AJPM focus最新文献

{"title":"Examining the Association Between Social Needs and Care Gap Closure Among Older Adults Receiving Dental Care","authors":"David M. Mosen PhD, MPH ,&nbsp;Matthew P. Banegas PhD, MPH ,&nbsp;Daniel J. Pihlstrom DDS ,&nbsp;Erin M. Keast MPH ,&nbsp;John F. Dickerson PhD ,&nbsp;Jeffrey L. Fellows PhD","doi":"10.1016/j.focus.2024.100212","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100212","url":null,"abstract":"<div><h3>Introduction</h3><p>The authors of this study sought to (1) describe the prevalence of social needs and (2) determine whether social needs were associated with closure of care gaps among patients aged ≥65 years seeking dental care.</p></div><div><h3>Methods</h3><p>In this retrospective cross-sectional study, the authors identified 754 Kaiser Permanente Northwest patients aged ≥65 years who completed an index dental visit; had at least 1 of 23 preventive care gaps (e.g., flu vaccination) or disease management care gaps (e.g., diabetes HbA1c screening test) documented in their medical record; and had completed a social needs assessment through survey evaluating financial strain, food insecurity, housing needs, social isolation, and transportation needs. The authors described the prevalence of social needs at the index visit and then used logistic regression to evaluate the association between the number of social needs (0, 1, ≥2) and closure of all care gaps over the following 60 days (yes versus no), adjusting for patient characteristics. Identification and closure of care gap were assessed through Kaiser Permanente Northwest's Panel Support Tool.</p></div><div><h3>Results</h3><p>Approximately 28% of patients reported ≥1 social needs. The prevalence of social needs was as follows: social isolation, 13.7%; financial strain, 11.3%; food insecurity, 7.7%; transportation needs, 5.4%; and housing needs, 3.3%. Those with 1 social need were more likely to close care gaps than those with no social needs (OR=1.82, 95% CI=1.17, 2.85). No significant association was found with care gap closure among those with ≥2 versus zero social needs.</p></div><div><h3>Conclusions</h3><p>The prevalence of social needs was nearly 30% among patients aged ≥65 years with dental and medical coverage. Patients with 1 social need were more likely than those with no social needs to close all care gaps after their visit.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000312/pdfft?md5=d5ee9e519bfd80b27313861d95d14e79&pid=1-s2.0-S2773065424000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190802","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":"Children's Perception of Food Marketing Across Digital Media Platforms","authors":"Jennifer E. Carroll PhD ,&nbsp;Jennifer A. Emond PhD ,&nbsp;Linda L. Griffin PhD ,&nbsp;Elizabeth R. Bertone-Johnson ScD ,&nbsp;Nicole A. VanKim PhD ,&nbsp;Susan R. Sturgeon DrPH","doi":"10.1016/j.focus.2024.100205","DOIUrl":"10.1016/j.focus.2024.100205","url":null,"abstract":"<div><h3>Introduction</h3><p>Exposure to food marketing increases the risk of poor diet. Children's perception and interpretation of food marketing across digital media platforms is understudied. Children aged 9–11 years are uniquely susceptible to food marketing because children may watch content alone, and it is unclear whether embedded ads are decipherable by children (e.g., social media influencers) and if children are receptive to advertisements.</p></div><div><h3>Methods</h3><p>The authors collected data from 21 child–parent dyads in 2022 to fill this gap. Children were interviewed about their food marketing exposure and media use and were asked to share their perspectives on food advertisements. Parents completed a survey for household digital devices, demographics, and perception of their child's food advertising knowledge.</p></div><div><h3>Results</h3><p>This study found that all children generally recognized direct food advertisements, could describe them with varying levels of confidence, and shared examples. Despite self-identifying ads and understanding the intent of advertising, many children are still receptive to advertisements on the basis of engaging content (e.g., liking the ads as entertainment, watching ads even when given the chance to skip the ad) and the food items marketed (e.g., liking the taste of foods).