Public Health [JOURNAL]
Sun
200 papers
Self-management of long COVID symptoms with over-the-counter medicines and other non-prescribed therapies: a cross-sectional survey.
Guan N, Turner G, Hotham R … +15 more , Lange D, Brown KR, McMullan C, Hughes SE, Aiyegbusi OL, Matthews K, Jackson L, Yahyouche A, Alder Y, Jeyes F, Buckland L, Chong A, Stanton D, Calvert M, Haroon S
BMC Public Health · 2026 Jul · PMID 42393618 · Full text
BACKGROUND: The high prevalence of long COVID globally necessitates investigation into its self-management, especially given the absence of definitive and effective treatments and uneven access to healthcare services. ME...
BACKGROUND: The high prevalence of long COVID globally necessitates investigation into its self-management, especially given the absence of definitive and effective treatments and uneven access to healthcare services. METHODS: This study surveyed the use of over-the-counter (OTC) medicines, supplements, remedies, and other non-prescription therapies for managing long COVID symptoms in the UK. It aimed to identify the range of treatments used for self-management, explore the sources of these treatments, factors influencing treatment choices, and associated out-of-pocket expenses. A cross-sectional electronic survey was provided to individuals experiencing long COVID. It included questions on the use of OTC medications, supplements, and other therapies, where they were sourced, decision-making influences, and financial costs. Descriptive statistics and thematic analysis were applied to analyse the data. RESULTS: Among the 193 surveyed participants, significant use of vitamins, minerals, and herbal treatments (88.8%), and analgesics (73.6%) was reported, with 42% exceeding recommended dosages. Some participants sought relief through alternative therapies such as physiotherapy and acupuncture, often incurring significant personal expenses. Choices about self-management were influenced by medical professionals, family, friends, and online sources, including support groups and social media. CONCLUSIONS: People with long COVID may access a wide range of OTC medicines, dietary supplements, herbal remedies, and non-pharmacological therapies to self-manage symptoms. Healthcare providers should be aware of the use of non-prescribed therapies among long COVID sufferers and consider these in their treatment plans. Public health policies should focus on providing accurate information and guidance for patients self-managing long COVID symptoms.
Identifying predictor factors for asthma using machine learning: evidence from the English Longitudinal Study of Ageing.
Yang ZC, Xiao Z
BMC Public Health · 2026 Jul · PMID 42393616 · Full text
BACKGROUND: Asthma is a common chronic inflammatory airway disease. Accumulating evidence highlights the roles of demographic, lifestyle, and comorbidity factors in the risk of asthma. This study aimed to identify predic...
BACKGROUND: Asthma is a common chronic inflammatory airway disease. Accumulating evidence highlights the roles of demographic, lifestyle, and comorbidity factors in the risk of asthma. This study aimed to identify predictor factors of asthma using machine learning approaches. METHODS: Data were obtained from the 10th wave (2021-2023) of the English Longitudinal Study of Ageing (ELSA). Participants aged ≥ 50 years with complete information on asthma status and relevant variables were included. Baseline characteristics were compared between asthma and control groups. Subsequently, Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to identify candidate variables. Eight machine learning algorithms were developed and compared to evaluate diagnostic performance. The optimal model was selected and used to determine key variables. Additionally, SHapley Additive exPlanations (SHAP) analysis was applied to interpret variable contributions. Finally, a nomogram was constructed based on the key variables. RESULTS: A total of 3429 participants (535 asthma cases) were analyzed. Asthma was significantly associated with 19 baseline variables. LASSO regression retained 14 candidate variables. Among eight machine learning models, the Bagging Tree (BT) model achieved the highest diagnostic performance (micro-averaged area under the curve (AUC) = 0.856; macro-averaged AUC = 0.881). SHAP analysis identified alcohol consumption, marital status, and disease lung as the most influential variables. A total of 11 key variables were identified by the BT model, including marital status, vigorous physical activity, moderate physical activity, alcohol consumption, frequency of feeling isolated, depression, headache, activity limitations, disease lung, arthritis, and psychiatric disease. The nomogram showed good calibration (Hosmer-Lemeshow test p = 0.0857), but its discriminatory ability was moderate (AUC = 0.662). CONCLUSIONS: This study demonstrated that socio-behavioral factors, psychological distress, and respiratory comorbidities played important roles in asthma risk stratification. Machine learning with multidimensional variables offers a useful exploratory framework for identifying potential predictor factors and generating hypotheses for asthma prevention, although its predictive accuracy remains moderate.
Retention and attrition of community health volunteers in rural Malawi; a mixed-methods study.
Kaunda-Khangamwa BN, Msuku H, Kamiza CT … +5 more , Chimala AA, Stanley CC, Chinkhumba J, Mwapasa V, Mathanga DP
BMC Public Health · 2026 Jul · PMID 42393611 · Full text
BACKGROUND: Community health volunteers (CHVs) are an important resource for supporting health service delivery, surveillance, and social programmes. However, retention and attrition of CHVs remain a big challenge. This...
