Journal of Community Health最新文献

Despite the availability of effective preventive measures, women in rural and underserved communities of Louisiana face health disparities regarding human papillomavirus infections. This study explores how perceived risk and socioeconomic factors, such as income, influence HPV vaccine awareness and attitudes toward HPV risk. A cross-sectional study was conducted among women in rural and underserved areas of Louisiana from November 2022 to December 2023. Participants were eligible to be included in the study if they were adult females aged 25 to 64 with no history of hysterectomy and no history of cervical cancer. We used convenience sampling through a mobile health unit that travels to rural and underserved areas of north and central Louisiana, offering cervical cancer screening. A total of 141 women participated in the study. Findings revealed significant gaps in HPV awareness and vaccination knowledge. Only 10.6% of participants considered themselves at risk for HPV. Higher HPV knowledge scores were positively associated with perceived HPV risk, increasing by approximately 20% per correct response. Approximately 40% of the participants were unaware of the existence of the HPV vaccine, 96.5% had never received the HPV vaccine, and 91.4% had never been offered it. Only 42% indicated that they would consider vaccination if offered. Addressing health disparities in rural Louisiana requires targeted interventions to improve healthcare access, education, and community engagement. Efforts to enhance education and awareness and foster community engagement should be prioritized.

This study assesses the livelihoods of waste pickers and the potential health challenges they face, with the primary goal of informing policy development and interventions in Lagos State, Nigeria. A total of 1,274 waste pickers across 20 local governments in Lagos State were interviewed using a structured questionnaire. The data collected were analyzed using descriptive and inferential statistics with SPSS for Windows. Results indicated that most waste pickers were male (69%) and aged between 18 and 40. Common hazards faced by waste pickers included harassment (19%), injuries (13%), accidents (11%), and burns (7%). Despite these hazards, 50% of waste pickers earned between ₦30,001 and ₦50,001 (approximately $23-38.5) per month, with only a few earning above ₦50,000. Additionally, 70% of respondents reported having savings. Respondents highlighted several measures to improve their livelihoods, including recognition, security, financial support, empowerment, and job opportunities. As a result, 71% of waste pickers expressed willingness to leave their jobs if empowered. The major hazards encountered by waste pickers include harassment (19%), injuries (13%), accidents (11%), and burns (7%).

The current study used a convergent mixed-methods design and identified Arkansas school professionals' perceptions about (1) their schools' tobacco use prevention needs and (2) the implementation of tobacco prevention programming at their schools. Differences in perceptions based on school-related factors and personal tobacco use history were examined. Surveys were collected from teachers, administrators, and school staff from K-12 schools in Arkansas (QUANT; N = 325) and in-depth interviews were conducted with a separate sample of school administrators (QUAL; N = 20). Logistic regressions identified the associations between dependent variables, school-related factors (school type, school position, years of education work experience, and school rurality), and school professionals' tobacco use histories. The tobacco prevention components perceived as most important were parent education, school tobacco-free policies, and up-to-date teacher training. Yet, parent education and up-to-date teacher training were perceived as being poorly integrated into schools. Quantitative and qualitative findings emphasized the importance of integrating parents into tobacco prevention. There were differences in school professionals' perceptions about important tobacco prevention components based on school level, personal tobacco use history, and work experience. There were also differences in perceptions about how well tobacco prevention was integrated into schools between teachers vs. administrators and related to school rurality, school level, and work experience. School professionals in Arkansas, a state with tobacco disparities, identified that: (1) student tobacco use is a top health priority; (2) key strategies include parent education, tobacco-free policies, and teacher training; and (3) barriers exist, particularly in implementing parent education and teacher training.

Introduction: 50% of permanent supportive housing (PSH) residents in the U.S. smoke cigarettes, and tobacco-related mortality is their number one cause of death. Over 30% of PSH residents have post-traumatic stress disorder (PTSD), and many perceive their built environment (e.g., housing) as inadequate for mental and physical health recovery. It is unknown whether built environment factors moderate the relationship between PTSD and tobacco use among PSH residents.

