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American Journal of Preventive Medicine
Oxford University Press
American Journal of Preventive Medicine

Oxford University Press

0749-3797

American Journal of Preventive Medicine/Journal American Journal of Preventive MedicineSCIAHCIISTPISSHP
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    American Journal of Preventive Medicine 2021 Article of the Year

    Boulton M.L.
    2页
      原文链接:
    • NSTL
    • Elsevier

    Trends in Opioid Prescribing by General Dentists and Dental Specialists in the U.S., 2012–2019

    Yan C.H.Lee T.A.Hubbard C.C.Evans C.T....
    10页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: Evidence suggests that U.S. dentists prescribe opioids excessively. There are limited national data on recent trends in opioid prescriptions by U.S. dentists. In this study, we examined trends in opioid prescribing by general dentists and dental specialists in the U.S. from 2012 to 2019. Methods: Dispensed prescriptions for oral opioid analgesics written by dentists were identified from IQVIA Longitudinal Prescription Data from January 2012 through December 2019. Autoregressive integrated moving average and joinpoint regression models described monthly population-based prescribing rates (prescriptions/100,000 individuals), dentist-based prescribing rates (prescriptions/1,000 dentists), and opioid dosages (mean daily morphine milligram equivalents/day). All analyses were performed in 2020. Results: Over the 8 years, dentists prescribed >87.2 million opioid prescriptions. Population- and dentist-based prescribing rates declined monthly by ?1.97 prescriptions/100,000 individuals (95% CI= ?9.98, ?0.97) and ?39.12 prescriptions/1,000 dentists (95% CI= ?58.63, ?17.65), respectively. Opioid dosages declined monthly by ?0.08 morphine milligram equivalents/day (95% CI= ?0.13, ?0.04). Joinpoint regression identified 4 timepoints (February 2016, May 2017, December 2018, and March 2019) at which monthly prescribing rate trends were often decreasing in greater magnitude than those in the previous time segment. Conclusions: Following national trends, dentists became more conservative in prescribing opioids. A greater magnitude of decline occurred post 2016 following the implementation of strategies aimed to further regulate opioid prescribing. Understanding the factors that influence prescribing trends can aid in development of tailored resources to encourage and support a conservative approach by dentists, to prescribing opioids.
      原文链接:
    • NSTL
    • Elsevier

    Predicting Homelessness Among U.S. Army Soldiers No Longer on Active Duty

    Koh K.A.O'Brien R.W.Kennedy C.J.Luedtke A....
    11页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: The ability to predict and prevent homelessness has been an elusive goal. The purpose of this study was to develop a prediction model that identified U.S. Army soldiers at high risk of becoming homeless after transitioning to civilian life based on information available before the time of this transition. Methods: The prospective cohort study consisted of observations from 16,589 soldiers who were separated or deactivated from service and who had previously participated in 1 of 3 baseline surveys of the Army Study to Assess Risk and Resilience in Servicemembers in 2011–2014. A machine learning model was developed in a 70% training sample and evaluated in the remaining 30% test sample to predict self-reported homelessness in 1 of 2 Longitudinal Study surveys administered in 2016–2018 and 2018–2019. Predictors included survey, administrative, and geospatial variables available before separation/deactivation. Analysis was conducted in November 2020–May 2021. Results: The 12-month prevalence of homelessness was 2.9% (SE=0.2%) in the total Longitudinal Study sample. The area under the receiver operating characteristic curve in the test sample was 0.78 (SE=0.02) for homelessness. The 4 highest ventiles (top 20%) of predicted risk included 61% of respondents with homelessness. Self-reported lifetime histories of depression, trauma of having a loved one murdered, and post-traumatic stress disorder were the 3 strongest predictors of homelessness. Conclusions: A prediction model for homelessness can accurately target soldiers for preventive intervention before transition to civilian life.
      原文链接:
    • NSTL
    • Elsevier

    Associations of Passive and Active Screen Time With Psychosomatic Complaints of Adolescents