BACKGROUND: Community health volunteers (CHVs) are an important resource for supporting health service delivery, surveillance, and social programmes. However, retention and attrition of CHVs remain a big challenge. This study explored factors affecting the retention and attrition of CHVs working as village reporters (VRs) responsible for community-based death notification in the Malaria Vaccine Implementation Program (MVIP) in Malawi. METHODS: This mixed-methods exploratory study, which intersected with the case studies, was conducted from November 2022 to March 2023 in nine rural districts in southern and central Malawi. Purposive sampling was used to select 64 study participants for qualitative interviews. Using case studies, we conducted six in-depth interviews (IDIs) with CHVs who had dropped out, were reachable, and agreed to be interviewed-many were dispersed, hesitant to attend meetings, or unreachable for focus group discussions (FGDs). We held five FGDs (n = 50) with CHVs who remained in the MVIP for shared norms and experiences and eight key informant interviews (KIIs) with health workers, opinion leaders, and program staff to provide insights into health workers motivation, supervisory and program perspectives. Thematic analysis and the social capital framework (roles, relationships, and empowerment) were used to analyse and interpret the qualitative data. The qualitative study was complemented by a cross-sectional survey involving 696 randomly selected participants from a pool of 2,861 CVHs to demonstrate the trends of retention over time. Descriptive statistics were computed from quantitative survey data, with retention as a primary outcome (defined as whether a CHVs was willing to stay in the program). RESULTS: At the start of the program in 2019, a total of 2,861 CHVs were recruited by March 2023; only 295 (10.3%) had dropped out. Among 696 CHVs surveyed, the most commonly reported factors associated with retention were incentives (643; 92%), participation in exchange visits (377; 54%), and managing a small geographical area (275; 40%). Qualitative data from FGDs and KIIs corroborated these findings and identified compassion for serving others, financial and non‑financial incentives, and flexibility to work across multiple programmes as key motivators for continued participation. Factors associated with attrition included experiences of ridicule or disrespect, lack of opportunities for personal development, and limited career progression. IDIs with CHVs who left the programme provided in‑depth accounts of these individual‑level drivers, which helped explain patterns observed in the survey. CONCLUSION: Engagement of CHVs in community-based programs can be promoted by offering opportunities to serve others, incentives, and flexibility to work on multiple programmes. However, it is also important to address ridicule-making fun or rude comments and limited personal and career development, which act as barriers to the continued engagement of lay health workers.
Defining quality of healthcare in Dutch police custody: the development of a conceptual framework for monitoring care quality through a scoping review and expert consultations.
Zinger ND, Slev VVN, Verheij RA … +3 more , Ramerman L, Bos I, Kringos DS
BMC Public Health · 2026 Jul · PMID 42393609 · Full text
BACKGROUND: Individuals in police custody may require medical attention, yet little is known about the quality of care in police custody. Research is lacking on appropriate standards and indicators for measuring care qua...
BACKGROUND: Individuals in police custody may require medical attention, yet little is known about the quality of care in police custody. Research is lacking on appropriate standards and indicators for measuring care quality. This study aimed to develop a conceptual framework to identify key aspects for measuring the quality of care in police custody in the Netherlands. METHODS: A scoping review supplemented by expert consultations was conducted to gather information on health needs and quality of care in short-term police custody settings. Searches were performed across seven electronic databases (Embase, Medline, PsycInfo, CINAHL, Criminal Justice Abstracts, PiCarta, and Cochrane) for articles published in English or Dutch between 2008 and February 2023, and were supplemented with Dutch documents of medical guidelines, protocols, work instructions, and additional grey literature. An initial conceptual framework was developed from the literature review and author expertise, which was subsequently discussed and validated by field experts through two expert consultation group meetings. RESULTS: This study included 69 scientific articles, 17 medical guidelines, protocols and work instructions, and 12 reports, alongside consultation with 27 experts. The resulting conceptual framework applies a structure-process-outcome model to evaluate the care quality in police custody, organized into 14 domains. At the structure level, it includes the scope and nature of care demand, (healthcare) staff, the legal framework, quality assurance, infrastructure and (medical) resources, and funding. The process level covers triage and access to healthcare, detection of care needs, continuity of healthcare information, coordination of care, general healthcare provision, and healthcare provision for common needs. The outcome level addresses effectiveness and health outcomes, and satisfaction. These domains are further classified into 48 subdomains. There were no existing indicators identified in the literature to populate the framework. CONCLUSIONS: The conceptual framework outlines key domains for measuring quality of care in Dutch police custody. Future research will be necessary to populate the framework with indicators to monitor quality of care and support improvement efforts tailored to the needs of specific stakeholders. The operationalization and implementation of the framework will be vital for improving the care provided within police custody.
Private garden exposure and public park access in relation to type-2 diabetes incidence: a UK Biobank cohort study.
Odebeatu CC, Darssan D, Roscoe C … +2 more , Reid S, Osborne NJ
BMC Public Health · 2026 Jul · PMID 42393608 · Full text
BACKGROUND: Existing longitudinal studies examining the relationship between greenspace exposure and incidence of type-2 diabetes (T2D) have primarily operationalized greenspace using vegetation indices. Little is known...
BACKGROUND: Existing longitudinal studies examining the relationship between greenspace exposure and incidence of type-2 diabetes (T2D) have primarily operationalized greenspace using vegetation indices. Little is known about the effect of greenspace types (e.g., private gardens) and public park access. METHODS: We investigated the associations between residential greenspace exposure, including private gardens (determined using Ordnance Survey MasterMap™ Greenspace) and public park access, with the incidence of T2D using the UK Biobank (UKBB) data. Public park access, such as nearest distances (i.e., walkable road network and Euclidean), and the number of parks were calculated for each participant. The incidence of T2D was ascertained through linkage of hospital admissions data. Cox proportional hazard models, adjusting for covariates, were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). We also performed stratified analyses by age, sex, neighbourhood deprivation, and family history of diabetes. RESULTS: Of the 423,282 UKBB participants (mean age:56.36 years) included in the study, 19,648 developed T2D over a median follow-up of 15.41 years. Compared to the first quartile, participants in the highest quartile of private garden cover (%) had a reduced risk of T2D (HR: 0.932; 95%CI: 0.88, 0.983). For park access, nearest distance (whether walkable or Euclidean) was not associated with the incidence of T2D. However, having a higher number of parks, particularly three or more parks within an 800-m buffer of the home location, was found to lower the incidence of T2D (HR: 0.943; 95% CI: 0.906, 0.981). Stratified analyses revealed that the beneficial effects of private gardens were stronger among participants in deprived areas and those without a family history of diabetes. CONCLUSION: Private residential gardens exposure (often overlooked in greenspace-health research) and a higher number of parks around homes were found to lower the incidence of T2D. This has implications for urban planning and public health, particularly in the prevention and management of diabetes.
