BMC Public Health [JOURNAL]
Sun
200 papers
Prevalence and factors associated with psychological aggression and physical punishment among children aged 12 to 59 months in Malaysia: findings from the National Health and Morbidity Survey 2022.
Rosslan NH, Ganapathy SS, Bakri MH … +1 more , Yoep N
BMC Public Health · 2026 Jun · PMID 42343305 · Full text
INTRODUCTION: Psychological aggression and physical punishment remain common disciplinary practices globally, despite evidence of their adverse effects on child development. This study investigated the prevalence and ass...
INTRODUCTION: Psychological aggression and physical punishment remain common disciplinary practices globally, despite evidence of their adverse effects on child development. This study investigated the prevalence and associated factors of these practices among children aged 12 to 59 months in Malaysia. METHOD: Data were obtained from the National Health and Morbidity Survey (NHMS) 2022, a nationally representative cross-sectional study employing a two-stage stratified random sampling design. The primary respondents were caregivers of children aged 12-59 months. Psychological aggression was defined as being scolded in a harsh tone or using hurtful names, while physical punishment was defined as actions intended to cause pain, such as shaking the child, spanking, or hitting them with a hand or object like a cane. These actions were measured based on occurrences within the past month intended to correct behaviour. Disciplinary practice data were collected through face-to-face interviews using a validated questionnaire adapted from the Multiple Indicator Cluster Survey (MICS). Prevalence estimates with 95% confidence intervals (CI) were generated, and adjusted prevalence ratios (aPR) with 95% CI were obtained using design-adjusted Poisson regression with robust variance. RESULTS: Among the 13,288 respondents, the prevalence of psychological aggression was 58.3% (95% CI: 55.9-60.6) and of physical punishment was 40.7% (95% CI: 38.4-43.0). Older children were significantly more likely to experience both forms of discipline. In adjusted models, compared with children aged 12-23 months, children aged 48-59 months had higher prevalence of psychological aggression (aPR 1.44, 95% CI: 1.33-1.56) and physical punishment (aPR 1.48, 95% CI: 1.31-1.69). Boys had higher adjusted prevalence of physical punishment than girls (aPR 1.13, 95% CI: 1.05-1.21). CONCLUSION: Harsh disciplinary practices remain common. Integration of evidence-based positive parenting programmes into maternal and child health services and community-based support platforms is recommended.
Insufficient mpox knowledge among public health professionals involved in infectious disease prevention and control in China: a large-scale online cross-sectional survey.
Hua M, Zhu W, Chen Z … +7 more , Wu Y, Liang S, Xie Y, Yue X, Li J, Zhang J, Gong X
BMC Public Health · 2026 Jun · PMID 42343300 · Full text
BACKGROUND: The World Health Organization has declared mpox a Public Health Emergency of International Concern twice. In China, public health professionals (PHPs) involved in infectious disease prevention and control are...
BACKGROUND: The World Health Organization has declared mpox a Public Health Emergency of International Concern twice. In China, public health professionals (PHPs) involved in infectious disease prevention and control are responsible for mpox control, case reporting, and health communications during outbreaks. This study aimed to assess mpox knowledge and factors associated with sufficient mpox knowledge among PHPs in China. METHODS: This study analyzed PHPs involved in infectious disease prevention and control from a large-scale online cross-sectional survey of healthcare workers conducted through a nationwide platform. An e-questionnaire was used to collect data on demographic and institutional characteristics, attention to mpox, mpox information sources, training history and 37 mpox knowledge items covering etiology, clinical features, transmission, and prevention. Univariable and multivariable logistic regression analyses were performed to identify factors associated with sufficient mpox knowledge. RESULTS: A total of 1,601 PHPs from 28 of 31 provincial-level regions in China completed the survey, and 1,568 valid responses were included. Among the 1,568 PHPs, 91.3% (1,432/1,568) were aware of mpox, and 61.7% (967/1,568, 95% CI: 59.3%-64.1%) had sufficient mpox knowledge. 44.6% (95% CI: 42.1%-47.0%), 74.2% (95%CI: 72.1%-76.4%) and 47.0% (95% CI: 44.5%-49.5%) PHPs aware of mpox had sufficient knowledge regarding etiology, clinical features and transmission and prevention, respectively. Multivariable logistic regression analysis showed that the associated factors with sufficient mpox knowledge included gender (female: OR = 1.34, 95% CI: 1.03-1.74), professional title (intermediate: OR = 1.85, 95% CI: 1.40-2.45, senior: OR = 2.05, 95% CI: 1.44-2.91), institution (CDC: OR = 2.07, 95% CI: 1.60-2.67), attention toward mpox (occasional: OR = 2.59, 95% CI: 1.72-3.90; daily/frequent: OR = 3.70, 95% CI: 2.39-5.73), mpox information sources (two sources: OR = 1.51, 95% CI: 1.14-2.00; three or more sources: OR = 1.77, 95% CI: 1.31-2.39), and training (OR = 2.44, 95% CI: 1.89-3.15). CONCLUSION: This study found insufficient mpox knowledge among the surveyed PHPs involved in infectious disease prevention and control across multiple regions of China, especially among males, those with junior professional titles, limited information access, low attention to mpox, no prior training, and hospital-based staff. Targeted training, continuing education, and multi-channel information dissemination should be strengthened to support mpox preparedness among frontline PHPs.
Association between road safety awareness and motorcycle riding behaviors with road traffic crashes among Thai university students: a cross-sectional study.
Chautrakarn S, Jaiprom E, Thongduang K … +1 more , Ong-Artborirak P
BMC Public Health · 2026 Jun · PMID 42343290 · Full text
BACKGROUND: Young people, particularly university students, are at significant risk of motorcycle accidents. This study aimed to investigate road safety awareness and motorcycle riding behavior, and their association wit...