    Khan A.Lee E.-Y.Janssen I.Tremblay M.S....
    9页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: Increased screen time is a ubiquitous part of adolescent life and is adversely associated with their well-being. However, it remains unclear whether different types of screen time have equivalent associations, or if relationships are dose-dependent. Methods: The data were from 2 nationally representative Health Behaviour in School-aged Children (2010, 2014) surveys across 44 European and North American countries. Psychosomatic health was assessed using 8 complaints and dichotomized as high or low. Discretionary time spent on passive (e.g., TV) and mentally active (e.g., electronic games, computer use) screen-based activities was categorized into 3 groups. Data were analyzed in 2021. Results: The study included 414,489 adolescents (average age, 13.6 [SD=1.63] years; 51.1% girls). Multilevel modeling showed that psychosomatic complaints increased monotonically once all forms of screen time exceeded 2 hours/day. Adolescents reporting high (>4 hours/day) TV time, compared with those reporting low (≤2 hours/day), had higher odds of reporting psychosomatic complaints with 67% higher odds (OR=1.67, 95% CI=1.62, 1.72) in boys and 71% (OR=1.71, 95% CI=1.66, 1.75) in girls. High electronic game use was associated with psychosomatic complaints, with odds being 78% higher in boys (OR=1.78, 95% CI=1.73, 1.84) and 88% higher in girls (OR=1.88, 95% CI=1.82, 1.94). Similar associations were found between computer use and psychosomatic complaints. Conclusions: Passive and mentally active screen time are adversely associated with psychosomatic complaints in a dose-dependent manner, with associations slightly stronger for active than passive screen time. This study supports limiting any type of screen time, either passive or active, to 2 hours/day to foster well-being.
      原文链接:
    • NSTL
    • Elsevier

    Healthy Lifestyle Score Including Sleep Duration and Cardiovascular Disease Risk

    Guasch-Ferre M.Li Y.Bhupathiraju S.N.Huang T....
    10页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: Although insufficient or prolonged sleep duration is associated with cardiovascular disease, sleep duration is not included in most lifestyle scores. This study evaluates the relationship between a lifestyle score, including sleep duration and cardiovascular disease risk. Methods: A prospective analysis among 67,250 women in the Nurses’ Health Study and 29,114 men in Health Professionals Follow-up Study (1986–2016) was conducted in 2021. Lifestyle factors were updated every 2–4 years using self-reported questionnaires. The traditional lifestyle score was defined as not smoking, having a normal BMI, being physically active (≥30 minutes/day of moderate physical activity), eating a healthy diet, and drinking alcohol in moderation. Low-risk sleep duration, defined as sleeping ≥6 to <8 hours/day, was included as an additional component in the updated lifestyle score. Cox proportional hazard regression models were used to estimate cardiovascular disease risk. The likelihood-ratio test and C-statistics were used to compare both scores. Results: A total of 11,710 incident cardiovascular disease cases during follow-up were documented. The multivariable-adjusted hazard ratios comparing 6 with 0 low-risk factors in the healthy lifestyle score including sleep duration were 0.17 (95% CI=0.12, 0.23) for cardiovascular disease, 0.14 (95% CI=0.10, 0.21) for coronary heart disease, and 0.20 (95% CI=0.12, 0.33) for stroke. Approximately 66% (95% CI=56%, 75%) of cardiovascular disease, 67% (95% CI=54%, 77%) of coronary heart disease, and 62% (95% CI=42%, 76%) of stroke cases were attributable to poor adherence to a healthy lifestyle including sleep. Adding sleep duration to the score slightly increased the C-statistics from 0.64 (95% CI=0.63, 0.64) to 0.65 (95% CI=0.64, 0.65) (p<0.001). Conclusions: Adopting a healthy lifestyle including sleep recommendations could substantially reduce the risk of cardiovascular disease in U.S. adults.
      原文链接:
    • NSTL
    • Elsevier

