American Journal of Preventive Medicine (AM J PREV MED )

Publisher: American College of Preventive Medicine; Association of Teachers of Preventive Medicine, Elsevier


The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association of Teachers of Preventive Medicine. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community. For information on the American College of Preventive Medicine (ACPM) and the Association of Teachers of Preventive Medicine (ATPM), visit their web sites at the following URLs: and

Impact factor 4.28

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    American Journal of Preventive Medicine website
  • Other titles
    American journal of preventive medicine
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  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

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  • Pre-print
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    • Pre-print allowed on any website or open access repository
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    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
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    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
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Publications in this journal

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    American Journal of Preventive Medicine 01/2015;
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    ABSTRACT: Oklahoma hospitals admit approximately 120,000 tobacco users each year, many for diseases resulting from tobacco use. To describe a unique partnership between the Oklahoma Hospital Association and Oklahoma Tobacco Settlement Endowment Trust to reach more tobacco users through the implementation of sustainable health system changes within hospitals and clinics to integrate an evidence-based tobacco treatment protocol for all tobacco-using patients. The Oklahoma Hospital Association tobacco-cessation model included (1) identifying all tobacco-using patients; (2) assessing addiction level and readiness to quit; (3) prescribing medications to manage withdrawal while in hospital; and (4) proactively faxing a referral to the Oklahoma Tobacco Helpline for all patients ready to quit. Helpline registration patterns and characteristics of fax-referred hospitalized patients were tracked for the 4 years of the initiative (2009-2013); data were analyzed in 2013. Twenty-one hospitals and 12 clinics participated in the initiative. Fax referrals to the Helpline increased by >150% in the first year, from about 600 during the year prior to the implementation of the program (July 2009 to June 2010) to 1,581 from Oklahoma Hospital Association facilities alone in the first year following the launch of the initiative. Nearly 5,600 Oklahoma Hospital Association fax referrals were made during the 4-year study period. About 41% of these referrals resulted in Helpline enrollment (n=2,289). Sustainable, evidence-based tobacco treatment interventions embedded in hospital systems can successfully identify tobacco users and provide effective treatment, including increased proactive Helpline referrals for quit coaching. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 01/2015; 48(1 Suppl 1):S65-70.
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    ABSTRACT: The prevalence of smokeless tobacco use in the U.S. is increasing and its use is a risk factor for a number of adverse health outcomes. Currently, there is limited evidence on the effectiveness of quitlines for tobacco cessation among smokeless tobacco users. To examine factors related to tobacco abstinence among exclusive smokeless tobacco users registering for services with the Oklahoma Tobacco Helpline. Participants included 959 male exclusive smokeless tobacco users registering with the Helpline between 2004 and 2012; a total of 374 completed a follow-up survey 7 months post-registration. Data were collected between 2004 and 2013 and included baseline data at Helpline registration, services received, and 7-month follow-up for 30-day point-prevalence for tobacco abstinence. Univariate and multiple logistic regression examined associations between abstinence and participant characteristics, intensity of Helpline intervention, and behavioral factors. ORs and 95% CIs were reported. Analyses were completed in 2013. At the 7-month follow-up, 43% of the participants reported 30-day abstinence from tobacco. Each additional completed Helpline call increased the likelihood of tobacco cessation by 20% (OR=1.20, 95% CI=1.05, 1.38). Smokeless tobacco users with higher levels of motivation to quit at baseline were twice as likely to be abstinent than those with low or moderate levels of motivation (OR=2.05, 95% CI=1.25, 3.35). Use of nicotine replacement therapy was not associated with abstinence when adjusted for Helpline calls, income, and level of motivation. Tobacco quitlines offer an effective intervention to increase smokeless tobacco abstinence. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 01/2015; 48(1 Suppl 1):S54-60.
  • American Journal of Preventive Medicine 01/2015; 48(1):116-119.
