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200 papers
Rates and characteristics of firearm access rules among U.S. parents of high-school age teens.
Seewald LA, Myers Mph MG, Zimmerman MA … +3 more , Walton MA, Haasz M, Carter PM
Prev Med · 2026 Jun · PMID 41865999 · Publisher ↗
OBJECTIVE: Firearm access is a risk factor for U.S. teen firearm injuries. We explore parental firearm rules for teens to inform prevention strategies. METHODS: Nationally representative web-based survey (6/2020-7/2020)...
OBJECTIVE: Firearm access is a risk factor for U.S. teen firearm injuries. We explore parental firearm rules for teens to inform prevention strategies. METHODS: Nationally representative web-based survey (6/2020-7/2020) among U.S. parents of teens (ages 14-18; N = 2727) to estimate what proportion of parents maintain rules for teens, characterize these rules, and examine factors associated with having rules. Bivariate and multivariate analyses were performed. RESULTS: Overall, 17.6% of parents never discussed firearm rules with their teen. For those with rules, 48.2% prohibited access, 42.8% allowed supervised access, and 8.9% allowed unsupervised access. Multivariable regression showed establishing rules was less likely among male parents (AOR = 0.63) and more likely among those reporting higher parental monitoring (AOR = 1.99), household firearm ownership (AOR = 3.99), and teen safety training (AOR = 4.40). Ordinal regression identified parents with permissive access rules were more likely male (AOR = 1.56), non-Hispanic White (AOR = 1.58), with teens that received safety training (AOR = 10.22); while parents of younger children (ages <10; AOR = 0.66) and reporting greater parental monitoring (AOR = 0.58) were less likely to have permissive rules. CONCLUSIONS: Nearly 20% of U.S. parents lack firearm rules for teens. Among those with rules, many parents allow unsupervised access. Interventions should engage both firearm-owning and non-owning families to prevent teen firearm injuries.
Child access prevention laws and firearm storage practices among households with children in 24 U.S. states, 2021-2024.
Lu YF, Berg MT
Prev Med · 2026 Jun · PMID 41862102 · Publisher ↗
OBJECTIVE: To examine whether the presence and strength of child access prevention (CAP) laws are associated with secure firearm storage among households with children and whether overall state firearm policy restrictive...
OBJECTIVE: To examine whether the presence and strength of child access prevention (CAP) laws are associated with secure firearm storage among households with children and whether overall state firearm policy restrictiveness moderates these associations. METHODS: We linked Behavioral Risk Factor Surveillance System data (2021-2024) with three firearm law databases. The sample included 26,466 firearm owners with children in households across 24 U.S. states. Unsecure storage was defined as having at least one loaded and unlocked firearm in the home. Logistic regression models estimated the odds of unsecure storage associated with CAP laws, state firearm policy restrictiveness, and their interaction. RESULTS: Overall, 7.0% of households in CAP states stored at least one firearm loaded and unlocked, compared to 11.8% in non-CAP states. After adjusting for covariates, the association between CAP laws and unsecure storage varied by state firearm policy restrictiveness: CAP laws were linked to a greater reduction in unsecure storage in states with less restrictive policy environments. CONCLUSIONS: CAP laws may play an important role in promoting secure storage in states where broader firearm policy supports are limited. Further research is needed to understand how CAP laws might operate across differing state policy contexts to affect child safety.
Beyond binary comparisons: A Bayesian dose-response meta-analysis of adherence to the planetary health diet and risks of all-cause mortality and cardiovascular outcomes in adults.
Khuc THH, Duc TQ, Di Khanh N … +3 more , Khoa DD, Huyen NTH, Anh NHP
Prev Med · 2026 Jun · PMID 41862101 · Publisher ↗
OBJECTIVES: The Planetary Health Diet (PHD) is associated with lower mortality and cardiovascular disease (CVD) risk, but evidence on specific CVD subtypes and risk patterns across the full range of adherence remains lim...