BACKGROUND: Young people, particularly university students, are at significant risk of motorcycle accidents. This study aimed to investigate road safety awareness and motorcycle riding behavior, and their association with road traffic crashes among Thai university students. METHODS: In this cross-sectional study, 854 university students who rode motorcycles at least three times per week completed an online self-administered survey. The questionnaire included self-reported road traffic crashes during the past year, basic knowledge of traffic regulations, road safety awareness, and motorcycle riding behavior. RESULTS: The prevalence of road traffic crashes in the past year was 28.7%. The mean scores for road safety awareness and motorcycle riding behavior were 80.44 ± 9.93 and 88.72 ± 8.25 (out of 100), respectively. Multiple logistic regression analysis showed that road traffic crashes were inversely associated with road safety awareness and motorcycle riding behavior scores (per 10-point increase) after adjusting for confounders (AOR = 0.823, 95% CI: 0.705-0.961 and AOR = 0.811, 95% CI: 0.675-0.975, respectively). When the presence of unsafe riding behaviors was categorized by domains, road traffic crashes were significantly associated with traffic law violations (AOR = 1.530, 95% CI: 1.012-2.313) and driving under the influence of alcohol or drugs (AOR = 1.695, 95% CI: 1.244-2.311). CONCLUSIONS: The findings highlight the need for integrated road safety interventions, including education, behavioral change strategies, and traffic law enforcement, to enhance safe riding practices among university students and reduce traffic-related injuries.
Association of combined healthy lifestyle factors with the risk of metabolic dysfunction-associated steatotic liver disease: the Korean National Health and Nutrition Examination Survey 2016-2021.
Jeong NN, Lim HJ, Kim WH … +1 more , Kim MJ
BMC Public Health · 2026 Jun · PMID 42343286 · Full text
BACKGROUND: Lifestyle factors strongly affect the prevention and improvement of liver-related outcomes. However, the relationship between combined lifestyle factors and metabolic dysfunction-associated steatotic liver di...
BACKGROUND: Lifestyle factors strongly affect the prevention and improvement of liver-related outcomes. However, the relationship between combined lifestyle factors and metabolic dysfunction-associated steatotic liver disease (MASLD) has not been comprehensively evaluated. Therefore, this study aimed to investigate the association between a combination of healthy lifestyle factors and MASLD in Korean adults. METHODS: This study analyzed data from 23,111 participants aged 19-80 years who were enrolled in the Korean National Health and Nutrition Examination Survey (2016-2021). A healthy lifestyle was defined based on four factors including diet quality, physical activity, smoking, and sleep duration. Participants were divided into three groups based on healthy lifestyle score ranging from 0 to 4. MASLD was defined as having both hepatic steatosis index ≥ 36 and cardiometabolic risk factor ≥ 1. Multivariate logistic regression analysis was conducted to identify the associations between healthy lifestyles and the risk of MASLD. Additional analyses were conducted based on the combination of lifestyle factors. RESULTS: The weighted prevalence of MASLD was 24.1%, with the highest rates observed in participants with an unfavorable lifestyle. The protective effect against the risk of MASLD increased with the number of lifestyle factors. Compared to individuals in the unfavorable lifestyle group, the multivariate-adjusted odds ratio for MASLD was 0.825 (95% confidence interval [CI], 0.728-0.935) for the intermediate lifestyle group and 0.714 (95% CI, 0.621-0.820) for the favorable lifestyle group. A significant association was found among individuals with combinations of healthy lifestyle factors, and the lowest risk was observed in those with combined diet, physical activity, and smoking, with an odds ratio of 0.680 (95% CI, 0.544-0.848). CONCLUSIONS: In this study, healthy lifestyle factors were inversely associated with MASLD risk. However, due to the cross-sectional design, causal relationships cannot be established, and future longitudinal studies are warranted to confirm these associations. From a public health perspective, our findings support the importance of promoting healthy lifestyle behaviors, particularly smoking cessation and regular physical activity, as potential strategies for MASLD prevention.
Prevalence of myopia among 26,697 school-aged children and adolescents in Taiyuan.
Zhang X, Wang C, Su Q … +3 more , Yan Z, Ma R, Li C
BMC Public Health · 2026 Jun · PMID 42343283 · Full text
PURPOSE: Investigation and analysis of the current status and influencing factors of vision screening-detected myopia among school-aged children and adolescents in primary, junior high, and senior high schools across var...
PURPOSE: Investigation and analysis of the current status and influencing factors of vision screening-detected myopia among school-aged children and adolescents in primary, junior high, and senior high schools across various urban districts of Taiyuan, the capital city of Shanxi Province, to provide directions and recommendations for myopia prevention and control in the region. METHODS: A cross-sectional survey study was conducted in March 2025, involving a total of 26,697 primary, junior high, and senior high school students in Taiyuan. Data were collected through questionnaires and non-cycloplegic autorefraction. RESULTS: The overall screening prevalence of myopia among school-aged children and adolescents in Taiyuan City was 81.8%. The prevalence of myopia was significantly lower in males than in females (χ² = 45.57, P < 0.001).The screening myopia prevalence rates were 71.0% in primary school, 90.4% in junior high school, and 94.4% in senior high school, while the high myopia prevalence rates were 1.7%, 9.6%, and 17.2%, respectively. In primary and junior high schools, the detection rate of myopia was significantly higher in females than in males (χ² = 15.32 and 17.41; P < 0.001). However, in senior high school, the detection rate of myopia was similar between females and males (χ² = 3.57; P > 0.05).At the primary, junior high, and senior high school levels, female students exhibited a significantly higher degree of SER than male students (P < 0.05).The higher prevalence of both myopia and high myopia was significantly associated with the following factors: prolonged near-work duration (≥ 12 h per day, OR = 1.43), insufficient near-work distance, and parental myopia (at least one parent with myopia, OR = 4.02). CONCLUSIONS: In 2025, the screening-detected prevalence of myopia and high myopia among school-aged children and adolescents in Taiyuan City, Shanxi Province, was notably high. This phenomenon was associated with factors such as near work activities and parental myopia. Furthermore, the detection rate of myopia exhibited an increasing trend with advancing educational stages, and the overall prevalence of myopia was higher in females than in males.
