Prev Chronic Dis
· 2025 Jul · PMID 40674657
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INTRODUCTION: Cognitive health is influenced by a complex interplay of factors throughout the lifespan. Identifying childhood adversities and social needs can be important in mitigating subjective cognitive decline and p...INTRODUCTION: Cognitive health is influenced by a complex interplay of factors throughout the lifespan. Identifying childhood adversities and social needs can be important in mitigating subjective cognitive decline and promoting healthy aging. This study analyzes the role of social drivers of health on adverse childhood experiences and subjective cognitive decline. METHODS: We conducted structural equation modeling on data from the 2023 Behavioral Risk Factor Surveillance System to investigate the association among adverse childhood experiences, social drivers of health, and subjective cognitive decline in a sample of adults aged 45 years or older (n = 35,754). RESULTS: In our study sample, 17.7% reported experiencing subjective cognitive decline within the past 12 months. Adverse childhood experiences were significantly associated with greater subjective cognitive decline (β = 0.136, P < .001). Adverse childhood experiences were negatively associated with both social drivers of health, perceived social support (β = -0.517, P < .001), and socioeconomic stability (β = -0.022, P = .047). However, greater perceived social support (β = -0.260, P < .001) and socioeconomic stability (β = -0.086, P < .001) reduced the effects of adverse childhood experiences on subjective cognitive decline. CONCLUSION: Adverse childhood experiences were significantly associated with subjective cognitive decline; however, this association was attenuated when mediated by perceived social support and socioeconomic stability. These findings can inform public health providers and policymakers to implement targeted interventions, such as promoting resilience, reinforcing nurturing parenting styles, strengthening community networks, and integrating behavioral health into primary care settings.
Kava CM, Smith JL, Kobernik EK
… +5 more, Eberth JM, French C, Nash SH, Zahnd WE, Hall IJ
Prev Chronic Dis
· 2025 Jul · PMID 40674655
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INTRODUCTION: An estimated 6,000 preventable cancer deaths - including from colorectal cancer (CRC) - occurred in rural America in 2022. Screening can prevent CRC or identify disease at earlier stages when it is more tre...INTRODUCTION: An estimated 6,000 preventable cancer deaths - including from colorectal cancer (CRC) - occurred in rural America in 2022. Screening can prevent CRC or identify disease at earlier stages when it is more treatable. However, national estimates for CRC screening lag behind Healthy People 2030 objectives. In rural settings, barriers to screening are unique and persistent. METHODS: We performed a scoping review to describe the types and effectiveness of interventions to increase CRC screening in primarily rural settings. We included US-based studies published during January 2010 through May 2024. Interventions were categorized according to US Community Preventive Services Task Force-recommended strategies for multicomponent interventions. RESULTS: Of 508 unique publications identified, 36 met inclusion criteria. Most studies were multicomponent interventions (n = 34). Most studies were associated with an increase in CRC screening uptake. The most common intervention approaches were client reminders (eg, telephone reminders about screening) (n = 25), small media (eg, pamphlets) (n = 25), and reducing structural barriers to screening (eg, patient navigation) (n = 24). Over half (n = 21) of studies reported using a theory, framework, or research approach to inform intervention development, implementation, or evaluation. Six studies (17%) included cost evaluations. The studies included in this review represented less than half of all US states. CONCLUSION: This scoping review provides insight into CRC screening intervention implementation in rural settings. The limited geographic representation of the interventions included in our review may highlight an opportunity to improve implementation and dissemination of effective CRC screening interventions in rural settings to reduce CRC incidence and death.