OBJECTIVES: The Planetary Health Diet (PHD) is associated with lower mortality and cardiovascular disease (CVD) risk, but evidence on specific CVD subtypes and risk patterns across the full range of adherence remains limited. To assess associations between PHD adherence and all-cause mortality, cardiovascular mortality, and CVDs, and to evaluate dose-response relationships. METHODS: We searched four databases from inception to January 2026 for prospective cohort studies in adults. Hazard ratios were pooled using random-effects models for highest vs. lowest adherence. Bayesian hierarchical dose-response models with centered RIDIT scores assessed graded associations. Study quality and evidence certainty were evaluated using the Newcastle-Ottawa Scale and NutriGrade. RESULTS: 23 studies were included. Highest adherence was associated with reduced risk of all-cause mortality (17%), cardiovascular mortality (16%), and total CVDs (18%). Dose-response analyses revealed risk reductions beginning at quintile 3 for all-cause mortality and total CVDs, and at quintile 4 for cardiovascular mortality. Highest adherence was associated with lower risks of coronary heart disease, ischemic heart disease, heart failure, and atrial fibrillation, but not myocardial infarction. Most studies were of high quality; the meta-evidence ranged from moderate to high. CONCLUSIONS: Randomized trials are needed to confirm causality and assess clinical effectiveness.
Toward cervical cancer prevention and elimination in the Eastern Mediterranean Region: Current landscape and opportunities for evidence-based action.
El-Zein M, Kassam P, Alhamlan F … +5 more , Zafar N, Abdelmoula B, Fadhil I, Nedjai B, IARC Study Group
Prev Med · 2026 Jul · PMID 41850588 · Publisher ↗
OBJECTIVE: This review aimed to provide the first comprehensive assessment of cervical cancer prevention initiatives across the Eastern Mediterranean Region (EMR). METHODS: We systematically searched PubMed on March 20,...
OBJECTIVE: This review aimed to provide the first comprehensive assessment of cervical cancer prevention initiatives across the Eastern Mediterranean Region (EMR). METHODS: We systematically searched PubMed on March 20, 2025, screened relevant literature, supplemented findings with WHO and HPV Information Centre data, and extracted country-level information on HPV vaccination and cervical cancer screening policies and practices in the EMR. RESULTS: Of 22 member countries, only eight have national HPV vaccination programs, and just seven offer cervical cancer screening, all of which are opportunistic and based on cytology, an obsolete technology. Barriers include limited public awareness, inadequate engagement of healthcare providers, and underdeveloped healthcare infrastructure. The review also highlights promising innovations such as HPV self-sampling to enhance screening accessibility and feasibility, and DNA methylation markers to improve detection accuracy and risk stratification. CONCLUSIONS: Cervical cancer prevention initiatives across the EMR remains insufficient. This review emphasizes the need for greater coordinated efforts to address the growing burden of cervical cancer in the region, strengthen prevention efforts, and enhance healthcare infrastructure. Bridging these gaps requires strengthened systems, expanded access, and multi-stakeholder advocacy and coordinated policies to reduce the region's cervical cancer burden.
Optimizing exercise prescription for blood pressure control after stroke or transient ischemic attack: A systematic review and meta-analysis.
Zhang Y, Huang H, Tan Z … +2 more , Lei L, Chen X
Prev Med · 2026 May · PMID 41839376 · Publisher ↗
OBJECTIVE: This study aimed to examine the dose-response relationships between different exercise modalities and blood pressure reduction in individuals after stroke or transient ischemic attack METHODS: Searches were pe...
OBJECTIVE: This study aimed to examine the dose-response relationships between different exercise modalities and blood pressure reduction in individuals after stroke or transient ischemic attack METHODS: Searches were performed in PubMed (1946), Web of Science (1975), Cochrane CENTRAL (1992), and EMBASE (1971) from inception up to December 10, 2025. Exercise dose was calculated as the product of duration, frequency, and intensity, expressed in metabolic equivalents of task minutes per week (METs-min/week). RESULTS: A total of 25 studies were included in the review. Aerobic exercise produced the greatest reductions in systolic blood pressure (SBP) at 590 METs-min/week (-3.79 mmHg, 95% CrI: -5.95, -1.86) and diastolic blood pressure (DBP) at 520 METs-min/week (-1.91 mmHg, 95% CrI: -3.56, -0.33). For combined aerobic and resistance training, the optimal doses were 780 METs-min/week for SBP (-7 mmHg, 95% CrI: -10.05, -3.87) and 660 METs-min/week for DBP (-3.58 mmHg, 95% CrI: -6.04, -1.23). Relative ranking analyses indicated that combined aerobic and resistance training at 780 METs-min/week and 660 METs-min/week produced the greatest reductions in SBP and DBP, respectively. CONCLUSIONS: These findings support evidence-based exercise prescriptions for blood pressure management in this high-risk population.