Caregivers' knowledge, attitudes, and practices toward pediatric dry eye disease: a cross-sectional study.
Wang W, Zhao H, Zeng Y … +2 more , Shi M, Chen Y
BMC Public Health · 2026 Jun · PMID 42343271 · Full text
BACKGROUND: This study aimed to investigate caregivers' knowledge, attitudes, and practices (KAP) concerning pediatric dry eye disease. METHODS: This cross-sectional study was conducted at the Pediatric Ophthalmology Out...
BACKGROUND: This study aimed to investigate caregivers' knowledge, attitudes, and practices (KAP) concerning pediatric dry eye disease. METHODS: This cross-sectional study was conducted at the Pediatric Ophthalmology Outpatient Department of Yuxi People's Hospital between December 2023 and April 2024. Demographic data and KAP scores were collected through questionnaires. RESULTS: A total of 515 valid questionnaires were collected. Of these, 393 respondents (76.31%) were mothers of the children, and 319 children (61.94%) had suffered from dry eye for less than three months. The participants' mean knowledge, attitude, and practice scores were 7.57 ± 4.14 (possible range: 0-18), 36.76 ± 3.51 (possible range: 9-45), and 40.99 ± 7.13 (possible range: 11-55), respectively. Knowledge, attitude, and practice scores were significantly correlated with each other (all P < 0.001). Mediation analysis showed that knowledge (β = 0.19, P < 0.001), income (β = 0.75, P < 0.001), and marital status (β = 1.63, P = 0.001) were statistically associated with attitude. Meanwhile, knowledge (β = 0.51, P < 0.001), attitude (β = 0.55, P < 0.001), and residence (β = 1.51, P < 0.001) were statistically associated with practice. Further, knowledge (β = 0.10, P < 0.001), income (β = 0.38, P < 0.001), marital status (β = 0.83, P = 0.004) showed statistically modeled indirect associations with practice within the specified mediation framework. CONCLUSIONS: This study revealed that caregivers exhibit inadequate knowledge but generally positive attitudes and moderately adequate yet inconsistent practices towards pediatric dry eye disease. The findings suggest that targeted educational programs may help address caregivers' knowledge gaps and support more appropriate management practices for pediatric dry eye disease.
Heat-related illness symptoms among migrant farmworkers: a systematic literature review and meta-analysis.
van Selm L, Williams S, Elafef E … +5 more , Marti-Soler H, Vecchi S, de'Donato F, De Sario M, Requena-Méndez A
BMC Public Health · 2026 Jun · PMID 42343263 · Full text
BACKGROUND: Farmworkers are at risk for heat-related illnesses (HRI) due to intensifying heat exposure resulting from climate change. Migrant farmworkers might be at further increased risk due to limited control over wor...
BACKGROUND: Farmworkers are at risk for heat-related illnesses (HRI) due to intensifying heat exposure resulting from climate change. Migrant farmworkers might be at further increased risk due to limited control over workplace conditions and language and cultural barriers. This systematic literature review and meta-analysis aims to assess the global prevalence of self-reported heat-related illnesses among migrant farmworkers. METHODS: We searched five databases for peer-reviewed literature and additional sources to capture grey literature in any language up to October 2024. Studies providing self-reported heat-related symptoms among migrant farmworkers were included. A random effects model was used to calculate the pooled proportion of individual and combined heat-related health outcomes. Separate pooled estimates were included for each symptom as well as the number of symptoms. Risk of bias was assessed using the JBI quality assessment tool. RESULTS: Seventeen papers were included, including data from 2966 migrant farmworkers. The pooled proportion for having at least one HRI symptom was 52% (95%CI 39-65) and 21% (95%CI 4-44) reported at least three HRI symptoms. Heterogeneity was high across all pooled estimates (I² ranging from 83% to 99%). The most common symptoms were extreme sweating (46%), weakness (45%), and headache (36%). No differences were found between internal and international migrants nor between studies asking about HRI symptoms experienced in a short-term (e.g., the past week) versus longer periods. DISCUSSION AND CONCLUSION: Migrant farmworkers reported a high proportion of HRI symptoms. Standardized HRI symptom questionnaires and physiological monitoring can aid in early detection to prevent more serious health issues, allow comparison across settings, and support interventions to mitigate heat-related occupational health risks.
Dyslipidemia in Lebanese children and adolescents: parents' knowledge and practices.
Hamadeh K, Boulos M, Atallah B … +4 more , Hamdan MB, Maddah D, Ghorayeb N, Yared MG
BMC Public Health · 2026 Jun · PMID 42343240 · Full text
BACKGROUND: Pediatric dyslipidemia is a common metabolic disorder worldwide, especially in Lebanon, and is an early risk factor for cardiovascular disease. Parents play a crucial role in prevention, screening, and manage...
