Public Health [JOURNAL]
Sun
200 papers
A silent epidemic? Poliomyelitis, disability burden, and social impact in Turkey (1942-1968).
Erkmen A, Tüzün N, Erkmen O
BMC Public Health · 2026 Jun · PMID 42351074 · Full text
BACKGROUND: Historical scholarship has largely framed poliomyelitis through narratives of biomedical progress and vaccination success, often marginalising its long-term clinical and social consequences in the pre-vaccina...
BACKGROUND: Historical scholarship has largely framed poliomyelitis through narratives of biomedical progress and vaccination success, often marginalising its long-term clinical and social consequences in the pre-vaccination era. This study examines the experience of poliomyelitis in Turkey between 1942 and 1968 by focusing on the discrepancy between official epidemiological indicators and the disease's actual societal burden. METHODS: Using a historical epidemiology approach, the study integrates multiple source types, including official health statistics, medical reports, contemporaneous clinical assessments, and national press coverage. These sources were analysed to assess trends in reported cases and deaths, patterns of underreporting, and the broader social and clinical consequences of poliomyelitis beyond conventional epidemiological measures. RESULTS: The analysis suggests that, despite relatively low reported case and mortality figures, poliomyelitis in Turkey generated a substantial cumulative burden through permanent disability, long-term care needs, and widespread social anxiety. A marked increase in reported cases in 1956 represents a non-linear trajectory characterised by persistence and periodic intensification rather than a single epidemic wave. Contemporary medical assessments consistently highlighted systematic underreporting, undermining the reliability of official statistics. Limited rehabilitation capacity, inadequate surveillance, and unequal access to healthcare shifted much of the long-term disease burden into the household sphere. CONCLUSION: Conceptualised as a 'silent but destructive' epidemic, poliomyelitis in Turkey can be interpreted as illustrating how low numerical visibility can coexist with substantial social impact. These findings underscore the importance of assessing epidemics beyond mortality- and incidence-based indicators, incorporating disability outcomes, care burdens, and structural inequalities into evaluations of public health impact.
A community-engaged public health research and outreach program for immigrant and racialized workers in meat processing during the COVID-19 pandemic.
Fabreau GE, Norrie E, Holdbrook L … +19 more , Antonio M, Essar MY, Youssef M, Sahilie A, Yemane M, Ramirez-Cerino E, Hassan N, Grewal R, Hussain Z, Altahsh D, Magwood O, Saad A, Santana M, Bharwani A, Nielssen I, Edwards ST, Spitzer D, Coakley A, Pottie K
BMC Public Health · 2026 Jun · PMID 42351072 · Full text
BACKGROUND: COVID-19 caused major outbreaks among immigrant and racialized workers in meat processing plants in North America, but trust barriers limited engagement with public health and research. This study investigate...
BACKGROUND: COVID-19 caused major outbreaks among immigrant and racialized workers in meat processing plants in North America, but trust barriers limited engagement with public health and research. This study investigates how community-based participatory research (CBPR) methods were employed to create a Community Scholar (CS) program to facilitate research and public health outreach among immigrant and racialized workers. METHODS: We conducted a qualitative case study of a CS program to describe its co-creation, failures, successes and experiences working across multiple Canadian meat processing plants affected by mass COVID-19 outbreaks. We hired six CSs from racialized ethnocultural minority groups, trained them in research ethics, public health protocols, survey tools, and vaccine operations, then embedded CSs within academic-public health teams. We used administrative document analysis to describe the project setting, training, and roles across research and vaccine operations between March 2020 and February 2022. CSs completed reflexivity activities using narrative analysis to summarize their experiences and impacts on themselves, immigrant and racialized workers, and their communities. Narrative analyses were triangulated with administrative, quantitative, and time-series data. FINDINGS: We summarize three study phases: (1) CS recruitment and training, (2) early engagement, and (3) outreach vaccination. Initial recruitment attempts lacked engagement, seemingly due to mistrust and fear of reprisals. Trust between workers and CSs appeared to increase over time as indicated by increased study engagement. CSs played key roles in nine onsite meat processing plant occupational and community outreach COVID-19 vaccine clinics. They also facilitated 191 surveys and 43 in-depth interviews across 11 meat processing plants in eight languages. CSs described their roles, successful outreach strategies, prerequisite skills and motivations. Key learnings included the skillset of empathetic listening, a greater understanding of meat processing plant workplaces and the role community presence plays in them, and how to empower workers through translating worker stories into advocacy. CS involvement appeared to increase trust, facilitate vaccine access through vaccine outreach clinics, and enable multilingual participation in research. INTERPRETATION: During public health crises, community-academic-healthcare partnerships can rapidly implement multicultural CBPR strategies to engage immigrant and racialized workers concurrently in research and public health outreach.
Factors influencing vaccination willingness in the context of the COVID-19 pandemic: data from the CoCo-Fakt study.
Derakhshani L, Feddern S, Grüne B … +7 more , Haberstock L, Kossow A, Niessen J, Rost S, Wiesmüller GA, Schmidt N, Joisten C
BMC Public Health · 2026 Jun · PMID 42351071 · Full text
BACKGROUND: During the COVID-19 pandemic, the population's willingness to be vaccinated was a decisive factor in containing infections. International studies have identified that health literacy and sociodemographic char...