Psychosocial factors can shape the use of preventive healthcare services.
Hajek A, König HH
Prev Med · 2026 May · PMID 41825699 · Publisher ↗
Abstract loading — click title to view on PubMed.
Healthcare quality in patients experiencing health-related social needs in a federally qualified health center network in Brooklyn, New York.
Azan A, Gore R, Norton JM … +5 more , McCaleb C, Anderman J, Lee C, Roy B, Dapkins I
Prev Med · 2026 May · PMID 41812827 · Full text
OBJECTIVE: To examine associations between patient-reported health-related social needs (HRSNs) and clinical quality measure (CQM) performance in an urban federally qualified health center (FQHC) network. METHODS: This c...
OBJECTIVE: To examine associations between patient-reported health-related social needs (HRSNs) and clinical quality measure (CQM) performance in an urban federally qualified health center (FQHC) network. METHODS: This cross-sectional study included adult patients (≥18 years) screened for HRSNs at a general internal medicine clinic, Clinic-1, and a prenatal healthcare clinic, Clinic-2, within a FQHC network, between January 1, 2018, and July 31, 2022. HRSNs were assessed across 9 domains. Performance was assessed for 13 process and 2 outcome-based CQMs at Clinic-1 and 5 process-based CQMs at Clinic-2. Prevalence ratios (PR) were estimated using logistic regression to compare CQM performance by HRSN status, adjusted for relevant demographic, clinical, and clinician factors. RESULTS: At Clinic-1, reporting a HRSN was associated with lower hemoglobin A1c control (PR, 0.81; 95%CI, 0.69, 0.95). At Clinic-2, reporting a HRSN was associated with higher cervical cancer screening (PR, 1.07; 95%CI, 1.03, 1.11). No other CQMs differed significantly by HRSN status. CONCLUSIONS: HRSNs were not associated with differences in performance for most CQMs at this FQHC network. Exceptions were observed negative associations with diabetes A1c control and positive associations with cervical cancer screening. Further research is needed to elucidate mechanisms through which unmet HRSNs impact CQMs across care settings.
Route of drug use among North Carolina drug overdose decedents, 2018-2023.
Remch M, Cox ME, Proescholdbell S … +2 more , Schulaka D, Moracco KE
Prev Med · 2026 May · PMID 41759788 · Publisher ↗
OBJECTIVE: To describe the route of drug use among overdose decedents in North Carolina. METHODS: We use data from the North Carolina State Unintentional Drug Overdose Reporting System from 2018 to 2023. We include varia...
OBJECTIVE: To describe the route of drug use among overdose decedents in North Carolina. METHODS: We use data from the North Carolina State Unintentional Drug Overdose Reporting System from 2018 to 2023. We include variables on the characteristics of the decedents and context of the overdose, including the reported route of drug use and the drugs involved. RESULTS: There were 19,520 overdose deaths, largely involving opioids (87.7%), particularly fentanyl and its analogues (75.5%), stimulants (61.3%), and benzodiazepines (20.9%). Route of drug use was not documented for most (53.9%) deaths. In 2018, the most common route of drug use among decedents was injection (36.6%), followed by snorting (6.3%), smoking (3.6%), and ingestion (1.7%). In 2023, the percentage of overdose deaths involving injection (18.1%), snorting (17.8%), and smoking (18.3%) were similar to one another and the prevalence of ingestion increased to 4.7%. CONCLUSIONS: Increasing numbers of overdoses caused by non-injection drug use suggests a need for broader public health intervention that extend beyond the population injecting drugs. However, data on route of drug use is missing for over half of all overdose fatalities in North Carolina. More complete data on route of drug use will allow for more nuanced interpretation.
Quantifying and visualising heterogeneity in cumulative adverse childhood experiences scores: A national survey of US children.
Elorza BCP, Matijasevich A, Peres MFT … +1 more , Bauer A
Prev Med · 2026 May · PMID 41740860 · Publisher ↗
OBJECTIVE: Adverse childhood experiences (ACEs) scores mask substantial heterogeneity within the 2-, 3-, and ≥ 4-ACE exposure categories. This exposure heterogeneity has not been systematically investigated. METHODS: Usi...
