Journal of Preventive Medicine and Public Health

Perspective

Fine Particulate Matter (PM_2.5), the Exposome, and Cumulative Health Risk: A Life-course Perspective: Sarawut Sangkham, Piyanuch Lonan, Narongsuk Munkong, Arthid Thim-Uam, Worradorn Phairuang; J Prev Med Public Health. 2026;59(4):432-436. Published online July 1, 2026; DOI: https://doi.org/10.3961/jpmph.26.219

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Abstract Summary PDF: Fine particulate matter (PM_2.5; aerodynamic diameter ≤2.5 μm) is a leading contributor to the global burden of disease and is associated with substantial morbidity and mortality. However, its health effects are often evaluated within single-exposure frameworks, limiting causal inference and reducing the translational relevance of evidence for policy development. In this study, we reconceptualise PM_2.5 within the exposome framework by integrating external exposures, internal biological responses, and structural determinants of health across the life course. PM_2.5 comprises a complex and dynamic mixture of pollutants from ambient and household sources, including biomass combustion, traffic emissions, and industrial activities. After inhalation, PM_2.5 particles can penetrate the respiratory tract, and finer fractions may enter the systemic circulation, where they induce oxidative stress, inflammation, epigenetic dysregulation, and endocrine disruption. These mechanisms contribute to a broad spectrum of adverse health outcomes, including cardiovascular, respiratory, metabolic, and neurodegenerative diseases as well as cancers. The multi-level and temporally accumulated nature of these effects highlights the limitations of reductionist exposure assessment and underscores the need for integrative, systems-based approaches. Integrating cumulative impact assessment with exposome-wide approaches that leverage satellite, clinical, land-use, urban planning, and socioeconomic data can improve the characterization of context-specific cumulative health effects. Positioning PM_2.5 as a sentinel indicator of cumulative environmental risk provides a unifying framework for exposome-informed science and supports the development of more precise, equitable, and policy-relevant interventions.; Summary

Key Message
This perspective considers PM 2.5 as a sentinel marker of cumulative environmental risk within the context of the exposome. The integration of external exposures, biological responses, and social determinants across the life course can help us understand chronic disease development. Moreover, this approach may facilitate more comprehensive, equitable, and policy-relevant environmental health strategies.

Original Articles

Spatio-temporal Distribution and Relative Risk of Dengue Fever in Peninsular Malaysia: Mohamad Afiq Amsyar Hamedin, Kamarul Imran Musa, Mohd Rahim Sulong; J Prev Med Public Health. 2026;59(4):364-372. Published online May 17, 2026; DOI: https://doi.org/10.3961/jpmph.26.035

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Abstract Summary PDF Supplementary Material: Objectives
Dengue fever remains a major public health concern in Malaysia, with marked spatial heterogeneity and evolving temporal dynamics. Although the incidence of dengue has increased substantially in recent years, district-level risk patterns and their changes over time remain insufficiently characterized. This study aimed to assess the spatio-temporal distribution of dengue risk in Peninsular Malaysia.
Methods
A retrospective analysis of dengue surveillance data was conducted using district-level monthly case counts from 2022 to 2024. Dengue risk was modeled with Bayesian spatio-temporal models incorporating spatial effects, temporal effects, and space–time interaction terms. Spatial variation was modeled using the Besag–York–Mollié 2 specification, while temporal trends were modeled using a first-order random walk. Competing models were compared using the deviance information criterion (DIC) and Watanabe–Akaike information criterion (WAIC). Relative risk (RR) and exceedance probability maps were generated from the best-fitting model.
Results
Dengue incidence increased markedly after 2022, with incidence rates nearly doubling in 2023 and remaining high in 2024. Incidence maps showed pronounced spatial heterogeneity, with persistent high-incidence districts concentrated in urban and peri-urban regions. Spatio-temporal models incorporating space–time interaction substantially outperformed the additive model, with lower DIC and WAIC values. The best-fitting model identified the highest RRs in districts within Selangor, while several districts in Penang, and Johor had high posterior probabilities of elevated risk [P(RR>1)>0.8].
Conclusions
This study demonstrates substantial spatial heterogeneity and evolving temporal dynamics in dengue risk across Peninsular Malaysia. Bayesian spatio-temporal disease mapping provides robust, localized, time-specific estimates of dengue risk and may support targeted surveillance and intervention in endemic settings.; Summary

