About The Study: The largest increase in children’s recreational screen time during the pandemic was on weekdays, especially at the outset of the pandemic when schools were closed; this increase was greater than expected for age-related growth. Change in weekend screen time during the pandemic was not significant compared with weekday screen time. Once in-person school resumed, weekday screen time decreased versus that during the COVID-1 wave (spring 2020), although it remained consistently higher than pre-pandemic estimates and age-related expectations.
Authors: Sheri Madigan, Ph.D., of the University of Calgary in Calgary, Canada, is the corresponding author.
(doi:10.1001/jamapediatrics.2023.0393)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this survey study of 9,400 adults ages 18 to 64, a higher rate of respondents with self-reported post–COVID-19 condition (PCC; also known as long COVID) did not obtain needed health care in the past year because of cost compared with adults without PCC. Adults with PCC were also more likely to have unmet needs because of difficulties getting timely appointments or health plan authorization, among other challenges with health care institutions or health insurance. These findings suggest that improved health care access for adults with PCC may require developing clinical protocols and addressing insurance-related barriers.
Authors: Michael Karpman, M.P.P., of the Urban Institute in Washington, D.C., is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.7455)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this randomized clinical trial, anakinra did not prevent the need for mechanical ventilation or reduce mortality risk compared with standard of care alone among hospitalized patients with severe COVID-19 pneumonia. Future research should assess anakinra in patients with less severe pneumonia.
Authors: Patricia Fanlo, M.D., Ph.D., of the Hospital Universitario de Navarra in Pamplona, Spain, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.7243)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This national-level analysis found substantial adverse maternal outcomes among pregnant patients with COVID-19 infection at delivery during the early pandemic in the U.S. Specifically, the odds of severe respiratory complications were increased among pregnant patients with COVID-19 infection at delivery.
Authors: Koji Matsuo, M.D., Ph.D., of the University of Southern California in Los Angeles, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.7149)
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About The Study: This population-based study found that pregnancy-associated cancers had increased overall 5-year mortality, though not all cancer sites presented the same risk.
Authors: Amy Metcalfe, Ph.D., of the University of Calgary in Calgary, Canada, is the corresponding author.
(doi:10.1001/jamaoncol.2023.0339)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This survey study found that partners of colorectal cancer survivors experienced long-term financial toxicity that was associated with worse health-related quality of life. Multilevel interventions for both patients and partners are needed to address factors at individual and systemic levels and incorporate behavioral approaches.
Authors: Christine M. Veenstra, M.D., M.S.H.P., of the University of Michigan in Ann Arbor, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.5897)
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About The Study: The prevalence of suicidal thoughts and behaviors has not increased for most U.S. veterans during the first three years of the COVID-19 pandemic. However, veterans with pre-existing loneliness, psychiatric distress, and lower purpose in life were at heightened risk of developing new-onset suicidal ideation and suicide planning during the pandemic. Evidence-based prevention and intervention efforts that target these factors may help mitigate suicide risk in this population.
Authors: Ian C. Fischer, Ph.D., of the VA Connecticut Healthcare System in West Haven, is the corresponding author.
(10.1001/jamapsychiatry.2023.0393)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This study found that historical redlining was associated with modern-day stroke prevalence in New York City independently of contemporary social determinants of health and community prevalence of some relevant cardiovascular risk factors.
Authors: Benjamin M. Jadow, B.A., of the Albert Einstein College of Medicine in Bronx, New York, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.5875)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study of 12,000 older adults suggest that more social, cultural, and community engagement (SCCE) was associated with more dental and outpatient care utilization and reduced inpatient and community health care utilization. SCCE might be associated with shaping beneficial early and preventive health-seeking behaviors, facilitating health care decentralization and alleviating financial burden by optimizing health care utilization.
Authors: Daisy Fancourt, Ph.D., of University College London in London, is the corresponding author.
(DOI: 10.1001/jamanetworkopen.2023.6636)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Prenatal telehealth visits increased substantially during the early phase of the COVID-19 pandemic. The highest percentage of pregnancies with telehealth was observed in April 2020. Deliveries in November 2020 had the highest telehealth visit rates during the 40-week pregnancy.
Authors: Hari Eswaran, Ph.D., of the University of Arkansas for Medical Sciences in Little Rock, is the corresponding author.
(doi: 10.1001/jamanetworkopen.2023.6630)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 460,000 privately insured postpartum women, patients who gave birth to a single, live newborn after March 2020 were more likely to fill more potent and more frequent opioid prescriptions than patients who gave birth prior to March 2020. Increases were larger for patients delivering via cesarean birth than those delivering vaginally. Increases in opioid prescriptions may be associated with increased risk of opioid misuse, opioid use disorder, and opioid-related overdose among postpartum women.
Authors: Shelby R. Steuart, M.P.A., of the University of Georgia in Athens, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.6438)
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About The Study: This study demonstrated that same-sex lesbian couples undergoing assisted reproductive technology (ART) had more favorable or similar birth outcomes to heterosexual couples who conceived naturally or underwent ART to conceive, suggesting that infertility-related factors rather than reproductive treatments contribute to higher rates of adverse birth outcomes in ART pregnancies.
