AJPM focus最新文献

{"title":"Breaking Academic Silos: Pedagogical Recommendations for Equitable Obesity Prevention Training and Research During an Age of Nutrition Polarization","authors":"Salima F. Taylor MS ,&nbsp;Danielle M. Krobath PhD ,&nbsp;Adolfo G. Cuevas PhD ,&nbsp;Erin Hennessy PhD ,&nbsp;Susan B. Roberts PhD","doi":"10.1016/j.focus.2024.100217","DOIUrl":"10.1016/j.focus.2024.100217","url":null,"abstract":"<div><h3>Introduction</h3><p>Obesity is a preventable chronic condition and a risk factor for poor health and early mortality. Weight stigma and weight-neutral medicine are popular topics in social media that are often at odds with current medical guidelines on obesity treatment and prevention. This conflict may erode the public’s trust in science, impede research progress on preventing obesity in marginalized groups, and uphold the ongoing and historical lack of diversity among nutrition trainees.</p></div><div><h3>Methods</h3><p>The authors conducted a series of student-led dialogue sessions with nutrition graduate students in Boston, Massachusetts, from March to May 2023 to understand perceptions of obesity research, health equity, and racism and discrimination. This article summarizes the lessons learned and provides pedagogical recommendations for jointly addressing obesity at the population level and the recruitment, training, and retention of diverse scholars, clinicians, and public health practitioners.</p></div><div><h3>Results</h3><p>Dialogue sessions revealed that students perceive a disproportionate focus on the harms of obesity as a chronic disease, highlighting that inadequate attention is given to weight stigma and discrimination. Some participants believed that weight-based discrimination is equally detrimental to individual health and wellbeing as having obesity. Discussions also emphasized the need to pinpoint the multidimensional and cultural manifestations of weight stigma, which necessitates collaboration across social sectors and academic disciplines. Students recognized the urgent need to apply an equity lens to obesity research and teaching but felt limited in their access to experts within nutrition science who specialize in racism, discrimination, eating disorders, and weight stigma.</p></div><div><h3>Conclusions</h3><p>This study identified concrete opportunities for urgently needed new training and research in population-level obesity prevention, emphasizing antiracism, harm reduction, and elimination of stigma and bias across multiple levels of science and society. Overall, the decision to use the BMI within pedagogy and training must be explicitly stated—research, population surveillance, decision-making, or treatment pedagogy and training—while acknowledging its strengths and limitations across diverse settings. Finally, the social determinants of obesity should incorporate not only weight stigma but also racism and multiple forms of discrimination.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000361/pdfft?md5=dbeb7dace6afc6b54f39c3496d9c8e42&pid=1-s2.0-S2773065424000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087468","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":"Colorectal Cancer Screening Among Individuals With a Substance Use Disorder: A Retrospective Cohort Study","authors":"Kento Sonoda MD ,&nbsp;Joanne Sales MPH ,&nbsp;Jennifer K. Bello MD, MSCP ,&nbsp;Richard A. Grucza PhD ,&nbsp;Jeffrey F. Scherrer PhD","doi":"10.1016/j.focus.2024.100218","DOIUrl":"10.1016/j.focus.2024.100218","url":null,"abstract":"<div><h3>Introduction</h3><p>There is limited evidence on colorectal cancer screening among individuals with a substance use disorder. This study aims to investigate the association between personal history of a substance use disorder and colorectal cancer colonoscopy screening completion rates.</p></div><div><h3>Methods</h3><p>This retrospective cohort study analyzed 176,300 patients, of whom 171,973 had no substance use disorder and 4,327 had a substance use disorder diagnosis from electronic health record data (January 1, 2008–December 31, 2022) in a Midwestern healthcare system. Baseline was January 1, 2013, and a 10-year follow-up period ran through December 31, 2022. The outcome was receipt of colonoscopy in the 10-year follow-up period. Patients were aged 50–65 years at baseline, meaning that they were eligible for a colonoscopy through the entirety of the 10-year follow-up period. Covariates included demographics (age, race, and neighborhood SES), health services utilization, psychiatric and physical comorbidities, and prior colonoscopy or fecal occult blood testing. Entropy balancing was used to control for confounding in weighted log-binomial models calculating RR and 95% CIs.