OBJECTIVE: Adverse childhood experiences (ACEs) scores mask substantial heterogeneity within the 2-, 3-, and ≥ 4-ACE exposure categories. This exposure heterogeneity has not been systematically investigated. METHODS: Using the US-based 2023 National Survey of Children's Health (N = 55,162), caregivers reported lifetime exposure to 10 ACEs covering family dysfunction and community- and discrimination-related adversities. We quantified heterogeneity of ACE co-occurrence within ACE exposure categories using combinatorial coverage (CC; proportion of possible patterns observed) and visualised common patterns with an UpSet. RESULTS: Analyses used complete ACE data (N = 51,468; 93.3% of the total sample); co-occurrence analyses were restricted to children with ≥2 ACEs (n = 7897). Across the 2-, 3-, and ≥ 4-ACE categories, 582 of 1013 combinations were observed: all 45/45 patterns for 2 ACEs (CC₂ = 1.00), 110/120 for 3 ACEs (CC₃ = 0.92), and 427/848 for ≥4 ACEs (CC ≥ 4 = 0.50). Fifty combinations met the display threshold (unweighted n ≥ 30) and accounted for 5204 (66%) of children with ≥2 ACEs. Parental divorce/separation appeared in 34 of the 50 displayed patterns, household substance use in 23, and household mental illness in 20. CONCLUSIONS: ACE scores masked heterogeneity in exposure patterns. Simple diagnostics such as combinatorial coverage and UpSet plots can make this heterogeneity explicit and may support pattern-specific analyses of outcomes.
Barriers to and facilitators of cancer prevention services for transgender and gender-diverse people: A systematic review.
Herrera DJ, Huber L, Ferrari A … +5 more , Van Hal G, Toes-Zoutendijk E, Vorsters A, Van Bos L, van de Veerdonk W
Prev Med · 2026 May · PMID 41730438 · Publisher ↗
OBJECTIVE: Despite the increasing adoption of gender-inclusive policies, transgender and gender-diverse (TGD) people continue to face significant barriers to cancer prevention services, resulting in low uptake of cancer...
OBJECTIVE: Despite the increasing adoption of gender-inclusive policies, transgender and gender-diverse (TGD) people continue to face significant barriers to cancer prevention services, resulting in low uptake of cancer screening and HPV vaccination. This review aimed to synthesize evidence on barriers and facilitators to cancer prevention among TGD people to inform more inclusive and effective policies and programmes. METHODS: Searches were performed in Medline (1946), Cochrane CENTRAL (1992), CINAHL (1982), PsycINFO (1806), Web of Science (1975), and EMBASE (1971) from inception up to July 18, 2025. Thematic synthesis was guided by SURE framework, and McLeroy's socioecological model of health behaviour, adapted to cancer prevention context. RESULTS: A total of 1648 records were retrieved; 119 full texts were assessed and 53 studies (55 reports) met inclusion criteria. Most studies addressed cervical cancer and HPV-related prevention. Barriers were identified at individual (knowledge gaps, gender dysphoria, financial precarity), interpersonal (misgendering, discrimination, inadequate communication), healthcare-system (gendered services, insurance mismatches, lack of provider training), and societal levels (gendered messaging, stigma). Facilitators across the same levels included informed provider recommendations, affirming care environments and self-administered screening. CONCLUSIONS: Findings show that TGD people continue to experience exclusion within cancer prevention services. Addressing these disparities requires coordinated action across individual, interpersonal, system and societal levels.
A 20-year study of incidence trends of anogenital warts in Denmark -population impact of human papillomavirus vaccination.
Bildsøe H, Kaderly Rasmussen EL, Rasmussen RMW … +3 more , Munk C, Baandrup L, Kjær SK
Prev Med · 2026 May · PMID 41707772 · Publisher ↗
BACKGROUND: Anogenital warts are caused by infection with low-risk human papillomavirus (HPV). In 2008/2009 and 2019, Denmark implemented HPV vaccination for girls and boys, respectively, in the childhood vaccination pro...