Key Message
This study mapped district-level dengue risk across Peninsular Malaysia from 2022 to 2024 using Bayesian spatio-temporal models. Dengue incidence nearly doubled in 2023 and remained high in 2024, with the greatest relative risks concentrated in districts within Selangor and additional districts in Penang and Johor showing high probabilities of elevated risk. These findings demonstrate how relative risk and exceedance probability mapping can support more targeted dengue surveillance, vector control, and resource allocation.

Risk and Protective Factors for Child Sexual Abuse in Indonesia: Cross-sectional Findings From the 2024 National Survey on Child and Adolescent Life Experiences (SNPHAR 2024): Kinanthi Estu Linadi, Dian Ayubi; J Prev Med Public Health. 2026;59(3):278-288. Published online May 13, 2026; DOI: https://doi.org/10.3961/jpmph.25.777

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Abstract Summary PDF: Objectives
Child sexual abuse is the most frequently reported form of violence against children in Indonesia, with reported cases increasing over the past 5 years. This study aimed to identify risk and protective factors associated with sexual abuse among adolescents aged 13–17 years in Indonesia.
Methods
The analysis used data from the 2024 National Survey of Children’s and Adolescents’ Life Experiences (SNPHAR), including 6811 respondents. Bivariate analyses were conducted using chi-square tests to identify variables associated with sexual abuse. Variables with p-values less than 0.25 in binary logistic regression were included in multivariable logistic regression. Odds ratios, adjusted odds ratios (aORs), and 95% confidence intervals (CIs) were calculated to identify risk and protective factors associated with the experience of sexual abuse.
Results
Overall, 8.7% of respondents reported experiencing sexual abuse. Protective factors included never having worked (aOR, 0.77; 95% CI, 0.61 to 0.99; p<0.05), never having witnessed violence (aOR, 0.20; 95% CI, 0.17 to 0.24; p<0.001), and no history of sexual intercourse (aOR, 0.08; 95% CI, 0.04 to 0.15; p<0.001). Conversely, positive gender attitudes (aOR, 1.56; 95% CI, 1.29 to 1.87; p<0.001) and knowledge of child protection services (aOR, 3.85; 95% CI, 3.15 to 4.72; p<0.001) were unexpectedly associated with elevated risk.
Conclusions
Violence-free environments and limited exposure to early sexual experiences appear to represent critical protective factors. Counterintuitive associations suggest potential influences of cultural norms, patriarchy, and limited access to services.; Summary

Key Message
This study found that 7% of Indonesian adolescents aged 13–17 years reported experiencing child sexual abuse, based on the 2024 SNPHAR data. Protective factors included never having worked, never witnessing violence, and no prior sexual intercourse, while positive gender attitudes and awareness of child protection services were associated with higher reported odds of abuse. These findings highlight the need for safe environments, early prevention of violence and sexual exposure, and culturally sensitive, accessible child protection services for adolescents.

Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia: Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda; J Prev Med Public Health. 2025;58(4):422-430. Published online April 12, 2025; DOI: https://doi.org/10.3961/jpmph.24.581

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Abstract Summary PDF Supplementary Material

Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Summary

Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

Citations

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The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
Pain and Therapy.2026; 15(1): 175. CrossRef

The Role of Time Preferences in Compliance With COVID-19 Preventive Behaviors in Iran: A Quasi-hyperbolic Discounting Approach: Moslem Soofi, Ali Kazemi Karyani, Shahin Soltani, Zahra Alipoor, Behzad Karamimatin; J Prev Med Public Health. 2025;58(3):326-335. Published online February 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.453

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Abstract Summary PDF: Objectives
This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran.
Methods
A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model.
Results
A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future.
Conclusions
Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people’s discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.; Summary

Key Message
This study explored how time preferences—patience and present bias—affect compliance with COVID-19 preventive behaviors among Iranian adults. Using a web-based survey and quasi-hyperbolic discounting model, it found that those with low patience or present-biased preferences were less likely to follow preventive measures than those with high patience or future-oriented preferences. The findings highlight the need to consider time preferences in designing effective public health interventions to improve adherence to preventive measures.