</p></div><div><h3>Results</h3><p>Patients were on average aged 57.1 (±4.5) years, 58.2% were female, 81.0% were White, and 16.9% were of Black race. The most prevalent comorbidities were obesity (29.6%) and hypertension (29.4%), followed by smoking/nicotine dependence (21.0%). The most prevalent psychiatric comorbidity was depression (6.4%), followed by anxiety disorder (4.5%). During the 10-year follow-up period, 40.3% of eligible patients completed a colorectal cancer colonoscopy screening test, and individuals with a substance use disorder diagnosis were significantly less likely to receive a colorectal cancer colonoscopy screening test both prior to and after controlling for confounding (RR=0.73; 95% CI=0.70, 0.77 and RR=0.81; 95% CI=0.74, 0.89, respectively). Results were not modified by sex, race, psychiatric comorbidity, or neighborhood SES.</p></div><div><h3>Conclusions</h3><p>Personal history of substance use disorder was independently associated with lower screening completion rates. Healthcare professionals should recognize unique barriers among individuals with substance use disorder and then address them individually as a multidisciplinary team in the outpatient setting to reduce this health disparity.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000373/pdfft?md5=1b986b88c50b115e02fb1158097897b9&pid=1-s2.0-S2773065424000373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084624","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":"Understanding Multiprogram Take-Up of Safety Net Programs Among California Families","authors":"Marisa M. Tsai MS, MPH ,&nbsp;Joseph A. Yeb BS ,&nbsp;Kaitlyn E. Jackson MPH ,&nbsp;Wendi Gosliner DrPH ,&nbsp;Lia C.H. Fernald PhD, MBA ,&nbsp;Rita Hamad MD, PhD","doi":"10.1016/j.focus.2024.100216","DOIUrl":"10.1016/j.focus.2024.100216","url":null,"abstract":"<div><h3>Introduction</h3><p>The U.S. safety net, which provides critical aid to households with low income, is composed of a patchwork of separate programs, and many people with low income benefit from accessing &lt;1 program. However, little is known about multiprogram take-up, that is, participation conditioned on eligibility. This study examined individual and multiprogram take-up patterns and sociodemographic factors associated with multiprogram take-up of U.S. safety net programs.</p></div><div><h3>Methods</h3><p>The Assessing California Communities’ Experiences with Safety Net Supports study interviewed Californians and reviewed their 2019 tax forms between August 2020 and May 2021. Take-up of safety net programs was calculated among eligible participants (<em>n</em>=365), including the Earned Income Tax Credit; Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; and Medicaid. Multivariable regressions identified sociodemographic factors associated with take-up of multiple programs.</p></div><div><h3>Results</h3><p>Take-up was highest for Medicaid (90.6%) and lowest for Supplemental Nutrition Assistance Program (57.5%). Among people who received benefits from at least 1 other program, take-up ranged from 81.7% to 84.8% for the Earned Income Tax Credit; 54.4%–62.0% for Supplemental Nutrition Assistance Program; 74.3%–80.1% for Special Supplemental Nutrition Program for Women, Infants, and Children; and 89.7%–98.1% for Medicaid. Having a lower income and being younger were associated with concurrent take-up of Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children. Among Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children recipients, having higher income, being older, and being primarily English speaking were associated with Earned Income Tax Credit take-up.</p></div><div><h3>Conclusions</h3><p>Individual and multiprogram take-up vary between programs and by sociodemographic factors. Findings suggest opportunities to increase take-up of potentially synergistic programs by improving cross-program coordination, data sharing, and targeted recruitment of underenrolled subgroups (Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children).