BACKGROUND: During the COVID-19 pandemic, the population's willingness to be vaccinated was a decisive factor in containing infections. International studies have identified that health literacy and sociodemographic characteristics play a significant role in vaccination decisions. This study investigated possible factors influencing vaccination willingness in Germany. METHODS: Data were collected from the CoCo-Fakt study, which used an online questionnaire to survey infected cases and contact persons from the health authorities in Cologne and Augsburg county. Sociodemographic data and information on chronic diseases, vaccination status, willingness to be vaccinated, and subjectively perceived health literacy via a modified HLS19-Q47 questionnaire were collected. A total of 9,705 people was included in the analysis. Factors associated with vaccination willingness were assessed using chi-squared-tests and t-tests, followed by binary logistic regression with backward elimination to identify independent associations. RESULTS: Of those surveyed, 91.6% had already been vaccinated against COVID-19 or were willing to be vaccinated, while 8.4% had refused. A higher willingness to be vaccinated was found among older people (OR = 1.02), infected individuals (OR = 1.98), individuals with chronic diseases (OR = 1.32), individuals with higher socioeconomic status (OR = 1.26), and those with high health literacy (OR = 1.28). By contrast, individuals with a migration background (OR = 0.39) and those with moderate health literacy (OR = 0.76) showed greater reluctance to be vaccinated. CONCLUSION: The results underscore the importance of individual and social factors for vaccination acceptance. Particularly vulnerable groups included younger adults, individuals with a migration background, and those with moderate health literacy. This highlights the need to tailor future vaccination campaigns to target specific groups, possibly through low-threshold, multilingual information services and targeted health literacy promotion.
Prevalence and associated factors of anxiety and depression among hemodialysis patients in Sudan during armed conflict: a multicenter cross-sectional study.
Fadlelmoula YAD, Madani MAAMA, Hussein IAM … +7 more , Gasmalha MEA, Gasmelseed NMI, Hmidah AJA, Mohammed MAA, Mohamed TMA, Mohammed HMM, Ahmed SMM
BMC Public Health · 2026 Jun · PMID 42351068 · Full text
BACKGROUND: Patients with chronic kidney disease (CKD) receiving hemodialysis are at high risk of depression and anxiety, especially in conflict settings where healthcare access is disrupted. No large-scale study in Suda...
BACKGROUND: Patients with chronic kidney disease (CKD) receiving hemodialysis are at high risk of depression and anxiety, especially in conflict settings where healthcare access is disrupted. No large-scale study in Sudan has simultaneously assessed depression and anxiety during armed conflict. This study aims to estimate the prevalence of anxiety and depressive symptoms and assess their associations with sociodemographic characteristics, dialysis duration, and comorbidities among hemodialysis patients in Sudan during the ongoing armed conflict. METHODS: A multicenter, cross-sectional study was conducted across 13 dialysis units in nine Sudanese states between April and December 2025. A total of 811 adult patients (≥ 18 years) on maintenance hemodialysis were recruited via convenience sampling. Depression and anxiety were assessed using the validated Arabic versions of the PHQ-9 and GAD-7, respectively. Binary logistic regression identified factors associated with depression and anxiety. RESULTS: The prevalence of depressive symptoms was 40.3% (n = 327) and anxiety symptoms 28.6% (n = 232). Comorbid diabetes mellitus (Depression: OR = 2.66, 95% CI: 1.71-4.13; Anxiety: OR = 2.01, 95% CI: 1.28-3.14) and use of neurotoxic medications were associated with higher odds of both conditions. Longer dialysis duration (> 12 months) was associated with lower odds. Female sex and lower dialysis frequency (one session/week) were uniquely linked to higher odds of depression, while older age (≥ 74 years) was protective against anxiety. Geographic variation was observed, with higher odds in Gadarif state. CONCLUSION: Depression and anxiety are highly prevalent among hemodialysis patients in Sudan, exacerbated by ongoing conflict. Diabetes, neurotoxic medications, and regional disparities are key associated factors. Targeted mental health screening and support should be integrated into nephrology care, focusing on high-risk subgroups and conflict-affected regions.
Application of health belief model (HBM) in health sciences and medical researches: systematic review on African and Asian countries.
Tolera ST, Zerihun E, Hunduma G … +1 more , Letta S
BMC Public Health · 2026 Jun · PMID 42351066 · Full text
BACKGROUND: The Health Belief Model (HBM) is a widely used psychological framework for explaining and predicting individual's health related attitudes, belief, and behaviors. Although the model has been applied across va...
BACKGROUND: The Health Belief Model (HBM) is a widely used psychological framework for explaining and predicting individual's health related attitudes, belief, and behaviors. Although the model has been applied across various fields of health and medical sciences, the extent of its global use, particularly across African and Asian countries has not been well documented. OBJECTIVE: This systematic review aimed to assess the application of HBM in health sciences and medical research conducted between 2010 and 2025 in Africa and Asian countries. METHODS: The review followed the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted using keywords "Health Belief Model" combined with Boolean operators (AND, OR) across major databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library and PsycINFO. Eligible studies included peer-reviewed research articles applying the HBM within African and Asian contexts. RESULT: From a total of 1,421 identified records, 77 studies met the inclusion criteria. Of these, 61% (n = 47) were conducted in Africa countries and 39% (n = 30) in Asian countries. Most studies (64.94%) employed cross-sectional quantitative design, while 12% used mixed-methods approaches. Random controlled trial account for 9.11% of studies, quasi-experimental design for 7%, and qualitative approaches (including focus groups and in-depth interviews) for 6%. Overall, 85.71% of the studies applied all core components of HBM. Fifteen studies examined COVID-19 vaccine acceptance, nine focused on HIV/AIDS testing, counseling and prevention, and eleven studies explored non-communicable diseases prevention. Additionally, six studies assessed women's adherence to breast cancer screening, and four studies examined cervical cancer screening behaviours using HBM. CONCLUSION: A current systematic review demonstrates that the HBM remain a valuable framework for understanding and influencing health behaviors across diverse settings. Its application in Africa and Asian research highlights its usefulness in guiding targeted interventions that address perceived susceptibility, severity, benefits, barriers, and cues to action, ultimately contributing to improved health outcomes.