Zablotsky B, Ng AE, Black LI
… +4 more, Haile G, Bose J, Jones JR, Blumberg SJ
Prev Chronic Dis
· 2025 Jul · PMID 40638804
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INTRODUCTION: Associations between screen time and health outcomes among teenagers are well established. However, most studies use parent-reported information, which may misrepresent the magnitude or nature of these asso...INTRODUCTION: Associations between screen time and health outcomes among teenagers are well established. However, most studies use parent-reported information, which may misrepresent the magnitude or nature of these associations. In addition, timely nationally representative estimates are needed to correspond with evolving screen use. This study aimed to address these gaps by using data from a nationally representative survey of teenagers. METHODS: Data came from the 2021-2023 National Health Interview Survey-Teen (NHIS-Teen), a follow-back web-based survey designed to collect health information directly from teenagers aged 12 to 17 years. NHIS-Teen provides a unique opportunity to assess teenagers' self-reported health in conjunction with a rich set of parent-reported covariates, including family income, from the National Health Interview Survey. This study examines associations between high daily non-schoolwork screen time, defined as 4 or more hours of daily screen time, and adverse health outcomes across the domains of physical activity, sleep, weight, mental health, and perceived support. RESULTS: Teenagers with higher non-schoolwork screen use were more likely to experience a series of adverse health outcomes, including infrequent physical activity, infrequent strength training, being infrequently well-rested, having an irregular sleep routine, weight concerns, depression symptoms, anxiety symptoms, infrequent social and emotional support, and insufficient peer support. CONCLUSION: Results of this study include associations between high screen time and poor health among teenagers using self-reported data. Future work may further investigate these associations and their underlying mechanisms, including the content viewed on screens and the interactions taking place across screens.
Schieb L, Tootoo J, Fiffer M
… +4 more, Casper M, Zephyr DP, Bunney EB, Miranda ML
Prev Chronic Dis
· 2025 Jul · PMID 40609022
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INTRODUCTION: Timely access to stroke care reduces death and disability due to stroke. Studies have investigated disparities in access by sociodemographic characteristics but not comorbidity prevalence. We used updated d...INTRODUCTION: Timely access to stroke care reduces death and disability due to stroke. Studies have investigated disparities in access by sociodemographic characteristics but not comorbidity prevalence. We used updated data to assess both types of disparities in drive times to certified stroke centers nationwide. METHODS: We conducted a cross-sectional spatial analysis of drive time from each contiguous US census tract (N = 72,517), using population-weighted centroids, to any certified stroke care (n = 1,825) or advanced (ie, endovascular-capable) stroke care (n = 426), using 2022 data from multiple state and nationwide databases. We compared median comorbidity prevalence and sociodemographic characteristics for census tracts within versus beyond a 60-minute drive time, using US Centers for Disease Control and Prevention PLACES 2020 data. RESULTS: Median (interquartile range) drive time was 11.8 (7.6-21.6) minutes to any certified stroke care, and 23.0 (12.6-53.9) minutes to advanced stroke care. Approximately 20% of the US adult population (n = 49 million) resided in census tracts beyond a 60-minute drive from advanced stroke care; most (65%) were rural. Census tracts more than 60 minutes from advanced stroke care had significantly higher prevalence of stroke, high blood pressure, coronary heart disease, high cholesterol, diabetes, chronic kidney disease, fair or poor self-rated health status, smoking, and obesity. They also had higher poverty rates, lower educational attainment, lower median income, and higher proportions of non-Hispanic White people and people older than 65 years. CONCLUSION: Residents in census tracts lacking timely access to stroke care have higher prevalence of health risk factors. The results highlight areas where education, telehealth infrastructure, and facility placement could improve stroke systems of care.