</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400035X/pdfft?md5=6793e6ee329fcf4728d557fb3d6c5073&pid=1-s2.0-S277306542400035X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463631","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":"Too Many Deaths, Too Many Left Behind: A People's External Review of the U.S. Centers for Disease Control and Prevention's COVID-19 Pandemic Response","authors":"Lara Z. Jirmanus MD, MPH ,&nbsp;Rita M. Valenti RN ,&nbsp;Eiryn A. Griest Schwartzman CHES ,&nbsp;Sophia A. Simon-Ortiz MPH ,&nbsp;Lauren I. Frey MPH ,&nbsp;Samuel R. Friedman PhD ,&nbsp;Mindy T. Fullilove MD","doi":"10.1016/j.focus.2024.100207","DOIUrl":"10.1016/j.focus.2024.100207","url":null,"abstract":"<div><p>The U.S. population has suffered worse health consequences owing to COVID-19 than comparable wealthy nations. COVID-19 had caused more than 1.1 million deaths in the U.S. as of May 2023 and contributed to a 3-year decline in life expectancy. A coalition of public health workers and community activists launched an external review of the Centers for Disease Control and Prevention's pandemic management from January 2021 to May 2023. The authors used a modified Delphi process to identify core pandemic management areas, which formed the basis for a survey and literature review. Their analysis yields 3 overarching shortcomings of the Centers for Disease Control and Prevention's pandemic management: (1) Centers for Disease Control and Prevention leadership downplays the serious impacts and aerosol transmission risks of COVID-19, (2) Centers for Disease Control and Prevention leadership has aligned public guidance with commercial and political interests over scientific evidence, and (3) Centers for Disease Control and Prevention guidance focuses on individual choice rather than emphasizing prevention and equity. Instead, the agency must partner with communities most impacted by the pandemic and encourage people to protect one another using layered protections to decrease COVID-19 transmission. Because emerging variants can already evade existing vaccines and treatments and Long COVID can be disabling and lacks definitive treatment, multifaceted, sustainable approaches to the COVID-19 pandemic are essential to protect people, the economy, and future generations.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000269/pdfft?md5=a7a5b8c4895344f841a396aa8be3d52b&pid=1-s2.0-S2773065424000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466576","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":"Adoption of New Oral Health Interventions in Primary Care: Qualitative Findings","authors":"Gloria C. Bales PhD ,&nbsp;Shelley Curtan Med ,&nbsp;Neel Agarwal ,&nbsp;Sarah D. Ronis MD, MPH ,&nbsp;Suchitra Nelson PhD","doi":"10.1016/j.focus.2024.100214","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100214","url":null,"abstract":"<div><h3>Introduction</h3><p>This is the first study to use the Common-Sense Model of Self-Regulation theory for oral health interventions in pediatric practices. The objective of this qualitative study was to assess adoption and implementation of theory-based multilevel oral health interventions, by clinicians (pediatricians and nurse practitioners) participating in a cluster randomized clinical trial, to create an oral health toolkit for widespread dissemination into pediatric practices.</p></div><div><h3>Methods</h3><p>Semistructured interviews were conducted at the conclusion of the cluster randomized clinical trial with 21 clinicians from 9 practices participating in the intervention arm. Clinicians in this arm received Common-Sense Model of Self-Regulation theory–based education and resources to deliver oral health interventions to parents/caregivers and document in electronic medical record. Semistructured interview questions were based on the Diffusion of Innovations Theory, assessing adoption and implementation. The interviews were coded using NVivo (QRS International) software. Main themes were identified using a thematic analysis approach.</p></div><div><h3>Results</h3><p>Five themes identified from the interviews included strengths of theory-based oral health training for clinicians, oral health resources to improve quality of care, considerations for efficient future implementation, financial considerations, and parent benefits and challenges. Clinicians found that the theory-based training and resources increased knowledge and confidence when addressing oral health with parents and required only ≤2 minutes in their workflow with no financial consequences. Clinicians reported an increase in oral health awareness among parents but suggested an overall need for more pediatric dentists.