The Diabetogenic Effect of Statin Use May Interact With Polygenic Risk Scores for Type 2 Diabetes: Evidence From the UK Biobank: Jong Hyun Park, Kyu-Taek Lim, Jooyeon Lee, Yongjin Gil, Joohon Sung; J Prev Med Public Health. 2025;58(1):92-102. Published online December 11, 2024; DOI: https://doi.org/10.3961/jpmph.24.671

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Abstract Summary PDF Supplementary Material

Objectives
Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk.
Methods
This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders.
Results
In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19).
Conclusions
PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.

Summary

Korean summary
스타틴은 심혈관 질환 예방에 필수적이지만, 제2형 당뇨병 발생 위험을 높인다고 알려져 있습니다. 본 연구는 영국 바이오뱅크 데이터를 활용하여, 스타틴 사용과 제2형 당뇨병 다유전자 위험 점수(Polygenic Risk Score, PRS)의 상호작용이 당뇨병 발생 위험에 미치는 영향을 분석했습니다. 연구 결과, PRS가 높은 집단에서는 스타틴 사용이 제2형 당뇨병 발생 위험을 유의하게 증가시켰으나, PRS가 낮은 집단에서는 스타틴 사용이 오히려 당뇨병 위험을 낮추는 경향을 보였습니다. 이러한 결과는 유전적 요인을 고려한 맞춤형 심혈관 질환 예방 전략의 중요성을 시사합니다.

Key Message
This study highlights that the diabetogenic effect of statins interacts significantly with genetic predisposition, as quantified by polygenic risk scores (PRS) for type 2 diabetes mellitus (T2DM). Individuals with high PRS are at a significantly increased risk of developing T2DM with statin use, while those with low PRS may experience a reduced risk. These findings underscore the potential of integrating genetic risk stratification into clinical decision-making to optimize the balance between cardiovascular benefits and T2DM risk in statin therapy.

Citations

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Statin: Scoping Review with ☸️SAIMSARA

SAIMSARA Journal.2026;[Epub] CrossRef
Bridging the Gap between Evidence and Practice: Nationwide Retrospective Analysis of Lipid-Modifying Therapy Prescription Patterns in 5 Million Patients with Type 2 Diabetes Mellitus
Ahmed Hassan, Menna A. Keshk, Mohamed Reyad, Nourhan Ahmed, Omar Nassar, Aisha Siraj, Salem Badr, Sherif Eltawansy, Anoop Misra, Muhammed Amir Essibayi, Ahmed Y. Azzam, Mahmoud Nassar, Diaa Hakim
ASIDE Internal Medicine.2025; 2(2): 6. CrossRef

The Impact of Student-led Community Health Screenings on Clients’ Health Knowledge and Outcomes: A Qualitative Study in New Zealand: JiaRong Yap, Wendy Wenming Zhai, Cindy Seunghee Pak, Sharon Brownie; J Prev Med Public Health. 2025;58(2):167-176. Published online November 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.366

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Abstract Summary PDF: Objectives
This study investigated the impact of community health screenings (CHS) on the Asian community, focussing on the role of a student-led health and wellness centre in promoting and improving health outcomes. The CHS is a collaboration between Te Kotahi Oranga | Health and Wellness Centre and The Asian Network Incorporated, offering free health screenings to Asian migrants in the Waikato region, New Zealand.
Methods
Employing a qualitative approach, we interviewed clients who participated in the CHS to determine their perceptions regarding the effectiveness of the programme, its influence on their health knowledge and actions, and their overall satisfaction with the service. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.
Results
Data analysis utilising reflexive thematic analysis yielded 5 themes: satisfaction and appreciation for the free health screening; strengthened commitment to better personal health; barriers and challenges in accessing public healthcare services; improved knowledge and awareness of health risks; and provision of more health screening tests and health seminars. The findings highlight the significance of culturally tailored health initiatives in addressing healthcare disparities, emphasising the need for innovative strategies to ensure continuity of care and support for underserved populations.
Conclusions
This research contributes to the understanding of how student-led health interventions can enhance public health efforts and improve health outcomes in Asian and migrant communities.; Summary

Key Message
This study explores the impact of a student-led community health screening (CHS) programme on Asian migrants in New Zealand, focusing on its effects on health knowledge and outcomes. Through qualitative interviews, five key themes emerged: participant satisfaction, commitment to personal health, barriers to healthcare access, increased awareness of health risks, and the need for expanded screening services. The findings underscore the value of culturally tailored health initiatives in reducing healthcare disparities and highlight the role of student-led interventions in enhancing preventative care and promoting health equity in underserved populations.