BACKGROUND: Anogenital warts are caused by infection with low-risk human papillomavirus (HPV). In 2008/2009 and 2019, Denmark implemented HPV vaccination for girls and boys, respectively, in the childhood vaccination program. This study investigates HPV vaccine impact by estimating the pre- and post-vaccination incidence of anogenital warts. METHODS: Information on anogenital warts diagnosed 2000-2022 was extracted from the National Patient Registry and the National Prescription Registry. Age-standardized- and age-specific incidence rates were calculated alongside estimated annual percentage change. Incidence rate ratios (IRRs) were estimated by comparing post-vaccination periods (2008-2012, 2013-2019, 2020-2022) with a pre-vaccination period (2005-2007). RESULTS: The incidence of anogenital warts decreased significantly after HPV vaccination was implemented. In the latest post-vaccine period (2020-2022), IRRs showed decreases of 95%, 87% and 35% in women aged 15-19, 20-29, and 30-39 years compared to the period 2005-2007. For men in the same age groups, similar trends were observed with decreases of 84%, 75% and 7%. CONCLUSIONS: Our study shows population-level decreases in incidence rates of anogenital warts in post-vaccine periods, especially in younger women, while cohorts not covered by HPV vaccination continued having increasing rates. Decreases in anogenital warts in younger men before implementation of gender-neutral vaccination, points to substantial herd effects.
Economically viable population-based interventions to promote physical activity behavior based on a systematic review.
Leinonen AM, Huikari S, Kärmeniemi M … +5 more , Kari JT, Korpelainen R, Kujala UM, Ding D, Nurkkala M
Prev Med · 2026 May · PMID 41702475 · Publisher ↗
OBJECTIVE: Physical inactivity contributes to substantial public health and economic burdens. This study reviews the cost-effectiveness of population-based physical activity interventions. The literature search focused o...
OBJECTIVE: Physical inactivity contributes to substantial public health and economic burdens. This study reviews the cost-effectiveness of population-based physical activity interventions. The literature search focused on studies that have successfully promoted physical activity behavior based on valid measurement. METHODS: The systematic literature search was conducted across five electronic databases in January 2021. To facilitate comparison between studies, the results on effect size and cost-effectiveness (incremental cost-effectiveness ratio, ICER) were harmonized. RESULTS: All five studies included in this review were trial-based economic evaluations, of which two studies modeled long-term cost-effectiveness. The included studies were mainly print-based interventions, and their ICER values ranged from 0.15 to 4.14 US$ (2024) per metabolic equivalent of task hour gained (including only intervention costs). The most economically viable intervention utilized computer-tailored physical activity advice in the general population, while three interventions targeted inactive adults. CONCLUSIONS: Only a few intervention studies showed positive effects on physical activity behavior and evaluated their cost-effectiveness at the population level. Future studies should consider accurate cost calculations and reporting, high-quality methods for measuring physical activity behavior, and inter-individual variations. Moreover, unified standardized methods for determining the cost-effectiveness of physical activity interventions are needed.
Improving adolescent tobacco surveillance: Prevalence and correlates of aberrant responding in the National Youth Tobacco Survey.
Seo YS, Chung KS
Prev Med · 2026 May · PMID 41692263 · Publisher ↗
OBJECTIVE: Youth tobacco surveillance depends on the National Youth Tobacco Survey (NYTS), yet self-reported data are vulnerable to aberrant responding (careless or inconsistent responses). This study identifies atypical...
OBJECTIVE: Youth tobacco surveillance depends on the National Youth Tobacco Survey (NYTS), yet self-reported data are vulnerable to aberrant responding (careless or inconsistent responses). This study identifies atypical response patterns in NYTS data and evaluates their implications for harm perception estimates. METHODS: We analyzed 2017-2019 NYTS data collected in the United States (N = 52,406) using four person-fit statistics (lzpoly, gpoly, gnormed.poly, U3poly) to assess the plausibility of response patterns on harm perception items. Cutoffs were generated through bootstrap resampling. Respondents flagged by two or more indices were classified as aberrant. Weighted multivariable logistic regression examined demographic and behavioral correlates. RESULTS: Aberrant responses were identified in 11-12% of adolescents. Higher odds were observed among youth who currently smoked (OR = 1.52, 95% CI = 1.30, 1.78), used e-cigarettes (OR = 1.41, 95% CI = 1.25, 1.59), or had ever tried cigarettes (OR = 1.26, 95% CI = 1.13, 1.41). Males (OR = 1.30, 95% CI = 1.21, 1.40) and Black adolescents (OR = 2.05, 95% CI = 1.84, 2.28) also showed higher odds. Including aberrant responses attenuated population estimates of perceived harm, resulting in modest downward bias. CONCLUSIONS: Approximately one in ten NYTS respondents exhibit aberrant response patterns that can subtly bias harm perception estimates. Person-fit analysis offers a practical diagnostic tool to enhance the validity of youth tobacco surveillance.