Medications for opioid use disorder, recovery supports, and overdose risk -- a database linkage study of a rural cohort of people who inject drugs and use opioids.
Gicquelais RE, Ballard HK, Becker M … +3 more , Doyle S, Bailey E, Westergaard RP
BMC Public Health · 2026 Jul · PMID 42393605 · Full text
BACKGROUND: Medications for opioid use disorder (MOUD) are the gold standard treatment for opioid use disorder, but rural-dwelling people who inject drugs (PWID) may have lower access. PWID may also receive outpatient or...
BACKGROUND: Medications for opioid use disorder (MOUD) are the gold standard treatment for opioid use disorder, but rural-dwelling people who inject drugs (PWID) may have lower access. PWID may also receive outpatient or residential treatments, attend mutual help groups, or reside in recovery housing. We aimed to investigate which supports were associated with time to first fatal or nonfatal opioid-involved overdose in a cohort of PWID who used opioids in the past 30 days. METHODS: PWID who used opioids (N = 751) in the past 30 days were recruited in Wisconsin using respondent-driven sampling and completed a cross-sectional survey in 2018-2019. Fatal and nonfatal opioid-involved overdose incidence was estimated through 2022 via linkage with vital records, emergency department, and hospitalization data. Cox proportional hazards models summarized associations of reporting MOUD, outpatient counseling, residential treatment, mutual help group participation, and living in recovery housing in the 30 days before enrollment with time to first fatal/nonfatal opioid overdose adjusted for sociodemographic characteristics, health insurance, drug use frequency, substance use severity, criminal legal system involvement, and overdose history. Self-reported barriers to MOUD were summarized among those who had never used each MOUD. RESULTS: Approximately 18.1% (N = 136) used MOUD, 22.0% (N = 165) had outpatient counseling, 7.2% (N = 54) had residential treatment, 19.7% (N = 148) participated in mutual help, and 7.2% (N = 54) lived in recovery housing in the 30 days before enrollment. During follow-up, 10.7% of participants experienced ≥ 1 opioid-involved overdose, including 114 nonfatal overdoses (incidence: 3,291.6 per 100,000 person-years) and 26 fatal overdoses (incidence: 784.5 per 100,000 person-years). Past 30-day MOUD was associated with a 78% reduction in risk of future opioid-involved fatal/nonfatal overdose (95% CI: 0.08, 0.57). Past 30-day counseling, residential treatment, mutual help, and recovery housing were not associated with fatal/nonfatal overdose. The top barrier to MOUD reported was being unable to afford MOUD (reported among 33.2% who never used buprenorphine, 27.7% who never used methadone, 22.7% who never used naltrexone). CONCLUSIONS: Recent MOUD was highly protective against experiencing fatal or nonfatal overdose in a cohort of PWID who used opioids in the past 30 days, reinforcing the need for widespread MOUD access in rural communities.
Early-onset cancer and modifiable risk: quantifying the combined impact of excess body weight and alcohol on breast and colorectal cancer in Italy (18-34 years).
Bolpagni F, Lanati S, Biino G … +7 more , Labrini L, Madini N, Vincenti A, Manuelli M, Sottotetti F, Locati LD, Cena H
BMC Public Health · 2026 Jul · PMID 42393603 · Full text
BACKGROUND: Rising rates of cancers diagnosed before the age of 50 have been reported worldwide, including in Italy. Among modifiable risk factors, excess body weight (overweight and obesity) and alcohol consumption inde...
BACKGROUND: Rising rates of cancers diagnosed before the age of 50 have been reported worldwide, including in Italy. Among modifiable risk factors, excess body weight (overweight and obesity) and alcohol consumption independently and synergistically increase the risk of breast and colorectal cancers, including early-onset disease. However, the population-level burden attributable to these exposures among adolescents and young adults (AYA) remains poorly quantified. METHODS: We combined a targeted overview of the literature with a quantitative Population Attributable Fraction (PAF) analysis to estimate the proportion of early-onset breast and colorectal cancers attributable to overweight/obesity, high-risk alcohol consumption, and their combined exposure in the Italian population aged 18-34 years. Sex- and age-specific prevalence data were derived from the national surveillance system "PASSI", while relative risks were obtained from meta-analyses and large cohort studies, prioritizing estimates from early-onset populations when available. PAFs were estimated using the Bruzzi et al. method, while combined PAFs were calculated assuming independence between exposures. Uncertainty was assessed through Monte Carlo simulations and sensitivity analyses on prevalence and relative risk assumptions. RESULTS: Among Italian young adults aged 18-34 years, overweight and obesity together accounted for a substantial proportion of early-onset colorectal cancer cases, while high-risk alcohol consumption showed the largest individual attributable fraction. The combined contribution of excess body weight and high-risk alcohol consumption reached 16.6% of early-onset colorectal cancer cases. For early-onset breast cancer in young women, high-risk alcohol consumption was associated with PAFs of 4.6%. Sensitivity analyses confirmed the robustness of the estimates and indicated that uncertainty in relative risk assumptions represented the main source of variability. CONCLUSIONS: Obesity and alcohol consumption contribute meaningfully to the burden of early-onset breast and colorectal cancers in Italy. Integrating weight management and alcohol risk assessment into clinical practice and public health strategies targeting young adults could prevent a measurable proportion of these cancers and help counteract the rising incidence of malignancies at young ages.
Accessibility and predictors of sexual and reproductive health services utilisation among adolescents and youth people with disabilities in Bono Region, Ghana: a cross-sectional survey.
Ojo L, Ginindza TG, Ansu-Mensah M … +1 more , Kuupiel D
BMC Public Health · 2026 Jul · PMID 42393602 · Full text
BACKGROUND: Despite global commitments to universal health coverage and the Sustainable Development Goals (SDGs), particularly SDGs 3, 4, 5, and 10 by 2030, adolescents and young people with disabilities (AYPWD), includi...