</p></div><div><h3>Conclusions</h3><p>The Common-Sense Model of Self-Regulation theory–based education and resources were well received by clinicians and perceived to be beneficial without adverse impact on workflow or practice finances. An online toolkit is planned because these oral health interventions can be successfully implemented and delivered in medical settings.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000336/pdfft?md5=9b1f46e5bdb9aa8a0955fd5158930430&pid=1-s2.0-S2773065424000336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140328040","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":"Prevalence of Diabetes by BMI: China Nutrition and Health Surveillance (2015–2017) and U.S. National Health and Nutrition Examination Survey (2015–2018)","authors":"Dongmei Yu PhD ,&nbsp;Crescent B. Martin MA, MPH ,&nbsp;Cheryl D. Fryar MSPH ,&nbsp;Craig M. Hales MD ,&nbsp;Mark S. Eberhardt PhD ,&nbsp;Margaret D. Carroll MSPH ,&nbsp;Liyun Zhao MPH ,&nbsp;Cynthia L. Ogden PhD","doi":"10.1016/j.focus.2024.100215","DOIUrl":"10.1016/j.focus.2024.100215","url":null,"abstract":"<div><h3>Introduction</h3><p>The risk of diabetes begins at a lower BMI among Asian adults. This study compares the prevalence of diabetes between the U.S. and China by BMI.</p></div><div><h3>Methods</h3><p>Data from the 2015–2017 China Nutrition and Health Surveillance (<em>n</em>=176,223) and the 2015–2018 U.S. National Health and Nutrition Examination Survey (<em>n</em>=4,464) were used. Diagnosed diabetes was self-reported. Undiagnosed diabetes was no report of diagnosed diabetes and fasting plasma glucose ≥126 mg/dL or HbA1c ≥6.5%. Predicted age-adjusted prevalence estimates by BMI were produced using sex- and country-specific logistic regression models.</p></div><div><h3>Results</h3><p>In China, the age-adjusted prevalence of total diabetes was 7.8% (95% CI=7.4%, 8.3%), lower than the 14.6% (95% CI=13.1%, 16.3%) in the U.S. The prevalence of diagnosed diabetes was also lower in China than in the U.S. There were no statistically significant differences in the prevalence of undiagnosed diabetes between China and the U.S. The distribution of BMI in China was lower than in the U.S., and the predicted prevalence of total diabetes was similar between China and the U.S. when comparing adults with the same BMI. The predicted prevalence of undiagnosed diabetes was higher in China than in the U.S. for both men and women, and this disparity increased with BMI. When comparing adults at the same BMI, there was little difference in the prevalence of total diabetes, but diagnosed diabetes was lower in China than in the U.S., and undiagnosed was higher.</p></div><div><h3>Conclusions</h3><p>Although differences in BMI appear to explain nearly all of the differences in total diabetes prevalence in the 2 countries, not all factors that are associated with diabetes risk have been investigated.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000348/pdfft?md5=07e0ad5aa92a97cf11a1f0a9ac8a885f&pid=1-s2.0-S2773065424000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464402","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 Between Cardiovascular Health Status and Healthcare Utilization in a Large Integrated Healthcare System","authors":"Irvin Lien MD ,&nbsp;Howard Moffet MPH ,&nbsp;Jennifer Liu MPH ,&nbsp;Andrew Karter PhD ,&nbsp;Matthew Solomon MD, PhD ,&nbsp;Alan Go MD ,&nbsp;Khurram Nasir MD, MPH ,&nbsp;Stephen Sidney MD, MPH ,&nbsp;Jamal Rana MD, PhD","doi":"10.1016/j.focus.2024.100213","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100213","url":null,"abstract":"<div><h3>Introduction</h3><p>The American Heart Association Life's Simple 7 schema can be used to categorize patients’ cardiovascular health status as poor, intermediate, or ideal on the basis of smoking, BMI, physical activity, dietary patterns, blood pressure, cholesterol, and fasting blood sugar. This study examined the association between cardiovascular health status and subsequent healthcare utilization.</p></div><div><h3>Methods</h3><p>This was an observational cohort study of adults from an integrated healthcare delivery system—Kaiser Permanente Northern California—that had outpatient care between 2013 and 2014. Patients were categorized by American Heart Association cardiovascular health status: poor, intermediate, or ideal. Individual-level healthcare utilization and costs in 2015 were accumulated for each patient and compared across the 3 cardiovascular health categories and stratified by age groups.