Association between risk perception and lifestyle modification practices among patients with diabetes mellitus attending the chronic follow-up clinic at Mizan-Tepi University teaching hospital, Southwest Ethiopia, Ethiopia, 2023.
Zegeye M, SofiyaYimerMengesha, Hussen S
BMC Public Health · 2026 Jun · PMID 42351063 · Full text
BACKGROUND: The association between risk Perception of Diabetes mellitus complications and lifestyle modification is an important issue in diabetes prevention and control. Also, an individual's ability to practice lifest...
BACKGROUND: The association between risk Perception of Diabetes mellitus complications and lifestyle modification is an important issue in diabetes prevention and control. Also, an individual's ability to practice lifestyle change by adhering to medication, exercise, and dietary requirements has reduced complications and deaths. However, many of the studies on diabetes in this study area from our review have often concentrated on the epidemiological aspect of the condition, with little on the relation between risk perception and lifestyle modification practices. OBJECTIVES: To determine the association between the risk perception and lifestyle modification practice among Diagnosed Diabetes Mellitus patients in Mizan-Tepi Teaching Hospital. METHODS: An institution-based cross-sectional study was conducted. A total of 436 registered diabetic patients were included and studied during the period from April 1, 2023, to May 30, 2023. Data on participants were gathered using an interviewer-administered questionnaire. Descriptive Statistical analysis, such as mean, standard deviation, frequency, and percentage, was done. The relation between Risk perception and lifestyle modification was analyzed using Pearson's χ2 statistics (p-value < 0.05, 95%CI), and the effect size was measured by Phi to measure the strength of association. RESULT: The study revealed that only half of the participants were perceived as potentially at risk for DM complications by the patient, and 63% of the respondents who practiced good lifestyle modification had a significant positive relationship in that good risk perception regarding the DM and its complications (Pearson's χ2 = 80.07914, p-value 0.0001), with a moderate association (0.44Phi-coefficient). About 48.8% with 95% CI (44.2, 53.1) and 42.4% with 95% CI (38.2, 47.5) respondents have good lifestyle modification actions of the practice and good risk perceptions for DM, respectively. Similarly, 41.7% with 95% CI (36.6, 47.2) of the respondents thought that alcohol drinking could not increase the risk of DM and its complications. CONCLUSION AND RECOMMENDATION: Good risk perception and good lifestyle modification practices have a positive association with preventing complications. Creating awareness of the risk factors, perception, and related or potential complications among DM patients may help strengthen adherence to recommended lifestyle modification practices.
Fragile cooperation in high-casualty traffic incidents: a grounded theory study of inter-organizational emergency response in Iran.
Farzinnia B, Khorasani-Zavareh D, Shojafard J … +3 more , Mortazavi M, Delshad V, Khankeh H
BMC Public Health · 2026 Jun · PMID 42351062 · Full text
BACKGROUND: Road traffic injuries remain one of Iran's top four causes of death, posing a continuing public health and governance concern. Inter-organizational cooperation is frequently fragmented, particularly in mass-c...
BACKGROUND: Road traffic injuries remain one of Iran's top four causes of death, posing a continuing public health and governance concern. Inter-organizational cooperation is frequently fragmented, particularly in mass-casualty traffic incidents, despite the existence of numerous emergency response organisations. In addition to developing a grounded conceptual framework that explains patterns of coordination failure, this study aims to theorise and model inter-organizational cooperation in such occurrences in Iran. METHODS: From 2020 to 2024, this qualitative grounded theory study was carried out. Through semi-structured interviews and expert panel discussions, twenty-seven managers, experts, and emergency response professionals from EMS, police, fire departments, the Iranian Red Crescent Society, and academic institutions took part. The Corbin and Strauss constant comparative approach, which uses open, axial, and selective coding, was used to analyse the data. RESULTS: "Fragile Cooperation" emerged as the main category from the investigation. Adaptive and maladaptive tendencies alternated in interorganisational collaboration. Paternalistic leadership in chaotic conditions, advocacy and volunteer participation, personalised crisis encounters, increased interaction after significant incidents, and selfless risk-taking were examples of adaptive tactics. Vague responsibility boundaries, cooperation-averse communication structures, interorganisational bias and competitiveness, conflicts of interest, and disorganised event scene management were examples of maladaptive tactics. The main tactic for enhancing collaboration, according to participants, is the creation of a unified emergency response system with a single national emergency number and integrated dispatch structure. CONCLUSIONS: The interorganisational collaboration of Iranian emergency response systems is highly dependent on relational and contextual factors and is structurally fragile. Sustainable improvement requires institutional reforms, unified emergency dispatch procedures, integrated operating protocols, and interoperable communication technology.
Differential effects of primary and latent syphilis co-infection on immune reconstitution and virological failure in HIV-positive adults on ART.
Shi L, Liu X, Qiu T … +8 more , Ding Q, Chen L, Chen Y, Lu J, Hu H, Xu X, Yang D, Wu Z
BMC Public Health · 2026 Jun · PMID 42351061 · Full text
BACKGROUND: HIV and syphilis are sexually transmitted diseases (STDs) that share transmission routes and risks factors. Many countries face the dual challenge of HIV and syphilis epidemics. Co-infection can mutually acce...