BACKGROUND: Despite global commitments to universal health coverage and the Sustainable Development Goals (SDGs), particularly SDGs 3, 4, 5, and 10 by 2030, adolescents and young people with disabilities (AYPWD), including those with long-term physical, sensory, speech, intellectual, or mental impairments, face persistent barriers to accessing sexual and reproductive health (SRH) services (including antenatal care, contraception, family planning) in low- and middle-income countries. Evidence from Ghana remains limited. This study assessed accessibility and predictors of SRH service utilisation among AYPWD aged 15-24 years in Ghana's Bono Region. METHODS: A community-based analytic cross-sectional survey was conducted among 440 AYPWD selected using multi-stage random sampling across urban and rural districts. Data were collected using structured questionnaires capturing sociodemographic characteristics, disability profiles, SRH service utilisation, and structural and perceived accessibility indicators. Descriptive statistics summarised patterns of service use, while logistic regression models identified predictors of SRH service access and perceived ease of access. Statistical significance was set at p < 0.05. RESULTS: Of the 440 respondents, most were female (62.0%), urban residents (80.7%), and aged 20-24 years (52.3%). Access to personal hygiene information was high (82.5%), whereas utilisation of contraceptive information (22.0%), sexually transmitted infection (STI) screening and treatment (32.0%), human immunodeficiency virus (HIV) testing (13.0%), safe abortion information (7.7%), and antenatal care (2.7%) was low. Females had significantly higher odds of accessing contraceptive information (AOR = 4.55; 95% CI: 2.43-8.50; p < 0.001) and menstrual health support (AOR = 13.42; 95% CI: 7.76-23.19; p < 0.001). Respondents with visual (OR = 0.15; 95% CI: 0.09-0.26; p < 0.001) and hearing disabilities (OR = 0.45; 95% CI: 0.25-0.81; p = 0.008) reported greater service-quality barriers, while visual disability was also associated with reduced perceived ease of access (OR = 0.50; 95% CI: 0.29-0.86; p = 0.013). CONCLUSION: SRH service utilisation among AYPWD in the Bono Region remains low and is shaped by gender, disability type, and structural and socioeconomic factors. Strengthening disability-inclusive infrastructure, communication support, gender-responsive programming, and targeted financing mechanisms is essential to improve equitable access and advance progress toward universal health coverage in Ghana.
Focusing on depressive symptoms in patients to mitigate the risk of pain: a nationwide, prospective cohort study.
Liu YW, Sun Y, Lei YL … +8 more , Di BR, Men XD, Zhu JZ, He KX, Wang JM, Peng L, Xiang L, Luo YH
BMC Public Health · 2026 Jul · PMID 42393600 · Full text
BACKGROUND: Depressive symptoms and pain frequently coexist and contribute substantially to individual and public health burdens. Although previous studies have demonstrated a bidirectional relationship between depressiv...
BACKGROUND: Depressive symptoms and pain frequently coexist and contribute substantially to individual and public health burdens. Although previous studies have demonstrated a bidirectional relationship between depressive symptoms and pain, several important knowledge gaps remain. Most investigations have focused on overall pain burden or specific pain conditions, limiting understanding of whether depressive symptoms are associated with the risk of pain across different anatomical sites. In addition, the dose-response relationship between depressive symptom severity and subsequent pain risk remains poorly characterized, particularly in nationally representative Chinese populations. METHODS: The China Health and Retirement Longitudinal Study (CHARLS), a national, multi-center, prospective cohort study initiated in 2011, enrolled 6,772 participants for the final analysis, based on specific inclusion and exclusion criteria. Depressive symptoms was defined as a Center for Epidemiologic Studies Short Depression (CESD) score ≥ 10. To investigate potential associations between depressive symptoms, CESD scores, and 15 distinct types of pain, Cox proportional hazards models were employed, with restricted cubic splines (RCS) applied to examine non-linear relationships. Lastly, subgroup analyses were performed to substantiate the reliability of the findings further. RESULTS: In the fully adjusted model, individuals with depressive symptoms exhibited a significantly higher risk of experiencing pain in specific body regions compared to their non-depressed counterparts. Furthermore, for every 1 standard deviation increase in CESD score, the risk of pain in certain body areas rose by 4%-7%. Moreover, CESD scores displayed a distinct S-shaped non-linear relationship with ten types of pain, including headache and shoulder ache. Additionally, in the majority of subgroups, both depressive symptoms and CESD scores were positively correlated with pain risk, aligning with the overall findings of the study. CONCLUSIONS: In the Chinese population, depressive symptoms and CESD scores represent significant potential risk factors for pain.
Effectiveness of an educational intervention in enhancing parents' knowledge, perception, and acceptability of human papillomavirus vaccine.
Abdulghani N, Faqih S, Alqurashi A … +1 more , Baljon K
BMC Public Health · 2026 Jul · PMID 42393589 · Full text
BACKGROUND: Cervical cancer is the fourth most common cancer among women worldwide, largely caused by the human papillomavirus (HPV). The HPV vaccine has been proven to effectively reduce HPV infection rates and cervical...
