Evidence map›Paper›PMID 40976367›Full record

ArticleAmerican journal of preventive medicine2026

A Multilevel Analysis of Social Environmental Factors Related to Substance Use, Tobacco Use, and Binge Drinking Behaviors Among Older Adults.

Xue Zhang, Braden K Linn, Jennifer L Moss

Abstract read
In one paragraph

Article in American journal of preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Xue ZhangDepartment of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania.
Braden K LinnDepartment of Family and Community Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania.
Jennifer L MossDepartment of Family and Community Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania. Electronic address: jmoss1@pennstatehealth.psu.edu.

Funding

The Population Research Institute: Development CoreP2CHD041025 · NICHD · PENNSYLVANIA STATE UNIVERSITY, THE · PI Sarah Damaske · 2016 to 2026
$9.0M
NICHD NIH HHS P2C HD041025
6 · The paper itself

Abstract

introductionSocial environmental factors are associated with risky health behaviors. However, limited research examines these relationships among older adults and across multiple levels of the social environment.

methodsThis study analyzed data from a 2021 survey of older adults (aged ≥50 years, n=2,774) in the mid-Atlantic region of the U.S. Using a socioecologic framework, the social environment was measured at the levels of the individual (loneliness, resilience, perceived discrimination), interpersonal (emotional social support), neighborhood (attraction to neighborhood, acts of neighboring, sense of belonging), and community (crime, area deprivation, racial residential segregation). Generalized structural equation models were used to examine the pathways from multilevel social environmental factors to risk behaviors (substance misuse, tobacco use, binge drinking), controlling for age, sex (male or female), race/ethnicity, marital status, educational level, household income, and metropolitan status. Analyses were conducted in 2024.

resultsIndividual characteristics, including higher loneliness and discrimination and lower resilience, were associated with a higher likelihood of risk behaviors. Attraction to neighborhood, acts of neighboring, and sense of belonging were indirectly, negatively associated with risk behaviors through their relationships with individual characteristics and social support. However, acts of neighboring and sense of belonging were directly, positively associated with tobacco use and binge drinking. Racial segregation was indirectly, positively associated with risk behaviors through discrimination and neighborhood factors.

conclusionsA multilevel approach is essential for understanding risk behaviors among older adults. Enhancing the built environment to improve neighborhood attractiveness and addressing structural factors that contribute to racial segregation could help reduce risk behaviors in this population.

Indexed as

Binge DrinkingSocial EnvironmentSubstance-Related DisordersTobacco UseAgedFemaleHumansMaleMiddle AgedMultilevel AnalysisNeighborhood CharacteristicsResidence CharacteristicsRisk-TakingSocial SupportUnited States

Identifiers

PMID40976367
PMCPMC12536940

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.