BACKGROUND: HIV and syphilis are sexually transmitted diseases (STDs) that share transmission routes and risks factors. Many countries face the dual challenge of HIV and syphilis epidemics. Co-infection can mutually accelerate disease progression and increase transmission risk, posing a major challenge to global public health. METHODS: This retrospective study was based on a cohort of people living with HIV (PLWH). All PLWH diagnosed between 2016 and 2023 were included. The Chi-square test was used to compare demographic and clinical characteristics between groups. Factors associated with syphilis co-infection were assessed using multivariate logistic regression, with adjusted odds ratio (aOR) and 95% confidence interval (95%CI) estimated. Kaplan-Meier analysis was used to estimate the cumulative probability of immune reconstitution (IR) and virological failure (VF) in syphilis co-infection versus HIV mono-infected individuals. Multivariate Cox regression was used to evaluate adjusted hazard ratio (aHR) and 95% CI for factors associated with IR and VF. To reduce potential confounding, we used propensity score matching (PSM) to balance baseline covariates between the syphilis co-infection and HIV mono-infection groups. All statistical analyses were performed by SPSS 23.0 and R 4.3.3. RESULTS: Among 39,924 PLWH in Jiangsu Province (2016-2023), the prevalence of syphilis co-infection was 14.1% (5,645/39,924). Factors independently associated with higher odds of co-infection included age < 60 years, male sex, current HIV stage, single, Han ethnicity, history of STDs, and homosexual HIV transmission. In the IR analysis, 56.6% of PLWH achieved IR. After stratifying by syphilis stage, primary syphilis was associated with a higher probability of IR before matching (log rank P < 0.001), but this difference disappeared after PSM (log rank P = 0.99). Latent syphilis showed no significant association with IR. In the virological failure (VF) analysis, latent syphilis co-infection was associated with an increased risk of VF in Cox regression models both before (log rank P = 0.0011) and after PSM (log rank P = 0.0032). Primary syphilis had no significant effect on VF. Younger age at ART initiation, early HIV stage, higher baseline CD4 T cell count, and college or higher education were protective against VF and/or promoted IR. CONCLUSIONS: HIV/syphilis co-infection prevalence was high among PLWH in Jiangsu. Latent syphilis co-infection independently increases the risk of VF. Younger age at ART initiation, current HIV stage, and higher education protected against VF and/or promoted IR; male, migrant, and homosexual HIV transmission were risk factors for poorer IR. Integrated screening and management of syphilis are essential to optimizing HIV treatment outcomes.
Psychological distress, financial literacy, loneliness, and coping in relation to financial difficulties: a cross-sectional study in Sweden.
Willborg E, Larsson J, Berge J … +4 more , Lindström S, Håkansson A, Ahlström R, Levinsson H
BMC Public Health · 2026 Jun · PMID 42351056 · Full text
BACKGROUND: Many individuals experience recurring or anticipated difficulties in meeting essential financial obligations, such as paying bills. Financial difficulties are associated with a range of adverse outcomes and a...
BACKGROUND: Many individuals experience recurring or anticipated difficulties in meeting essential financial obligations, such as paying bills. Financial difficulties are associated with a range of adverse outcomes and are influenced not only by objective economic conditions but also by psychological factors, including psychological distress, loneliness, coping strategies, and financial literacy, which may shape how individuals perceive, manage, and respond to their financial situation. Against this background, it is important to further examine the economic and psychological factors associated with financial difficulties. METHOD: The present cross-sectional study examined whether financial literacy, psychological distress, loneliness, and coping were associated with financial difficulties, operationalised as recurring difficulties paying bills during the past 12 months and expected difficulties paying bills in the upcoming two months. Data was collected through an online questionnaire completed by 2,035 adults aged 18-96 during the autumn of 2024. Logistic regression analyses were conducted to identify variables independently associated with financial difficulties when considered simultaneously. RESULTS: The analyses showed that financial literacy, psychological distress, loneliness, and avoidant coping were independently associated with both outcomes. CONCLUSIONS: This study examines contemporaneous associations between economic and psychological variables and self-reported financial difficulties. The cross-sectional design precludes conclusions regarding causality. Further longitudinal research is needed to clarify the direction and nature of these relationships.
Efficacy of codesigned COVID-19 booster vaccine promotion materials for long-term care staff: a cluster-randomized trial.
Hsu C, Piccorelli AV, Green BB … +15 more , Arthur KC, Becker M, Berry B, Binion B, Derus A, Gachuiri M, Hansen K, Koné A, McCracken C, McDonald B, Nisotel L, Senturia K, Volney J, Wilson KB, Williamson BD
BMC Public Health · 2026 Jun · PMID 42351054 · Full text
BACKGROUND: Among health care workers, long-term care center (LTCC) staff are among the most hesitant to obtain COVID-19 vaccines and boosters. Our objective was to compare the effectiveness of enhanced usual care (EUC)...