BACKGROUND: Pediatric dyslipidemia is a common metabolic disorder worldwide, especially in Lebanon, and is an early risk factor for cardiovascular disease. Parents play a crucial role in prevention, screening, and management, but their knowledge and practices remain poorly studied. METHODS: A cross-sectional questionnaire-based study was conducted between March and November 2025 among parents of school-aged children from eight schools in Greater Beirut and Mount Lebanon. An electronic questionnaire was used to collect sociodemographic data and to assess parents' knowledge (using a composite score) and practices regarding dyslipidemia. Factors associated with knowledge levels and their relationship with parental practices were also examined. RESULTS: A total of 946 parents were included (861 women and 85 men) with a mean age of 43.9 ± 6.2 years, 94.1% had a university education, and 11.6% were healthcare professionals. Among them, 42.4% had heard of pediatric dyslipidemia, mainly through the media (25.2%) and healthcare professionals (24.4%). The mean knowledge score was 14.1 ± 4.4 out of 23. Blood test-based lipid screening for dyslipidemia in children had been performed by only 6.7% of parents. The independent determinants of a higher knowledge score were female gender, university education, healthcare professional status, and having heard of pediatric dyslipidemia (p < 0.001, p = 0.007, p < 0.001, p < 0.001, respectively). In addition, higher knowledge scores were significantly associated with favorable preventive practices, including implementation of healthy eating habits (p = 0.02) and lipid screening in children (p < 0.001). CONCLUSION: Parents demonstrated moderate knowledge levels. The association between knowledge level and the adoption of favorable preventive measures suggests that educational campaigns targeting parents and health care professionals could play a role in promoting healthier practices.
The relationship between occupational balance and physical activity level, physical fitness, and body composition in older adults.
Elmas Ö, Cemali M
BMC Public Health · 2026 Jun · PMID 42337733 · Full text
OBJECTIVES: The aim of this study is to compare occupational balance, physical fitness, and body composition parameters according to physical activity levels in older adults and to examine the relationships between occup...
OBJECTIVES: The aim of this study is to compare occupational balance, physical fitness, and body composition parameters according to physical activity levels in older adults and to examine the relationships between occupational balance and other variables. METHODS: This cross-sectional study included a total of 150 older adults aged 65-75 years. Participants were classified according to their International Physical Activity Questionnaire-Short Form (IPAQ-SF) scores as inactive (n = 51), minimally active (n = 50), and active (n = 49). Occupational balance was assessed using the Occupational Balance Questionnaire-11 Turkish (OBQ11-T). Physical fitness level was assessed using the Timed Up and Go Test (TUG) and hand grip strength measured with a Jamar dynamometer (Sammons Preston, USA). For body composition assessment, skeletal muscle mass and body mass index (BMI) were measured using an InBody 120 device (InBody Co., Ltd., Seoul, Korea). Occupational balance, physical fitness, and body composition parameters were compared among older adults according to their physical activity levels. In addition, the relationships between occupational balance, physical activity, physical fitness, and body composition were examined in all participants. RESULTS: According to IPAQ-SF classification, significant differences were found in occupational balance, physical fitness, and body composition among inactive, minimally active, and active older adults (p < 0.001). Older adults with higher levels of physical activity demonstrated higher occupational balance, greater hand grip strength, greater skeletal muscle mass, shorter TUG durations, and lower BMI values. Regression model results showed that physical activity level, functional mobility, and skeletal muscle mass together explained approximately 52% of the total variation in occupational balance level (Adjusted R² = 0.520). In addition, physical activity level, TUG duration, and skeletal muscle mass were found to be independently associated with OBQ11-T scores (p < 0.05). CONCLUSION: Older adults with higher levels of physical activity were found to have higher occupational balance levels, hand grip strength, functional mobility, and skeletal muscle mass, while their BMI values were lower. Furthermore, physical activity level, functional mobility, and skeletal muscle mass were found to be significantly associated with occupational balance. The findings indicate that occupational balance is an important parameter that should be assessed in older adults along with physical health, physical fitness, and activity participation.
Algorithmic recommendation and adolescent mental health: a grounded theory study of social and commercial determinants.
Winstone L, Parsonage J, Cross L … +5 more , Muir C, Randhawa A, MacArthur G, Garavini E, Asiedu-Addo E
BMC Public Health · 2026 Jun · PMID 42337729 · Full text
BACKGROUND: Existing digital mental health research tends to frame social media in individualistic terms, emphasising screen-time, self-control, or personal vulnerability. Less attention has been given to the role of alg...
BACKGROUND: Existing digital mental health research tends to frame social media in individualistic terms, emphasising screen-time, self-control, or personal vulnerability. Less attention has been given to the role of algorithmic recommendation systems in population mental health. We aimed to develop a grounded theory of how adolescents experience algorithmically curated feeds and how these experiences relate to mental health and wellbeing. METHODS: We conducted semi-structured, photo-elicitation interviews with 27 UK young people aged 14-19 years. Participants shared screenshots from their TikTok 'For You' and Instagram 'Explore' pages to support discussion of algorithmically recommended content. Data were analysed using constructivist grounded theory, with iterative coding, memo-writing, and theoretical sampling. RESULTS: We identify algorithmically structured exposure as a central mechanism through which engagement-driven recommendation systems shape young people's digital mental health. Algorithms organised what content participants encountered, how frequently, and with what emotional intensity, within broader socioecological contexts. Three interlocking processes sustained exposure; algorithmic reinforcement of engagement, emotional feedback loops between mood and recommendations, and a persistent sense of limited control despite high awareness. Although participants developed adaptive strategies and algorithmic literacy, these were unevenly distributed and often insufficient within engagement-driven, profit-oriented systems. CONCLUSIONS: Digital mental health may be produced through interactions between individual capacities, social environments, and commercially driven platform design. Protecting population mental health therefore requires multi-level action, including developmentally appropriate social media and algorithmic literacy education alongside structural reforms to recommendation systems, transparency, and platform governance.
Navigating sexuality information: A comparative study on the actual and preferred sources by young people in Uganda's island communities.
Kirwana VB, Kabagenyi A, Ndugga P … +3 more , Misinde C, Wandera SO, Kakuba C
BMC Public Health · 2026 Jun · PMID 42337715 · Full text
BACKGROUND: Young people's access to sexuality information plays a central role in shaping sexual behaviour. Sexuality information comes from various sources, yet young people often lack access to their preferred and tru...