Population-based cervical screening with Human Papillomavirus self-sampling at home and incidence of cervical cancer in Sweden.
Andersson H, Dillner J
Prev Med · 2026 May · PMID 41692262 · Publisher ↗
OBJECTIVE: To describe the Swedish 2020 switch to primary cervical screening using Human Papillomavirus (HPV) self-sampling at home and compare with cervical cancer incidence trends. METHODS: Statistics on HPV self-sampl...
OBJECTIVE: To describe the Swedish 2020 switch to primary cervical screening using Human Papillomavirus (HPV) self-sampling at home and compare with cervical cancer incidence trends. METHODS: Statistics on HPV self-sampling and cervical cancer incidence up to 2024-12-31 were obtained from comprehensive nationwide registries. RESULTS: HPV self-sampling was recommended in 2017 for non-attending women and was in 2020 recommended as a primary screening for all women aged 23-70 years of age. During 2016-2020 there were < 20,000 annual self-samples taken, but since 2021 > 200,000 self-samples are taken annually (about half of all screening tests). During 2015 to 2020 the cervical cancer incidence was stable, between 11 and 12 per 100,000 women. From 2021 and onwards the incidence is declining and was 7,7/100,000 in 2024. The decline is stronger among women younger than 30 (-60%) but is strong in all ages (-27%). CONCLUSIONS: A rapid introduction of primary HPV self-sampling at home in 2020-2021 was followed by a rapid decline in invasive cervical cancer incidence.
A cross-sectional analysis of disparities in neighborhood physical activity environments across the urban-rural Spectrum in the contiguous United States.
Xiong N, Wan N, Wen M
Prev Med · 2026 May · PMID 41690602 · Full text
OBJECTIVES: Neighborhood physical activity environments (PAEs), including built, facility, natural, and civic environments, support active living but are inequitably distributed. We examined racial/ethnic and socioeconom...
OBJECTIVES: Neighborhood physical activity environments (PAEs), including built, facility, natural, and civic environments, support active living but are inequitably distributed. We examined racial/ethnic and socioeconomic disparities in PAEs and described variations by urbanicity. METHODS: We used population-weighted multivariable ordinary least squares regression with urbanicity and county fixed effects (2018; 69,889 contiguous United States census tracts) to estimate associations between standardized PAE indicators across four dimensions (built, facilities, natural, social) and categorical racial/ethnic composition and neighborhood poverty. Sensitivity analyses compared models with and without county fixed effects and weighting; urbanicity-stratified models examined variations. RESULTS: Non-Hispanic Black and Hispanic tracts had lower land-use mix (β = -0.53; -0.31), fewer fitness centers (β = -0.51; -0.60), lower green space (β = -0.08; -0.33), and higher pollution (β = 0.18; 0.38) than non-Hispanic White tracts. High-poverty tracts had greater road and intersection density (β = 0.29; 0.36), fewer fitness centers (β = -0.15), lower green space (β = -0.23), and lower civic engagement (β = -0.97). Their 95% confidence intervals excluded 0. Associations were generally larger in urban and suburban areas. County fixed effects reversed walkability advantages for non-Hispanic Black tracts. CONCLUSIONS: Findings underscore the need for equitable environmental investment that supports active living.
Awareness and use of pre-exposure prophylaxis and awareness of treatment-as-prevention among adults in the United States: National estimates and associations with exposure to the Let's Stop HIV Together campaign, 2022-2024.
Paquin RS, Boudewyns V, Getachew-Smith H … +2 more , Stryker JE, Uhrig JD
Prev Med · 2026 May · PMID 41687883 · Publisher ↗
OBJECTIVE: Benchmarks for public awareness of pre-exposure prophylaxis (PrEP) and human immunodeficiency virus (HIV) Treatment-as-Prevention (TasP) are sparse, and evidence about whether public health communication campa...
OBJECTIVE: Benchmarks for public awareness of pre-exposure prophylaxis (PrEP) and human immunodeficiency virus (HIV) Treatment-as-Prevention (TasP) are sparse, and evidence about whether public health communication campaigns are associated with awareness and use is lacking. This study assessed whether exposure to the Centers for Disease Control and Prevention's (CDC) Let's Stop HIV Together campaign was associated with self-reported PrEP and TasP awareness and PrEP use. METHODS: Data were drawn from the 2022-2024 SpringStyles, a probability-based online survey of adults in the United States. Weighted logistic regression models assessed PrEP awareness, TasP awareness, and PrEP use by sociodemographic characteristics, prior HIV testing, and campaign exposure. RESULTS: Awareness of PrEP and TasP increased from 2022 to 2024, reaching 38.0% and 39.0%, respectively. Respondents who recalled the CDC's campaign were significantly more likely to be aware of PrEP (52.9% vs 34.1%) and TasP (55.9% vs 35.8%), and to report PrEP use (1.9% vs. 1.0%). CONCLUSIONS: These nationally representative, repeated cross-sectional estimates reveal gains in PrEP and TasP awareness over time. The association of campaign exposure with PrEP and TasP awareness and PrEP use underscores the importance of federally funded health communication initiatives to end the HIV epidemic in the United States.
Injunctive substance use norms among substance-naïve youth in the United States: Differences by sexual identity and sex assigned at birth.
Krueger EA, Hai AH
Prev Med · 2026 May · PMID 41687882 · Publisher ↗
BACKGROUND: Sexual minority (SM) youth are more likely than heterosexual youth to engage in substance use. Injunctive norms, or perceptions of others' substance use attitudes, contribute to youth substance use initiation...
BACKGROUND: Sexual minority (SM) youth are more likely than heterosexual youth to engage in substance use. Injunctive norms, or perceptions of others' substance use attitudes, contribute to youth substance use initiation and progression. METHODS: Among substance-naïve youth (ages 12-17; N = 7628) in the 2023 National Survey on Drug Use and Health, we examined differences in perceived parental, close friend, and personal disapproval of cigarette smoking, marijuana experimentation, monthly marijuana use, and near-daily alcohol use across five sexual identity groups (heterosexual, gay, bisexual, different term, unsure) and sex assigned at birth. RESULTS: Across groups and substances, youth perceived the highest substance use disapproval from parents (range = 72.4% - 97.4%), followed by personal disapproval (range = 52.1% - 87.7%) and disapproval by close friends (range = 48.6% - 81.6%). In multivariable models, bisexual, different term, and unsure youth reported lower close friend (IRR range = 0.89-0.97) and personal (IRR range = 0.89-0.92) disapproval, compared to heterosexual youth. SM females reported lower close friend and personal disapproval than heterosexual females. CONCLUSIONS: SM youth perceive more permissive norms towards substance use. Prevention strategies addressing peer norms and personal permissiveness may be critical for addressing SM youth substance use inequities.
E-cigarette switching, smoking cessation, and the risk of hepatocellular carcinoma in patients with chronic hepatitis B: A nationwide cohort study in South Korea.
Song BG, Lee M, Cho J … +3 more , Gwak GY, Kang D, Sinn DH
Prev Med · 2026 Apr · PMID 41654088 · Publisher ↗
OBJECTIVE: E-cigarettes (ECs) may reduce harm from combustible cigarettes (CCs), but their impact on hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) is unknown. We compared smoking cessation or EC switching v...