Authors: Alice Goisis, Ph.D., of University College London, is the corresponding author.
(doi:10.1001/jama.2023.1345)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this updated systematic review and meta-analysis of 107 studies involving more than 4.8 million participants, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than men.
Authors: Jinhui Zhao, Ph.D., of the University of Victoria in Victoria, British Columbia, Canada, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.6185)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About The Study: While the decline in employer-sponsored insurance in 2020 was offset by an increase in Medicaid coverage among newly unemployed white working-age adults, there was no such rise among newly unemployed Black and Hispanic workers.
Authors: Peter J. Huckfeldt, Ph.D., of the University of Minnesota School of Public Health in Minneapolis, is the corresponding author.
(doi:10.1001/jamahealthforum.2023.0168)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 690 patients with early-stage breast cancer, racial disparities in response to neoadjuvant chemotherapy were associated with disparities in survival and varied across different breast cancer subtypes. This study highlights the potential benefits of better understanding the biology of primary and residual tumors.
Authors: Olufunmilayo I. Olopade, M.B.B.S., and Dezheng Huo, M.D., Ph.D., of the University of Chicago, are the corresponding authors.
(doi:10.1001/jamanetworkopen.2023.3329)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Declines in smoking prevalence and increases in the age of smoking initiation occurred more slowly for young adults with less formal education, widening existing education disparities between 2002 and 2019. Black young adults had lower smoking prevalence and older age of smoking initiation than white young adults. However, declines in smoking prevalence and increases in the age of smoking initiation occurred more slowly for this group.
Authors: Alyssa F. Harlow, Ph.D., of the University of Southern California in Los Angeles, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.5742)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This study of suicide decedents who had consumed alcohol prior to their death suggests that, as alcohol consumption increased, the probability of a firearm-involved suicide increased until a certain blood alcohol concentration, at which point the probability started to decrease. The findings suggest that interventions targeting heavy alcohol use may aid in efforts to reduce the suicide mortality rate, particularly suicides involving a firearm.
Authors: Shannon Lange, M.P.H., Ph.D., of the Centre for Addiction and Mental Health in Toronto, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.5248)
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About The Study: Researchers found in this study that among Medicare beneficiaries initiating opioid use disorder-related care during the COVID-19 pandemic, receipt of opioid use disorder-related telehealth services was associated with reduced risk for fatal drug overdose, as was receipt of medications for opioid use disorder from opioid treatment programs and receipt of buprenorphine in office-based settings.
Authors: Christopher M. Jones, Pharm.D., Dr.P.H., M.P.H., of the Centers for Disease Control and Prevention in Atlanta, is the corresponding author.
(10.1001/jamapsychiatry.2023.0310)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study that included 29,000 patients suggest that recent COVID-19 infection was not associated with risk of adverse postoperative outcomes, regardless of timing within the previous 60 days.
Authors: William J. O’Brien, M.S., of Veterans Affairs Boston, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4876)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 3,101 adult participants, the number of days per week taking 8,000 steps or more was associated with a lower risk of all-cause and cardiovascular mortality in a curvilinear fashion. The findings suggest that for adults who face difficulties in exercising regularly, achieving the recommended daily steps only a couple days a week may have meaningful health benefits.
Authors: Kosuke Inoue, M.D., Ph.D., of Kyoto University in Kyoto, Japan, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.5174)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 1,678 participants, expectations of low benefit and high adverse effects, the tendency to catastrophize instead of normalize benign bodily sensations, and prior negative experiences were associated with COVID-19 vaccination adverse effects. Clinician-patient interactions and public vaccine campaigns may both benefit from these insights by optimizing and contextualizing information provided about COVID-19 vaccines.
Authors: Ingmar Schafer, Ph.D., of the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4732)
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About The Study: In this analysis of a national data set representing an estimated 4.7 million pediatric hospitalizations between 2009 and 2019, the number and proportion of pediatric acute care hospitalizations due to mental health diagnoses increased significantly. The majority of mental health hospitalizations in 2019 included a diagnosis of attempted suicide, suicidal ideation, or self-injury, underscoring the increasing importance of this concern.
Authors: Mary Arakelyan, M.P.H., of the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, is the corresponding author.
(doi:10.1001/jama.2023.1992)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study using data from 3,037 community-dwelling Medicare beneficiaries, food insecurity was prevalent and associated with a decline in executive function. Interventions and policies aiming to increase healthy food access or reduce food insecurity should be assessed for their impact on older adults’ cognitive outcome.
Authors: Boeun Kim, Ph.D., M.P.H., R.N., of Johns Hopkins University in Baltimore, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4674)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About The Study: Marriage and children were associated with a greater earnings penalty for female physicians, primarily due to fewer hours worked relative to men, in this study of 95,000 U.S. physicians. Addressing the barriers that lead to women working fewer hours could contribute to a reduction in the male-female earnings gap while helping to expand the effective physician workforce.
Authors: Lucy Skinner, M.P.H., of the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire, is the corresponding author.