BACKGROUND: Young people's access to sexuality information plays a central role in shaping sexual behaviour. Sexuality information comes from various sources, yet young people often lack access to their preferred and trusted sources. This paper examined the gap between actual and preferred sources of sexuality information, critical for inclusive and responsive interventions in the underserved, yet high-risk settings. METHODS: A cross-sectional mixed-methods study, guided by the Information-Motivation-Behavioral Skills (IMB) and bioecological models, was conducted among young people aged 10-24 years in Kkoome islands communities. A survey of 569 young people and six focus group discussions were conducted. McNemar tests were used to compare differences between actual and preferred sources of sexuality information by topic, and the rationale for preference was analyzed thematically. RESULTS: Significant differences (p < 0.001) were observed between actual and preferred sources across all sources. Books and recordings were consistently among the most preferred sources (48.2%-49.2%) despite minimal actual use (0.2%-0.4%), while healthcare workers were highly preferred for human body development (46.6% vs. 15.1%) and pregnancy, HIV, and STIs (47.3% vs. 16.2%) topics. Biological parents, teachers, and friends/confidants were also preferred significantly more than they were accessed (all p < 0.001). For higher preference, young people valued privacy, emotional comfort, flexibility, accuracy, and trust in books and recordings; professional expertise and structured guidance from healthcare workers and teachers; and accessibility and emotional support from parents and other close social networks, consistent with the IMB constructs. CONCLUSION: The pronounced mismatch between young people's actual and preferred sources of sexuality information indicates a substantial unmet demand for trusted, structured, and young people-responsive sexuality information and education in Uganda's island communities. Strengthening access to books and recordings, the capacity of healthcare workers, and parents to provide sexuality information, and aligning interventions with IMB components may enhance informed decision-making and improve sexual and reproductive health outcomes among young people in high-risk and underserved settings.
Factors associated with COVID-19 preventive behaviors among patients with hypertension and type 2 diabetes in southern Iran: a structural equation modeling study.
Shamsnia SA, Mobasheri N, Kaveh MH … +2 more , Nazari M, Karimi M
BMC Public Health · 2026 Jun · PMID 42337710 · Full text
BACKGROUND: During the transitional phase of the COVID-19 pandemic-when vaccines were available but coverage remained low-individuals with chronic diseases such as hypertension and type 2 diabetes faced elevated risks, y...
BACKGROUND: During the transitional phase of the COVID-19 pandemic-when vaccines were available but coverage remained low-individuals with chronic diseases such as hypertension and type 2 diabetes faced elevated risks, yet their adherence to nonpharmaceutical preventive behaviors was uneven, and the psychological determinants of this variability remained unclear. This study examined the HBM constructs as correlates of COVID-19 preventive behaviors among this high-risk population in southern Iran. METHODS: A cross-sectional survey was conducted among 338 patients (mean age = 43.83 ± 9.79 years) in Kavar, Iran, using a validated HBM-based questionnaire (CVR > 0.6, CVI > 0.79, Cronbach's α = 0.65-0.92). Structural equation modeling (SEM) was performed using AMOS 24. RESULTS: SEM demonstrated good fit (χ/df = 1.46, CFI = 0.995, RMSEA = 0.037). Perceived barriers exerted the strongest negative association with preventive behaviors (β = -0.311, p < 0.001). Perceived severity (β = 0.206) and cues to action (β = 0.203) were significant positive factors. Perceived benefits (β = 0.150) had a modest positive association, while perceived susceptibility and self-efficacy were nonsignificant. CONCLUSION: Among the studied diabetic and hypertensive patients, practical and psychological barriers- not lack of knowledge or risk awareness-were the primary determinants of behavior. The non-significance of perceived susceptibility and self-efficacy may suggest that due to the prolonged nature of the COVID-19 pandemic, behavior was more heavily influenced by persistent structural barriers than by individual beliefs or confidence. Public health interventions should therefore prioritize reducing access-related, financial, and sociocultural barriers (e.g., mask affordability, misinformation) rather than solely promoting risk perception. These findings may offer actionable insights for epidemic preparedness strategies in similar regional low-resource settings, though validation across diverse contexts remains important.
Circadian syndrome and its components in relation to incident gastroesophageal reflux disease: a prospective cohort study from the UK Biobank.
Lu H, Wu Z, Zhou X … +5 more , Yang W, Lv Y, Shi J, Zheng Y, Ji R
BMC Public Health · 2026 Jun · PMID 42337586 · Full text
BACKGROUND: Circadian Syndrome (CircS), a cluster encompassing metabolic dysregulation, short sleep duration, and depression, has been implicated in various chronic diseases. Gastroesophageal reflux disease (GERD) is a h...
BACKGROUND: Circadian Syndrome (CircS), a cluster encompassing metabolic dysregulation, short sleep duration, and depression, has been implicated in various chronic diseases. Gastroesophageal reflux disease (GERD) is a highly prevalent digestive disorder; however, its prospective association with CircS remains unclear. METHODS: This prospective cohort study utilized data from the UK Biobank, including 330,925 participants free of GERD at baseline. CircS was defined as meeting at least four of seven components. The primary outcome was incident GERD, identified through the first recorded diagnosis code from linked hospital, primary care, death registry, and self-report data. Cox proportional hazards models were used to estimate hazard ratios with sequential adjustments for demographics, socioeconomic status, lifestyle factors, and medication use. RESULTS: Over a median follow-up of 13.05 years, 28,554 incident GERD cases were documented. In the fully adjusted model, CircS was associated with a significantly increased risk of GERD (HR = 1.20; 95% CI: 1.16-1.23). All seven individual components were each associated with GERD risk in separate fully adjusted models, with the strongest associations observed for depression (HR = 1.38) and short sleep (HR = 1.29). A significant dose-response relationship was evident as the number of components increased. Subgroup analyses revealed stronger associations among individuals aged under 65 years, women, non-White participants, and those not using proton pump inhibitors. CONCLUSIONS: Circadian Syndrome is independently associated with incident GERD, with depression and short sleep as core driving components. These findings support the integration of circadian, metabolic, and psychological health assessments into GERD risk stratification.
