AJPM focus最新文献

{"title":"Patient Perspectives on Personalized Risk Communication Using Polygenic Risk Scores to Inform Colorectal Cancer Screening Decisions","authors":"Shauna R. Goldberg MPH ,&nbsp;Linda K. Ko PhD ,&nbsp;Li Hsu PhD ,&nbsp;Hang Yin MS ,&nbsp;Charles Kooperberg PhD ,&nbsp;Ulrike Peters PhD, MPH ,&nbsp;Andrea N. Burnett-Hartman PhD, MPH","doi":"10.1016/j.focus.2024.100308","DOIUrl":"10.1016/j.focus.2024.100308","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal cancer is increasingly diagnosed in people aged &lt;50 years. New U.S. guidelines recommend screening initiation at age 45 years. Providing personalized risk for colorectal cancer using polygenic risk scores may be an opportunity to engage this younger population in colorectal cancer screening. There is limited research on patient understanding of polygenic risk scores results and use of polygenic risk scores to inform colorectal cancer screening decisions.</div></div><div><h3>Methods</h3><div>From May 2022 to June 2023, 20 Kaiser Permanente Colorado members aged 46–51 years who had been offered colorectal cancer screening but had never completed it signed consent to provide a saliva sample for colorectal cancer polygenic risk score analysis. After receiving personalized polygenic risk scores for colorectal cancer, participants completed a semistructured interview regarding the understanding of their polygenic risk scores, perceived colorectal cancer risk, and intention to screen. Thematic analysis was conducted using Atlas.ti, Version 8.</div></div><div><h3>Results</h3><div>Of the 19 participants who successfully completed polygenic risk score–related testing and a semistructured interview, 13 were female, 14 never smoked cigarettes, 6 were Hispanic, and 13 were non-Hispanic White. One participant had high risk for colorectal cancer on the basis of polygenic risk score results. Qualitative interviews showed participants’ understanding of their results, trust in polygenic risk scores, perception of risk for colorectal cancer, plans to complete colorectal cancer screening, intent to share polygenic risk scores with healthcare providers, and concerns about genetic results impacting health care.</div></div><div><h3>Conclusions</h3><div>Qualitative analyses suggest that participants were interested in and understood their polygenic risk score results. Further study is needed to develop guidelines, effective calls to action, provider engagement, and health education materials on use of polygenic risk scores for health decision making.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100308"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048826","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":"Editorial Board and Journal Information","authors":"","doi":"10.1016/S2773-0654(25)00004-5","DOIUrl":"10.1016/S2773-0654(25)00004-5","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377710","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":"An Estimate of Preventable Harms Associated With Screening Colonoscopy Overuse in the U.S.","authors":"Shannon Brownlee MSc ,&nbsp;Alison N. Huffstetler MD ,&nbsp;Joseph Fraiman MD ,&nbsp;Kenneth W. Lin MD, MPH","doi":"10.1016/j.focus.2024.100296","DOIUrl":"10.1016/j.focus.2024.100296","url":null,"abstract":"<div><h3>Introduction</h3><div>Screening colonoscopy is often performed on patients who are younger or older than the ages specified in national guidelines or at shorter intervals than recommended. The annual incidence of harms associated with overuse of screening colonoscopy in the U.S. is not known. This study estimated the incidence of low-value screening colonoscopies annually in the U.S. and the number of preventable harms associated with them.</div></div><div><h3>Methods</h3><div>The 2018 National Health Interview Survey was used to estimate the number of annual screening colonoscopies. Rates of colonoscopy overuse and serious (bleeding and bowel perforation) and minor harms were drawn from 3 recent systematic reviews.</div></div><div><h3>Results</h3><div>Approximately 12.4 million screening colonoscopies were completed in the U.S. in 2018. Given the credible range of overuse rates of screening colonoscopy, between 2.1 and 3.2 million low-value colonoscopies occur per year. Applying the credible ranges identified for serious and minor harms secondary to screening colonoscopy resulted in an estimated annual incidence of serious harm from unnecessary colonoscopies ranging from 9,055 to 11,874. The estimate for minor harms ranged from 359,5790 to 1,566,846.