OBJECTIVE: E-cigarettes (ECs) may reduce harm from combustible cigarettes (CCs), but their impact on hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) is unknown. We compared smoking cessation or EC switching versus continued smoking on HCC risk in CHB patients. METHODS: This retrospective cohort used Korean National Health Insurance data (2018-2023) on CHB patients who smoked at baseline. Participants were categorized as continued smokers (n = 86,338), quitters (n = 19,521), or EC switchers (n = 21,337). Secondary analysis included 83,540 with consistent behaviors. RESULTS: Over median follow-up of 4.93 years, 4184 developed HCC. Compared to continued CC smokers, both quitters (adjusted HR, 0.78; 95% CI, 0.70, 0.86) and ECs switchers (adjusted HR, 0.78; 95% CI, 0.70, 0.87) exhibited reduced HCC risk. Only 12% of EC switchers eventually quit smoking while 61% of initial quitters remained quit at follow-up. Persistent quitters showed greater HCC risk reduction (adjusted HR, 0.64; 95% CI, 0.52, 0.77) than persistent CCs-to-ECs switchers (adjusted HR, 0.73; 95% CI, 0.59, 0.89), though not significant. CONCLUSIONS: Complete tobacco cessation should remain the primary strategy given superior behavioral sustainability, with no significant difference in HCC risk reduction versus EC switching.
Avoidable loss of life expectancy from ambient fine particulate matter in Korea: A national assessment based on mortality data for 2010-2019 and 2023.
Sung J, Kwon HJ, Kim JH
Prev Med · 2026 Apr · PMID 41651077 · Publisher ↗
OBJECTIVE: Fine particulate matter (PM) is a major environmental risk factor for premature death. Although global studies have estimated its health burden, most focused on excess deaths. Evaluations remain limited regard...
OBJECTIVE: Fine particulate matter (PM) is a major environmental risk factor for premature death. Although global studies have estimated its health burden, most focused on excess deaths. Evaluations remain limited regarding its impact on life expectancy, an intuitive measure. This study estimated the avoidable life expectancy loss attributable to long-term PM exposure in Korea using cause-specific years of life lost (YLL) derived from national mortality data. METHODS: Modeled annual PM concentrations were used to calculate population-weighted exposures at the regional and national levels for 2010-2019 and 2023. Age- and sex-standardized YLL were computed by cause of death. Negative binomial mixed-effects models assessed associations between PM and YLL. Excess YLL were estimated for reductions in PM to target levels (5, 10, and 15 μg/m) and converted into avoidable life expectancy loss per person using population size and national life expectancy at birth. RESULTS: PM was significantly associated with YLL from all-cause, non-accidental, circulatory, ischemic heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer mortality. Meeting the World Health Organization guideline (5 μg/m) could have prevented 0.32 years of life expectancy loss in 2023, with regional disparities persisting (0.24-0.45 years). CONCLUSIONS: Continued reductions in PM could yield life expectancy gains.
Rurality, racial marginalization, and severe maternal morbidity risk in California, 1997-2019.
Hailu EM, Berkowitz RL, Kan P … +2 more , Carmichael SL, Mujahid MS
Prev Med · 2026 Apr · PMID 41619911 · Publisher ↗
OBJECTIVE: The compounded impact of racialization and rurality on risk of severe maternal morbidity (SMM) remains underexplored. We aimed to examine how residence in rural neighborhoods may shape differential SMM risk by...
OBJECTIVE: The compounded impact of racialization and rurality on risk of severe maternal morbidity (SMM) remains underexplored. We aimed to examine how residence in rural neighborhoods may shape differential SMM risk by racial marginalization. METHODS: Data were from all live births in California born at 20-45 weeks' gestation between 1997 and 2019 (N = 10,681,950). Census-tract (neighborhood) rurality was defined using Rural-Urban Commuting Area codes. We used race/ethnicity stratified generalized estimating equation models accounting for neighborhood clustering, sociodemographic factors, clinical characteristics, and neighborhood poverty to estimate risk ratios (RR) of SMM comparing those residing in rural versus urban neighborhoods. Population attributable fractions (PAF%) were also calculated to estimate the contribution of rural residence to SMM risk. RESULTS: Residing in rural compared to urban neighborhoods was associated with increased risk of SMM for each racial/ethnic group in fully adjusted models. Associations were strongest among Pacific Islander individuals (RR = 1.63; 95% Confidence Interval (CI): 1.19,2.24) and weakest among White individuals (RR = 1.04; 95% CI: 1.00,1.09). The highest PAFs were observed for American Indian/Alaska Native (PAF% = 6.30; 95% CI: 2.01,10.63) and Pacific Islander (PAF% = 1.84; 95% CI: 0.43,3.32) individuals. CONCLUSIONS: Findings highlight the need for targeted interventions that alleviate rural-urban disparities in maternal health within the context of racial marginalization.
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