Scoping Review

Is Farming a Risk Occupation for Cardio-cerebrovascular Diseases? A Scoping Review on Cardio-cerebrovascular Disease Risk in Farmers: Hyeonjun Kim, Wongeon Jung, Sunjin Jung, Seunghyeon Cho, Inho Jung, Hansoo Song, Ki-Soo Park, Seong-Yong Yoon, Joo Hyun Sung, Seok-Ju Yoo, Won-Ju Park; J Prev Med Public Health. 2024;57(6):521-529. Published online August 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.302

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Abstract Summary PDF Supplementary Material

Objectives
In Korea, cardio-cerebrovascular disease (CCVD) is recognized as an occupational disease when sufficient evidence of a work-related burden exists. In 2021, approximately 26.8% of the payments from occupational disease insurance under the Industrial Accident Compensation Insurance Act were allocated to CCVDs. However, due to the specific nature of insurance policies for farmers, CCVD is not acknowledged as an occupational disease in their case.
Methods
We reviewed studies on the differences in the incidence, prevalence, and mortality rates of CCVDs between farmers and the general population or other occupations and described the exposure of farmers to risk factors for CCVDs.
Results
Several studies showed that farming is a high-risk occupation for CCVDs, with the following risk factors: long working hours, night work, lack of holidays, and strenuous physical labor; physical factors (noise, cold, heat, humidity, and vibration); exposure to hazardous gases (diesel exhaust, carbon monoxide, hydrogen sulfide, carbon disulfide, nitrogen oxides, and polycyclic aromatic hydrocarbons), pesticides, and dust (particulate matter, silica, and organic dust); exposure to a hypoxic environment; and job-related stress. Social isolation and lack of accessible medical facilities also function as additional risk factors by preventing farmers from receiving early interventions.
Conclusions
Farmers are exposed to various risk factors for CCVDs and are an occupation at risk for CCVDs. More studies are needed in the future to elucidate this relationship. This study lays the groundwork for future research to develop guidelines for approving CCVDs as occupational diseases among farmers.

Summary

Korean summary
이 연구는 농업이 뇌심혈관질환과 연관된 고위험 직업임을 입증하는 근거를 검토하였습니다. 농업인은 긴 근무 시간, 격렬한 신체 노동, 유해 가스 및 살충제 노출 등 다양한 위험 요인과 더불어 의료 접근성 부족과 같은 문제에 직면해 있습니다. 이는 뇌심혈관질환을 농업인의 업무 관련 질병으로 인정하기 위한 가이드라인 개발에 중요한 기초를 제공합니다.

Key Message
This study reviewed evidence supporting that farming is a high-risk occupation associated with cardio-cerebrovascular diseases. Farmers face various risk factors, including long working hours, strenuous physical labor, exposure to hazardous gases and pesticides, and challenges such as limited access to medical care. This provides an essential foundation for developing guidelines to recognize cardio-cerebrovascular diseases as work-related illnesses among farmers.

Citations

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Labour-type physical activity, alcohol use and hypertension in rural older adults in Northeast China
Yongheng Zhao, Gaixia Hou, Yimeng Gu, Zhuangzhuang Guo, Dehui Zhang, Xuefeng Xi, Limeng Liu, Lizhen Ning
Frontiers in Public Health.2026;[Epub] CrossRef
Leveraging Administrative Health Databases to Address Health Challenges in Farming Populations: Scoping Review and Bibliometric Analysis (1975-2024)
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JMIR Public Health and Surveillance.2025; 11: e62939. CrossRef

Original Article

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia: Tofan Agung Eka Prasetya, Nurul Izzah Abdul Samad, Aisy Rahmania, Dian Afif Arifah, Ratih Andhika Akbar Rahma, Abdullah Al Mamun; J Prev Med Public Health. 2024;57(5):451-460. Published online July 25, 2024; DOI: https://doi.org/10.3961/jpmph.24.214

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Abstract Summary PDF

Objectives
This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia.
Methods
A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance.
Results
The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032).
Conclusions
Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.