Prev Chronic Dis
· 2025 Jul · PMID 40609021
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INTRODUCTION: Nationally representative estimates of mental health symptoms and services in adults with kidney disease are limited. The objective of this study was to examine the mental health status and use of health ca...INTRODUCTION: Nationally representative estimates of mental health symptoms and services in adults with kidney disease are limited. The objective of this study was to examine the mental health status and use of health care among adults with and without kidney disease. METHODS: We used data from the 2021 National Health Interview Survey. Diagnosed kidney disease is based on adults who reported ever being told by a doctor or other health professional that they had weak or failing kidneys. The survey question captures data on adults who are aware of having kidney disease and most likely have advanced kidney disease. Mental health measures examined were serious psychological distress (SPD), current symptoms of anxiety and depression, diagnosed anxiety and depressive disorder, prescription medication use for these disorders, and receipt of counseling. We used logistic regression models, with predicted marginal proportions, to calculate unadjusted and adjusted prevalence ratios, controlling for sociodemographic and health characteristics. RESULTS: About 2.9% of adults reported having a diagnosis of kidney disease; prevalence varied by sociodemographic and health characteristics. The prevalence of SPD; current symptoms of anxiety or depression or both; history of diagnosed anxiety or depression or both; and receiving counseling and prescription use for these disorders were higher among adults with kidney disease than among adults without kidney disease. In multivariable models adjusted for sociodemographic and health characteristics, adults with diagnosed kidney disease remained more likely than adults not diagnosed with kidney disease to experience mental health conditions and receive counseling. CONCLUSION: A survey of the US population found a higher prevalence of poor mental health and receipt of mental health care among people diagnosed with kidney disease than among people not diagnosed with kidney disease.
Prev Chronic Dis
· 2025 Jun · PMID 40576375
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INTRODUCTION: Recent literature suggests blood pressure variability (BPV) is an independent risk factor for cardiovascular disease (CVD). Ours is the first study to assess the prognostic value of the intraindividual SD o...INTRODUCTION: Recent literature suggests blood pressure variability (BPV) is an independent risk factor for cardiovascular disease (CVD). Ours is the first study to assess the prognostic value of the intraindividual SD of systolic blood pressure (SBPSD) and diastolic blood pressure (DBPSD) in American Indians. METHODS: We computed BPV for 3,352 American Indians who had 8 nonurgent visit-to-visit blood pressure checks according to their electronic health records, and linked those measurements with Strong Heart Study cohort data. We used Cox proportional hazards models to determine whether the risk of all-cause mortality, CVD mortality, or major adverse cardiovascular events (MACE), was different for SBPSD and DBPSD quartiles, while controlling for covariates. RESULTS: Mean participant age was 54.5 years (SD = 17.3), 66% were female, mean SBPSD was 13.47 (SD = 5.71), and mean DBPSD was 8.05 (SD = 3.02). Over the 20-year follow-up, 45.4% died, 14.6% experienced CVD-related mortality, and 20.8% experienced MACE. Compared with the lowest SBPSD quartile (quartile 1), the risk of all-cause mortality was 35% higher for the highest quartile (quartile 4), while controlling for covariates (HR = 1.35; 95% CI, 1.13-1.61). The risk of CVD mortality and MACE was higher for quartile 4 SBPSD compared with quartile 1 (CVD mortality, HR = 1.81, 95% CI, 1.29-2.53; MACE HR = 1.39, 95 % CI, 1.07-1.80). The risk for quartile 4 DBPSD was not significant for these outcomes (all-cause mortality, HR = 1.15, 95% CI, 0.97-1.36; CVD mortality, HR=1.22, 95% CI, 0.91-1.65; MACE, HR = 1.11, 95% CI, 0.87-1.40). CONCLUSION: Our study identified SBPSD as a significant risk factor for all-cause mortality, cardiovascular mortality, and MACE, whereas DBPSD in our cohort of American Indian subjects was not a significant risk factor after adjustment for covariates.
