Journal of Community Health最新文献

Migrant and seasonal agricultural workers are essential to the food systems of the United States (U.S.), yet they experience some of the most persistent health inequities in the nation. In the U.S. Midwest, particularly Iowa and Nebraska, workers arriving from Mexico and Central America confront structural, linguistic, geographic, and policy barriers that disrupt continuity of care and limit access to preventive services. Despite carrying disproportionate burdens of chronic diseases such as diabetes, hypertension, and musculoskeletal conditions, migrant and seasonal workers face fragmented health systems shaped by immigration status, mobility, lack of insurance, transportation barriers, and fear of institutional discrimination. Drawing on emerging models, including community health workers, mobile agricultural clinics, and cross-border health initiatives, this commentary reflects on how more portable and culturally grounded approaches could improve health outcomes for migrant agricultural populations. The Midwest serves as a critical case for reimagining continuity of care within mobile workforces globally, highlighting the need for health systems capable of moving with people rather than confining care to place. Ensuring consistent access to preventive and chronic disease care for migrant workers is essential for advancing equity, strengthening public health resilience, and honoring the labor of those who help feed the nation.

Human papillomavirus (HPV) is the leading cause of cervical cancer, a major public health challenge in Tanzania. National and global efforts continue to prioritise HPV vaccination; however, coverage remains suboptimal. In Tanga City, no prior data exists on HPV vaccine uptake. This study assesses HPV vaccine uptake and factors influencing parental acceptance among girls aged 9-14 years. A community-based cross-sectional study was conducted among 409 parents or guardians selected through multistage cluster sampling. Data were collected using structured interviewer-administered questionnaires. Descriptive statistics determined uptake, while bivariate and multivariate logistic regression were used to identify predictors of HPV vaccine uptake, with significance set at p < 0.05. HPV vaccine uptake was 57.2%. Parental age < 30 years (AOR = 0.411; 95% CI: 0.221-0.765), secondary education (AOR = 0.340; 95% CI: 0.124-0.930) and living within 5 km of a vaccination point (AOR = 0.478; 95% CI: 0.246-0.929), were associated with lower uptake, while being married and school-based vaccination increased uptake (AOR = 2.898; 95% CI: 1.723-4.876; AOR = 10.275; 95% CI: 5.518-19.133). Knowledge, attitudes, and healthcare worker recommendation showed no significant association in the multivariate model. HPV vaccine uptake in Tanga remains below national and global targets (90%). Parental demographics, access-related factors, and school-based delivery play a central role in uptake. Strengthening school-based vaccination, enhancing parent engagement, particularly among younger and more educated parents, and addressing contextual barriers may improve coverage and contribute to cervical cancer prevention efforts in Tanzania.

Pediatric obesity remains a major public health concern in the United States and is associated with early development of cardiometabolic and psychosocial comorbidities. Although early recognition and escalation to evidence-based interventions are recommended, the extent to which primary care providers are prepared to manage pediatric obesity varies. This study assessed the knowledge, attitudes, and practices (KAP) of pediatric and family medicine providers regarding pediatric obesity management, including the use of pharmacologic and surgical treatments. A cross-sectional, anonymous electronic survey was distributed to pediatricians and family medicine providers across Oklahoma through professional networks. The survey included multiple-choice, Likert-scale, and open-ended questions evaluating knowledge of obesity definitions, comfort with treatment options, practice patterns, and access to supportive resources. Quantitative responses were analyzed descriptively, and qualitative responses underwent thematic analysis. Forty providers met inclusion criteria. While most respondents correctly identified obesity thresholds, only 60% accurately defined severe obesity and 65% reported minimal familiarity with pediatric metabolic and bariatric surgery. Limited comfort with obesity management (55%) and poor access to exercise counseling (83%), behavioral health (44%), and bariatric surgical consultation (61%) were common. Pharmacotherapy and surgical referrals remained substantially underutilized. Primary care providers demonstrated knowledge gaps, limited confidence, and restricted access to resources for managing pediatric obesity. Enhanced provider education and improved system-level support are needed to facilitate timely, evidence-based care.

Access to evidence-based mental health care remains limited for Latine immigrants. We tested the effectiveness of an evidence-based intervention, Strong Minds, delivered by community-health workers (CHWs) for improving depression symptoms. We used a single-arm pretest-posttest design to evaluate the effectiveness of Strong Minds in a sample of uninsured, Spanish-speaking, Latine immigrant adults recruited between October 7, 2020, and December 6, 2024. The intervention, adapted from cognitive behavioral therapy, includes 10 individual sessions. We performed a longitudinal analysis using linear mixed-effects models to estimate the trajectories of depression symptoms across five time points: baseline and sessions 1, 3, 6, and 9. Effectiveness was determined by changes in depression symptoms (PROMIS Depression 8a), and as a secondary outcome, changes in anxiety symptoms (PROMIS Anxiety 7a). We also analyzed potential selection bias by evaluating differences in baseline scores between participants who completed and discontinued participation. Of the 129 participants enrolled in the intervention (mean age, 39 years), 73 (56.6%) completed it (defined as attending at least 8 of 10 sessions). Completing the intervention was associated with improved symptoms of depression and anxiety. Participants with greater symptoms of depression at baseline were more likely than those with less severe symptoms to complete the intervention. These results add to the growing body of evidence in the United States that CHW-delivered mental health interventions are effective. Nonetheless, research is needed to rigorously demonstrate that CHW-delivered interventions are an equitable, clinically effective, sustainable, and scalable alternative to traditional models of mental health care.