BACKGROUND: Among health care workers, long-term care center (LTCC) staff are among the most hesitant to obtain COVID-19 vaccines and boosters. Our objective was to compare the effectiveness of enhanced usual care (EUC) to codesigned materials (Codesign) in increasing COVID-19 booster vaccination rates and willingness to promote the booster among long term care center (LTCC) staff. METHODS: We conducted a two-arm cluster-randomized trial in 40 LTCCs in Georgia (n = 21) and Washington (n = 19) from August 2021 to December 2023. EUC LTCCs distributed standard government COVID-19 booster promotion materials. LTCCs in the Codesign arm allowed staff to participate in virtual codesign teams. Over 10 weekly meetings, the teams developed tailored COVID-19 booster promotion materials. Materials were distributed to both arms in January 2023. Primary outcomes were LTCC-level COVID-19 booster vaccination and a Net Promoter Score (NPS) measuring booster promotion to coworkers. Secondary outcomes included staff-level vaccine hesitancy and confidence scores and booster promotion to friends and family. RESULTS: We did not detect a significant difference between the EUC and Codesign arms in COVID-19 booster rates or primary NPS measure. Similarly, secondary and exploratory outcomes were not significantly different between either arm. CONCLUSIONS: The null findings of this trial are consistent with the challenges of other clinical trials of COVID-19 vaccine-promotion interventions in improving COVID-19 vaccine uptake among LTCC staff. Lessons for future research include identifying better ways to: (1) engage leaders and staff, (2) design more effective targeting messages, and (3) develop ways to target and customize dissemination. TRIAL REGISTRATION: This study is registered at www. CLINICALTRIALS: gov. CLINICALTRIALS: gov #NCT05449418. Date of registration: 6/22/2022.
Can curriculum-integrated health education improve postgraduate student well-Being? One-group pretest-posttest design.
Maciel EDS, Pontes-Silva A, Quaresma FRP … +1 more , Nascimento LRD
BMC Public Health · 2026 Jun · PMID 42351053 · Full text
OBJECTIVE: To evaluate whether a curriculum-integrated educational intervention focused on psychosocial well-being is associated with changes in perceived stress and quality of life among postgraduate students. METHODS:...
OBJECTIVE: To evaluate whether a curriculum-integrated educational intervention focused on psychosocial well-being is associated with changes in perceived stress and quality of life among postgraduate students. METHODS: This pre-experimental study (one-group pretest-posttest design without a control group) was conducted over one academic semester. A total of 31 postgraduate students were enrolled. The intervention consisted of a curriculum-integrated course addressing mental health, self-care, and well-being strategies through structured weekly sessions. Outcomes included perceived stress (PSS-10), quality of life (WHOQOL-bref), self-compassion, and life satisfaction. Pre-post comparisons were performed using paired-sample t-tests, with 95% confidence intervals and effect sizes (Cohen's d). RESULTS: A total of 31 postgraduate students were enrolled and completed both baseline and post-intervention assessments, with no loss to follow-up. A statistically significant reduction in perceived stress was observed (mean difference: -3.63; 95% CI: -6.08 to - 1.18; p = 0.005; d = 0.59). Overall quality of life showed a statistically significant increase (mean difference: 0.15; 95% CI: 0.03 to 0.27; p = 0.010; d = 0.30). No statistically significant changes were observed for self-compassion, life satisfaction, or health satisfaction (p > 0.05). Domain-specific analyses of quality of life showed no significant changes in the environmental domain (p = 0.325), while other domains presented identical mean values at both time points, precluding inferential analysis. CONCLUSION: The curriculum-integrated educational intervention was associated with reduced perceived stress and improved overall quality of life among postgraduate students. Given the pre-experimental design and absence of a control group, causal inferences cannot be established. These findings suggest that curriculum-based strategies may represent a feasible approach to promote psychosocial well-being in postgraduate education.
Exploratory thresholds for ambient PM constituents in relation to blood pressure levels in Chinese children.
Wang J, Wang X, Huang S … +5 more , Dong B, Jiang Y, Tao M, Liu J, You C
BMC Public Health · 2026 Jun · PMID 42351052 · Full text
BACKGROUND: This study aimed to examine the associations of fine particulate matter (PM) constituents and their interactions with meteorological factors with blood pressure (BP) among Chinese school-aged children, to inf...
BACKGROUND: This study aimed to examine the associations of fine particulate matter (PM) constituents and their interactions with meteorological factors with blood pressure (BP) among Chinese school-aged children, to inform targeted protection strategies. METHODS: We analyzed 16,446 children from the Zhongshan Student Growth Cohort, with annual physical examinations conducted from 2006 to 2020 in Southeast China. Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS), distributed lag non-linear models (DLNMs) and restricted cubic splines (RCS) were used to analyze the joint effects, exposure-response threshold, and effect modification by meteorological factors of PM constituents on BP. RESULTS: Overall, 20.2% were classified with high blood pressure (HBP). Each IQR increase in PM over lag0-14d was associated with a higher risk of HBP (RR = 1.97, 95%CI: 1.61-2.34) among overweight children. BKMR and WQS models consistently revealed joint effects of PM constituents on BP, with Black carbon (BC) as the dominant driver. RCS models established non-linear exposure-response relationships and suggested potential threshold concentrations for key components (BC: 1.98 µg/m³). Notably, both low temperature and low relative humidity (RH) significantly amplified the toxicity of PM constituents. CONCLUSIONS: PM constituents were adversely associated with BP in children, particularly for BC. These associations were modified by meteorological factors, with both low temperature and low RH exacerbating the adverse effects. These findings highlight the importance of considering meteorological factors in developing evidence-based air quality guidelines.
The association between living environmental factors and hearing loss in Chinese middle-aged and older adults: Results from a cross-sectional and longitudinal study hearing loss and living environment.
Huang W, Wang S, Liu Y … +6 more , Wang Y, Zheng L, Chen Y, Liu T, Liu J, Wang S
BMC Public Health · 2026 Jun · PMID 42351049 · Full text
BACKGROUND: Hearing loss (HL) substantially impairs quality of life and functional independence among middle-aged and older adults. Although individual environmental exposures have been associated with hearing health, th...