    Injury-Related Emergency Department Visits During the COVID-19 Pandemic

    Law R.K.Wolkin A.F.Patel N.Alic A....
    8页
    查看更多>>摘要：? 2022Introduction: On March 13, 2020, the U.S. declared COVID-19 to be a national emergency. As communities adopted mitigation strategies, there were potential changes in the trends of injuries treated in emergency department. This study provides national estimates of injury-related emergency department visits in the U.S. before and during the pandemic. Methods: A secondary retrospective cohort study was conducted using trained, on-site hospital coders collecting data for injury-related emergency department cases from medical records from a nationally representative sample of 66 U.S. hospital emergency departments. Injury emergency department visit estimates in the year before the pandemic (January 1, 2019–December 31, 2019) were compared with estimates of the year of pandemic declaration (January 1, 2020–December 31, 2020) for overall nonfatal injury-related emergency department visits, motor vehicle, falls-related, self-harm-, assault-related, and poisoning-related emergency department visits. Results: There was an estimated 1.7 million (25%) decrease in nonfatal injury-related emergency department visits during April through June 2020 compared with those of the same timeframe in 2019. Similar decreases were observed for emergency department visits because of motor vehicle?related injuries (199,329; 23.3%) and falls-related injuries (497,971; 25.1%). Monthly 2020 estimates remained relatively in line with 2019 estimates for self-harm?, assault-, and poisoning-related emergency department visits. Conclusions: These findings provide updates for clinical and public health practitioners on the changing profile of injury-related emergency department visits during the COVID-19 pandemic. Understanding the short- and long-term impacts of the pandemic is important to preventing future injuries.
      原文链接:
    • NSTL
    • Elsevier

    Obesity Incidence in U.S. Children and Young Adults: A Pooled Analysis

    Rafei A.Elliott M.R.Jones R.E.Riosmena F....
    9页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: Obesity prevalence among children and adolescents has risen sharply, yet there is a limited understanding of the age-specific dynamics of obesity as there is no single nationally representative cohort following children into young adulthood. Investigators constructed a pooled data set of 5 nationally representative panels and modeled age-specific obesity incidence from childhood into young adulthood. Methods: This longitudinal prospective follow-up used 718,560 person-years of observation in a pooled data set of 5 high-quality nationally representative panels—National Longitudinal Survey of Youth 1979 and 1997, National Longitudinal Study of Adolescent Health, and Early Childhood Longitudinal Study-Kindergarten cohorts of 1998 and 2011—constructed by the authors, covering 1980–2016. Differences in obesity incidence across birth cohorts and disparities in obesity incidence by sex and race/ethnicity (non-Hispanic Black, Hispanic, and non-Hispanic White) were tested in multivariate models. Data were analyzed from September 2018 to October 2021. Results: Obesity incidence increased by approximately 6% for each 1 year of age (hazard ratio=1.06, 95% CI=1.05, 1.07); however, incidence was nonlinear, exhibiting an inverted “U”-shaped pattern before 15 years of age and then rising from adolescence through 30 years. Obesity incidence more than doubled between the cohorts born in 1957–1965 and those born in 1974–1985 during adolescence. There was no significant change among those born in 1991–1994 and 2003–2006 up to age 15 years. Compared with non-Hispanic White children, non-Hispanic Black and Hispanic children had higher obesity incidence in all study cohorts. The magnitude of these disparities on the relative scale remained stable throughout the study period. Conclusions: Although many children become obese before the age of 10, obesity incidence rises from about 15 years into early adulthood, suggesting that interventions are required at multiple developmental stages.
      原文链接:
    • NSTL
    • Elsevier

    Dual Use of Nicotine and Cannabis Through Vaping Among Adolescents

    Moustafa A.F.Rodriguez D.Pianin S.H.Testa S.M....
    8页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: This study seeks to identify adolescent nicotine and cannabis vaping patterns and the characteristics of those adolescents who comprised each pattern. Methods: This prospective longitudinal survey study measured the relationship between nicotine and cannabis vaping among 1,835 adolescents from 4 public high schools outside of Philadelphia, Pennsylvania. Adolescents completed in-classroom surveys, including questions of lifetime and past 30–day nicotine and cannabis vaping, at Wave 1 (fall 2016, ninth grade) and 6-month intervals for the following 36 months (fall 2019, 12th grade). Data were analyzed in 2021. Results: A sequential processes growth mixture model revealed 4 latent conjoint classes of nicotine and cannabis vaping: early, declining dual use (Class 1: n=259); rapidly increasing dual use (Class 2: n=128); later, slower dual use (Class 3: n=313); and no use (Class 4: n=1,136). Increased odds of belonging to Class 1 and Class 2 versus belonging to Class 4 were significantly associated with cigarette smoking (OR=3.71, OR=2.21), alcohol use (OR=2.55, OR=4.39), peer vaping (OR=1.24, OR=1.20), sensation seeking (OR=1.03, OR=1.11), positive E-cigarette expectations (OR=1.21, OR=1.17), and cigar smoking (OR=2.39 Class 2 only). Increased odds of belonging to Class 3 versus Class 4 were significantly associated with alcohol use (OR=1.66), perceived benefits of E-cigarette use (OR=1.03), positive E-cigarette expectations (OR=1.08), depressive symptoms (OR=1.02), and sensation seeking (OR=1.03). Conclusions: From middle to late adolescence, vaping of nicotine and cannabis develop in close parallel. Regulatory policy and prevention interventions should consider the interplay between these 2 substances during this period of adolescence.
      原文链接:
    • NSTL
    • Elsevier

    Elective Deliveries and the Risk of Autism

    Liu K.-Y.Teitler J.O.Rajananda S.Chegwin V....
    9页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: Cesarean section and induced deliveries have increased substantially in the U.S., coinciding with increases in autism spectrum disorder. Studies have documented associations between cesarean section deliveries and autism spectrum disorder but have not comprehensively accounted for medical risks. This study evaluates the extent to which cesarean section and induced deliveries are associated with autism spectrum disorder in low-risk births. Methods: In this retrospective cohort study, California's birth records (1992–2012) were linked to hospital discharge records to identify low-risk births using a stringent algorithm based on Joint Commission guidelines. Autism spectrum disorder status was based on California Department of Developmental Service data. Logistic regression models were used to estimate associations between autism spectrum disorder and induced vaginal deliveries, cesarean section deliveries not following induction, and cesarean section deliveries following induction, with noninduced vaginal deliveries as the reference category. Results: A total of 1,488,425 low-risk births took place in California from 1992 to 2012. The adjusted odds of autism spectrum disorder were 7% higher for induced vaginal deliveries (AOR=1.07, 95% CI=1.01, 1.14), 26% higher for cesarean section deliveries not following induction (AOR=1.26, 95% CI=1.19, 1.33), and 31% higher for cesarean section deliveries following induction (AOR=1.31, 95% CI=1.18, 1.45) than for noninduced vaginal deliveries. Lower gestational age and neonatal morbidities did not appear to be important underlying pathways. The associations were insensitive to alternative model specifications and across subpopulations. These results suggest that, in low-risk pregnancies, up to 10% of autism spectrum disorder cases are potentially preventable by avoiding cesarean section deliveries. Conclusions: After accounting for medical risks, elective deliveries—particularly cesarean section deliveries—were associated with a substantially increased risk of autism spectrum disorder.
      原文链接:
    • NSTL
    • Elsevier

    Predictors of Public Support for Social Safety Net Policy During the COVID-19 Pandemic

    Hatton C.R.Topazian R.J.Barry C.L.McGinty E.E....
    8页
    查看更多>>摘要：? 2022 American Journal of Preventive MedicineIntroduction: U.S. residents had varying experiences of the COVID-19 pandemic and social safety net policy in 2020. Past research has suggested that partisanship, ideology, racial attitudes, and personal experience may each influence policy attitudes. In this study, we explore whether variation in support for social safety net policy in 2020 is predicted by negative experiences of the pandemic when controlling for racial attitudes, partisanship, and ideology. Methods: Support for 12 social safety net policies in 2020 was estimated using data from a nationally representative panel survey of U.S. adults conducted in 2020 (n=1,222). Logistic regression was used to examine differences in the predicted probability of supporting a majority of social safety net policies related to health, housing, and employment by partisanship, ideology, racial attitudes, and negative experiences of the pandemic. Analyses were conducted in 2021. Results: Higher levels of symbolic racism was a consistently strong predictor of lower social safety net policy support across health, housing, and employment policies; as was identifying as either Conservative or Republican. Negative experiences of the pandemic were generally unpredictive of support for the social safety net policy. Conclusions: Despite the pandemic's consequences as well as the potential for social safety net policy to address these consequences, negative experiences of the pandemic failed to predict policy support, even as racial attitudes, partisanship, and ideology strongly predicted these preferences in 2020. Building public support for social safety net policy requires communication strategies that identify the shared benefits of these policies.
      原文链接:
    • NSTL
    • Elsevier