</div></div><div><h3>Conclusions</h3><div>In the U.S., screening colonoscopies are often completed at intervals and in populations that are inconsistent with national recommendations, resulting in unnecessary serious and minor harm. Although individual risk is relatively low, the large number of nonindicated screening colonoscopies results in large numbers of adverse events that are preventable with better adherence to recommendations.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857095","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":"Health- and Non–Health-Related Corporate Social Responsibility Statements in Top Selling Restaurant Chains in the U.S. Between 2012 and 2018: A Content Analysis","authors":"Megan P. Mueller PhD ,&nbsp;Alyssa Leib MS ,&nbsp;Deborah C. Glik PhD ,&nbsp;Sara N. Bleich PhD ,&nbsp;Jason Wang PhD ,&nbsp;Catherine M. Crespi PhD ,&nbsp;May C. Wang DrPH","doi":"10.1016/j.focus.2024.100295","DOIUrl":"10.1016/j.focus.2024.100295","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to understand the prevalence and content of corporate social responsibility statements in the top-selling chain restaurants between 2012 and 2018 to inform the ways restaurants can impact population health.</div></div><div><h3>Methods</h3><div>The study used a web scraping technique to abstract relevant text information (<em>n</em>=6,369 text sections that contained possible corporate social responsibility statements or thematically coded portions of the text section) from the archived web pages of the 96 top-selling chain restaurants. Content analysis was used to identify key themes in corporate social responsibility statements across restaurants and over time. All data were abstracted, and analyses were completed between November 2019 and November 2023.</div></div><div><h3>Results</h3><div>The majority of restaurants (68.8%) included a corporate social responsibility statement on their web pages between 2012 and 2018, and approximately half of the restaurants featured a health-related corporate social responsibility statement (51.0%). There were increases in corporate social responsibility statements by chain restaurants over the study period from 186 corporate social responsibility statements in 2012 to 1,218 corporate social responsibility statements in 2018, with most statements focused on philanthropy (37.1% of coded statements), community activities that were not health related (18.4% of coded statements), and sustainability initiatives (18.3% of coded statements). Only one quarter (24.4%) of these corporate social responsibility statements were health related, and many were vague in nature (only 28% of the eligible statements could be coded by theme).</div></div><div><h3>Conclusions</h3><div>There is a need for more actionable health-focused initiatives in the corporate social responsibility statements for chain restaurants. Public health initiatives that engage with the restaurant industry should work to promote corporate social responsibility statements that are in line with other collective positions around improving health and reducing diet-related disease.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048823","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 Association Between a Summary Measure of Social Determinants of Health/Health Equity and Cardiovascular Disease Burden Among Mississippi Adults","authors":"Vincent L. Mendy DrPH, MPH, CPH ,&nbsp;Tawandra L. Rowell-Cunsolo PHD ,&nbsp;Byambaa Enkhmaa MD, PHD","doi":"10.1016/j.focus.2024.100297","DOIUrl":"10.1016/j.focus.2024.100297","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular disease is the leading cause of death among Mississippi adults. Social determinants of health are significant contributors to cardiovascular disease risk and associated mortality as well as health disparities. The authors examined the association between a summary measure of social determinants of health and cardiovascular disease among Mississippi adults.</div></div><div><h3>Methods</h3><div>Using the social determinants of health and health equity module data from 3,994 respondents to the 2022 Mississippi Behavioral Risk Factor Surveillance System survey, the authors conducted multivariable logistic regression models to examine the association between cardiovascular disease and a social determinants of health/health equity summary measure.</div></div><div><h3>Results</h3><div>Participants who received food stamps or were enrolled in the Supplemental Nutrition Assistance Program (AOR=2.28; 95% CI=1.35, 3.86), experienced food insecurity (AOR=1.74; 95% CI=1.08, 2.79), and experienced mental distress (AOR=2.39; 95% CI=1.54, 3.73) had significantly higher odds of cardiovascular disease than their counterparts without any of these factors. Mississippi adults experiencing 4 or more of social determinants of health/health equity risk factors had a 2.56 (AOR=2.56; 95% CI=1.49, 4.41) higher odds of cardiovascular disease than those experiencing no social determinants of health/health equity risk factors.</div></div><div><h3>Conclusions</h3><div>Mississippi adults with 4 or more social determinants of health/health equity risk factors had significantly higher odds of cardiovascular disease than those with no social determinants of health/health equity risk factors. These findings highlight the importance of social determinants of health/health equity factors in cardiovascular disease burden and suggest that interventions targeted at individuals with multiple social determinants of health/health equity risk factors are needed to reduce the high burden of cardiovascular disease among Mississippi adults.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959874","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":"Determining Filipinos’ Preferences for Colorectal Cancer Screening Tests: Insights From a Choice-Based Conjoint Analysis","authors":"Austin Crochetiere MD ,&nbsp;Marie Lauzon MS ,&nbsp;Antwon Chaplin BA ,&nbsp;Christopher V. Almario MD, MSHPM","doi":"10.1016/j.focus.2024.100300","DOIUrl":"10.1016/j.focus.2024.100300","url":null,"abstract":"<div><h3>Introduction</h3><div>Filipinos in the U.S. have worse colorectal cancer screening rates and outcomes than non-Hispanic Whites, despite 85% of Filipinos being proficient in English and having insurance rates, education, and incomes that exceed those of the general population. To begin to address this disparity, the authors used conjoint analysis—a method that assesses complex decision making—to better understand Filipinos’ preferences for the different colorectal cancer screening test options.</div></div><div><h3>Methods</h3><div>The authors conducted a conjoint analysis survey among unscreened Filipinos aged ≥40 years at average risk for colorectal cancer to determine the relative importance of screening test attributes in their decision making (e.g., modality, effectiveness at reducing colorectal cancer risk, bowel prep). The authors also performed simulations to estimate the proportion of people who would prefer to do an annual fecal immunochemical test or colonoscopy every 10 years for their screening.</div></div><div><h3>Results</h3><div>Overall, 105 Filipinos completed the survey; most respondents were female (74.3%) and aged 40–49 years (84.8%). The authors observed that test modality was the most important factor in respondents’ decision making. After conducting simulations using the conjoint analysis data, the authors noted that 70 (66.7%) Filipinos preferred to do an annual fecal immunochemical test for their screening, whereas 35 (33.3%) wanted to do a colonoscopy every 10 years.</div></div><div><h3>Conclusions</h3><div>The authors found that 2 in 3 Filipinos prefer fecal immunochemical test to colonoscopy for their colorectal cancer screening. To address colorectal cancer disparities in the Filipino community, investigators, health systems, public health agencies, and community organizations need to develop culturally tailored, sustainable interventions, and such programs may want to focus on improving education on and access to fecal immunochemical test.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985412","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":"Demographic Characteristics Associated With Adolescent Receipt of Provider E-Cigarette Screening and Advice and the Impact on Harm Perception","authors":"John S. Acosta-Peñaloza MS,&nbsp;Karen W. Geletko MPH,&nbsp;Jon Mills PhD","doi":"10.1016/j.focus.2024.100309","DOIUrl":"10.1016/j.focus.2024.100309","url":null,"abstract":"<div><h3>Introduction</h3><div>The growing prevalence of E-cigarette use among adolescents is alarming because it increases the probability of persistent tobacco use and addiction to nicotine. Healthcare providers are in a unique position to influence their patients’ use of E-cigarettes. The purpose of the study is to determine the frequency at which providers screen adolescents for E-cigarette use and advise against use during healthcare visits. The study also examines associations between provider intervention and adolescent harm perception.