</p></div><div><h3>Conclusions</h3><p>These findings suggest that knowledge of advertisement exposure and intent of advertising are not sufficient to reduce receptiveness of unhealthy food ad exposure. Additional research on the potential impacts of embedded ads, such as through social media influencers, is needed to understand children's interaction with the current digital media landscape.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000245/pdfft?md5=273aa403b5b8268a891e301c01a52dae&pid=1-s2.0-S2773065424000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139875469","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":"Cohort Study of Downgraded Misdemeanor Convictions and Subsequent Violent Crime: Differences by Defendant Race and Ethnicity","authors":"Julia P. Schleimer MPH ,&nbsp;Miriam J. Haviland PhD, MSPH ,&nbsp;Amy Gallagher MPH ,&nbsp;Ayah Mustafa BS ,&nbsp;Rachel Ross MPH ,&nbsp;Garen Wintemute MD, MPH ,&nbsp;Deirdre Bowen JD, PhD ,&nbsp;Ali Rowhani-Rahbar MD, PhD, MPH","doi":"10.1016/j.focus.2024.100206","DOIUrl":"10.1016/j.focus.2024.100206","url":null,"abstract":"<div><h3>Introduction</h3><p>Criminal convictions may be imperfect markers of criminalized behavior, in part because of criminal legal system processes (e.g., plea bargaining). In this retrospective cohort study of individuals convicted of misdemeanors, authors compared the risk of subsequent criminal charges for a violent crime among those initially charged with a felony with that among those initially charged with only misdemeanors, overall and by defendant race and ethnicity.</p></div><div><h3>Methods</h3><p>The study population included individuals aged ≥18 years who were convicted of a misdemeanor in Washington Superior Courts from January 1, 2015 to December 31, 2019. Those with and without initial felony charges were age/gender matched in a 4:1 ratio. The primary outcome was the first subsequent violent crime charge in Washington Superior Courts through December 31, 2020. Data were analyzed with Fine–Gray hazard models from June 2022 to November 2023.</p></div><div><h3>Results</h3><p>There were 3,841 individuals with initial felony charges and 956 with initial misdemeanor charges only. Median follow-up was 2.4 years for both groups. During follow-up, there were 166 new violent crime charges. In multivariable models, White defendants with initial felony charges had a greater risk of subsequent violent crime charges (subdistribution hazard ratio=2.58; 95% CI=1.24, 5.36) than White defendants with initial misdemeanor charges only. Among Black and Hispanic/Latinx defendants, initial felony versus misdemeanor charges were not associated with subsequent violent crime charges (subdistribution hazard ratio=0.93; 95% CI=0.44, 1.97 among Black defendants; subdistribution hazard ratio=0.49; 95% CI=0.15, 1.57 among Hispanic/Latinx defendants).</p></div><div><h3>Conclusions</h3><p>Findings suggest differential associations between downgrading of felony charges to misdemeanor convictions and future violent crime charges by defendant race and ethnicity, with implications for inequitable collateral consequences of criminal convictions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000257/pdfft?md5=046b4b03801ab667e9739e306d693e3f&pid=1-s2.0-S2773065424000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139884515","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":"Wastewater Surveillance for Xylazine in Kentucky","authors":"Chris Delcher PhD ,&nbsp;Dana Quesinberry JD, DrPH ,&nbsp;Soroosh Torabi PhD ,&nbsp;Scott Berry PhD ,&nbsp;James W. Keck MD ,&nbsp;Abhya Rani ,&nbsp;Bikram Subedi PhD","doi":"10.1016/j.focus.2024.100203","DOIUrl":"10.1016/j.focus.2024.100203","url":null,"abstract":"<div><h3>Introduction</h3><p>In the U.S., xylazine, the veterinary non-opioid sedative, has emerged as a major threat to people who use illicitly manufactured fentanyl and other drugs. The aim of this study was to compare wastewater detection of xylazine with other public health and safety surveillance data from 2019 to 2023 in Kentucky.</p></div><div><h3>Methods</h3><p>Wastewater samples from 5 rest areas, 2 truck weigh stations, and 4 wastewater treatment plants were tested for xylazine. Wastewater xylazine positivity rates were compared with xylazine-positive submission rates from the National Forensic Laboratory Information System and Kentucky's fatal overdoses in 6-month periods (Period 1=January–June; Period 2=July–December).</p></div><div><h3>Results</h3><p>Xylazine was detected in 61.6% (424 of 688) of daily wastewater samples from roadway sites/wastewater treatment plants. For roadways, detection increased from 55% (Period 1, 2021) to 94% (Period 1, 2023), and wastewater treatment plants had an overall detection of 25.8% (<em>n</em>=66 samples, Periods 1 and 2, 2022). Increasing roadway positivity corresponded to trends in National Forensic Laboratory Information System xylazine-positive submission rates: from 0.19 per 1,000 submissions (Period 1, 2019) to 2.9 per 1,000 (Period 2, 2022, latest available). No deaths from xylazine were reported publicly in Kentucky, although this study's authors identified 1–4 deaths (true count suppressed) in the overdose surveillance system, which, in back-of-the-envelope comparisons with other states, is far fewer than expected.</p></div><div><h3>Conclusions</h3><p>Wastewater signals indicate broad geographic exposure to xylazine in Kentucky, yet health outcomes data suggest otherwise. These findings may inform regional, national, and international efforts to incorporate wastewater-based drug surveillance. Harm-reduction activities along roadways and other suitable locations may be needed.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000221/pdfft?md5=e0e45691477f8f3c321f1dc14382915a&pid=1-s2.0-S2773065424000221-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139879838","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":"The Impact of a Global Pandemic on Young Adult Sedentary Behavior and Physical Activity","authors":"Brett D. Baker PhD,&nbsp;Darla M. Castelli PhD","doi":"10.1016/j.focus.2024.100202","DOIUrl":"10.1016/j.focus.2024.100202","url":null,"abstract":"<div><h3>Introduction</h3><p>The novel COVID-19 disease detected in 2019 widely affected individuals’ social movements, likely disrupting the ability to participate in leisure-related physical activity. Because of this, participation in sedentary behavior is thought to have increased. The purpose of this study was to determine how the COVID-19 pandemic affected U.S. young adult physical activity and sedentary behavior.</p></div><div><h3>Methods</h3><p>A total of 333 U.S. young adults (aged between 18 and 30 years) completed an online, comprehensive questionnaire during the early parts of COVID-19. Wilcoxon signed-rank tests were used to determine the change in time spent in physical activity and sedentary behavior during COVID-19 compared with that before COVID-19.</p></div><div><h3>Results</h3><p>There was a significant decrease in physical activity minutes (<em>p</em>&lt;0.0001) and a significant increase in sedentary behavior (<em>p</em>&lt;0.005) during COVID-19 compared with that before COVID-19. Significant differences were found by stratifying the data by sex and relationship status. Although both males and females reduced their physical activity, only males significantly increased their time in sedentary behavior during COVID-19 compared with that before COVID-19 (<em>p</em>&lt;0.05). Furthermore, married young adults significantly reduced their physical activity during COVID-19 (<em>p</em>&lt;0.001), whereas single individuals did not. Single young adults saw significant increases in sedentary behavior during COVID-19 (<em>p</em>&lt;0.005), whereas married individuals did not exhibit any change in sedentary behavior.</p></div><div><h3>Conclusions</h3><p>Stay-at-home orders enforced in the U.S. during the summer of 2020 led to increases in sedentary behavior and decreases in physical activity, particularly among males and single young adults. Future studies should determine whether these behavior changes persist.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400021X/pdfft?md5=770497e7a04386ba7719aa2373864afb&pid=1-s2.0-S277306542400021X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893067","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":"Pivoting COVID-19 Resources for an Equitable Mpox Vaccine Response in Louisiana","authors":"Arundhati Bakshi PhD ,&nbsp;John McClure BS ,&nbsp;Theresa Sokol MPH ,&nbsp;Lee Mendoza PhD ,&nbsp;Arun Adhikari PhD ,&nbsp;Nancy Zhao MPH ,&nbsp;Suryatapa Kar MPH ,&nbsp;Jimmy Gale BS ,&nbsp;Javone Davis Charles MPH ,&nbsp;Kyle Freese PhD, MPH ,&nbsp;Ousswa Kudia MPH ,&nbsp;Sara Brown MPH","doi":"10.1016/j.focus.2024.100204","DOIUrl":"10.1016/j.focus.2024.100204","url":null,"abstract":"<div><h3>Introduction</h3><p>The first case of mpox in Louisiana was identified 2 months ahead of Southern Decadence Festival in New Orleans, the largest LGBTQ+ Pride festival in the South. With mpox case numbers reflecting racial disparities, the objective was to mount an equitable vaccination response.</p></div><div><h3>Methods</h3><p>The Louisiana Department of Health rapidly pivoted its COVID-19 resources and strategies—specifically, using vaccine strike teams and mobile events, in-state vaccine redistribution through centralized warehousing and shipping support, and community partnerships—to now control mpox transmission. Here, the authors have evaluated state-based Immunization Information System data to examine whether the vaccination response was geographically and racially equitable. Geographic equity was measured by taking into account vaccine availability as well as uptake in areas with high Social Vulnerability Index.</p></div><div><h3>Results</h3><p>A total of 113 providers were enrolled in the vaccination program, and 96 mobile vaccination events were held in locations frequented by at-risk populations. Racial disparities among vaccine recipients decreased over time, and vaccine availability and uptake were equitable in areas with high Social Vulnerability Indices. However, Black, female, and Hispanic/Latinx patients had significantly higher risk of not completing the 2-dose series than their counterparts.</p></div><div><h3>Conclusions</h3><p>The mpox vaccination response in Louisiana was geographically equitable, though some demographic disparities remained.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000233/pdfft?md5=48a906fe898e76eb4e7c53e8d8ed210c&pid=1-s2.0-S2773065424000233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833054","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":"Neighborhood Environment and Poor Maternal Glycemic Control–Associated Complications of Gestational Diabetes Mellitus","authors":"Leela V. Thomas PhD ,&nbsp;Claudine T. Jurkovitz MD, MPH ,&nbsp;Zugui Zhang PhD, FAHA ,&nbsp;Mitchell R. Fawcett MBA ,&nbsp;M. James Lenhard MD, FACP, FACE","doi":"10.1016/j.focus.2024.100201","DOIUrl":"10.1016/j.focus.2024.100201","url":null,"abstract":"<div><h3>Introduction</h3><p>Risk of complications due to gestational diabetes mellitus is increasing in the U.S., particularly among individuals from racial minorities. Research has focused largely on clinical interventions to prevent complications, rarely on individuals’ residential environments. This retrospective cohort study aims to examine the association between individuals’ neighborhoods and complications of gestational diabetes mellitus.</p></div><div><h3>Methods</h3><p>Demographic and clinical data were extracted from electronic health records and linked to American Community Survey data from the U.S. Census Bureau for 2,047 individuals who had 2,164 deliveries in 2014–2018. Data were analyzed in 2021–2022 using Wilcoxon rank sum test and chi-square test for bivariate analyses and logistic regression for analysis of independent effects. All census tract–based variables used in the model were dichotomized at the median.</p></div><div><h3>Results</h3><p>Bivariate analysis showed that the average percentage of adults earning &lt;$35,000 was higher in neighborhoods where individuals with complications were living than in neighborhoods where individuals without complications were living (30.40%±12.05 vs 28.94%±11.71, <em>p</em>=0.0145). Individuals who lived in areas with ≥8.9% of residents aged &gt;25 years with less than high school diploma had a higher likelihood of complications than those who lived in areas with &lt;8.9% of such residents (33.43% vs 29.02%, <em>p</em>=0.0272). Individuals who lived in neighborhoods that had ≥1.8% of households receiving public assistance were more likely to have complications than those who lived in areas where &lt;1.8% of households received public assistance (33.33% vs 28.97%, <em>p</em>=0.0287). Logistic regression revealed that the odds of deliveries with complications were 44% higher for individuals with obesity (OR=1.44; 95% CI=1.17, 1.77), 35% greater for individuals residing in neighborhoods with higher percentages of households living below the poverty level (OR=1.35; 95% CI=1.09, 1.66), and 28% lower for individuals from neighborhoods where a higher percentage of households had no vehicles available for transportation to work (OR=0.72; 95% CI=0.59, 0.89).</p></div><div><h3>Conclusions</h3><p>Clinical interventions in concert with environmental changes could contribute to preventing maternal and neonatal complications of gestational diabetes mellitus.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000208/pdfft?md5=c683a679c6cf02145c5f31bf36852f46&pid=1-s2.0-S2773065424000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139824394","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":"Rapid Operationalization of COVID-19 Immunization Clinics With Medical and Physician Assistant Students Serving as Vaccinators","authors":"Robert D. Bradshaw MD, MPH ,&nbsp;Cynthia C. Romero MD ,&nbsp;Jovanna A. Tracz BS ,&nbsp;Lydia Lukomski BS ,&nbsp;Julie L. Stoner PhD, MPH ,&nbsp;Shambhawi Thakur BS, MS ,&nbsp;Michael A. Wilson BS","doi":"10.1016/j.focus.2024.100199","DOIUrl":"10.1016/j.focus.2024.100199","url":null,"abstract":"<div><h3>Introduction</h3><p>In anticipation of institutional and community-wide COVID-19 immunization clinics, an educational program for the administration of COVID-19 vaccines was developed, collaborating with the Virginia Department of Health to train doctor of medicine and physician assistant students to serve as vaccinators. Faculty and students also worked with state legislatures to propose and enact a bill that would enable such students to vaccinate patients.</p></div><div><h3>Methods</h3><p>Between January 2021 and August 2022, 263 student volunteers completed 3,685 person-hours, administering 48,279 doses. On the basis of community need, the majority of vaccines were administered at mass vaccination clinics in Chesapeake (47%) and Norfolk (22%) in Virginia. One year after the first COVID-19 immunization clinic, the authors surveyed students who assisted with clinics, utilizing a Likert scale and free-text responses to elicit feedback about the training and volunteer experience.</p></div><div><h3>Results</h3><p>Volunteers ranked the vaccination clinics among the top third of established volunteer experiences offered at Eastern Virginia Medical School, and 75% of respondents believed that this training should be a permanent part of their program curriculum.</p></div><div><h3>Conclusions</h3><p>This paper presents a strategy for preparing students to serve as vaccinators during public health emergencies and show how other institutions of medical education can prepare for and engage student participation in vaccination campaigns and emergent health initiatives.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400018X/pdfft?md5=d82bf8cca65358bd45b6ea67af9de7de&pid=1-s2.0-S277306542400018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882589","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":"Impact of Race on Classification of Atherosclerotic Risk Using a National Cardiovascular Risk Prediction Tool","authors":"Jarett R. Beaudoin MD, MPH ,&nbsp;Jill Curran MS ,&nbsp;G. Caleb Alexander MD, MS","doi":"10.1016/j.focus.2024.100200","DOIUrl":"10.1016/j.focus.2024.100200","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of race in clinical risk prediction tools may exacerbate racial disparities in healthcare access and outcomes. This study quantified the number of individuals reclassified for primary prevention of cardiovascular disease owing to a change in their race alone on the basis of a commonly used risk prediction tool.</p></div><div><h3>Methods</h3><p>This is a cross-sectional analysis of individuals aged 40–75 years without a history of cardiovascular events, diabetes, or other high-risk features using the 2005–2018 National Health and Nutritional Examination Survey. Authors compared atherosclerotic cardiovascular disease risk scores using the American Heart Association/American College of Cardiology equation recommended for White individuals or individuals of other races with that recommended for Black individuals.