BACKGROUND: Hearing loss (HL) substantially impairs quality of life and functional independence among middle-aged and older adults. Although individual environmental exposures have been associated with hearing health, the relationship between overall living environment quality and HL remains insufficiently understood. This study aimed to examine the association between a composite living environment score and HL in a nationally representative sample of Chinese adults. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Cross-sectional analyses included 4,404 adults aged ≥ 45 years, and longitudinal analyses followed 3,603 participants without HL at baseline for up to 7 years. A composite living environment score (range: 0-6) was constructed based on ambient PM₂.₅ exposure, household fuel type, drinking water source, building type, and indoor temperature. Cross-sectional associations were assessed using logistic regression models, while longitudinal associations were assessed using Cox proportional hazards models. RESULTS: In cross-sectional analyses, higher living environment scores were inversely associated with prevalent HL (all P < 0.05). During longitudinal follow-up, 645 incident HL cases were identified. Each one-point increase in the living environment score was associated with a 5.7% lower risk of incident HL (fully adjusted hazard ratio [HR] = 0.943, 95% confidence interval [CI]: 0.889-0.999). Compared with participants in high-risk environments, those in low-risk environments showed a lower risk of HL (HR = 0.801, 95% CI: 0.638-1.005), with evidence of a dose-response relationship (P for trend = 0.038). Restricted cubic spline analyses indicated a linear association (P for nonlinearity > 0.05). CONCLUSION: Better overall living environment quality was associated with a lower risk of hearing loss among middle-aged and older adults, suggesting that improvements in living conditions may contribute to healthier auditory aging.
Development and pilot of a drug use and HIV stigma reduction training for Tajik migrants who work in Moscow: the SRI-AVLOD intervention.
Mackesy-Amiti ME, Levy JA, Williams LD … +1 more , Jonbekov J
BMC Public Health · 2026 Jun · PMID 42351039 · Full text
BACKGROUND: Tajik labor migrants who inject drugs while working in Moscow are subject to the negative effects of stigma within the diaspora community in Russia. They are also at risk of acquiring HIV, which further compo...
BACKGROUND: Tajik labor migrants who inject drugs while working in Moscow are subject to the negative effects of stigma within the diaspora community in Russia. They are also at risk of acquiring HIV, which further compounds their stigmatization. An intervention to reduce both drug-related and HIV-related stigma within the Tajik diaspora community is needed to prevent adverse social and health effects among its members who inject drugs. METHODS: We conducted a series of focus groups and interviews, from January to June 2024, with Tajik migrant workers (n = 65) and health workers (n = 18) who treat migrants in Moscow to inform the development of a four-session anti-discrimination training for Tajik community leaders. The training sessions are designed to educate leaders about substance use disorder and HIV and prepare them to act as change agents in reducing stigma toward both disorders within the Moscow Tajik diaspora community. In September 2025, we pilot tested the Stigma Reduction Intervention Approach Via Leaders of Diaspora (SRI-AVLOD) for cultural acceptability and feasibility with two groups of 8 traditional migrant community (avlod) leaders while residing in Tajikistan before returning to Moscow for work. Measures of drug use and HIV-related stigma were administered prior to the first and after the final training session. We collected participant feedback on the acceptability and feasibility of the intervention and conducted a brief follow-up interview post-training to assess participants' experience in delivering the anti-stigma messages to their community. RESULTS: Participant ratings and comments indicated high acceptability and satisfaction with the training. Ratings of acceptability, feasibility, appropriateness and usefulness were uniformly high. Measures of stigmatizing attitudes among the avlod leaders were reduced following the intervention. In follow-up interviews, participants reported favorable experiences in delivering the anti-stigma message to people in their community. CONCLUSION: The SRI-AVLOD intervention proved feasible and acceptable to Tajik community leaders and was judged to have considerable potential for effective diffusion within the migrant diaspora community.
Spatio-temporal dynamics, trend analysis, and incidence prediction of echinococcosis in Xinjiang, China (2005-2024).
Jiang L, Zhang L, Yang Y … +7 more , Tursunjiang K, Cao X, Maimaitiyiming Y, Shi G, Simayi A, Zhao J, Li L
BMC Public Health · 2026 Jun · PMID 42351036 · Full text
OBJECTIVE: Given the persistent transmission and marked spatial heterogeneity of echinococcosis in endemic settings, a comprehensive spatiotemporal assessment is warranted. This study aimed to characterize the spatiotemp...
OBJECTIVE: Given the persistent transmission and marked spatial heterogeneity of echinococcosis in endemic settings, a comprehensive spatiotemporal assessment is warranted. This study aimed to characterize the spatiotemporal epidemiology of echinococcosis in the Xinjiang Uygur Autonomous Region from 2005 to 2024, develop a time-series forecasting framework, and inform region-specific prevention and control strategies. METHODS: Spatiotemporal clustering analysis was conducted to delineate geographic heterogeneity and dynamic transmission patterns at the county level. An interrupted time series framework was employed to estimate changes in the level and slope associated with the implementation of the universal free health examination policy in September 2016. Subsequently, a seasonal autoregressive integrated moving average (SARIMA) model was fitted to characterize temporal autocorrelation structures and seasonal fluctuations and to produce short-term forecasts of incidence trends. RESULTS: From 2005 to 2024, a total of 23,813 echinococcosis cases were reported in Xinjiang, with an average annual incidence of 5.48 per 100,000 population. Incidence increased significantly from January 2005 to August 2016 (β = 0.0026 per 100,000 per month, P < 0.001), with an immediate increase observed in September 2016 (0.2265 per 100,000, P < 0.05), and then declined significantly through December 2024 (β = -0.0069 per 100,000 per month, P < 0.001). Spatial clustering was observed in the Ili and Altay regions. Incidence increased and then decreased across sex and age groups, with larger declines among males. Significant reductions were observed in the 15-44 and ≥ 45 year groups, but not in the 0-14 year group. The optimal first-stage model was SARIMA(1,1,0)(2,0,0)₁₂, and the second-stage model was SARIMA(0,1,1)(1,0,2)₁₂. The second-stage model produced a relative prediction error of - 14.06% and projected 1,040 cases in 2025. CONCLUSION: Echinococcosis incidence in Xinjiang demonstrated a temporal increase followed by a sustained decline, with pronounced spatial heterogeneity across regions. Despite inherent uncertainty, SARIMA-based projections offer evidence to strengthen early warning systems and guide region-specific control strategies.