</div></div><div><h3>Methods</h3><div>Using data from the 2021 National Youth Tobacco Survey, the authors examined provider E-cigarette screening and advice to not use from 16,910 participants who self-reported receiving medical care within the preceding year. Multivariable logistic regression models were used to assess whether the odds of provider intervention varied by age, sex, and race/ethnicity and whether receiving provider intervention was associated with a likelihood for harm perception.</div></div><div><h3>Results</h3><div>Provider intervention was more likely among those aged 13–18 years, who are male, and who are White and/or non-Hispanic (<em>p</em>&lt;0.001). The authors found no association between provider intervention and increased harm perception of E-cigarettes; however, provider intervention was associated with the belief that E-cigarettes are equally or more addictive than cigarettes (<em>p</em>&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>Study findings emphasize the significance of addressing disparities in E-cigarette use and healthcare provider intervention among minority adolescents, underscoring the need for healthcare providers to be thorough in screening for E-cigarette use and providing appropriate cessation support.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048808","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":"Person-Centered Preventive Health Care: Gathering Stakeholder Input on Evidence and Implementation","authors":"Leila C. Kahwati MD, MPH ,&nbsp;Hanan J. Aboumatar MD, MPH ,&nbsp;Alison K. Banger MPH ,&nbsp;Sarah I. Bean MPH ,&nbsp;Laurie W. Hinnant PhD ,&nbsp;Daniel E. Jonas MD, MPH ,&nbsp;Julia M. Kim MD, MPH ,&nbsp;Jennifer S. Lin MD, MCR ,&nbsp;Carrie D. Patnode PhD ,&nbsp;Meagan R. Pilar PhD ,&nbsp;Samantha I. Pitts MD, MPH ,&nbsp;Shivani M. Reddy MD, MSc ,&nbsp;Ritu Sharma BSc ,&nbsp;Christiane E. Voisin MSLS ,&nbsp;Elizabeth M. Webber MS ,&nbsp;Jodi Blake MBA ,&nbsp;Nora M. Mueller PhD, MAA","doi":"10.1016/j.focus.2025.100319","DOIUrl":"10.1016/j.focus.2025.100319","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical preventive services, such as screening tests, vaccinations, behavioral counseling, or preventive medication, are offered to most people on the basis of age, sex, health behaviors, or clinical risk factors, with goals of detecting early disease, preventing future disease, or mitigating the impact of unhealthy behaviors on future health. However, many people do not receive all the recommended services for which they are eligible.</div></div><div><h3>Methods</h3><div>The Agency for Healthcare Research and Quality identified 4 topics for gathering stakeholder input on evidence and implementation for the equitable delivery of clinical preventive services. These included technology, innovative delivery models, public health linkages, and disparities. For each topic, the authors conducted an environmental scan to identify existing programs or interventions to promote the delivery of clinical preventive services, a technical expert panel meeting, and key informant interviews. The authors synthesized input from each topic's technical expert panel and key informant interviews and used inductive reasoning to identify themes. Within each overarching theme, the authors identified subthemes supported by specific statements, examples, and illustrative quotes.</div></div><div><h3>Results</h3><div>A total of 90 individuals participated on stakeholder panels, technical expert panels, or key informant interviews; some individuals participated in multiple roles. Across the topics, the authors identified 3 overarching themes from synthesis of the technical expert panel and key informant interview comments across topics: (1) transitioning to holistic healthcare delivery and financing models, (2) including community and patient voice in healthcare system design, and (3) leveraging technology to improve clinical preventive services delivery.</div></div><div><h3>Conclusions</h3><div>Promoting the equitable delivery of clinical preventive services requires improving access to primary care but also expanding efforts beyond clinical settings to encompass public health and community infrastructure and engagement. Experts recommended that person-centered preventive care should empower patients to make informed decisions about clinical preventive services on the basis of their values, risks, and preferences. This more individualized approach tailored to needs and context may reduce barriers to receipt of clinical preventive services.