Although the Hispanic/Latino/Latina immigrant population group has been documented to use a higher number of herbs, spices and supplements, research findings on this topic are still insufficient. This study aimed to evaluate the supplements chosen by Hispanic/Latino/Latina immigrants in relation to their evidence for use in the literature as well as the number of herbs and spices used. This cross-sectional study utilized convenience sampling to survey 62 Hispanic/Latino/Latina immigrants in central Indiana. The research collected data regarding herbs and spice consumption, supplement usage and beliefs, therapeutic diet practices, disease history, and food frequency information. Dietary supplement use was more prevalent among females and individuals with a high school education. A statistically significant difference between male and female participants was observed regarding the use of green tea supplements, as well as all herbal products and single vitamins combined (p <.001). Significant associations were also found when comparing individuals with bone and joint (p =.030), cardiovascular (p =.024), gastrointestinal (p =.031), and endocrine diseases (p =.020) to those adhering to a special diet. There was a lack of evidence supporting supplement use based on research findings. These results suggest for the need of supplement and therapeutic diet use education in the Hispanic/Latino/Latina population residing in the United States. Further research is needed to advance these findings.

Magazines are periodicals characterized by their articles, pictures, and advertisements to generally inform and entertain readers on a variety of topics. In contrast, professional journals are publications that update and provide new research results for professionals in a specific field. Unlike magazines, the articles in professional journals have undergone assessments by their professional peers for validity and reliability of their content. In other words, peer review is the hallmark of professional journals informing and advancing the knowledge of a professional field. No where else is it more important than in health-related journals to have valid and reliable information. This commentary's purpose is to review the process of peer review, and the journals professional roles involved in that process.

Background: The tobacco retailer environment (TRE) harms communities, but the implementation of policies to address it have been slow and uneven and receive tepid public support.

Objective: To test whether a smartphone app's photo-mapping activity could raise community awareness of the TRE.

Methods: This was a non-randomized study with a pre-post design. For three weeks, 75 university students engaged with the app, which incentivized participants to submit photos of significant aspects of tobacco in their environments (e.g., tobacco litter, tobacco retailers). Surveys administered before and after the app period assessed tobacco- and policy-related perceptions.

Results: Repeated-measures analyses indicated that, over the course of the study, participants increased in their awareness of tobacco advertising, awareness of tobacco litter, anti-tobacco industry attitudes, and support for an outdoor tobacco-free campus policy. Those most engaged in the study (as indicated by the total number of photo submissions) also increased in their attitudes about there being too many tobacco retailers.

Conclusions: Overall, findings suggest an app-based, photo-mapping activity could be an innovative means of directing people's attention to the impact of the tobacco industry in their local community. Such activities could help increase public support for tobacco retailer licensing and other TRE-focused policies.

Synthetic oral nicotine pouches (ONP) are an increasingly popular route for non-tobacco nicotine consumption. While there is a growing understanding of ONP use internationally, especially in countries where these products have been available longer, few studies address ONP use in Canada. This cross-sectional study sought to quantify and characterize current ONP use in Canadian post-secondary students. A Qualtrics-based web survey of Canadian post-secondary (university or college) students was conducted in September/October 2024. This collected demographics, participant ONP history, recent use, and other nicotine/non-nicotine substance use. The Penn State Nicotine Pouch Dependence Index (PSNPDI) was embedded within the broader survey to assess nicotine dependence. Descriptive analysis was performed for ever- and recent-ONP use prevalence, poly-use of ONP with other products/substances, and ONP use with key demographic or contextualizing factors. Of 452 post-secondary student respondents (22% male, 78% female; age: 20.2 ± 2.6y), 27% reported ever-use of ONPs, with a mean ± SD age at first use of 19.2 ± 3.0y and 12% of all respondents reporting ONP use in the last 30 days. 77% and 89% of ONP users reported ever-use of tobacco and e-cigarettes, respectively, versus 24% and 44% of non-ONP users (p < 0.001). Among ONP ever-users, 62.3% reported no (PSNPDI score 0-3), 29.5% reported low (PSNPDI score 4-8), and 8.2% reported medium (PSNPDI score 9-12) dependence. These data provide a first glimpse into ONP use in Canadian post-secondary students, against which to assess future use patterns.