Disease risk perception, health intervention intention and their influencing factors among prehypertensive and hypertensive populations: a cross-sectional study with 1050 participants.
Zhang J, Liu J, Xu J … +4 more , Tang F, Xu Y, Zeng Z, Wan J
BMC Public Health · 2026 Jun · PMID 42351033 · Full text
BACKGROUND: Prehypertension and hypertension are major modifiable cardiovascular risk factors that impose a substantial global public health burden. Disease risk perception and health beliefs are critical determinants of...
BACKGROUND: Prehypertension and hypertension are major modifiable cardiovascular risk factors that impose a substantial global public health burden. Disease risk perception and health beliefs are critical determinants of health behaviors, yet few studies have compared the heterogeneous patterns influencing intervention intention between prehypertensive and hypertensive individuals. OBJECTIVE: To compare differences in health cognition, health beliefs, lifestyle behaviors, and intervention intention between prehypertensive and hypertensive groups, and to explore heterogeneous predictors of intervention intention to inform targeted prevention strategies. METHODOLOGY: A cross-sectional study enrolled 1050 adults (525 prehypertensive, 525 hypertensive) via convenience sampling from community centers and hypertension clinics (January-December 2025). Questionnaires included demographic characteristics, lifestyle behaviors, Health Belief Model (HBM) scales, and intervention intention. Data were analyzed using SPSS 25.0 with t-tests, χ² tests, correlation analyses, and multivariate logistic regression. RESULTS: Hypertensive patients were older, had more comorbidities, higher perceived severity, better lifestyle behaviors, and stronger intervention willingness (all P < 0.001). Lifestyle behaviors were positively correlated with intervention intention (r = 0.533, P < 0.01). Universal predictors included family history of hypertension, lifestyle behaviors, perceived severity, and health motivation (all P < 0.05). Prehypertensive individuals were primarily predicted by lifestyle behaviors (OR = 1.533, P < 0.001) and health motivation (OR = 1.398, P = 0.001); hypertensive patients by self-efficacy (OR = 1.464, P < 0.001), perceived susceptibility (OR = 1.163, P = 0.029), and lifestyle (OR = 1.089, P = 0.012). The prehypertension model had the highest explanatory power (Nagelkerke R²=0.849). CONCLUSIONS: Significant differences exist in health cognition, health beliefs, and intervention willingness between groups. Lifestyle behaviors serve as universal predictors of intervention intention, whereas disease perception factors play a more critical role among hypertensive patients. Targeted strategies-lifestyle optimization for prehypertension and self-efficacy enhancement for hypertension-are needed to improve self-management and reduce cardiovascular risk.
Community gardening as a conduit for bolstering wellbeing, employment, education and volunteering in vulnerable communities: a feasibility study.
Tracey D, Gray T, Pigott F
BMC Public Health · 2026 Jun · PMID 42351023 · Full text
BACKGROUND: Growing evidence promotes community gardening as an effective community-based initiative to enhance the wellbeing of community members, including those considered vulnerable. Whilst this expanding evidence-ba...
BACKGROUND: Growing evidence promotes community gardening as an effective community-based initiative to enhance the wellbeing of community members, including those considered vulnerable. Whilst this expanding evidence-base is encouraging, little is known about the feasibility of community gardening thus limiting its scalability. METHODS: The current mixed-method study assesses the feasibility, acceptability and implementation of the Community Greening program delivered in vulnerable communities in New South Wales, Australia. Data was gathered from 33 survey participants, 39 interview participants, and case notes from seven sites. RESULTS: Findings demonstrate that participants have particular needs in wellbeing and employment outcomes, especially for those with reported disability. Attendance is variable with identified enablers and barriers. Satisfaction with the program is evident with suggestions for improvements. Finally, fidelity of implementation is strong, with an opportunity to increase community-led workshops, and enhance future implementation informed by the reported enablers and barriers. CONCLUSIONS: With the positive impact of community gardening now established, findings guide how we effectively resource and sustainably implement programs with the fidelity required to realise their potential. TRIAL REGISTRATION: N/A.
Translational applications of artificial intelligence and machine learning for mosquito-borne disease control in low- and middle-income countries.
Ohia CMD, Jannatkhah M, Ahmad T
Public Health · 2026 Jun · PMID 42349209 · Publisher ↗
OBJECTIVES: To synthesize evidence on the application of artificial intelligence (AI) and machine learning (ML) for mosquito-borne disease (MBD) control in low- and middle-income countries (LMICs), with emphasis on trans...