Lutski M, Stark AH, Dichtiar R
… +3 more, Lubel SY, Ornan EM, Sinai T
Prev Chronic Dis
· 2025 Jun · PMID 40576374
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INTRODUCTION: Whether using nutrition facts labels (NFLs) leads to adherence to higher-quality dietary patterns - such as the Dietary Approaches to Stop Hypertension (DASH) diet, which is associated with lower risk of ch...INTRODUCTION: Whether using nutrition facts labels (NFLs) leads to adherence to higher-quality dietary patterns - such as the Dietary Approaches to Stop Hypertension (DASH) diet, which is associated with lower risk of chronic diseases - is unclear. We investigated whether people aged 21 to 64 years who use NFLs were more likely to adhere to the DASH dietary pattern. METHODS: We analyzed data from the nationally representative, cross-sectional Israeli National Health and Nutrition Survey for Adults from 2014-2016. Adherence to the DASH diet was determined from a single 24-hour dietary recall using a DASH score calculated on the basis of adherence to 9 nutrient targets. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs for DASH accordance (DASH score ≥4.5 [accordant] vs DASH score <4.5 [nonaccordant]) and for each separate nutrient target of the DASH diet. RESULTS: The data set comprised 2,579 participants (NFL users, n = 931 [36.1%]). Of the NFL users, 299 (32.1%) were classified as DASH accordant, compared with 339 (20.6%) of the non-NFL users. After adjusting for potential confounders, the OR for DASH adherence among NFL users was 1.52 (95% CI, 1.20-1.93) compared with non-NFL users. Compared with non-NFL users, NFL users' odds of meeting individual DASH nutrient targets were 1.30 (95% CI, 1.06-1.59) for protein; 1.46 (95% CI, 1.17-1.81) for dietary fiber; 1.48 (95% CI, 1.18-1.85) for magnesium; 1.38 (95% CI, 1.12-1.70) for calcium; and 1.60 (95% CI, 1.30-1.97) for potassium. Age, female sex, and performing recommended physical activity were associated with DASH adherence. CONCLUSION: These results highlight the importance of nutrition education and awareness, as well as the potential role of NFLs in promoting healthier dietary habits.
Foster AL, Boring MA, Lites TD
… +3 more, Croft JE, Odom EL, Fallon EA
Prev Chronic Dis
· 2025 Jun · PMID 40539903
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INTRODUCTION: Arthritis is a common chronic disease, affecting an estimated 53.2 million adults (21.2%) in the US. "Arthritis" is a general term, describing over 100 conditions with different etiologies, pathogeneses, sy...INTRODUCTION: Arthritis is a common chronic disease, affecting an estimated 53.2 million adults (21.2%) in the US. "Arthritis" is a general term, describing over 100 conditions with different etiologies, pathogeneses, symptoms, and treatments. Few studies have examined the prevalence and distribution of arthritis subtypes in the US. METHODS: We used National Health and Nutrition Examination Survey data from 2017 to March 2020 to estimate the prevalence of arthritis subtypes overall and by sociodemographic characteristics. RESULTS: The overall prevalence of any type of diagnosed arthritis among US adults aged 20 years or older in this study was 27.9% (67.1 million). Among adults with diagnosed arthritis, osteoarthritis (49.6%, 33.2 million) was the most common arthritis subtype, followed by rheumatoid arthritis (15.8%, 10.6 million) and psoriatic arthritis (1.4%, 1.0 million). More than 1 in 10 reported some other type of unlisted arthritis (11.5%, 7.7 million), and 1 in 5 did not know their arthritis subtype (21.6%, 14.4 million). Prevalence of not knowing arthritis type was approximately 1 in 4 for adults identifying as non-Hispanic Black (26.7%) or other Hispanic (29.5%) and for adults who reported low family income (26.7%) and was approximately 1 in 3 for adults identifying as Mexican American (31.9%), having less than a high school education (31.8%), or not having health insurance (36.1%). CONCLUSION: Understanding arthritis type is important for improving treatment, self-management, and health outcomes associated with arthritis. Improving organizational and personal health literacy are potential strategies that may reduce the prevalence of not knowing arthritis type.