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 2","pages":"Article 100319"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436858","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":"Advancing Equity in Diabetes Prevention for Both Black and Hispanic Women: An Executive Summary of Lessons Learned and Action Steps","authors":"Anita Balan MPH, MCHES ,&nbsp;Mary Claire Gugerty BS ,&nbsp;Kate Shreve MPH ,&nbsp;Raga Ayyagari MS ,&nbsp;Madeline Brady MPH ,&nbsp;Janet Williams MA ,&nbsp;Tamkeen Khan PhD","doi":"10.1016/j.focus.2025.100314","DOIUrl":"10.1016/j.focus.2025.100314","url":null,"abstract":"<div><h3>Introduction</h3><div>This report presents challenges, lessons learned, and action steps for healthcare organizations referring to or delivering the National Diabetes Prevention Program lifestyle change program to create culturally responsive Type 2 diabetes prevention strategies for disproportionately affected populations, specifically Black and Hispanic women with prediabetes.</div></div><div><h3>Methods</h3><div>The American College of Preventive Medicine, American Medical Association, and Black Women's Health Imperative identified healthcare organizations to build provider capacity to screen, test, and refer disproportionately affected populations to the National Diabetes Prevention Program. Sites provided data on participants screened, referred, and enrolled and qualitative reporting on barriers and facilitators to enrollment over a 36-month period. Key informant interviews were conducted with organizations implementing the National Diabetes Prevention Program to reduce prevalence of prediabetes in disproportionately affected populations, integrating thematic analysis to identify unique strategies.</div></div><div><h3>Results</h3><div>Healthcare organizations play a critical role in advancing equity at every level of diabetes prevention, including screening, testing, and referring participants to the National Diabetes Prevention Program lifestyle change program; engaging and retaining participants in the program; and screening and addressing social needs.</div></div><div><h3>Conclusions</h3><div>Healthcare organizations reduce disparities and advance health equity for disproportionately affected populations by cultivating program champions, engaging in community outreach, and advocating for systemic changes to increase accessibility.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 2","pages":"Article 100314"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551942","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":"A Diabetes Prevention Cascade Model for Healthcare Organizations: Results From a Pilot for Disproportionately Affected Populations","authors":"Tamkeen Khan PhD ,&nbsp;Alejandro Hughes MPH ,&nbsp;Madeline Brady MPH ,&nbsp;Janet Williams MA ,&nbsp;Mary Claire Gugerty BS ,&nbsp;Anita Balan MPH, MCHES","doi":"10.1016/j.focus.2025.100315","DOIUrl":"10.1016/j.focus.2025.100315","url":null,"abstract":"<div><h3>Introduction</h3><div>A conceptual cascade model was developed to track diabetes prevention efforts in the process for managing patients with prediabetes and compared with observed data from healthcare organizations.</div></div><div><h3>Methods</h3><div>The cascade tracked patients eligible for diabetes prevention at each level of the cascade derived from multiple data sources. This was aligned with eligible (aggregated) data from 3 pilot healthcare organizations (<em>n</em>=70,911), including disproportionately affected population of both Black and Hispanic women (<em>n</em>=18,079).</div></div><div><h3>Results</h3><div>Healthcare organizations had higher screening eligibility than expected (43% vs 35%). Laboratory tests ordered were lower than expected for the total population (42% vs 60%) and aligned well for the disproportionately affected population (57% vs 60%). Ranges for prediabetes laboratory tests were close to expected for the total (38% vs 35%) and disproportionately affected population (39% vs 35%). Referral rates were higher (assuming awareness of the condition) in the total (188% vs 25%) and disproportionately affected population (264% vs 25%). Conversion rates from referral to enrollment were lower than expected in the total (14% vs 25%) and disproportionately affected population (13% vs 25%).</div></div><div><h3>Conclusions</h3><div>Despite increased referral rates, there is still a need to improve the enrollment conversion rate. Feedback from the conceptual model to observed data can provide critical findings to facilitate diabetes prevention efforts.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 2","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551943","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}