</p></div><div><h3>Results</h3><p>A total of 991,698 patients were included in the study. A total of 194,003 (19.6%) were aged 18–39 years; 554,129 (55.9%) were aged 40–64 years; and 243,566 (24.6%) were aged ≥65 years. A total of 259,931 (26.2%) had ideal cardiovascular health; 521,580 (52.6%) had intermediate cardiovascular health; and 210,187 (21.2%) had poor cardiovascular health. Healthcare utilization measured by average relative cost per patient increased monotonically across age categories (<em>p</em>&lt;0.001). In addition, cardiovascular health category was inversely associated with lower cost in each age group (<em>p</em>&lt;0.001).</p></div><div><h3>Conclusions</h3><p>Adults who were younger and had more ideal cardiovascular health had relatively lower healthcare costs across age groups. Interventions to promote better cardiovascular health may improve patient outcomes and reduce overall healthcare expenditures.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000324/pdfft?md5=781d1ef9383bad4ba6f60629df006bdc&pid=1-s2.0-S2773065424000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341119","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":"U.S. Filipino Adults Have Elevated Prevalence of Hypertension Across the Adult Lifespan: Findings From a Cross-Sectional Electronic Health Record Study","authors":"Nancy P. Gordon ScD ,&nbsp;Irvin C. Lien MD ,&nbsp;Jamal S. Rana MD, PhD ,&nbsp;Joan C. Lo MD","doi":"10.1016/j.focus.2024.100211","DOIUrl":"10.1016/j.focus.2024.100211","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of hypertension increases with age and differs by race and ethnicity. Among U.S. Asian adults, prevalence is higher for Filipino adults than for other major Asian subgroups, but whether this disparity exists across the adult lifespan is unknown. This study examined hypertension prevalence by age decade, comparing Filipino adults with South Asian, Chinese, Black, Hispanic, and White adults.</p></div><div><h3>Methods</h3><p>This cross-sectional study used 2015–2016 electronic health record data from a Northern California integrated healthcare delivery system for 1,839,603 adults aged 30–79 years, including 128,124 Filipino adults. Hypertension was defined by diagnosis codes. Sex-specific prevalence was calculated by race and ethnicity overall and by 10-year age decade from ages 30–39 years to 70–79 years. The prevalence of hypertension among 5 racial and ethnic groups was compared within each decade (with Filipino as the reference), adjusting for age, English language, diabetes, smoking, and weight category.</p></div><div><h3>Results</h3><p>Decade-specific prevalence of hypertension among Filipino men and women, respectively, was 9.7% and 8.5% for ages 30–39 years, 26.0% and 23.9% for ages 40–49 years, 45.9% and 44.4% for ages 50–59 years, 65.4% and 63.9% for ages 60–69 years, and 82.1% and 82.9% for ages 70–79 years. Across all age decades, hypertension prevalence among Filipino adults largely tracked with Black adults and was much higher than among South Asian, Chinese, White, and Hispanic adults. This pattern remained after adjusting for covariates, with the largest differences observed for adults aged &lt;60 years.</p></div><div><h3>Conclusions</h3><p>Similar to Black adults, Filipino adults have persistently higher hypertension prevalence than South Asian, Chinese, Hispanic, and White adults across the adult lifespan. These findings underscore the importance of surveillance and prevention efforts for this high-risk Asian group beginning in early adulthood.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000300/pdfft?md5=76ac5f6deeebc69be222e09d8899f50e&pid=1-s2.0-S2773065424000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462532","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":"Cardiovascular Risk Profile Among Reproductive-Aged Women in the U.S.: The Behavioral Risk Factor Surveillance System, 2015–2020","authors":"Ellen Boakye MD, MPH ,&nbsp;Chigolum P. Oyeka MD, MPH ,&nbsp;Yaa A. Kwapong MD, MPH ,&nbsp;Faith E. Metlock BSN ,&nbsp;Sadiya S. Khan MD, MSc ,&nbsp;Mamas A. Mamas MBBCh ,&nbsp;Amanda M. Perak MD, MS ,&nbsp;Pamela S. Douglas MD ,&nbsp;Michael C. Honigberg MD, MPP ,&nbsp;Khurram Nasir MD, MPH, MSc ,&nbsp;Michael J. Blaha MD, MPH ,&nbsp;Garima Sharma MD","doi":"10.1016/j.focus.2024.100210","DOIUrl":"10.1016/j.focus.2024.100210","url":null,"abstract":"<div><h3>Introduction</h3><p>Suboptimal cardiovascular health is associated with adverse pregnancy outcomes and long-term cardiovascular risk. The authors examined trends in cardiovascular risk factors and correlates of suboptimal cardiovascular risk profiles among reproductive-aged U.S. women.