Summary

Key Message
This study investigates workstation risk factors contributing to work-related musculoskeletal disorders (WMSDs) among IT professionals in Indonesia. Findings indicate that neck discomfort is the most prevalent, with significant associations identified between WMSDs and factors such as screen use duration, seating arrangements, and work conditions. The results underscore the need for ergonomic improvements and targeted preventive measures to enhance occupational health and safety for IT workers.

Citations

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Evaluation of working posture and neck pain among IT professionals – an observational study
Amita Aggarwal, Tushar J. Palekar
International Journal of Occupational Safety and Ergonomics.2026; : 1. CrossRef
The correlation between workplace ergonomics and musculoskeletal complains in Iranian technical and vocational training organization; a semi-quantitative study to provide preventive educational strategies
Maryam Ebrahimi, Fereshteh Kordestani, Mohammad Ghasemi
Journal of Education and Health Promotion.2026;[Epub] CrossRef
Workplace Risks for IT Professionals Associated with Barriers to Healthy Behavior: A Review of International Research in the Context of the Healthy Workplace Model
Olga O. Gofman, Elena Shumeiko, German S. Nikiforov
RUDN Journal of Psychology and Pedagogics.2026; 22(4): 671. CrossRef
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Marzieh Abbasinia, Elham Entezarizarch
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Systematic Review

Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications: Seung Jin Han, Kyoung Hoon Kim; J Prev Med Public Health. 2024;57(1):1-7. Published online November 16, 2023; DOI: https://doi.org/10.3961/jpmph.23.250

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Abstract Summary PDF

Objectives
Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders.
Methods
We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included.
Results
Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively.
Conclusions
This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.

Summary

Korean summary
건강보험청구자료를 사용한 성과연구에서는 교란요인 통제가 중요하다. 최근 발표된 연구들은 연구설계와 통계 분석 과정에 적절하게 교란요인을 통제하였다. 연구의 질을 높이기 위해서는 건강보험청구자료에서 수집 가능한 교란 요인에 대한 이해와 방법론적 가이드라인이 요구된다.

Key Message
All recently published studies using Health Insurance Claims Database adjusted for confounders with appropriate study designs and statistical methodologies. The review suggests the need for careful application of confounding variables and the methodological guidance to improve the quality of outcome studies.

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Journal of Preventive Medicine and Public Health.2025; 58(1): 92. CrossRef
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Perspective

A Lifestyle Communication Tool: Association of E-cigarette Use and Pre-diabetes: Nilanga Aki Bandara, Tanisha Vallani, Xuan Randy Zhou, Senara Hansini Palihawadane, Rochelle Gamage, Miles Mannas, Jay Herath; J Prev Med Public Health. 2023;56(4):384-387. Published online July 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.086

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Abstract PDF: The aim of this study was to present a framework for clinicians to use when discussing electronic cigarette (e-cigarette) use and its association with pre-diabetes. A communication tool was designed using evidence-based strategies from the academic literature. A four-step framework is presented, which includes: step (1) helping patients to understand the association between e-cigarette use and pre-diabetes; step (2) the synergistic health impacts of e-cigarette use and pre-diabetes; step (3) management of diabetes-related lifestyle factors; and step (4) stages of change assessment related to e-cigarette reduction. This communication tool provides support for clinicians to discuss the risk of pre-diabetes associated with e-cigarette use. Moving forward, implementation and evaluation of this model are needed.; Summary

Special Article

Examining the Role of Psychosocial Stressors in Hypertension: Komal Marwaha; J Prev Med Public Health. 2022;55(6):499-505. Published online November 30, 2022; DOI: https://doi.org/10.3961/jpmph.21.266

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565 Download
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