Methods: We used baseline data from 400 participants in a smoke-free home intervention in PSH sites in the San Francisco Bay Area between 2022 and 2024. We explored whether perceived housing quality and perceived neighborhood safety moderated the relationship between PTSD symptoms and cigarettes per day (CPD) using linear mixed models.

Results: 62.8% of the participants were male, 41.8% were Black, 30.5% screened positive for PTSD, 54.3% rated their housing as average/poor, and the mean neighborhood safety score was 3.4 (SD 0.9). Mean CPD was significantly higher in participants with PTSD compared to those without PTSD among participants who rated their housing as good/excellent (5.1; 95% CI: 2.7, 7.5) or their neighborhood as safer (7.8; 95% CI: 2.8, 12.8). Mean CPD was not significantly different between those with and without PTSD among participants who rated their housing as average/poor or their neighborhood as less safe.

Conclusions: Perceived housing quality and neighborhood safety moderated the association between PTSD symptoms and CPD. Findings have implications for developing trauma-informed, multi-level interventions for tobacco use that combine individually directed approaches with those that consider the built environment.

Betel quid chewing is a culturally significant practice among the indigenous people (Orang Asli) in Malaysia, but it poses serious health risks, including oral cancer and systemic diseases. Studies on betel quid chewing are limited, making it difficult to develop effective public health interventions. This study aimed to explore the cultural significance, perceived health effects, and misconceptions surrounding betel quid chewing among the indigenous people, assess their awareness of health risks, and explore factors influencing their intentions to quit or reduce betel quid chewing. A qualitative phenomenological design was used, with five groups of Focus Group Discussions conducted with 15 participants from an Orang Asli village in Johor. The discussions revealed that betel quid chewing is deeply embedded in Orang Asli culture, often beginning in childhood and associated with social and ceremonial occasions. However, awareness of health risks, particularly oral cancer, was inconsistent. Social support and personal motivation were critical in influencing quitting behaviors. These findings highlight the need for culturally tailored cessation programs that address the unique social and environmental factors influencing betel quid use in this population.

Risky behaviours have been a global problem that affects both developed and developing countries. This study explored the risky behaviours and students' academic life in Higher Education Institutions (HEIs) in Tanzania. It was a qualitative study and data were collected through open-ended questionnaires, interviews, and documentary reviews. The study involved a sample of 94 undergraduate students and 3 hostel wardens making 97 participants from the selected university. The findings indicate that students involved in having more than one sexual partner, alcoholism, and unsafe sex, and were prone to be exposed to the Sexually Transmitted Diseases (STDs) that affected their academic life at university. The findings also indicate that having more than one sexual partner was the most alarming risky behaviour among students. The findings indicate further that female students were exposed to early pregnancies, carry-over cases, and poor academic performance in the University Examinations. It is argued in this study that if HEIs have to safeguard their students from risky behaviours, they need to strengthen the orientation programmes, guidance, and counselling services including gender-relation training programmes for students to cope with their studies and survive after their graduation. Nevertheless, enforcing the rules and regulations by dealing with those who violate them and provision of Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and sexually transmitted infections (STIs) preventive programmes to safeguard the students also remain imperative.

Food culture plays a vital role in societal dynamics, with various factors influencing dietary choices beyond hunger. Among these factors are external eating, triggered by environmental cues, and emotional eating, which are common stress-coping mechanisms among college students. Social media has a significant impact on nutrition by providing access to food-related content, which can lead to restrictive diets or unhealthy eating habits. High social media engagement is associated with an increased risk of chronic diet-related conditions such as metabolic syndrome. This study investigated the association between social media use and dietary habits among college students in Riyadh, Saudi Arabia. The cross-sectional study surveyed 401 participants online. The findings revealed that 74.6% of participants were women, with a mean age of 20.75 years. A significant portion (51.9%) reported spending over four hours daily on social media, with TikTok, Instagram, and YouTube being the primary sources of nutritional information. Statistical analysis indicated significant differences in dietary scores related to having children, medical conditions, and social media usage time. This study highlights the negative impact of extensive social media use on dietary habits and suggests the need for targeted public health interventions. Recommendations include promoting reliable nutrition-related content on social media, offering affordable healthy food options on campuses, and conducting further research to establish causality between social media use and dietary habits.

Chronic hepatitis B (CHB) is a condition that disproportionately affects Asian Americans in the United States. Knowledge of transmission is crucial for CHB patients to practice prevention methods to limit the spread of the hepatitis B virus (HBV), but also live their lives free from unwarranted fears or restrictions. Among Asian CHB patients, several misperceptions about HBV transmission have been identified. This analysis aims to assess the current state of HBV knowledge among a cohort of Korean-American CHB patients. This mixed-methods study includes 363 respondents who completed a survey in either Korean (N = 298) or English (N = 65) at two clinical care settings in Philadelphia (N = 161) and Los Angeles (N = 202); 30 participants also completed in-depth interviews. Knowledge was measured on a 10-point scale, asking patients yes or no transmission questions (n = 10, alpha = 0.87). The average knowledge score was 6.3. In multivariate analyses, older age was associated with lower knowledge (β=-0.25, p < 0.001). More years of formal education (β = 0.09, p = 0.076) and utilizing more sources for health information (β = 0.12, p = 0.023) were both independently associated with higher knowledge scores. Qualitative findings show that misperceptions about transmission through shared food still exist and that provider communication is an important part of knowledge acquisition. These results suggest that despite receiving specialized, culturally concordant medical care for their disease, some Korean-American CHB patients have an inadequate understanding of transmission and that opportunities exist to improve education in this population. Identifying additional factors that influence knowledge acquisition and retention is key to developing culturally effective education interventions for this population.

Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities to detect and document suicide attempt in EHR records. Using VA administrative data, we examined three cohorts of all patients from 2014 to 2018 who had housing instability (n = 659,987), justice involvement (n = 200,487), and unemployment (n = 346,556). Administrative records were used to determine ordinal indicators of receipt of VA social services (no services, low, or high). The outcome was suicide attempt noted in the healthcare record (i.e., documented suicide attempt) in the 1-6 months following the incident adverse social factor. We conducted logistic regressions utilizing a discrete-time survival framework with person-month as the unit of analysis, which facilitated accounting for covariates while isolating the independent association of social service utilization. After adjusting for covariates, high receipt of housing services (vs. no services) was significantly associated with documented suicide attempt during the 6-month observation period (aOR = 1.14, 95%CI = 1.06-1.22). A similar association was observed for high vs. no use of justice programs (aOR 1.24; 95% CI:1.12-1.37). There was no significant association between employment services utilization and documented suicide attempt during the 6-month observation period. Our finding that utilization of social services as positively associated with documented suicide attempt likely reflects increased suicide attempt surveillance and documentation with social service involvement. Future research should explore operationalizing patient-level distress in administrative data.

The aim of this project is to explore perceptions towards and adherence to COVID-19 public health preventive measures in Indigenous communities within Northwest Territories, Canada. Utilizing a cross-sectional study design the project took place within ten Northwest Territories communities between 1st April and 30th November 2021. Convenience sampling methods were utilized and adhered to public health restrictions. Self-identifying Indigenous adults (≥ 18 years old) were invited to complete a semi-structured interviewer-administered questionnaire. Participants (n = 287; 33.1% men, 66.6% women) had a mean age of 41.6 years (SD ± 13.5). Preventive measures were practiced by 98.6% of participants. Most participants reported often or always practicing three measures: avoiding gatherings (67.2%), avoiding usual greetings (63.3%), and limiting contact with high-risk individuals (71.4%). Most participants reported rarely/never practicing self-isolation (67.5%) and self-quarantining (76.5%) measures. Significant associations existed between the August 2021 COVID-19 outbreak and self-quarantining (p = 0.0023), self-isolating (p = 0.0023), and going onto the land (p = 0.0001). Participants found masking and travel restrictions challenging. Sadness and loneliness resulted from limited access to Elders. Kinship and community safety were important to Indigenous community members and influenced COVID-19 preventive measure utilization. The findings can inform culturally specific COVID-19 public health policy development.