OBJECTIVES: To synthesize evidence on the application of artificial intelligence (AI) and machine learning (ML) for mosquito-borne disease (MBD) control in low- and middle-income countries (LMICs), with emphasis on translational integration into routine public health decision-making systems. STUDY DESIGN: Structured narrative review. METHODS: Peer-reviewed studies published between 2010 and 2025 were identified from PubMed, Scopus, and Google Scholar using predefined search terms combining mosquito-borne diseases, AI/ML techniques, and LMIC relevance. Studies were included if they applied AI/ML to surveillance, outbreak prediction, vector monitoring, diagnostics, or intervention planning in LMIC contexts. Evidence was thematically synthesized and qualitatively appraised for translational readiness, implementation feasibility, and public health relevance. RESULTS: AI/ML applications demonstrate strong technical performance in outbreak forecasting, mosquito species identification, spatial risk mapping, and microscopy-based malaria diagnostics. However, approximately half of identified studies focus on surveillance and forecasting, while fewer address intervention optimization or policy integration. Most applications remain proof-of-concept, relying on retrospective datasets with limited prospective validation, cost-effectiveness evaluation, or sustained embedding within national health systems. Translational bottlenecks are most pronounced between model validation and real-world deployment. CONCLUSIONS: AI/ML holds meaningful potential to strengthen MBD control in LMICs when embedded within integrated digital public health systems. Advancing translational impact will require investments in interoperable data infrastructure, local technical capacity, ethical governance frameworks, and implementation science to ensure scalable, sustainable, and policy-aligned deployment.
COVID-19-related disruptions and measles vaccination uptake among children attending urban health centers in Guelmim, Morocco: a cross-sectional study.
Asraoui A, Soulaymani A
BMC Public Health · 2026 Jun · PMID 42343352 · Full text
BACKGROUND: The COVID-19 pandemic disrupted routine immunization services and may have widened measles immunity gaps. Morocco has experienced a widespread measles outbreak since late 2023. This study assessed the associa...
BACKGROUND: The COVID-19 pandemic disrupted routine immunization services and may have widened measles immunity gaps. Morocco has experienced a widespread measles outbreak since late 2023. This study assessed the association between COVID-19-related disruptions and measles vaccination uptake among children in Guelmim, Morocco, and described additional informational and access barriers. METHODS: A descriptive cross-sectional study was conducted from March to May 2025 in three urban public health centers in Guelmim. Using an interviewer-administered questionnaire, data were collected from 350 mothers of children aged 0-59 months. Descriptive statistics and Pearson's chi-square tests were used to examine associations between child measles vaccination status and COVID-19-related, informational, and access-related factors. RESULTS: Only 44.29% of children were reported as vaccinated against measles. Lower uptake was significantly associated with delaying child vaccination during COVID-19 (27.27% vaccinated vs. 69.61% among those reporting no delay; p < 0.001), missing a measles dose during the pandemic (28.64% vs. 67.96%; p < 0.001), insufficient vaccine information (28.19% vs. 73.98%; p < 0.001), lack of trust in vaccines offered by the public health system (28.29% vs. 68.92%; p < 0.001), difficulty accessing vaccination services (35.88% vs. 69.32%; p < 0.001), and lack of information on post-pandemic vaccination dates (25.00% vs. 68.83%; p < 0.001). Receipt of a measles catch-up dose was strongly associated with vaccination uptake (82.79% among those receiving catch-up; p < 0.001). CONCLUSIONS: In this urban sample, measles vaccination uptake was low and was associated with both COVID-19-related service disruptions and broader informational, trust, and access barriers. Strengthening catch-up activities, service communication, and trust-building strategies may help close immunity gaps in similar settings.
A global scoping review of interventions to increase participation in screening programmes for breast, cervical and colorectal cancer between 2016 and 2025.
Kigongo E, Heaney C, McBride L … +2 more , Gliga G, Burns RM
BMC Public Health · 2026 Jun · PMID 42343351 · Full text
BACKGROUND: Implementation of timely and targeted health screening programmes is strongly aligned with the United Nations Sustainable Development Goals (SDGs) in promoting prevention, early detection, and timely interven...
BACKGROUND: Implementation of timely and targeted health screening programmes is strongly aligned with the United Nations Sustainable Development Goals (SDGs) in promoting prevention, early detection, and timely intervention across populations. However, participation in breast, cervical, and colorectal cancer screening remains suboptimal and inequitable, and is increasingly challenged. This review synthesised global evidence on implementation interventions aimed at increasing screening participation and reducing disparities, to identify gaps that must be addressed to achieve screening targets. METHODS: This scoping review was conducted and reported in accordance with PRISMA-ScR and the Joanna Briggs Institute methodological guidance. The Consolidated Framework for Implementation Research (CFIR) was used to extract and synthesise barriers and facilitators, while the RE-AIM framework for the performance of interventions. We used descriptive quantitative methods and a hybrid (deductive-inductive) thematic analysis to summarise and interpret the evidence. RESULTS: One hundred ten studies were included and identified ten intervention categories: educational, reminders, self-sampling, outreach, peer education and counselling, quality improvement, promotional messages, patient navigation and tracking, mass media, and multicomponent interventions. Barriers and facilitators to screening participation were assessed using the CFIR framework, while intervention performance was synthesised using RE-AIM components. Although most interventions demonstrated promising effectiveness, multicomponent interventions showed the greatest impact. However, most interventions were implemented in highly controlled settings, limiting their real-world applicability and scalability. CONCLUSION: Findings revealed important gaps in culturally responsiveness and real-world intervention approaches for cancer screening. Future research should prioritise pragmatic, culturally appropriate, and multiple component interventions, supported by sufficiently long follow-up periods to assess sustainability and real-world effectiveness.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe