of restrictive legislation in promoting safe firearm ownership. The authors find that firearm acquisition considerably increases after the implementation of restrictive firearm laws, and simultaneously, firearm deaths decrease. These effects vary with respect to death by intent and the geographic region the laws were implemented in.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000683/pdfft?md5=3865f9183887baddce3420405d9e2dca&pid=1-s2.0-S2773065424000683-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141593422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Utilization and Expenditures Among Commercially Insured U.S. Adults With Diabetes During the COVID-19 Pandemic: Preliminary Findings","authors":"Xilin Zhou PhD,&nbsp;Elizabeth A. Lundeen PhD,&nbsp;Deborah B. Rolka MS","doi":"10.1016/j.focus.2024.100254","DOIUrl":"10.1016/j.focus.2024.100254","url":null,"abstract":"<div><h3>Introduction</h3><p>People with diabetes were among the populations that experienced the most profound impacts during the COVID-19 pandemic. The authors estimated changes in healthcare utilization and expenditures for commercially insured adults aged 18–64 years with diabetes during the pandemic.</p></div><div><h3>Methods</h3><p>Medical claims data were from IQVIA PharMetrics Plus. Linear regressions were used to estimate the changes in utilization (per 1,000 individuals) for inpatient stays, emergency room visits, physician office visits, and ambulatory surgery center procedures. Changes in expenditures, in total and out of pocket, were estimated using generalized linear models. Expenditures were adjusted to 2021 U.S. dollars using the Consumer Price Index.</p></div><div><h3>Results</h3><p>Utilization was reduced significantly for all service types during the pandemic. Although the largest reduction occurred between March 2020 and May 2020, the decrease persisted throughout 2021. During March 2020–May 2020, ambulatory surgery center procedures were reduced by 4.7 visits per 1,000 individuals. The reduction ranged between 0.4 and 1.3 visits per 1,000 individuals subsequently. Expenditures declined for all service types during March 2020–May 2020. However, after May 2020, the reduction remained statistically significant only for physician office visits for all months, with varying changes in expenditures for other service types.</p></div><div><h3>Conclusions</h3><p>Healthcare utilization and expenditures reduced among commercially insured adults with diabetes during the COVID-19 pandemic.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000725/pdfft?md5=69d317890fc710079ae34d76152470d6&pid=1-s2.0-S2773065424000725-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity and Sedentary Time Among U.S. Adolescents Before and During COVID-19: Findings From a Large Cohort Study","authors":"Ethan T. Hunt MPH, PhD ,&nbsp;Keith Brazendale PhD ,&nbsp;Augusto C.F. De Moraes PhD ,&nbsp;Raja Malkani MS ,&nbsp;Natalia I. Heredia PhD ,&nbsp;Christopher D. Pfledderer PhD ,&nbsp;Denver M. Brown PhD ,&nbsp;Deanna M. Hoelscher PhD ,&nbsp;Michael W. Beets PhD ,&nbsp;Robert G. Weaver PhD","doi":"10.1016/j.focus.2024.100253","DOIUrl":"10.1016/j.focus.2024.100253","url":null,"abstract":"<div><h3>Introduction</h3><p>Evidence suggests that adolescents engage in less physical activity during the summer break. Less is known regarding physical activity during the summer months of the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Utilizing data from the Adolescent Brain Cognitive Development study, the authors examined daily activity measured by Fitbit Charge 2 devices before and after the onset of the COVID-19 pandemic during school and summer months. Linear models estimated activity during pre–COVID-19 school, pre–COVID-19 summer, COVID-19 school, and COVID-19 summer.</p></div><div><h3>Results</h3><p>Participants (N=7,179, aged 11.96 years, 51% female, 51% White) accumulated 8,671.0 (95% CI=8,544.7; 8,797.3) steps, 32.5 (95% CI=30.8, 32.3) minutes of moderate-to-vigorous physical activity, and 507.2 (95% CI=504.2, 510.2) minutes of sedentary time. During COVID-19 school, adolescents accumulated fewer daily steps and minutes of moderate-to-vigorous physical activity (−1,782.3 steps [95% CI= −2,052.7; −1,511.8] and −6.2 minutes [95% CI= −8.4, −4.0], respectively). Adolescents accumulated more minutes of daily sedentary time (29.6 minutes [95% CI=18.9, 40.3]) during COVID-19 school months than during the pre–COVID-19 school months. During pre–COVID-19 summer months, adolescents accumulated 1,255.1 (95% CI=745.3; 1,765.0) more daily steps than during COVID-19 months. Boys accumulated more daily steps and moderate-to-vigorous physical activity (2,011.5 steps [95% CI=1,271.9; 2,751.0] and 7.9 minutes [95% CI=1.4, 14.4], respectively) during the summer before COVID-19 than in summer during COVID-19. Both girls and boys accumulated more minutes of sedentary time during COVID-19 school months (47.4 [95% CI=27.5, 67.3] and 51.2 [95% CI=22.8, 79.7], respectively) than during COVID-19 summer months.</p></div><div><h3>Conclusions</h3><p>Societal restrictions during COVID-19 negatively impacted activity levels in the U.S., particularly during the summer months during COVID-19.