Staying active, staying satisfied: how subjective well-being shapes ageing after retirement.
Lee GM, Hong J, Hwang YS … +3 more , Lee H, Lee H, Kim JH
BMC Public Health · 2026 Jun · PMID 42337533 · Full text
BACKGROUND: Retirement is a major life transition that may influence functional capacity and overall well-being in later life. This study examined whether life satisfaction buffers declines in active ageing following ret...
BACKGROUND: Retirement is a major life transition that may influence functional capacity and overall well-being in later life. This study examined whether life satisfaction buffers declines in active ageing following retirement. METHODS: We used nationally representative data from the Korean Longitudinal Study of Ageing (2014-2022). Participants were adults aged 55 years and older who experienced a self-reported retirement transition during the observation period. Life satisfaction was measured on a 0-100 scale and categorized into higher and lower groups. The primary outcome was the continuous Active Ageing Index (AAI), and subdomains of health, participation, and security were also examined. Propensity score matching and comparative interrupted time series analyses were applied, and generalized estimating equation models estimated post-retirement changes. RESULTS: Individuals with higher life satisfaction had higher AAI levels across retirement-centered time points, and GEE models suggested a relatively less pronounced post-retirement decline in the continuous AAI index. In subdomain analyses, significant group-by-time interactions were observed in the health domain at retirement and in the participation domain at selected post-retirement time points, whereas no significant interactions were observed in the security domain. CONCLUSIONS: Life satisfaction may serve as a protective psychological resource during retirement transitions. Policies and interventions that enhance subjective well-being may promote sustained active engagement and resilience in later life.
Forecasting monthly hepatitis B cases in China: a nationwide comparative study based on surveillance data.
Lu S, Lin Z, Yeung C … +5 more , Zou F, Xie X, Liang X, Gao Y, Zhu S
BMC Public Health · 2026 Jun · PMID 42337522 · Full text
BACKGROUND: Robust forecasting of hepatitis B trends is important for long-term surveillance and public health planning in China. However, evidence remains limited regarding how different forecasting frameworks perform w...
BACKGROUND: Robust forecasting of hepatitis B trends is important for long-term surveillance and public health planning in China. However, evidence remains limited regarding how different forecasting frameworks perform when applied to a long-term national hepatitis B surveillance series under a unified out-of-sample evaluation design. METHODS: Monthly reported hepatitis B cases in China from January 2004 to December 2024 were obtained from national public surveillance databases. Data from January 2004 to December 2023 were used as the training set, whereas data from January to December 2024 were reserved as an independent validation set. Ten forecasting models were evaluated, including Seasonal autoregressive integrated moving average (SARIMA), Bayesian structural time series (BSTS), four standalone machine-learning models (random forest, support vector machine, XGBoost, and LightGBM), and four residual-based SARIMA-machine-learning hybrid models. Model performance was assessed using mean absolute error (MAE), range-normalized root mean square error (NRMSE), mean absolute percentage error (MAPE) and Nash-Sutcliffe Efficiency (NSE). In addition, the average annual percentage change (AAPC) was estimated to summarize the long-term annual trend in reported case counts.The best-performing models were further used to forecast monthly hepatitis B case counts in 2025. RESULTS: A total of 252 monthly observations were included. The mean monthly number of reported hepatitis B cases was 91,901. The annual reported case counts did not show a statistically significant long-term trend (AAPC = - 0.561%, P = 0.12), whereas the monthly series exhibited a stable seasonal pattern, with peaks typically occurring in March and troughs in December followed by January. Among the candidate SARIMA structures, SARIMA(2, 1, 0)(1, 0, 3) was selected as the optimal model. In the overall model comparison, BSTS achieved the best validation performance, with the lowest MAE (10014.27), NRMSE (38.49%), MAPE (7.18%) and highest NSE(-0.92) among all ten models. Among the hybrid models, SARIMA-LightGBM performed best, with corresponding validation values of 10903.35, 40.14%, 8.07% and - 1.09, respectively. In 2025, BSTS achieved an MAE of 13,437.42, NRMSE of 9.53%, MAPE of 12.04%, and NSE of - 0.41, with 95% posterior predictive intervals used to quantify forecast uncertainty. CONCLUSIONS: Forecasting performance differed across model classes in long-term national hepatitis B surveillance. BSTS showed the best overall predictive performance. These findings support empirical model selection and suggest that BSTS-based forecasting may serve as a supportive tool for early warning, resource allocation, and long-term hepatitis B surveillance planning when interpreted together with reporting-system and policy context.
A path analysis examination of factors affecting early childhood educators' health, burnout, and turnover.
Carmona BA, Reyes LI, Orman MC … +1 more , Bellows LL
BMC Public Health · 2026 Jun · PMID 42337517 · Full text
BACKGROUND: Early Childhood Education (ECE) educators experience high levels of stress, burnout, and job turnover, contributing to workforce instability. Efforts to better understand how interpersonal and environmental w...