(doi:10.1001/jamahealthforum.2023.0136)
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About The Study: This cohort study found that in people with SARS-CoV-2 infection who had at least one risk factor for progression to severe disease, treatment with nirmatrelvir within five days of a positive SARS-CoV-2 test result was associated with reduced risk of post−COVID-19 condition (also known as long COVID) across the risk spectrum in this cohort and regardless of vaccination status and history of prior infection. The totality of the findings suggests that treatment with nirmatrelvir during the acute phase of COVID-19 may reduce the risk of post–acute adverse health outcomes.
Authors: Ziyad Al-Aly, M.D., of the VA St. Louis Health Care System in St. Louis, is the corresponding author.
(doi:10.1001/jamainternmed.2023.0743)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This case control study found that for female individuals, the loss of abortion rights was associated with a 10% increase in prevalence of mental distress relative to the mean over the three months after the Supreme Court of the U.S. decision. Restricting legal abortion access may be associated with disproportionate outcomes among individuals of lower socioeconomic status and in medically underserved areas, who may experience greater economic and mental health burdens of having unwanted pregnancies due to increased travel costs of obtaining abortions.
Authors: Muzhe Yang, Ph.D., of Lehigh University in Bethlehem, Pennsylvania, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4509)
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About The Study: This systematic review and meta-analysis of 41 studies including 860,000 patients found that certain demographic characteristics (e.g., age and sex), comorbidities, and severe COVID-19 were associated with an increased risk of post−COVID-19 condition (PCC; also known as long COVID), whereas vaccination had a protective role against developing PCC sequelae. These findings may enable a better understanding of who may develop PCC and provide additional evidence for the benefits of vaccination.
Authors: Vassilios S. Vassiliou, M.B.B.S., Ph.D., of Norfolk and Norwich University Hospital in Norwich, United Kingdom, is the corresponding author.
(doi:10.1001/jamainternmed.2023.0750)
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About TheStudy: Statin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD) was low among all race and ethnicity groups regardless of ASCVD risk, with the lowest use occurring among Black and Hispanic adults in this study of survey data representing 39.4 million adults. Improvements in access to care may promote equitable use of primary prevention statins in Black and Hispanic adults.
Authors: Joshua A. Jacobs, Pharm.D., of the Spencer Fox Eccles University of Utah School of Medicine in Salt Lake City, and Ambarish Pandey, M.D., of the University of Texas Southwestern Medical Center in Dallas, are the corresponding authors.
(doi:10.1001/jamacardio.2023.0228)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this analysis involving 19,000 female participants, mailing human papillomavirus (HPV) self-sampling kits to women overdue for cervical cancer screening was cost-effective for increased screening uptake relative to usual care. These results support mailing HPV kits as an efficient outreach strategy for increasing screening rates among eligible women in U.S. health care systems.
Authors: Richard T. Meenan, Ph.D., M.P.H., M.B.A., of Kaiser Permanente Northwest in Portland, Oregon, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4052)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study suggest that adolescents’ positive perceptions of their relationships with their mothers and fathers are associated with a wide range of favorable outcomes in young adulthood. Investments in improving parent-adolescent relationships may have substantial benefits for young adult population health.
Authors: Carol A. Ford, M.D., of Children’s Hospital of Philadelphia, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3944)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 31 million births in the United States from 2011 to 2018, neonatal Down syndrome diagnoses increased more in states that enacted 20-week abortion bans compared with states that did not enact bans. Because these abortion bans were enacted throughout the study period and are known to inhibit choice in patient decision-making, it is possible that the difference in the rates of diagnosis is associated with these policies.
Authors: Sarina R. Chaiken, B.A., and Aaron B. Caughey, M.D., Ph.D., of the Oregon Health & Science University in Portland, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3684)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This study including 608,000 obstetric discharges found that Black and Hispanic patients experienced higher adjusted odds of postpartum emergency department visits across all hospital types, particularly at safety net hospitals and those disproportionately serving racial and ethnic minority populations. These findings support the urgent need to mitigate structural racism underlying maternal health disparities.
Authors: Michelle P. Lin, M.D., M.P.H., M.S., of Stanford University in Palo Alto, California, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3927)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The results of this study of National Institutes of Health (NIH)-funded surgeons suggest that women surgeons remained underrepresented among surgeon-scientists over a 25-year period despite early career success in receiving NIH funding. These findings suggest that substantial additional support for women surgeon-scientists is necessary to achieve a gender-diverse surgical research workforce.
Authors: Mytien Nguyen, M.S., of the Yale School of Medicine in New Haven, Connecticut, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3630)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study suggest a consistent, widespread, and significant decline in activity following the onset of COVID-19 in the United States. Vulnerable populations, including individuals at a lower socioeconomic status and those reporting worse mental health in the early COVID-19 period, were at the highest risk of reduced activity. The researchers found a significant decline in daily step counts that persisted even after most COVID-19–related restrictions were relaxed, suggesting COVID-19 affected long-term behavioral choices. It is currently unknown whether this reduction is steps is clinically meaningful over time.
Authors: Evan L. Brittain, M.D., M.Sc., of Vanderbilt University Medical Center in Nashville, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3526)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