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000713/pdfft?md5=ebad16e83a698de01416e417f88c64ae&pid=1-s2.0-S2773065424000713-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Medicaid Coverage and Reimbursement of Adult Vaccines Administered by Physicians and Pharmacists","authors":"Julian J.Z. Polaris JD ,&nbsp;Amanda L. Eiden PhD ,&nbsp;Anthony P. DiFranzo PhD ,&nbsp;Helen R. Pfister JD ,&nbsp;Matthew C. Itzkowitz JD ,&nbsp;Alexandra A. Bhatti JD","doi":"10.1016/j.focus.2024.100252","DOIUrl":"10.1016/j.focus.2024.100252","url":null,"abstract":"<div><h3>Introduction</h3><p>Effective from October 2023, federal law requires Medicaid programs to cover all recommended adult vaccines administered by physicians with no cost sharing for all eligibility groups. However, uniform coverage does not always translate to optimal uptake. Rather, other factors such as Medicaid reimbursement rates influence vaccine access and ultimately patient uptake. This study reviewed Medicaid policies to understand vaccine coverage and reimbursement, for both physicians and pharmacists, in all 50 U.S. states; Washington, DC; and Puerto Rico (collectively referred to as states).</p></div><div><h3>Methods</h3><p>Between March and September 2022, the researchers reviewed states’ public Medicaid policies regarding adult vaccines, focusing on the service of injectable vaccine administration and 3 products: hepatitis A, 9-valent human papilloma virus, and 23-valent pneumococcal polysaccharide.</p></div><div><h3>Results</h3><p>Among 50 states with available data, 7 (14%) restricted Medicaid coverage for hepatitis A, 9-valent human papilloma virus, and/or 23-valent pneumococcal polysaccharide administered by physicians, and 15 (30%) did so for pharmacists. Median physician reimbursement rate was below the private sector rate for hepatitis A (89%) and 9-valent human papilloma virus (94%) but above the rate for 23-valent pneumococcal polysaccharide (108%). Median physician reimbursement for vaccine administration during an office visit was $11.86; the median pharmacist administration fee was $10.67.</p></div><div><h3>Conclusions</h3><p>Although federal law now requires all state Medicaid programs to cover, without cost sharing, all recommended adult vaccines administered by physicians, equitable vaccine access may be hindered by state coverage restrictions for pharmacists and by relatively low reimbursement rates relative to Medicare and commercial coverage for both physicians and pharmacists.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100252"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000701/pdfft?md5=48e2e9e8d41d70d4de7104cd9f0f205a&pid=1-s2.0-S2773065424000701-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Prescription Fills of Opioids and Benzodiazepines Among Postpartum Women During COVID-19","authors":"Amanda J. Abraham PhD ,&nbsp;Shelby R. Steuart PhD ,&nbsp;Emily C. Lawler PhD ,&nbsp;Hailemichael Shone PhD ,&nbsp;Grace Bagwell Adams PhD","doi":"10.1016/j.focus.2024.100251","DOIUrl":"10.1016/j.focus.2024.100251","url":null,"abstract":"<div><h3>Introduction</h3><p>Concurrent prescribing of opioids and benzodiazepines is associated with increased risk of emergency department visits and overdose. Postpartum women commonly receive opioids for pain after delivery and are at risk for postpartum depression/anxiety. Although prior research finds increases in opioid prescribing and symptoms of depression/anxiety during COVID-19, concurrent prescribing among postpartum women has not been examined in the context of COVID-19.</p></div><div><h3>Methods</h3><p>Using data from a large sample of privately insured postpartum women (N=514,120), the authors compared concurrent prescription fills of opioids and benzodiazepines before March 1, 2020, and after March 1, 2020. Primary outcome variables measured whether a patient ever filled concurrent opioid and benzodiazepine prescriptions and the number of concurrent prescription fills per patient in the 6 months after delivery.</p></div><div><h3>Results</h3><p>Roughly 46.4% of postpartum women filled an opioid prescription, 2.4% filled a benzodiazepine prescription, and 1.2% of women filled a concurrent prescription. Among postpartum women filling a benzodiazepine prescription, 50.7% filled a concurrent opioid prescription. The number of concurrent fills among postpartum women significantly increased during the early period of COVID-19. On average, postpartum women filled 0.009 more concurrent prescriptions than expected on the basis of the preexisting trend, representing a 22.0% increase in the number of concurrent prescriptions relative to the sample mean.</p></div><div><h3>Conclusions</h3><p>Concurrent prescribing of opioids and benzodiazepines places postpartum women at higher risk of emergency department visits and overdose. To reduce the harms associated with concurrent prescribing, clinicians should carefully consider whether opioids and/or benzodiazepines are clinically necessary for treatment and consult their state prescription drug monitoring program prior to prescribing these medications.