BACKGROUND: Early Childhood Education (ECE) educators experience high levels of stress, burnout, and job turnover, contributing to workforce instability. Efforts to better understand how interpersonal and environmental work-related factors contribute to burnout and job turnover intentions are essential to improving ECE educator wellbeing. Grounded in the social ecological model, this study quantitatively examined how stress, the social climate (social support and social strain), and health behaviors contribute to burnout and job turnover intentions in ECE educators. METHODS: The StayWell ECE (Staff and Youth Wellness for Early Childhood Educators) project administered two online surveys to licensed ECE educators in New York: the Health Behaviors Survey (n = 1,423), assessing burnout, stress, turnover intentions, and health behaviors (diet, physical activity, and sleep), and the Social Environment Survey (n = 263), assessing workplace social climate (social support and social strain). Multiple linear regression analyses examined associations between burnout, the social climate, and health behaviors. Path analysis was conducted to test relationships among perceived stress, the social climate, burnout, and turnover intentions, controlling for age, income, and education; model fit was evaluated using chi-square, comparative fit index, root mean square error of approximation, and standardized root mean square residual. RESULTS: Higher burnout was significantly associated with poorer diet quality and lower physical activity and sleep. Lower workplace social support was also associated with poorer diet quality and sleep. Path analysis demonstrated adequate model fit and showed that stress was associated with lower social support, higher social strain, and higher levels of burnout. Social strain was strongly associated with two burnout subdomains (lower emotional exhaustion and depersonalization; p < 0.01 and p < 0.01), while social support was associated with one (greater personal accomplishment; p < 0.01). All burnout subdomains were associated with higher turnover intentions. CONCLUSIONS: Findings highlight burnout as a key mechanism linking stress and workplace social climate to health behaviors and turnover intentions among ECE educators. Interventions that reduce perceived stress and address both social support and social strain may improve wellbeing, support healthier behaviors, and reduce job turnover in this workforce.
Exploring potential factors influencing perinatal mental health in Kajiado County, Kenya: a qualitative study with mothers and healthcare workers.
Kamau C, Gabrielsson S, Makokha FW … +6 more , Ntinina T, Karimi J, Munteiyan L, Ekman K, Öhlund L, Werneke U
BMC Public Health · 2026 Jun · PMID 42337516 · Full text
BACKGROUND: Perinatal depression affects up to 30% of women in Kenya, yet many contributing factors remain poorly understood. We explored mental health problems, social needs, and associated risk factors among women ante...
BACKGROUND: Perinatal depression affects up to 30% of women in Kenya, yet many contributing factors remain poorly understood. We explored mental health problems, social needs, and associated risk factors among women ante- and postnatally in Kajiado County, southern Kenya, from the perspectives of women and health-care workers (HCWs). METHODS: We conducted a qualitative study based on dual-perspective focus group interviews with mothers (ante- and postnatal) and HCWs in five health-care facilities (two urban and three rural) across Kajiado County (5-11 March 2025). Interviews were recorded, transcribed verbatim, translated into English when needed, and analysed using qualitative content analysis with an explorative and inductive approach. The text was divided into meaning units and manually coded in Atlas.ti ( https://atlasti.com ). Themes, subthemes and categories were articulated following a stepwise, iterative and reflexive process of abstraction and interpretation. RESULTS: Across five sites, 51 mothers and 39 HCWs participated. Three themes were developed relating to stress, distress and affecting mental wellbeing, (a) Women's autonomy and self-determination - mothers lacked control over resources or decision-making, while shouldering most household responsibilities, and HCWs highlighted the vulnerability of girls subjected to early marriage and female genital mutilation, often unprepared for motherhood, (b) Responsive maternal and mental health care - distance, costs, and low expectations limited access, while women feared traumatic births, miscarriage, and caesarean sections, and (c) Community knowledge and acceptance of mental health problems - mental health problems were often seen as irrationality or spiritual possession, delaying care. Stigma was particularly associated with caesarean sections, mental health problems, and HIV. CONCLUSIONS: Our findings describe how maternal mental health is closely intertwined with gender norms and prevailing perceptions of mental illness including stigma. Expanding maternal mental health services may be important but it is unlikely to be sufficient in isolation. Sustainable change may depend on the promotion of women's rights, increased mental health literacy at the community level, and the engagement of men. In addition, fear of traumatic birth and stigma associated with CS may need to be addressed not only at the individual level but also within the broader community context.
Associations between discrimination and mental healthcare utilization among racial and ethnic minority cancer survivors in the All of Us Research Program.
Wen YP, Brauer ER, Choi S … +2 more , Comulada WS, Choi KR
BMC Public Health · 2026 Jun · PMID 42337515 · Full text
BACKGROUND: Cancer survivors are twice as likely to experience psychological distress, with racial and ethnic minorities reporting higher distress and healthcare needs compared to non-Hispanic White Americans. However, t...
BACKGROUND: Cancer survivors are twice as likely to experience psychological distress, with racial and ethnic minorities reporting higher distress and healthcare needs compared to non-Hispanic White Americans. However, this group is more likely to seek informal support over formal care. Discrimination has been identified as a key factor influencing individuals' mental health and help-seeking behaviors, but its impact on mental healthcare utilization remains unclear. METHODS: This cross-sectional study used surveys and electronic health records from the All of Us Research Program. Adults aged 18 or older who self-identify as Asian, Hispanic, or Black/African American, have a cancer history, and responded to surveys on discrimination and mental healthcare utilization were included. Multivariable regression models estimated the association between discrimination and mental healthcare utilization, stratified by race and ethnicity. RESULTS: One thousand nine hundred twenty-two ethnic minority cancer survivors participated. 249 (13.0%) were Asian Americans, 909 (47.3%) were Black/African Americans, and 673 (39.8%) were Hispanic Americans. Most participants were female (70.1%, n = 1,348), had health insurance (95.1%, n = 1,828), and were US-born (71.2%, n = 1,368). Demographic patterns varied across groups. 78.8% (n = 1514) and 67.7% (n = 1301) of respondents experienced everyday and healthcare discrimination, respectively. 24.5% (n = 470) used mental healthcare within the past year. Experiencing everyday discrimination was associated with higher odds of mental healthcare utilization among Hispanic American cancer survivors (OR = 2.40, 95% CI [1.68, 3.51]) and increased it by 57% among Black/African American cancer survivors (OR = 1.57, 95% CI [1.07, 2.31]). However, it did not significantly influence such use among Asian Americans. Conversely, discrimination in healthcare settings was not associated with the odds of mental healthcare utilization. Increased age and an advanced degree were independently associated with lower odds of mental healthcare utilization, while specific cancer types, like head and neck cancers, were correlated with higher odds of such use. CONCLUSIONS: Racial and ethnic minority cancer survivors experienced high levels of discrimination, and those experiencing everyday discrimination were more likely to use mental healthcare. Healthcare discrimination did not significantly increase mental healthcare utilization, suggesting unsuccessful engagement with mental healthcare. Anti-discrimination efforts should be organizational initiatives with clear benchmarks. Survivors of head and neck, thyroid, endocrine, and colorectal cancers may benefit most from integrated mental health services in routine oncology care.