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    ABSTRACT: Counter-marketing in tobacco control plays an important role in increasing smoking cessation, reducing overall tobacco use, and reducing exposure to secondhand smoke. To evaluate the Tobacco Stops With Me campaign in Oklahoma by determining awareness and impact on tobacco-related attitudes, knowledge, and behavior among tobacco users and non-users. A 2-year longitudinal population-based study of 4,001 Oklahomans aged 18-54 years was conducted to evaluate campaign-related changes in knowledge, attitudes, and behaviors. Baseline data were collected using landline and cellular phones in 2007 prior to the launch of the campaign, with follow-up surveys at 1 year after baseline (n=2,466) and 2 years after baseline (n=2,266). Data were analyzed in 2012 using methods appropriate for weighted longitudinal data. Overall campaign awareness was 81%. Exposure to Tobacco Stops With Me doubled quit attempts among tobacco users and increased knowledge about the harm of secondhand smoke. Tobacco non-users exposed to the campaign were 1.5 times more likely to help someone quit using tobacco than those not exposed, report that tobacco is a serious problem in Oklahoma, believe that tobacco companies should not be allowed to give away free samples or advertise at public events, and believe that smoking should be banned at public outdoor places. These findings were statistically significant after controlling for potential confounding variables. This study demonstrates the campaign's impact on tobacco-related attitudes, knowledge, and behaviors among both tobacco users and non-users. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 01/2015; 48(1 Suppl 1):S71-7.
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    ABSTRACT: Background: Despite the health benefits associated with smoking cessation, continued smoking and relapse following cessation are common. Physical activity is associated with reduced risk of cardiovascular disease in general, though less is known about how increased cardiorespiratory fitness (CRF) may influence cardiometabolic risk among smokers. Strategies are needed to protect against the health consequences of smoking among those unwilling or unable to quit smoking. Purpose: To determine whether greater CRF was associated with reduced metabolic risk among smokers. Methods: The prospective influence of estimated CRF (i.e., maximal metabolic equivalents) on the development of metabolic syndrome and its components were examined among adult smokers (N=1249) who completed at least two preventive medical visits at the Cooper Clinic (Dallas, Texas) between 1979 and 2011. Statistical analyses were completed in 2013 and 2014. Results: The rate and risk for metabolic syndrome, as well as abnormal fasting glucose and HDL cholesterol levels declined linearly with increases in CRF (all p's<0.05). Smokers in the moderate and high fitness categories had significantly reduced risk of developing metabolic syndrome and elevated fasting glucose relative to smokers in the lowest fitness category. In addition, smokers in the high fitness category were less likely to develop abnormal HDL cholesterol levels. Conclusions: Moderate to high CRF among smokers is associated with a reduced likelihood of developing certain cardiovascular disease risk factors and metabolic syndrome.
    American Journal of Preventive Medicine 01/2015;
  • American Journal of Preventive Medicine 01/2015; 48(1 Suppl 1):S3-5.
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    ABSTRACT: Developmental assets protect adolescents from tobacco use; however, their influence during the transition to young adulthood is unknown. To determine the prospective associations among assets and tobacco use in older adolescents and young adults. Prospective analyses were conducted using five waves of annual data collected from 467 randomly selected ethnically diverse youth (baseline age, 15-17 years) from 2003 to 2008. Logistic regression was conducted in 2013 to prospectively examine associations between ten Wave 1 assets with no tobacco use in the past 30 days over the five waves of the study (no use). Assets that were significantly associated with no use were included in a second analysis to examine the cumulative effect of Wave 1 assets on no use. Youth who possessed Family Communication, Relationship with Mother, Aspirations for the Future, Parental Monitoring, or Responsible Choices assets had significantly higher odds of no tobacco use. There were significant interactions between Relationship with Father, Non-Parental Adult Role Models, Future Educational Aspirations, and Peer Role Models assets and family structure, gender, or both. There was a significant interaction between cumulative assets and family structure. For youth in two-parent households at Wave 1, those with more assets had significantly greater odds of reporting no tobacco use over five waves compared to those with the fewest assets. The influence of assets in adolescents can influence tobacco use into young adulthood. Family structure and gender can influence the asset-tobacco use relationship. Copyright © 2015. Published by Elsevier Inc.
    American Journal of Preventive Medicine 01/2015; 48(1S1):S94-S101.