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100251"},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000695/pdfft?md5=084872df64f62d08e1422ae5e298e152&pid=1-s2.0-S2773065424000695-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air Quality Perceptions, Awareness, and Associated Behaviors Among U.S. Adults With and Without Heart Disease","authors":"Tia C. Dowling MPhil ,&nbsp;Audrey F. Pennington PhD ,&nbsp;Hilary K. Wall MPH ,&nbsp;Maria C. Mirabelli PhD","doi":"10.1016/j.focus.2024.100249","DOIUrl":"10.1016/j.focus.2024.100249","url":null,"abstract":"<div><h3>Introduction</h3><p>Exposure to ambient air pollution can worsen cardiovascular disease and increase the risk of stroke, myocardial infarction, and cardiovascular disease mortality. Strategies to reduce air pollution exposure can therefore help prevent cardiovascular morbidity and mortality. This study was conducted to assess the awareness among U.S. adults of the effect of air pollution on cardiovascular health and actions individuals can take to reduce their air pollution exposure.</p></div><div><h3>Methods</h3><p>In May–July 2022, 4,156 adults responded to the summer wave of the 2022 ConsumerStyles survey and self-reported their heart disease status and perceptions, awareness, and behaviors about ambient air pollution and health. In 2023, the data were analyzed to generate weighted population estimates representative of noninstitutionalized U.S. adults. Associations between heart disease and responses about perceptions, awareness, and behaviors were estimated using binomial and multinomial regression methods for weighted data.</p></div><div><h3>Results</h3><p>Overall, 90% of the weighted population estimate of U.S. adults reported that air pollution can impact a person's health, and 44% reported that air pollution can cause or worsen heart disease. Percentages of adults reporting that air pollution can impact a person's health (prevalence ratio=1.09; 95% CI=1.06, 1.12) and that air pollution can cause or worsen heart disease (prevalence ratio=1.28; 95% CI=1.08, 1.51) were higher among adults with than without heart disease.</p></div><div><h3>Conclusions</h3><p>Less than half of U.S. adults are aware that air pollution affects heart disease. Improvements in awareness of the effect of air pollution on cardiovascular health and strategies to reduce exposure could help protect individuals with heart disease.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100249"},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000671/pdfft?md5=c03d07b311712d3469ac6b808b1ea1fa&pid=1-s2.0-S2773065424000671-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141416267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absenteeism and Health Behavior Trends Associated With Acute Respiratory Illness Before and During the COVID-19 Pandemic in a Community Household Cohort, King County, Washington","authors":"Erin Chung MD ,&nbsp;Yongzhe Wang MS ,&nbsp;Eric J. Chow MD, MS, MPH ,&nbsp;Anne Emanuels MPH ,&nbsp;Jessica Heimonen MPH ,&nbsp;Constance E. Ogokeh MPH ,&nbsp;Melissa A. Rolfes PhD, MPH ,&nbsp;James P. Hughes PhD ,&nbsp;Timothy M. Uyeki MD, MPH, MPP ,&nbsp;Lea M. Starita PhD ,&nbsp;Samara Hoag MN, RN ,&nbsp;Michael Boeckh MD, PhD ,&nbsp;Janet A. Englund MD ,&nbsp;Helen Y. Chu MD, MPH ,&nbsp;Seattle Flu Study Investigators","doi":"10.1016/j.focus.2024.100248","DOIUrl":"10.1016/j.focus.2024.100248","url":null,"abstract":"<div><h3>Introduction</h3><p>Longitudinal data on how acute respiratory illness (ARI) affects behavior, namely school or work participation, and nonpharmaceutical intervention (NPI) usage before and during the COVID-19 pandemic is limited. The authors assessed how ARIs and specific symptoms affected school, work, and health-related behaviors over time.</p></div><div><h3>Methods</h3><p>From November 2019 to June 2021, participating households with children in King County, Washington, were remotely monitored for ARI symptoms weekly. Following ARIs, participants reported illness-related effects on school, work, and NPI use. Using logistic regression with generalized estimating equations, the authors examined associations between symptoms and behaviors.</p></div><div><h3>Results</h3><p>Of 1,861 participants, 581 (31%) from 293 households reported 884 ARIs and completed one-week follow-up surveys. Compared with the prepandemic period, during the period of the pandemic pre–COVID-19 vaccine, ARI-related school (56% vs 10%, <em>p</em>&lt;0.001) absenteeism decreased and masking increased (3% vs 28%, <em>p</em>&lt;0.001). After vaccine authorization in December 2020, more ARIs resulted in masking (3% vs 48%, <em>p</em>&lt;0.001), avoiding contact with non-household members (26% vs 58%, <em>p</em>&lt;0.001), and staying home (37% vs 69%, <em>p</em>&lt;0.001) compared with the prepandemic period. Constitutional symptoms such as fever were associated with work disruptions (OR=1.91; 95% CI=1.06, 3.43), staying home (OR=1.55; 95% CI=1.06, 2.27), and decreased contact with non-household members (OR=1.58; 95% CI=1.05, 2.36).</p></div><div><h3>Conclusions</h3><p>This remote household study permitted uninterrupted tracking of behavioral changes in families with children before and during the COVID-19 pandemic, identifying increased use of some NPIs when ill but no additional illness-associated work or school disruptions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400066X/pdfft?md5=420c5a099b45d128bb31e98d366b1ede&pid=1-s2.0-S277306542400066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}