BACKGROUND: Cervical cancer is the fourth most common cancer among women worldwide, largely caused by the human papillomavirus (HPV). The HPV vaccine has been proven to effectively reduce HPV infection rates and cervical cancer risk, making vaccination a crucial preventive measure. OBJECTIVES: This study aims to evaluate the effectiveness of an educational intervention in improving parents' knowledge, perception, and acceptability of the HPV vaccine. METHODS: A pre-post research study was conducted in 2024 involving 140 parents in a specialized hospital in Makkah, Saudi Arabia. The intervention consisted of structured educational lectures, PowerPoint presentations, workshops, and parents' group discussions. Pre- and postintervention self-administered surveys were used to assess changes in knowledge, perception, and vaccine acceptability. RESULTS: The intervention resulted in a significant improvement in parents' knowledge regarding HPV and its associated risks. Parental understanding of HPV transmission and vaccine benefits improved greatly following the intervention, rising from 17% to 87%. The mean knowledge score significantly increased from 5.2 ± 2.1 to 9.9 ± 1.8 (P < 0.001), indicating a large effect size (Cohen's d = 0.58). Interestingly, parents with lower educational levels demonstrated the greatest improvement in knowledge scores compared with higher-educated parents (P = 0.039), suggesting that the intervention was particularly effective among this group. Additionally, the intervention positively influenced parental perception and acceptability of the HPV vaccine. CONCLUSIONS: The research provides valuable insights into the effectiveness of educational interventions in enhancing parental understanding and HPV vaccine acceptance. The findings contribute to the development of targeted interventions, explicitly challenge prevalent misconceptions about HPV infection, and suggest strategies to improve parental awareness and facilitate informed decision-making regarding HPV prevention and testing in collaboration with stakeholders and community leaders.
Associations of age, health literacy, BMI, tobacco use, and COVID-19 infection history with sexual dysfunction among COVID-19 survivors: A multicenter study.
Tran TT, Dang LT, Do BN … +15 more , Do TX, Nguyen TT, Pham KM, Vu VH, Pham LV, Nguyen HC, Nguyen TH, Nguyen AT, Nguyen HV, Nguyen PB, Pham TTM, Le TT, Nguyen TTP, Tran CQ, Duong TV
Public Health · 2026 Jul · PMID 42391829 · Publisher ↗
OBJECTIVES: Sexual dysfunction is a prevalent and often overlooked issue among COVID-19 survivors. This study aimed to investigate the factors associated with sexual dysfunction in this population. STUDY DESIGN: A cross-...
OBJECTIVES: Sexual dysfunction is a prevalent and often overlooked issue among COVID-19 survivors. This study aimed to investigate the factors associated with sexual dysfunction in this population. STUDY DESIGN: A cross-sectional study. METHODS: A multicenter survey was conducted involving 2809 COVID-19 survivors. Sexual dysfunction was assessed using the 14-item Sexual Functioning Questionnaire (CSFQ-14). Unadjusted and adjusted logistic regression analyses were performed to determine the factors associated with sexual dysfunction. RESULTS: The CSFQ-14 scores indicated that 52.2% of the participants experienced sexual dysfunction, with higher rates observed among males (53.1%) compared to females (46.9%). Several risk factors were identified, including higher age (odds ratio, OR, 2.20; 95% confident interval, 95%CI, 1.58, 3.07; p < 0.001), a greater number of family members with COVID-19 (OR, 1.28; 95%CI, 1.02, 1.62; p = 0.037), multiple COVID-19 infections (OR, 2.13; 95%CI, 1.20, 3.77; p = 0.01), higher body mass index (BMI) (OR, 1.50; 95%CI, 1.23, 1.81; p < 0.001), COVID-19 treatment at the hospital (OR, 1.26; 95%CI, 1.06, 1.50; p = 0.01), and a history of tobacco use (OR,1.48; 95%CI, 1.13, 1.95; p = 0.005). Conversely, higher education levels (OR, 0.66; 95%CI, 0.53, 0.84; p = 0.001), current employment (OR, 0.64; 95%CI, 0.44, 0.93; p = 0.019), and greater health literacy (OR, 0.98; 95%CI, 0.97, 0.99; p = 0.004) were found to be protective factors against sexual dysfunction. CONCLUSION: This study highlights the significant burden of sexual dysfunction among COVID-19 survivors. Targeted interventions should focus on weight management, smoking cessation, and improving education and health literacy to enhance sexual well-being in this population.
Costing the mental health harms of sexual and physical violence in adulthood: A prevalence-based analysis in England.
McManus S, Walby S, Hashemi L … +3 more , Fadeeva A, Blom N, Barbosa EC
Public Health · 2026 Jul · PMID 42391828 · Publisher ↗
OBJECTIVES: Economic costings tend not to address the longer-term mental health harms resulting from sexual violence in adulthood, nor the combined impact of sexual and physical violence. We estimated the annual cost of...
OBJECTIVES: Economic costings tend not to address the longer-term mental health harms resulting from sexual violence in adulthood, nor the combined impact of sexual and physical violence. We estimated the annual cost of experience of violence throughout adulthood, in terms of reduced quality of life and health service costs. STUDY DESIGN: Prevalence-based modelling. METHODS: Data were analysed from multiple sources, including the probability sample Adult Psychiatric Morbidity Survey and service delivery costs. Prevalence estimates used weighted data, controlling for survey design. Adjusted marginal effects for limiting mental health conditions and substance dependence were estimated for experience in adulthood of sexual violence, physical violence, and combined sexual and physical violence. Disability weights were applied to estimate associated reduced quality of life and relative risks applied for health service costs. RESULTS: The estimated cost of long-term reduced quality of life adults in England experienced because of violence during adulthood was £3767 million in 2019, with associated healthcare costs in that year of £4130 million. Costs of long-term lost quality of life and healthcare were higher in women than men. Costs associated with combined sexual and physical violence were particularly high, the great majority of these costs resulting from experience of violence in women. Combined sexual and physical violence in women was associated with the highest cost per victim. CONCLUSIONS: Both sexual and physical violence have sizeable and independent associations with long-term mental health and treatment and service use. Violence reduction has potential to reduce health service costs and increase population level quality of life.
Effectiveness of interventions to support healthcare workers' mental health and well-being: An umbrella review of systematic reviews.
Mohd Nadzir AYB, Gopinath D, Rajiah K … +2 more , Fang CM, Maharajan MK
Public Health · 2026 Jul · PMID 42391827 · Publisher ↗
OBJECTIVES: To synthesise evidence from existing systematic reviews on the effectiveness of mental health interventions for healthcare professionals and examine the contextual factors influencing their implementation and...