A prospective study on the association between hypertension, high-normal blood pressure, and life expectancy in middle-aged and elderly Chinese adults: findings from the China Health and Retirement Longitudinal Study (CHARLS).
Yuan K, Huang Y, Song J … +4 more , Chen Z, Wang X, Wang Z, Zhang L
BMC Public Health · 2026 Jun · PMID 42337512 · Full text
OBJECTIVE: This study aims to investigate the association between different blood pressure levels and all-cause mortality, as well as their impact on life expectancy, among middle-aged and elderly Chinese adults. METHODS...
OBJECTIVE: This study aims to investigate the association between different blood pressure levels and all-cause mortality, as well as their impact on life expectancy, among middle-aged and elderly Chinese adults. METHODS: The data from China Health and Retirement Longitudinal Study (CHARLS) (2011-2020) was used. Participants with complete baseline and follow-up data was included in this analysis. According to the baseline blood pressure participants were categorized into three groups: normal blood pressure, high-normal blood pressure, and hypertension. The Cox proportional hazards regression model was employed to assess the impact of different blood pressure levels on all-cause mortality risk and the model with age as the time scale was used to estimate the life expectancy gap. RESULTS: This study included a total of 9,972 participants aged 45 and above, comprising 4,924 males and 5,048 females. After multivariable adjustment, compared to the normal blood pressure, the hazard ratios (HRs) for all-cause mortality in the high-normal blood pressure and hypertension groups were 1.14 (95% CI: 0.97-1.34) and 1.69 (95% CI: 1.46-1.95), respectively. Life expectancy analysis indicated that, compared to individuals with normal blood pressure, the years of life lost due to high-normal blood pressure and hypertension were 2.26 (95% CI: 2.05-2.45) and 5.75 (95% CI: 5.54-5.96) years at age 45, 2.19 (95% CI: 2.05-2.35) and 5.46 (95% CI: 5.31-5.63) years at age 55, and 2.05 (95% CI: 1.94-2.16) and 4.79 (95% CI: 4.68-4.89) years at age 65. Sex-stratified analysis revealed that hypertension was associated with a greater reduction in life expectancy among females, whereas high-normal blood pressure had a more pronounced impact on males. Sensitivity analyses yielded results consistent with the primary analysis, further confirming the robustness of the study findings. CONCLUSION: This study confirms that in the middle-aged and elderly population in China, hypertension is significantly associated with an increased risk of all-cause mortality. Both high-normal blood pressure and hypertension lead to a reduction in life expectancy, with noticeable gender differences. These findings underscore the importance of early intervention for individuals with hypertension, even when blood pressure is in the high-normal range. Additionally, it is crucial to develop precise intervention strategies tailored to gender differences to reduce the burden of cardiovascular diseases and improve the overall health of the Chinese population.
Climate-based forecasting from national Culex mosquito surveillance to support West Nile and Usutu virus preparedness in England and Wales.
de Klerk JN, Haziqah-Rashid A, Widlake E … +18 more , Wilson R, Pilgrim J, Vaux AGC, Tanianis-Hughes J, Delnicka A, Jealous AS, Abbott AJ, Haines C, Johnston CJ, Miller F, Sherlock K, Bursali F, Gandy S, Biddlecombe SM, Medlock JM, Blagrove MSC, Baylis M, Sedda L
BMC Public Health · 2026 Jun · PMID 42337508 · Full text
Culex mosquitoes are widespread in temperate regions and play a key role in transmitting veterinary and human vector-borne diseases. In the United Kingdom, Culex pipiens s.l. is highly prevalent and a competent vector of...
Culex mosquitoes are widespread in temperate regions and play a key role in transmitting veterinary and human vector-borne diseases. In the United Kingdom, Culex pipiens s.l. is highly prevalent and a competent vector of West Nile and Usutu viruses. Coupled with the northward expansion of West Nile virus in Europe, this raises concerns about emergence in the UK. For public and animal health preparedness, and effective vector control planning, it is essential to better understand the distribution of Culex mosquitoes in this area.This study developed species distribution maps for Culex pipiens pipiens, Culex pipiens molestus, and Culex torrentium abundance using data from the first nationwide stratified active mosquito surveillance programme in England and Wales in 2023, supplemented with adaptive surveillance in 2024. Culex p. pipiens models predicted higher abundances than the other two taxa. Regions of high abundance occurred across most of England, apart from the northwest, with the highest in eastern regions and estuarine areas. In contrast, higher elevation areas, including most of Wales, the North Pennines, and Yorkshire Dales, showed markedly lower abundances. Environmental drivers differed between forms. Culex p. pipiens abundance was strongly associated with precipitation-related covariates, whereas Culex p. molestus was mostly influenced by temperature covariates. These findings highlight the importance of modelling the two forms separately in risk analyses and distribution studies.The resulting models provide timely ecological insights to support surveillance prioritisation and provide a foundation for future work aimed at guiding public health planning and targeted vector management.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe