AJPM focus最新文献

{"title":"Advancing the Field of Deimplementation: Perspectives on Low-Value Clinical Preventive Services","authors":"Meagan Pilar PhD, MPH ,&nbsp;Gerald Gartlehner MD, MPH ,&nbsp;Shannon Kugley MLIS ,&nbsp;Karen Strazza MPH ,&nbsp;Valerie Ng BS ,&nbsp;Laurie Hinnant PhD, MS ,&nbsp;Alison Banger MPH ,&nbsp;Shivani Reddy MD, MSc ,&nbsp;Jodi Blake MBA, BSN ,&nbsp;Nora Mueller PhD, MAA ,&nbsp;Christiane Voisin MSLS ,&nbsp;Leila Kahwati MD, MPH","doi":"10.1016/j.focus.2025.100339","DOIUrl":"10.1016/j.focus.2025.100339","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical preventive services, such as screening tests, vaccinations, and health behavior counseling provided in primary care settings, aim to prevent future disease, detect early disease, or mitigate the impact of unhealthy behaviors on future health. However, research advances have shown that some clinical preventive services do not confer benefit and may even cause harm for some populations. Experts have increasingly emphasized discontinuing low-value health services, a process known as deimplementation. This project gathered expert input on the state of deimplementation of low-value clinical preventive services.</div></div><div><h3>Methods</h3><div>The author conducted (1) an environmental scan of current work on deimplementation, (2) key informant interviews (<em>n</em>=4 individuals), and (3) a facilitated discussion with a technical expert panel (<em>n</em>=12 members) and synthesized the findings. The author used an iterative, inductive approach to identify themes from the discussions with experts.</div></div><div><h3>Results</h3><div>The environmental scan and technical experts identified no frameworks and few empiric studies specific to the deimplementation of low-value clinical preventive services. The experts advised that terminology surrounding deimplementation efforts and low-value health services be revised to better resonate with patients and families. Experts suggested refining existing health services deimplementation frameworks and recommended future research to test deimplementation strategies specific to low-value clinical preventive services. Experts also described unintended consequences of deimplementation that could increase health inequities. Finally, experts emphasized the importance of engaging patients and families in deimplementation efforts.</div></div><div><h3>Conclusions</h3><div>These findings offer guidance for future work, including advancing methods; testing strategies specific to low-value clinical preventive services; and engaging patients, families, and communities in deimplementation efforts.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100339"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U.S. Physicians’ Views on E-Cigarette Risks and Benefits to Adults Who Smoke Versus Young People Who Do Not Smoke","authors":"Monica Magalhaes PhD ,&nbsp;Michelle T. Bover Manderski PhD, MPH ,&nbsp;Michelle Jeong PhD ,&nbsp;William J. Young PhD ,&nbsp;Michael B. Steinberg MD, MPH ,&nbsp;Nir Eyal DPhil","doi":"10.1016/j.focus.2025.100363","DOIUrl":"10.1016/j.focus.2025.100363","url":null,"abstract":"<div><h3>Introduction</h3><div>Emerging evidence suggests that E-cigarettes are likely less harmful than combustible cigarettes, presenting an opportunity for adults who smoke to quit or switch. E-cigarettes also risk increasing the number of young people who become addicted to nicotine. Physicians’ perceptions of and attitudes toward this tradeoff remain underexplored.</div></div><div><h3>Methods</h3><div>A random sample of U.S. physicians (N=940) were surveyed on a variety of tobacco-related issues and on their treatment practices and demographics. Questions aimed to elicit tradeoffs between protecting youth from becoming addicted to nicotine and helping adult smokers quit.</div></div><div><h3>Results</h3><div>Most respondents (93%) reported caring about both helping adults quit smoking and protecting the young, with the majority (66.2%) prioritizing the latter. Of the various specialties, pediatricians were most likely to believe that preventing nicotine addiction among young people matters more than helping adults quit. Prioritization of youth over adults who smoke was also associated with being female, being younger, and having negative beliefs about the utility of E-cigarettes for smoking cessation.</div></div><div><h3>Conclusions</h3><div>The findings show that physicians attribute greater ethical priority to protecting young people than to reducing risk to adults. Improved education on the risks versus benefits of E-cigarettes may assist physicians in making appropriate recommendations depending on patients' needs.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board and Journal Information","authors":"","doi":"10.1016/S2773-0654(25)00081-1","DOIUrl":"10.1016/S2773-0654(25)00081-1","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Electronic Health Record–Based Platform for Social Needs Assessment and Navigation Services: Preliminary Results of an RCT","authors":"Elham Hatef MD, MPH, FACPM ,&nbsp;Thomas Richards MS ,&nbsp;Sofia Hail MD ,&nbsp;Talan Zhang PhD ,&nbsp;Kristin Topel MS ,&nbsp;Christopher Kitchen MS ,&nbsp;Katherine C. Shaw MD ,&nbsp;Jonathan P. Weiner DrPH","doi":"10.1016/j.focus.2025.100344","DOIUrl":"10.1016/j.focus.2025.100344","url":null,"abstract":"<div><h3>Introduction</h3><div>The study team has developed an electronic health record–integrated platform, including a clinical decision support and closed-loop referral tool, to identify patients with social needs and to provide assessment and navigation services. This paper presents the results of the first 6 months of the study assessing the effectiveness of this platform.</div></div><div><h3>Study design</h3><div>This was an RCT.</div></div><div><h3>Setting</h3><div>This study took place in 5 primary care clinics at the Johns Hopkins Health System and 5 community-based organizations participating in the digital closed-loop referral system.</div></div><div><h3>Participants</h3><div>This study included African-American adult (aged ≥18 years) patients living in socioeconomically challenged neighborhoods in Baltimore City.</div></div><div><h3>Intervention</h3><div>The study compared the electronic health record–integrated digital platform with the standard of care.</div></div><div><h3>Main outcome measures</h3><div>The main outcome was a change in the number of identified social needs from enrollment to 3-month follow-up, comparing intervention with control groups.</div></div><div><h3>Results</h3><div>During the first ∼6 months of the study, the authors reached out to 1,648 eligible patients, 92 (5.59%) of whom enrolled and consented to join the trial. Among the intervention group, using only information provided by the electronic health record–based digital platform, the authors identified 25 patients (56.82%) whom they deemed not to require further social needs assessment (Intervention Group A) and 19 patients (43.18%) in whom the information provided in the digital platform suggested that high social need may be present (Intervention Group B). This latter group was deemed to require further in-depth social needs assessment and subsequent social services navigation support, potentially including referral to the participating community-based organizations. More patients in Intervention Group B than in the control group and Intervention Group A experienced a decrease in social needs documented by providers across the Johns Hopkins Health System outside the study setting (8 patients [42.11%], 11 [22.92%], and 2 [8.00%]; <em>p</em>=0.021) or by the study team (3 patients [15.79%], 1 [2.08%], and 1 [4.00%]; <em>p</em>=0.078).</div></div><div><h3>Conclusions</h3><div>These preliminary findings show that structuring a social needs assessment and intervention within clinical electronic health records can improve the social needs assessment and intervention process.</div></div><div><h3>Trial registration</h3><div>This trial is registered through the NIH on clnicaltrials.gov (NCT05574699).</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Access to Uncontaminated Omega-3 Polyunsaturated Fatty Acids Requires Attention","authors":"Timothy H. Ciesielski ScD, MD, MPH","doi":"10.1016/j.focus.2025.100341","DOIUrl":"10.1016/j.focus.2025.100341","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Healthcare System’s Path to Carbon Neutrality: Addressing Climate Change and Role of the Health Care","authors":"Edward D. Shin MD ,&nbsp;Rame Hemstreet PE ,&nbsp;Stacey Alexeeff PhD ,&nbsp;Seema S. Wadwa MA ,&nbsp;Jamal S. Rana MD, PhD","doi":"10.1016/j.focus.2025.100377","DOIUrl":"10.1016/j.focus.2025.100377","url":null,"abstract":"<div><h3>Introduction</h3><div>Anthropogenic climate change, according to the WHO, results in approximately 150,000 deaths annually through mechanisms such as heat-related mortality, altered food production, and the spread of infectious diseases. With climate change predicted to cause over half a million climate-related deaths by 2050, healthcare systems, which contribute significantly to greenhouse gas emissions, must adopt roles in environmental stewardship.</div></div><div><h3>Methods</h3><div>This descriptive case study details how Kaiser Permanente, a large nonprofit organization, became the first carbon-neutral healthcare system in the country.</div></div><div><h3>Results</h3><div>Kaiser Permanente has demonstrated environmental stewardship through initiatives such as an on-site solar program, sustainability scorecards for suppliers, and extensive partnerships with organizations to support community health and environmental building efforts. Initiatives included scaling renewable energy usage, constructing Leadership in Energy and Environmental Design–certified facilities, and reducing water use intensity led to Kaiser Permanente being the first carbon-neutral health system in the country.</div></div><div><h3>Conclusions</h3><div>The WHO has declared climate change as the most significant threat to human health. Kaiser Permanente’s journey to carbon neutrality highlights the critical role healthcare systems play in environmental stewardship. Continued focus on climate initiatives by the healthcare sector is essential to address the growing health impacts of climate change. Kaiser Permanente’s efforts provide a real-life and practical framework for achieving significant positive climate effects.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100377"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young Adult Cannabis, Alcohol, Nicotine, and Nonprescribed Pain Reliever Use in Washington State Before and During COVID-19 Pandemic","authors":"Charles B. Fleming MA ,&nbsp;Griselda Martinez PhD ,&nbsp;Isaac C. Rhew PhD ,&nbsp;Jason R. Kilmer PhD ,&nbsp;Mary E. Larimer PhD ,&nbsp;Katarina Guttmannova PhD","doi":"10.1016/j.focus.2025.100342","DOIUrl":"10.1016/j.focus.2025.100342","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic may have affected young adult use of cannabis and other drugs. Prior research provides information about these effects, but additional estimates are needed using data collected in a consistent manner across years and in an established legalized cannabis context. The authors assessed changes in substance use among young adults in Washington State during the pandemic relative to prior trends.</div></div><div><h3>Methods</h3><div>Data were from young adults aged 18–25 years in 6 annual waves of the statewide Washington State Young Adult Health Survey (N=12,516). In analyses conducted in 2023 and 2024, the authors estimated trends in substance use from 2016 to 2019 and deflections from those trends in 2020 and 2021.</div></div><div><h3>Results</h3><div>Past-month cannabis use increased across years (annual percentage point change in 2016–2019 =1.6; 95% CI=0.6, 2.6), with little deflection from the prepandemic trend in 2020 or 2021. Prevalence of past-month alcohol use, heavy episodic drinking, cigarette use, and nonprescribed pain reliever use decreased across years (annual percentage point change range= −1.2, −0.5), with a further downward deflection from the prepandemic trend for cigarette use in 2020 (percentage point change= −3.8; 95% CI= −6.2, −1.4). Prevalence of simultaneous alcohol and cannabis use was stable across the study period. E-cigarette use increased before pandemic (annual percentage point change=1.8; 95% CI=1.2, 2.5) but fell below this trend in 2020 (percentage point change= −2.9; 95% CI= −4.8, −1.1) and 2021 (percentage point change= −3.2; 95% CI= −5.3, −1.0). For those aged &lt;21 years compared with those aged ≥21 years, there was a downward deflection in cannabis use in 2020 (percentage point change=7.5; 95% CI=0.1, 14.9) and greater decrease in nonprescribed pain reliever use before pandemic (annual percentage point change=1.3; 95% CI=0.3, 2.3) followed by a relative increase in 2020 (percentage point change= −5.5; 95% CI= −11.6, 0.5). Sex differences in changes were not statistically significant, but females increased in most types of substance use relative to males across the study period.</div></div><div><h3>Conclusions</h3><div>Prepandemic trends in cannabis and alcohol use continued through 2021, pointing to continuity in demand and supply, although the pandemic may have dampened cannabis use in 2020 for young adults aged &lt;21 years. Decreases in nicotine use after 2019 may be partly due to restrictions on sales enacted in 2020 and warnings of COVID-19 risk linked to smoking and vaping. The findings point to the need for continued substance use prevention and treatment services during disruptive public health crises.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Strain and Child Health: Measures and Evidence From a Systematic Literature Review","authors":"Laura J. Samuel PhD, MSN, RN ,&nbsp;Martha Abshire Saylor PhD, RN ,&nbsp;Melissa Lutz MD, MHS ,&nbsp;Monica Y. Choe DNP, CRNP, RN ,&nbsp;Rhonda Smith Wright PhD, MHSA, RN ,&nbsp;Boeun Kim PhD ,&nbsp;Sarah L. Szanton PhD, RN ,&nbsp;Manka Nkimbeng PhD, RN ,&nbsp;Fernando Mena-Carrasco MSN, MSW, RN ,&nbsp;Rachel Austin MPH ,&nbsp;Eliana M. Perrin MD, MPH","doi":"10.1016/j.focus.2025.100337","DOIUrl":"10.1016/j.focus.2025.100337","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the focus on pediatric social needs, there is a dearth of research on financial strain, which is characterized by challenges in meeting basic needs. This study systematically reviewed the literature on different measures of self-reported financial strain and health outcomes.</div></div><div><h3>Methods</h3><div>A systematic literature search in PubMed, PsychINFO, and Web of Science identified papers that examined relationships between self-reported financial strain and health outcomes among U.S. children or adolescents. Two blinded reviewers screened each paper (65 papers, 39 studies) and extracted data. Financial strain measures were coded for content. Findings were synthesized based on age and type of measure.</div></div><div><h3>Results</h3><div>Financial strain measures asked about the lack of money for basic needs (32 studies), difficulty making ends meet (23 studies), relying on coping strategies (13 studies), experiencing stress or worry about finances (4 studies) anticipating future strain (4 studies), and the lack of money for leisure (4 studies). Financial strain was associated with poorer health and well-being and more behavior challenges among children of all ages, poorer academic performance among school-age children, and more depressive symptoms among adolescents. Associations were consistent across diverse samples when accounting for other socioeconomic factors and across financial strain measures, including a single item about difficulty making ends meet. Fourteen studies tested hypothesized mechanistic factors that explain associations, including material, psychosocial, and behavioral pathways.</div></div><div><h3>Discussion</h3><div>The consistency of associations between financial strain and pediatric health and well-being highlights an urgent need to address financial strain to advance health equity. Results show predictive validity for a simple financial strain question, similar to one recommended by the National Academy of Medicine.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100337"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Impact and Cost-Effectiveness of Resealing First Permanent Molars","authors":"Christina R. Scherrer PhD ,&nbsp;Pritam Deb BS ,&nbsp;Jayden Ayash MS ,&nbsp;Shillpa Naavaal BDS, MS, MPH","doi":"10.1016/j.focus.2025.100345","DOIUrl":"10.1016/j.focus.2025.100345","url":null,"abstract":"<div><h3>Introduction</h3><div>This study examined the cost-effectiveness and health impact of various dental sealant resealing scenarios for first permanent molars from the payer perspective.</div></div><div><h3>Methods</h3><div>The authors used a discrete event simulation model for 4,000 recently sealed first molars in a hypothetical cohort of 1,000 children aged 7 years over a 10-year time horizon. Scenarios included a base case of no resealing, resealing at first dental visit, and resealing at the age of 12 years.</div></div><div><h3>Results</h3><div>Without resealing, only 34.88% of teeth retained sealants after 10 years, whereas resealing at the age of 12 years increased this to 53.05%, and resealing at first dental visit increased it to 43.48%. Resealing at age 12 years significantly reduced decay experience to 26.65%, and resealing at first dental visit reduced it to 25.30%, compared with 41.15% for no resealing. The number of accrued disability-adjusted life years was highest for no resealing (5.35). This number reduced to 3.52 for resealing at age of 12 years and 3.19 for resealing at the first dental visit. Cost-effectiveness analysis showed that the most effective resealing scenario, resealing at the first dental visit, also had the lowest cost per averted cavity ($43.03) and cost per averted disability-adjusted life year ($6,753).</div></div><div><h3>Conclusions</h3><div>This simulation model indicates that resealing significantly reduces dental decay over 10 years at reasonable costs, using conservative modeling assumptions. These findings suggest that insurance companies and Medicaid could benefit from implementing resealing policies to improve dental health outcomes by reducing caries and filling costs.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Health Screening Rates and Visits to Their Primary Care Provider in Young Adults Transitioning From Pediatrics to Adult Medicine","authors":"Abigail Eaton PhD ,&nbsp;Stephanie R. Prausnitz MS ,&nbsp;Heather A. Baskind MD ,&nbsp;H. Nicole Tran MD","doi":"10.1016/j.focus.2025.100353","DOIUrl":"10.1016/j.focus.2025.100353","url":null,"abstract":"<div><h3>Introduction</h3><div>This study examines associations between a young adult's visit to a designated primary care physician (PCP) in the 18 months after transitioning from pediatrics and their completion of preventive healthcare screenings. The period from 18 to 25 years is marked by transition and continued brain development, making it an ideal period for impactful intervention on healthy behaviors and outcomes.</div></div><div><h3>Methods</h3><div>Completion of screening for alcohol use, mental health issues, exercise habits, and tobacco use was measured in members upon turning 18 during 2020-2021. These members had transitioned from pediatrics to adult medicine at an integrated healthcare system at Kaiser Permanente Northern California. Associations of sex, race and ethnicity, need of interpreter, insurance type, neighborhood deprivation, pediatric PCP visit, and chronic conditions were compared for members with or without a visit with their new PCP during the 18 months of transition.</div></div><div><h3>Results</h3><div>A multivariate model showed that young adults with a visit to their PCP had increased likelihood of completion of screening: 21% for alcohol use, 12% for mental health issues, 18% for exercise, and 16% for tobacco use. Several characteristics were associated with a reduced likelihood of a visit with a PCP: 15% reduced likelihood for residence in more deprived neighborhoods (incidence rate ratio=0.85, 95% CI=0.82, 0.88); between a 6% and 3% reduced likelihood for individuals who were Asian, Black or Hispanic (incidence rate ratio=0.96, 95% CI=0.93, 0.99), (incidence rate ratio=0.94, 95% CI=0.90, 0.98), (incidence rate ratio=0.97, 95% CI=0.94, 0.99) respectively; 55% reduced likelihood for those requiring an interpreter (incidence rate ratio=0.45, 95% CI=0.37, 0.53); and 16% reduced likelihood for males (incidence rate ratio=0.84, 95% CI=0.82, 0.86). Individuals who had a visit to their pediatric PCP, and individuals with chronic conditions, were 20% and 29% more likely, respectively, to have had a visit with their adult PCP (incidence rate ratio=1.20, 95% CI=1.18, 1.23) and (incidence rate ratio=1.29, 95% CI=1.27, 1.32).</div></div><div><h3>Conclusion</h3><div>Promotion of PCP visits and outreach to individuals with a reduced likelihood of visiting their PCP during this transition could provide opportunities for preventive health interventions among young adults.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 4","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}