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Purpose: To examine associations of adolescent sugar-sweetened beverage (SSB) intake with parent SSB intake and parent and adolescent attitudes about limiting SSB and junk food (SSB/JF) intake.Design: Quantitative, cross-sectional study.Setting: The 2014 Family Life, Activity, Sun, Health, and Eating study.Sample: Parent-adolescent dyads (N = 1555).Measures: The outcome was adolescent SSB intake. Exposure variables were parent SSB intake, sociodemographics, and parent and adolescent attitudes about SSB/JF intake (responses: agree, neither, or disagree).Analysis: Multinomial logistic regressions estimated adjusted odds ratios (aOR) and 95% confidence intervals (CIs).Results: Half (49.5%) of adolescents and 33.7% of parents consumed SSB ≥1 time/day. Parent daily SSB intake was associated with adolescent daily SSB intake (aOR = 8.9; CI = 4.6-17.3) [referent: no consumption]. Adolescents who disagreed on having confidence to limit SSB/JF intake had higher odds of daily SSB intake (aOR = 3.5; CI = 1.8-6.8), as did those who disagreed they felt bad about themselves if they did not limit SSB/JF intake (aOR = 1.9; CI=1.1-3.3), compared to adolescents who agreed with these attitudes. No parental attitudes were significant.Conclusion: Higher odds of daily SSB intake among adolescents was associated with parent SSB intake and adolescent attitudes about confidence in, and feeling bad about, limiting SSB/JF intake. Parent attitudes were not associated with daily adolescent SSB intake. Efforts to reduce adolescent SSB intake could consider strategies geared toward improving adolescent attitudes and dietary behaviors and parental SSB intake. [ABSTRACT FROM AUTHOR]

Background: Native Hawaiian and Pacific Islander (NHPI) adults have historically been grouped with Asian adults in U.S. mortality surveillance. Starting in 2018, the 1997 race and ethnicity standards from the U.S. Office of Management and Budget were adopted by all states on death certificates, enabling national-level estimates of cardiovascular disease (CVD) mortality for NHPI adults independent of Asian adults., Objective: To describe CVD mortality among NHPI adults., Design: Race-stratified age-standardized mortality rates (ASMRs) and rate ratios were calculated using final mortality data from the National Vital Statistics System for 2018 to 2022., Setting: Fifty states and the District of Columbia., Participants: Adults aged 35 years or older at the time of death., Measurements: CVD deaths were identified from International Classification of Diseases, 10th Revision codes indicating CVD (I00 to I99) as the underlying cause of death., Results: From 2018 to 2022, 10 870 CVD deaths (72.6% from heart disease; 19.0% from cerebrovascular disease) occurred among NHPI adults. The CVD ASMR for NHPI adults (369.6 deaths per 100 000 persons [95% CI, 362.4 to 376.7]) was 1.5 times higher than for Asian adults (243.9 deaths per 100 000 persons [CI, 242.6 to 245.2]). The CVD ASMR for NHPI adults was the third highest in the country, after Black adults (558.8 deaths per 100 000 persons [CI, 557.4 to 560.3]) and White adults (423.6 deaths per 100 000 persons [CI, 423.2 to 424.1])., Limitation: Potential misclassification of underlying cause of death or race group., Conclusion: NHPI adults have a high rate of CVD mortality, which was previously masked by aggregation of the NHPI population with the Asian population. The results of this study support the need for continued disaggregation of the NHPI population in public health research and surveillance to identify opportunities for intervention., Primary Funding Source: National Institute of General Medical Sciences, National Institutes of Health., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M24-0801.

Stroke was the fifth leading cause of death in the United States in 2021, and cost U.S. residents approximately $56.2 billion during 2019-2020. During 2006-2010, self-reported stroke prevalence among noninstitutionalized adults had a relative decrease of 3.7%. Data from the Behavioral Risk Factor Surveillance System were used to analyze age-standardized stroke prevalence during 2011-2022 among adults aged ≥18 years. From 2011-2013 to 2020-2022, overall self-reported stroke prevalence increased by 7.8% nationwide. Increases occurred among adults aged 18-64 years; females and males; non-Hispanic Black or African American (Black), non-Hispanic White (White), and Hispanic or Latino (Hispanic) persons; and adults with less than a college degree. Stroke prevalence was higher among adults aged ≥65 years than among younger adults; among non-Hispanic American Indian or Alaska Native, non-Hispanic Native Hawaiian or Pacific Islander, and Black adults than among White adults; and among adults with less than a high school education than among those with higher levels of education. Stroke prevalence decreased in the District of Columbia and increased in 10 states. Initiatives to promote knowledge of the signs and symptoms of stroke, and the identification of disparities in stroke prevalence, might help to focus clinical and programmatic interventions, such as the Million Hearts 2027 initiative or the Paul Coverdell National Acute Stroke Program, to improve prevention and treatment of stroke., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Limited health literacy is associated with worse health outcomes. It is standard practice in many primary care clinics to provide patients with written patient education materials (PEM), which often come directly from an electronic health record (EHR). We compared the health literacy of patients in a primary care residency clinic with EHR PEM readability by grade level. We assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF), and determined grade level readability for the PEM distributed for the five most common clinical diagnoses using the Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid metrics. Among 175 participants, health literacy was ≥9th grade for 76 patients (43.4%), 7th to 8th grade for 66 patients (37.7%), and ≤6th grade for 30 patients (17.1%). Average standard PEM readability by SMOG was grade 9.2 and easy-to-read PEM readability was grade 6.8. These findings suggest a discrepancy between the health literacy of most patients who were surveyed and standard PEM readability. Despite national guidelines encouraging clinicians to provide PEM at an appropriate reading level, our results indicate that PEM from EHR may not be readable for many patients. [ Health Literacy Research and Practice . 2017;1(4):e203-e207.] .