OBJECTIVES: To synthesise evidence from existing systematic reviews on the effectiveness of mental health interventions for healthcare professionals and examine the contextual factors influencing their implementation and impact. STUDY DESIGN: Umbrella review of systematic reviews evaluating interventions to support the mental health of healthcare workers. METHODS: An umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible systematic reviews were identified through a comprehensive database search supplemented by manual searching of reference lists. A thematic analysis and narrative synthesis were undertaken to categorise intervention types, examine implementation characteristics and evaluate reported contextual influences. RESULTS: A total of 882 records were identified, of which 14 systematic reviews met the eligibility criteria for inclusion. Eight categories of interventions were identified: (1) mindfulness-based and mind-body interventions, (2) digital and online-based interventions, (3) cognitive- and behavioural-based interventions, (4) educational- and training-based interventions, (5) organizational, structural and environmental interventions, (6) well-being, reflective and relaxation-based interventions, (7) peer and relational support interventions and (8) medical and clinical interventions. Mindfulness-based and cognitive-behavioural interventions demonstrated the strongest evidence of effectiveness; however, substantial heterogeneity was evident across intervention design, implementation processes and outcome measures. CONCLUSIONS: Although individual interventions show measurable benefits, sustainable improvements in the mental health of the healthcare workforce require integrated multilevel public health approaches. Embedding mental health support within organisational structures, workforce policies and health system governance is essential for strengthening system capacity.
Experiential and Structural Determinants of Communicable Disease Reporting Among Health Care Providers in Alameda County, California.
Martinson T, Khan SM, Heaton DT … +3 more , Shemsu M, Moss NJ, Trivedi KK
Public Health Rep · 2026 Jul · PMID 42389875 · Full text
Communicable disease reporting is essential for public health surveillance, yet underreporting is common. California Title 17 mandates that health care providers report >80 communicable diseases to local health departmen...
Communicable disease reporting is essential for public health surveillance, yet underreporting is common. California Title 17 mandates that health care providers report >80 communicable diseases to local health departments, according to the patient's residence. We conducted a cross-sectional survey assessing health care provider knowledge, attitudes, and practices related to reporting requirements in Alameda County, California. Of 145 health care providers surveyed from April through June 2025, 127 (87.6%) were aware of Title 17 requirements and 105 (72.4%) had submitted at least 1 report. In multivariable logistic regression analysis using Firth penalized likelihood, the following were significantly associated with higher odds of reporting communicable diseases: having an awareness of reporting requirements versus no awareness (adjusted odds ratio [AOR] = 6.91; 95% CI, 1.21-58.36), having >10 years of clinical experience versus <5 years of clinical experience (11-20 years: AOR = 11.07 [95% CI, 2.30-64.68]; >20 years: AOR = 10.89 [95% CI, 2.28-62.59]), and having training in systems of institutional reporting versus no training (AOR = 5.37; 95% CI, 1.56-22.52). Misunderstanding reporting responsibility versus accurately identifying reporting responsibility was associated with lower odds of reporting communicable diseases. Improving clinician training, clarifying reporting expectations, and expanding electronic reporting systems may strengthen public health surveillance.
Maternal and child health challenges during and after flooding: a qualitative study in Makassar, Indonesia.
Goel R, Tarpenning MS, Ansar J … +8 more , Ansariadi A, Syahrani ZPA, Anggraeni N, Coombe KD, Weber W, Blythe E, Ansariadi A, Rosser JI
BMC Public Health · 2026 Jul · PMID 42387525 · Full text
BACKGROUND: Flooding is a recurrent and worsening public health threat in Indonesia, disproportionately affecting women and children in low-elevation urban areas. Pregnant and postpartum women in Indonesia experience uni...
BACKGROUND: Flooding is a recurrent and worsening public health threat in Indonesia, disproportionately affecting women and children in low-elevation urban areas. Pregnant and postpartum women in Indonesia experience unique physical and emotional burdens during floods, yet their lived experiences remain underexplored. Understanding how mothers adapt to recurrent flooding is critical for developing context-relevant interventions to improve maternal and child outcomes. This study aimed to explore (1) how recurrent flooding shapes the daily lived experiences and caregiving responsibilities of pregnant and postpartum women, (2) how flooding affects access to food, water, and healthcare, and (3) what community-informed interventions mothers identify as most impactful. METHODS: We conducted a qualitative descriptive study using in-depth interviews with 20 women who gave birth within the past three years and reported prior flood experience in the Tallo District of Makassar. They were randomly selected from a mother-child cohort based out of Hasanuddin University. Sample size was determined by data saturation. Interviews were transcribed and translated from Makassarese into English. They were then coded and analyzed thematically using MAXQDA. RESULTS: Flooding occurs annually, with severity differing between years. Mothers bore primary responsibility for lifting furniture, protecting children, and cleaning contaminated homes. Recurrent floods disrupted food preparation and reduced meal variety. Floodwater contaminated government-owned piped water and borehole well water. Toilets overflowed and bathing was often skipped to conserve clean water. Prenatal and routine health visits were frequently postponed until floodwaters receded; however, many mothers reported wading through deep water to attend scheduled appointments. The distress of these burdens was worsened by lost income from disrupted work. Mothers identified food distribution, drain maintenance, and improved housing infrastructure as the most impactful interventions. CONCLUSIONS: These findings provide translatable insights for flood-prone coastal urban communities. Educating households about water preparation and implementing timely food staple distribution through existing community networks can reduce illness and hunger during flooding. Supporting neighborhood-based drainage maintenance and subsidizing incremental home elevation with locally available materials can address the burdens placed on mothers during flooding.
Social and attitudinal predictors of tobacco use among Peruvian adolescents: a Structural Equation Modeling (SEM) of the Theory of Planned Behavior using Global Youth Tobacco Survey 2019.
Calle D, Cruz-Montero J, Durand-Gonzáles E … +2 more , Lora-Loza MG, Hualparuca-Olivera L
BMC Public Health · 2026 Jul · PMID 42387512 · Full text
BACKGROUND: The use of manufactured tobacco cigarettes and e-cigarettes continues to be an important determinant of adverse health outcomes during adolescence, especially in Latin America, despite existing prevention pol...
BACKGROUND: The use of manufactured tobacco cigarettes and e-cigarettes continues to be an important determinant of adverse health outcomes during adolescence, especially in Latin America, despite existing prevention policies. In Peru, there is a stabilization in cigarette consumption and a notable increase in the use of Electronic Nicotine Delivery Systems (ENDS), which requires new explanatory studies. Based on the Theory of Planned Behavior, the aim was to analyze how subjective norms and attitudes toward tobacco predict the intention and subsequent consumption of manufactured and e-cigarettes among Peruvian adolescents. METHODS: This was a cross-sectional study using secondary data from the Global Youth Tobacco Survey 2019 in Peru. The sample included 2593 school adolescents aged 13 to 15 from different regions of the country. Structural Equation Modeling was applied to evaluate a partial version of the Theory of Planned Behavior including the effects of exposure to tobacco consumption in environments close to adolescents such as the home, school, and other settings (descriptive subjective norms), as well as attitudes toward tobacco on the intention to use tobacco products, and the predictive effect of this intention on frequency of manufactured and e-cigarette consumption. Perceived Behavioral Control was not included in the model due to an insufficient number of indicators. RESULTS: Exposure to tobacco consumption at home and in adolescents' everyday environments was a significant predictor of the intention to use tobacco products, whereas exposure at school showed a weaker and not significant effect. Negative attitudes toward tobacco predicted lower intention, indicating a protective cognitive factor. Together, these variables explained 32% of the variance in the intention to consume tobacco. In turn, the intention to use tobacco products was significantly associated with both manufactured cigarette use and e-cigarette use, with a stronger predictive effect for manufactured cigarettes than for e-cigarettes, explaining 79% and 37% of their variance, respectively. CONCLUSIONS: Manufactured and e-cigarette consumption among Peruvian adolescents represents distinct behavioral outcomes that merit examination in relation to antecedents such as tobacco-related use intention, social norms, and attitudes. Preventive interventions should address both the family and public environment while also targeting adolescents' cognitive perceptions about tobacco, especially in a context of increasing e-cigarette use.
Reduction in suicides and suicide attempts following implementation of AI-based video surveillance in the Stockholm metro system: an intervention study.
Fredin-Knutzén J, Hadlaczky G, Andersson AL … +1 more , Sokolowski M
BMC Public Health · 2026 Jul · PMID 42387492 · Full text
BACKGROUND: Over 700,000 suicides occurring globally each year are a major public health issue. Railways and metros provide a lethal means of suicide, mainly occurring by persons under train (PUT) events. Restriction of...
BACKGROUND: Over 700,000 suicides occurring globally each year are a major public health issue. Railways and metros provide a lethal means of suicide, mainly occurring by persons under train (PUT) events. Restriction of means has been shown to be effective in reducing suicides and is increasingly being prioritized in railway settings, e.g., using physical barriers. Here, we instead investigated the changes in suicidal behavior on metro platforms following the implementation of an AI-based CCTV detection system. METHODS: We used longitudinal data about PUT due to suicidality in the Swedish metro system in Stockholm (2010-2025). A controlled interrupted time series (CITS) analysis, as well as uncontrolled analyses, were used to test if an AI-CCTV implementation in Q4 2021 (at 14 stations) was associated with decreased rates of PUT due to suicidality, compared to the other 86 stations as controls. We also evaluated secondary outcomes (e.g., suicide deaths and train-traffic cancellations). Sensitivity analyses assessed the robustness of the primary model. A separate exploratory analysis examined an extended post-period, which included multiple heterogeneous system-wide exposures. RESULTS: Rates of PUT due to suicidality were lower after AI-CCTV implementation, in analyses with (IRR = 0.27, p < 0.05) or without (IRR = 0.41, p < 0.05) controls. Secondary outcomes showed consistent point estimates, e.g. death by suicide after PUT (IRR = 0.3), safeguarded individuals (IRR = 0.8) and less cancelled train-kilometers in the metro system. The robustness of the changes in PUT and death by suicide outcomes were confirmed by Bayesian sensitivity analyses using weak priors. CONCLUSIONS: Implementation of AI-CCTV as described herein was associated with lower rates of PUT due to suicidality at metro stations, as well as changes in the same direction for e.g. deaths by suicide and less cancelled train-kilometers. This preliminary study of AI-CCTV in the metro system provides a specific example of how such an intervention may support suicide prevention in the metro system, at least in the short-term.
Improving healthy eating behaviour among in-school adolescents through collaborative instructional intervention: a theory-driven quasi-experimental study.
Ademiluyi DD, Adepoju OT, Oladosu GS … +9 more , Uthman-Akinhanmi YO, Akinsanya OB, Adewale IO, Asha OE, Olubiyi ED, Ojo-Adalumo AR, Adepoju AB, Ogunniyi AE, Oyewunmi BT
BMC Public Health · 2026 Jul · PMID 42387491 · Full text
BACKGROUND: Adolescence is a critical window for establishing dietary behaviours that shape long-term health outcomes. In Nigeria and other Sub-Saharan African countries, school-based nutrition education has been largely...
BACKGROUND: Adolescence is a critical window for establishing dietary behaviours that shape long-term health outcomes. In Nigeria and other Sub-Saharan African countries, school-based nutrition education has been largely ineffective when delivered through conventional didactic approaches. This study evaluated the effect of a Health Belief Model-guided collaborative learning intervention on diet quality, nutrition knowledge, and perceived dietary behaviour among in-school adolescents in Ogun State, Nigeria. METHODS: A quasi-experimental, pre-test-post-test control group design was used. Three hundred adolescents aged 13-19 years from two public secondary schools in Odeda Local Government Area were recruited, with 150 assigned to each group. The intervention group received eight weeks of structured nutrition education delivered through collaborative learning techniques, while the control group received the same content through conventional didactic instruction. Diet quality was assessed using the Global Diet Quality Questionnaire (DQQ), nutrition knowledge using a validated 20-item questionnaire, and perceived dietary behaviour using an HBM-based scale. Data were analysed using paired t-tests, independent t-tests, Difference-in-Differences analysis, and ANCOVA. RESULTS: The intervention group demonstrated statistically significant improvements in dietary diversity (DDS: 33.74%), NCD-Protect score (153.22%), and GDR score (39.86%), while the NCD-Risk score showed no significant change in either group (p = 0.967). Nutrition knowledge improved significantly in the intervention group (DiD = 7.94; p = 0.007), with no meaningful change in the control group. All six HBM constructs improved significantly in the intervention group, including self-efficacy (13.46%) and perceived severity (18.96%). ANCOVA confirmed that the intervention independently predicted improvements in both dietary diversity and nutrition knowledge after adjusting for baseline scores and sociodemographic covariates. CONCLUSIONS: The findings of this study suggest that collaborative learning-based nutrition education guided by the Health Belief Model was associated with meaningful improvements in diet quality, nutrition knowledge, and health beliefs among in-school adolescents. These findings support further evaluation of participatory and theory-driven instructional approaches within school-based nutrition programming in Nigeria and similar low-resource settings, ideally through cluster-randomised designs involving larger numbers of schools.
Challenges and countermeasures of the "Xinjiang Model" in tuberculosis prevention and control: a qualitative study based on health specialists' perspectives.
Zhang Y, Wei R, Wang S … +5 more , Wang X, Razbek J, Wen B, Wang J, Cao M
BMC Public Health · 2026 Jul · PMID 42387490 · Full text
BACKGROUND: Tuberculosis (TB) remains a significant public health threat, particularly in Xinjiang Uygur Autonomous Region of China, showing a high incidence. The "Xinjiang Model" is a TB service delivery system integrat...
BACKGROUND: Tuberculosis (TB) remains a significant public health threat, particularly in Xinjiang Uygur Autonomous Region of China, showing a high incidence. The "Xinjiang Model" is a TB service delivery system integrating universal chest X-ray screening, hospitalization for infectious patients, community-based follow-up for non-infectious cases, and nutritional support. Since 2018, Xinjiang has implemented the "Xinjiang model" for TB prevention and control to improve early screening and cure rates, but it continues to face challenges in long-term implementation. OBJECTIVE: This qualitative study aimed to explore the challenges encountered during the implementation of the "Xinjiang Model" and identify sustainability strategies to optimize and enhance TB prevention and control efforts. METHODS: Semi-structured interviews were conducted with 26 healthcare professionals from the Centers for Disease Control and Prevention across various Xinjiang prefectures, selected through purposive sampling. Data collection followed a tailored interview outline, and thematic analysis using Colaizzi's method was applied. RESULTS: Six significant challenges were identified: workforce fragility and insufficient incentives for TB providers; physical and psychological vulnerabilities affecting patients' treatment continuity; gaps in funding standards and policy alignment; limited public awareness and TB-related health literacy; capacity pressures affecting the quality and timeliness of universal health check-ups; and delays across referral pathways. Participants expressed confidence in the sustainability of the model and proposed strategies grouped into three domains: strengthening system inputs, including financial and policy support and provider compensation; improving patient-centered care, such as patient management, follow-up, and psychosocial or social support; and enhancing service delivery capacity by optimizing the TB workforce and improving the quality of universal health check-ups. CONCLUSION: This study revealed key operational barriers to sustaining the "Xinjiang Model" and underscores the need for strengthened financing, workforce incentives, and patient-centered support within ongoing health system reforms. These findings are essential for maintaining TB control efforts in Xinjiang, serve as a reference for similar regions in China, and offer contextual insights for comparable low- and middle-income countries seeking to implement integrated TB control strategies.
Enhancing collaborative relationships and mental health literacy to improve school behavioral health for middle school students: a randomized controlled trial.
Weist MD, Patterson B, McQuillin SD … +10 more , Fairchild AJ, Chehoski BE, Stevens RN, Haines C, Cox J, Chandler T, Hoover S, Reaves S, Lu Q, Obeid JS
BMC Public Health · 2026 Jul · PMID 42387471 · Full text
BACKGROUND: Escalating youth mental health challenges have challenged schools and providers to effectively support student well-being. School behavioral health (SBH) programs are evolving rapidly to meet this need, and t...
BACKGROUND: Escalating youth mental health challenges have challenged schools and providers to effectively support student well-being. School behavioral health (SBH) programs are evolving rapidly to meet this need, and this study pursued implementation of community-partner recommended enhancements to improve SBH programming and outcomes for students. METHODS: This study aimed to evaluate the effectiveness of stakeholder-recommended enhancements to SBH on increasing the number of students and families engaged in therapy; and to evaluate the impact of the intervention on social, emotional, behavioral and academic outcomes. This comparative effectiveness trial tested two approaches to effective SBH, both involving core evidence-based strategies, and one including four community partner-recommended enhancements: mental health literacy, family-school-clinician partnerships, therapeutic alliance, and cultural responsiveness and equity. RESULTS: The enhanced condition was associated with an increased use of telehealth services and improvements in behavioral functioning of students at a 6-month post assessment. Treatment effect heterogeneity analyses indicated a potential amplifying effect of stigma reduction on improvement in students' behavioral functioning. CONCLUSIONS: Emphasizing mental health literacy (MHL) and enhanced relationships (including collaboration with families, focus on therapeutic alliance, understanding cultural responsiveness and equity) shows promise for enhancing SBH programming to improve practice and points to a range of important future research directions grounded in implementation science. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT03901274. First submitted March 29, 2019.
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