</p></div><div><h3>Methods</h3><p>With data from 335,959 women in the Behavioral Risk Factor Surveillance System (2015–2020), the authors conducted serial cross-sectional analysis among nonpregnant reproductive-aged women (18–44 years) without cardiovascular disease who self-reported information on 8 cardiovascular risk factors selected on the basis of Life's Essential 8 metrics. The authors estimated the prevalence of each risk factor and suboptimal cardiovascular risk profile (≥2 risk factors) and examined trends overall and by age and race/ethnicity. Using multivariable Poisson regression, the authors assessed the sociodemographic correlates of suboptimal cardiovascular risk profile.</p></div><div><h3>Results</h3><p>The weighted prevalence of women aged &lt;35 years was approximately 64% in each survey year. The prevalence of suboptimal cardiovascular risk profile increased modestly from 72.4% (71.6%–73.3%) in 2015 to 75.9% (75.0%–76.7%) in 2019 (<em>p</em>&lt;0.001). This increase was mainly driven by increases in overweight/obesity (53.1%–58.4%; <em>p</em>&lt;0.001). Between 2015 and 2019, significant increases in suboptimal cardiovascular risk profile were observed among non-Hispanic White (69.8%–72.6%; <em>p</em>&lt;0.001) and Hispanic (75.1%–80.3%; <em>p</em>&lt;0.001) women but not among non-Hispanic Black (82.7%–83.7%; <em>p</em>=0.48) or Asian (68.1%–73.2%; <em>p</em>=0.09) women. Older age, rural residence, and non-Hispanic Black and Hispanic race and ethnicity were associated with a higher prevalence of suboptimal cardiovascular risk profile.</p></div><div><h3>Conclusions</h3><p>There has been a modest but significant increase in suboptimal cardiovascular risk profile among U.S. women of reproductive age. Urgent preventive efforts are needed to reverse this trend and improve cardiovascular health, particularly among subgroups at increased risk, to mitigate its implications.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000294/pdfft?md5=64f7ae06e39e6148ec090913bb541e9e&pid=1-s2.0-S2773065424000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469958","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":"How Do Anger and Impulsivity Impact Fast-Food Consumption in Transitional Age Youth?","authors":"Alejandro D. Meruelo MD, PhD ,&nbsp;Ty Brumback PhD ,&nbsp;William E. Pelham III PhD ,&nbsp;Natasha E. Wade PhD ,&nbsp;Michael L. Thomas PhD ,&nbsp;Emil F. Coccaro MD ,&nbsp;Kate B. Nooner PhD ,&nbsp;Sandra A. Brown PhD ,&nbsp;Susan F. Tapert PhD ,&nbsp;Sylvie Mrug PhD","doi":"10.1016/j.focus.2024.100208","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100208","url":null,"abstract":"<div><h3>Introduction</h3><p>Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger, and impulsivity has not been widely investigated. The National Consortium on Alcohol and Neurodevelopment in Adolescence community-based cohort consists of 831 youth, half at elevated risk factors for substance use disorders during adolescence, followed annually.</p></div><div><h3>Methods</h3><p>Impulsivity using Urgency, Premeditation, Perseverance, and Sensation Seeking Impulsive Behavior scale from annual assessments was examined in relation to self-reported fast-food consumption frequency and mobile application questions of anger. This study tested the hypotheses that youth anger may be predicted by fast-food consumption frequency and impulsivity using multiple regression, in addition to whether adolescent fast-food consumption frequency may be predicted by anger and impulsivity.</p></div><div><h3>Results</h3><p>Among youth, higher anger levels and impulsivity predicted greater frequency of fast-food consumption, and greater fast-food consumption frequency and impulsivity predicted higher anger levels.</p></div><div><h3>Conclusions</h3><p>This study's longitudinal findings are consistent with those of other studies that have found fast-food consumption and anger associated with impulsivity and also reveal a bidirectional link between anger and fast-food consumption. These results may point attention to food selection considerations for those at risk of anger and poorer psychiatric outcomes.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000270/pdfft?md5=ec022578f4472ce99e7a065ca68367da&pid=1-s2.0-S2773065424000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187219","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}