Zaganjor H, Chen TJ, Van Dyke ME
… +7 more, Soto GW, Whitfield GP, Smith A, Devlin HM, Irani K, Rose K, Matjasko JL
Prev Chronic Dis
· 2025 Jun · PMID 40539902
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INTRODUCTION: Increasing walking for transportation is a strategy to integrate physical activity into daily life. We examined reported environmental, access, and individual reasons for not walking to places near home amo...INTRODUCTION: Increasing walking for transportation is a strategy to integrate physical activity into daily life. We examined reported environmental, access, and individual reasons for not walking to places near home among US adults, by sociodemographic characteristics and geographic location. METHODS: We used data from the 2022 SummerStyles survey on 3,967 US adults aged 18 years or older. We calculated prevalence of reporting 11 selected reasons for not walking to places within 10 minutes of home, overall and by sex, race or ethnicity, age, education, income, US census region, and metropolitan residence (an area with at least 1 urban area of ≥50,000 inhabitants) versus nonmetropolitan residence. We used Bonferroni-corrected pairwise comparisons and orthogonal polynomial contrasts (ordered groups) to compare prevalence by subgroup. RESULTS: Overall, 79.0% of respondents identified at least 1 reason for not walking to places near home (within 10 minutes). Commonly reported reasons were hot and humid conditions (36.0%), no places to walk within 10 minutes (24.9%), a preference for driving (22.1%), and inconvenience (21.5%). The reasons varied significantly across sociodemographic and geographic subgroups. The prevalence of reporting none of the listed reasons was higher among males than females, higher among non-Hispanic Black and non-Hispanic Asian adults than non-Hispanic White adults, and higher among adults from the Northeast versus the South. CONCLUSION: Eight of 10 US adults reported at least 1 environmental, access, or individual reason for not walking to places near home. Designing communities to make walking for transportation more accessible, convenient, and desirable may help address the leading reasons reported, which may support adults in adding more physical activity to their daily lives.
Reid A, You W, Markwalter T
… +5 more, Porter K, Brock DJ, Chow P, Ritterband L, Zoellner J
Prev Chronic Dis
· 2025 Jun · PMID 40505691
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The intake of sugar-sweetened beverages (SSBs) is a public health concern. Evidence-based behavior-change interventions can facilitate reductions in intake. Understanding maintenance of reductions after an initial interv...The intake of sugar-sweetened beverages (SSBs) is a public health concern. Evidence-based behavior-change interventions can facilitate reductions in intake. Understanding maintenance of reductions after an initial intervention period is essential. In a cluster randomized controlled trial of 12 middle schools in Appalachia, we examined the 19-month maintenance effects of a 6-month school-based SSB reduction intervention tailored for middle school students and caregivers and demonstrated to be effective. Relative to their control counterparts, intervention students maintained significant reductions in SSB intake, while intervention caregivers did not show sustained effects. This study offers valuable insights into the long-term effect of school-based behavioral interventions designed to reduce intake of SSBs.
Prev Chronic Dis
· 2025 Jun · PMID 40471851
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Community engagement is a pivotal public health tool for addressing population health challenges and advancing health equity. Community-academic partnerships that use community-engaged approaches can prioritize community...Community engagement is a pivotal public health tool for addressing population health challenges and advancing health equity. Community-academic partnerships that use community-engaged approaches can prioritize community strengths and ensure that resources and interventions match local needs. In 2021-2022, a community-academic partnership, guided by the principles of community engagement, collaborated with residents of Milwaukee's Near West Side (NWS) to identify strengths and assets and prioritize actions to improve health and quality of life. To inform the development of a planned community resource center, residents were invited for group concept mapping (GCM). GCM includes idea generation, sorting and rating, and developing cluster maps. Residents (N = 165) generated 71 unique ideas in response to the question, "To make the Near West Side a healthier community we need _____." Residents sorted ideas into clusters based on conceptual similarity and prioritized the importance of each. Data were managed with The Concept System Global MAX Software. By using the 71 ideas, a cluster map with 9 domains best fit the data. Domains were high-quality and affordable housing, community-engaged public safety, health and wellness services, strong and inclusive neighborhoods, investments in young people, public infrastructure, sustainable businesses, alternative modes of transportation, and vibrant social spaces. Eight of the 9 domains were highly rated for importance. These domains became focus areas for our partnership's efforts to advance health and well-being in NWS. Our work highlights the significance of projects incorporating community engagement principles within the context of a community-academic partnership to generate mutually beneficial solutions that are strength-based and aligned with partners' priorities.