</p></div><div><h3>Results</h3><p>A total of 2,946 White individuals; 1,361 Black individuals; and 2,495 individuals of other races were included in the analysis. Using the American Heart Association/American College of Cardiology equation, the mean 10-year atherosclerotic cardiovascular disease risk was 5.80% (95% CI=5.54, 6.06) for White individuals, 7.04% (956% CI=6.69, 7.39) for Black individuals, and 4.93% (95% CI=4.61, 5.24) for individuals of other races. When using the American Heart Association/American College of Cardiology equation designated for the opposite race (White/other race versus Black), the mean atherosclerotic cardiovascular disease risk score increased by 1.02% (95% CI=0.90, 1.13) for White individuals, decreased by 1.82% (95% CI= −1.67, −1.96) for Black individuals, and increased by 0.98% (95% CI=0.85, 1.10) for individuals of other races. When using clinical atherosclerotic cardiovascular disease categories of &lt;7.5%, 7.5%–10%, and &gt;10%, 16.93% of all individuals were reclassified when using the American Heart Association/American College of Cardiology's equation designated for the opposite race.</p></div><div><h3>Conclusions</h3><p>Changing race within a commonly used cardiovascular risk prediction tool results in significant changes in risk classification among eligible White and Black individuals in the U.S.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 2","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000191/pdfft?md5=4d12b2f671069d41da5a93e6b075e7be&pid=1-s2.0-S2773065424000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827209","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":"Representative Public Health Surveys Pose Several Challenges: Lessons Learned Across 9 Communities During the COVID-19 Pandemic","authors":"Jeanne W. Lawless PhD ,&nbsp;Diego G. Diel DVM, PhD ,&nbsp;Bettina Wagner DVM, PhD ,&nbsp;Kevin J. Cummings DVM, PhD ,&nbsp;Genevive R. Meredith DrPH ,&nbsp;Lara Parrilla MPH, RD ,&nbsp;Elizabeth F. Plocharczyk MD ,&nbsp;Robert Lawlis MEng ,&nbsp;Samantha Hillson MPH ,&nbsp;Benjamin D. Dalziel PhD ,&nbsp;Jeffrey W. Bethel PhD ,&nbsp;Jane Lubchenco PhD ,&nbsp;Katherine R. McLaughlin PhD ,&nbsp;Roy Haggerty PhD ,&nbsp;Kathryn A. Higley PhD ,&nbsp;F. Javier Nieto MD, PhD ,&nbsp;Tyler S. Radniecki PhD ,&nbsp;Christine Kelly PhD ,&nbsp;Justin L. Sanders PhD ,&nbsp;Casey L. Cazer DVM, PhD","doi":"10.1016/j.focus.2024.100198","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100198","url":null,"abstract":"<div><p>Community surveillance surveys offer an opportunity to obtain important and timely public health information that may help local municipalities guide their response to public health threats. The objective of this paper is to present approaches, challenges, and solutions from SARS-CoV-2 surveillance surveys conducted in different settings by 2 research teams. For rapid assessment of a representative sample, a 2-stage cluster sampling design was developed by an interdisciplinary team of researchers at Oregon State University between April 2020 and June 2021 across 6 Oregon communities. In 2022, these methods were adapted for New York communities by a team of veterinary, medical, and public health practitioners. Partnerships were established with local medical facilities, health departments, COVID-19 testing sites, and health and public safety staff. Field staff were trained using online modules, field manuals describing survey methods and safety protocols, and in-person meetings with hands-on practice. Private and secure data integration systems and public awareness campaigns were implemented. Pilot surveys and field previews revealed challenges in survey processes that could be addressed before surveys proceeded. Strong leadership, robust trainings, and university–community partnerships proved critical to successful outcomes. Cultivating mutual trust and cooperation among stakeholders is essential to prepare for the next pandemic.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 2","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000178/pdfft?md5=1aa5b55a80ff16a80f7c65bfdb37e0f4&pid=1-s2.0-S2773065424000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139737294","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}