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    ABSTRACT: Obese and overweight women who smoke are more likely to be concerned about weight gain following cessation, impacting ability to quit and relapse. To determine differences in weight concerns for underweight, normal weight, overweight, and obese female smokers by race/ethnicity. From March to November 2008, female adult tobacco users calling the Oklahoma Tobacco Helpline were asked questions to determine the prevalence of obesity and concern for cessation-related weight gain. A score of 50 or greater, where 0=not at all concerned and 100=very concerned, on one of two weight concerns questions defined the outcome. BMI was calculated from self-reported height and weight. For the current analyses in 2013, race, ethnicity, age, education, marital status, and tobacco use history were examined as covariates. Multiple logistic regression was used to calculate ORs and 95% CIs. A significant interaction between race and BMI was observed; thus, separate models were created for white (n=3,579); black (n=330); American Indian (n=441); and Hispanic (n=125) women. BMI was independently associated with weight concerns among all racial/ethnic groups, but the strength of the association varied. For black and Hispanic women, there was a particularly strong association between BMI and weight concerns among obese women (OR=9.55, 95% CI=5.05, 18.07, and OR=8.46, 95% CI=2.57, 27.83, respectively), although sample sizes were small. State quitlines should consider tailoring promotional efforts and treatment protocols to include concerns about weight gain, especially for obese African American and Hispanic smokers. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 01/2015; 48(1 Suppl 1):S61-4.
  • American Journal of Preventive Medicine 12/2014;
  • American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: Promoting active commuting by walking or biking to and from school could increase physical activity and reduce obesity among youth. However, exposure to the retail food environment while commuting may lead to greater dietary intake among active commuters. To examine the relationship between commute patterns and dietary intake and quality in elementary students. Fourth and fifth grade students (N=3,316) in 44 California schools reported commute modes to and from school and dietary intake for the same 24-hour period in 2012. Differences between active and passive commuters in total energy intake (kcal), energy from purchased foods, and energy from sweets and snack-type foods were compared, stratified by after-school program (ASP) participation (analysis conducted in 2013). Twenty-three percent of youth actively commuted to school; 27% actively commuted from school. Passive commuters, 87% of whom traveled by car, consumed 78 more kcal from purchased foods (p<0.01) than active commuters in the 24-hour period, though total energy intake did not differ by commute mode overall or by ASP participation. Among the 72% of students who did not attend an ASP, passive commuters consumed 56 more kcal from purchased foods (p<0.01) and 25 more kcal from sweets and snack-type foods (p=0.02) than active commuters. Passive commuters consumed more sweets and snack-type foods and more purchased foods than active commuters. These results, which suggest that parents are providing unhealthy foods for their children during the school commute, reinforce the need for multilevel strategies to promote energy balance in youth. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: There is currently no population-based research on the maternal characteristics or birth outcomes of U.S. women with intellectual and developmental disabilities (IDDs). Findings from small-sample studies among non-U.S. women indicate that women with IDDs and their infants are at higher risk of adverse health outcomes. To describe the maternal characteristics and outcomes among deliveries to women with IDDs and compare them to women with diabetes and the general obstetric population. Data from the 1998-2010 Massachusetts Pregnancy to Early Life Longitudinal database were analyzed between November 2013 and May 2014 to identify in-state deliveries to Massachusetts women with IDDs. Of the 916,032 deliveries in Massachusetts between 1998 and 2009, 703 (<0.1%) were to women with IDDs. Deliveries to women with IDDs were to those who were younger, less educated, more likely to be black and Hispanic, and less likely to be married. They were less likely to identify the father on the infant's birth certificate, more likely to smoke during pregnancy, and less likely to receive prenatal care during the first trimester compared to deliveries to women in the control groups (p<0.01). Deliveries to women with IDDs were associated with an increased risk of adverse outcomes, including preterm delivery, very low and low birth weight babies, and low Apgar scores. Women with IDDs are at a heightened risk for adverse pregnancy outcomes. These findings highlight the need for a systematic investigation of the pregnancy-related risks, complications, costs, and outcomes of women with IDDs. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: Background An Internet safety decision aid was developed to help abused women understand their risk for repeat and near-lethal intimate partner violence, clarify priorities related to safety, and develop an action plan customized to these priorities. Purpose To test the effectiveness of a safety decision aid compared with usual safety planning (control) delivered through a secure website, using a multistate RCT design. The paper evaluates the effectiveness of the safety decision aid in reducing decisional conflict after a single use by abused women. Design RCT referred to as Internet Resource for Intervention and Safety (IRIS). Setting/participants Abused women who spoke English (n=708) were enrolled in a four-state RCT. Intervention The intervention was an interactive safety decision aid with personalized safety plan; the control condition was usual safety planning resources. Both were delivered to participants through the secure study website. Main outcome measures This paper compares women’s decisional conflict about safety: total decisional conflict and the four subscales of this measure (feeling: uninformed, uncertain, unsupported, and unclear about safety priorities) between intervention/control conditions. Data were collected from March 2011 to May 2013 and analyzed from January to March 2014. Results Immediately following the first use of the interactive safety decision aid, intervention women had significantly lower total decisional conflict than control women, controlling for baseline value of decisional conflict (p=0.002, effect size=0.12). After controlling for baseline values, the safety decision aid group had significantly greater reduction in feeling uncertain (p=0.006, effect size=0.07) and in feeling unsupported (p=0.008, effect size=0.07) about safety than the usual safety planning group. Conclusions Abused women randomized to the safety decision aid reported less decisional conflict about their safety in the abusive intimate relationship after one use compared to women randomized to the usual safety planning condition.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: Background: Fifty years after the first Surgeon General’s report, tobacco use remains the nation’s leading preventable cause of death and disease, despite declines in adult cigarette smoking prevalence. Smoking-attributable healthcare spending is an important part of overall smoking attributable costs in the U.S. Purpose: To update annual smoking-attributable healthcare spending in the U.S. and provide smoking-attributable healthcare spending estimates by payer (e.g., Medicare, Medicaid, private insurance) or type of medical services. Methods: Analyses used data from the 2006–2010 Medical Expenditure Panel Survey linked to the 2004–2009 National Health Interview Survey. Estimates from two-part models were combined to predict the share of annual healthcare spending that could be attributable to cigarette smoking. The analysis was conducted in 2013. Results: By 2010, 8.7% (95% CI¼6.8%, 11.2%) of annual healthcare spending in the U.S. could be attributed to cigarette smoking, amounting to as much as $170 billion per year. More than 60% of the attributable spending was paid by public programs, including Medicare, other federally sponsored programs, or Medicaid. Conclusions: These findings indicate that comprehensive tobacco control programs and policies are still needed to continue progress toward ending the tobacco epidemic in the U.S. 50 years after the release of the first Surgeon General’s report on smoking and health.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: Background: In 2012, CDC launched the first federally funded national mass media antismoking campaign. The Tips From Former Smokers (Tips) campaign resulted in a 12% relative increase in population-level quit attempts. Purpose: Cost-effectiveness analysis was conducted in 2013 to evaluate Tips from a funding agency’s perspective. Methods: Estimates of sustained cessations; premature deaths averted; undiscounted life years (LYs) saved; and quality-adjusted life years (QALYs) gained by Tips were estimated. Results: Tips saved about 179,099 QALYs and prevented 17,109 premature deaths in the U.S. With the campaign cost of roughly $48 million, Tips spent approximately $480 per quitter, $2,819 per premature death averted, $393 per LY saved, and $268 per QALY gained. Conclusions: Tips was not only successful at reducing smoking-attributable morbidity and mortality but also was a highly cost-effective mass media intervention.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: Sociodemographic determinants of predicted 10-year risk for stroke or myocardial infarction are vital to identify patients who are at increased risk. Although some risk factors of predicted cardiovascular disease (CVD) risk are documented, further exploration is necessary considering various socioeconomic and demographic factors. To examine risk factors for stroke or myocardial infarction according to 10-year prediction, among hypertensive patients and by sociodemographic risk differences, using a nationally representative survey. Data were obtained from the 2011 Bangladesh Demographic Health Survey and analyzed in March and July 2014. The analyses were based on responses from 1,620 hypertensive individuals. WHO guidelines for predicting 10-year risk of stroke or myocardial infarction were applied to categorize risk of CVD into low, medium, or high strata. A total of 21.8% of hypertensive adults were at high risk for CVD. An adjusted ordinal logistic regression model showed that a female- versus male-headed household (AOR=1.85); an urban versus rural residence (AOR=1.32); being overweight/obese versus underweight (AOR=1.80); and being aged 55-69 years (AOR=1.95) or ≥70 years (AOR=2.87) versus 35-54 years were significantly associated with higher CVD risk. A regional difference in distribution of CVD risk strata was observed. Living in a female-headed household, having an urban residence, being overweight/obese, old age, and regional variations are factors associated with higher risk of CVD among hypertensive patients. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 12/2014;
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    ABSTRACT: The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes. To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae. This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease. Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years. Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 12/2014;