Journal of Community Health最新文献

The rise in internet use among students is a growing concern about its impact on physical health. This study aimed to assess the prevalence of internet addiction and its association with musculoskeletal pain among medical students in Jordan. A national cross-sectional study was conducted from February to March 2025 across undergraduate medical students in six Jordanian universities, using an online questionnaire that included three sections: demographics, the Internet Addiction Test (IAT), and the Nordic Musculoskeletal Questionnaire-Extended (NMQ-E). Data were analysed using descriptive statistics, chi-square tests, and multivariable logistic regression for the associations between internet addiction and musculoskeletal complaints across nine body regions. Among 1100 students, 65.9% were females. Most students fell within mild (38.7%) or moderate (27.6%) internet addiction levels, while 29.5% were classified as having normal internet use, and 4.1% showed severe addiction. Gender and academic year were not significantly associated with addiction level, though university affiliation was (p = 0.017). Musculoskeletal pain was very common, especially in the neck (67.6%), shoulders (43.5%), and lower back (38.2%). Regression analysis showed that male students had higher odds of experiencing elbow (p = 0.011) and ankle/foot pain (p = 0.049), but lower odds of neck (p < 0.001), shoulder (p < 0.001), and upper back pain (p < 0.001). Internet addiction scores showed no strong link to musculoskeletal symptoms, except for elbow discomfort (p = 0.036). Internet addiction is common among medical students in Jordan, but it shows a limited association with musculoskeletal disorders. Nonetheless, the high prevalence of both conditions highlights the need for integrated strategies that promote healthy digital habits and physical well-being among students.

Evictions are a major social and public health concern in the United States. The development of Natural Language Processing (NLP) technologies allows for analysis of medical record notes to identify eviction cases in healthcare systems. The current study uses medical records data from the largest integrated healthcare system in the United States to develop a surveillance system to estimate incidence rates of NLP-identified evictions (NIEs) and associated patient characteristics. Data on over 8.5 million unique patients in the Veterans Affairs (VA) healthcare system from March 2018-March 2020 were analyzed and NLP was used to identify incidences of eviction. The 2-year incidence rate for NIEs was 2.38% (95% CI = 2.37-2.39%), with an annualized rate of 1.37% (95% CI = 1.36-1.38%). Logistic regression analyses found greater risk for NIEs among patients who were 45-64 years old, were male, non-Hispanic Black, were unmarried, had a high school education or less, had annual household income equal to or below $45,000, lived in an urban area, lived in a high area deprivation index, lived in the West region of the country, and had a history of military sexual trauma. Patients with a history of homelessness (aOR = 6.45; 95% CI = 6.36-6.54), and diagnoses of drug use disorder (aOR = 2.53; 95% CI = 2.49-2.57) or schizophrenia (aOR = 1.88; 95% CI = 1.83-1.93) were also at greater risk for NIEs. These findings suggest evictions are a rare, but important event among veterans, and may inform homeless prevention efforts by identifying veterans from certain backgrounds at greater risk. This study helps demonstrate the utility of using NLP for a surveillance system to identify evictions and track changes over time.

Seasonal influenza represents a significant public health challenge, with high hospitalization and mortality rates among the most vulnerable populations. Despite healthcare recommendations and the availability of safe and effective vaccines, vaccination coverage remains below the targets set by the WHO. This study analyzes the role of socioeconomic factors, knowledge, and individual attitudes in adherence to influenza vaccination in the City of Syracuse, Italy. A cross-sectional study was conducted on 394 adults from the ASP of Siracusa, recruited through General Practitioners. A questionnaire collected sociodemographic data, vaccination information, and assessments of knowledge and attitudes. Statistical analysis was performed using logistic regressions to evaluate the factors associated with vaccination. Multivariate analysis highlighted a significant association between vaccination adherence and socioeconomic and demographic factors. Older age was associated with a higher likelihood of vaccination (OR = 1.04; p = 0.002), while being married or cohabiting was linked to a lower probability of getting vaccinated (OR = 0.33; p = 0.002). Moreover, residents of small towns had a significantly lower probability of vaccination compared to those living in urban areas (OR = 0.04; p < 0.001). Knowledge about the vaccine had a marginal impact on adherence, whereas a favorable attitude did not show a significant association. Adherence to influenza vaccination is influenced by sociodemographic factors, with lower coverage in small municipalities and younger age groups. The active involvement of General Practitioners and targeted strategies for communication and accessibility could improve vaccination coverage.

Colorectal cancer (CRC) is the third most prevalent cancer worldwide, with its incidence rising in the Middle East. In the United Arab Emirates (UAE), higher numbers of younger individuals are being diagnosed, likely due to unhealthy lifestyle habits. This study aims to investigate the relationship between CRC awareness and preventive lifestyle practices among varying risk groups. A cross-sectional study was conducted among the adult UAE population between October and December 2024. Data was collected using a self-administered questionnaire consisting of sociodemographics, CRC risk assessment, screening eligibility, and the Bowel Cancer Awareness Measure (BoCAM). Adherence to cancer-preventive lifestyle behaviors was assessed using the WCRF/AICR Score. 910 participants were surveyed. The median CRC knowledge score was 10 out of 22 (IQR = 6, 13). 57.4% lacked confidence in recognizing CRC symptoms. Higher knowledge scores were significantly associated with female sex, non-Emirati nationality, higher education, employment or studies in healthcare, and a first-degree family history of CRC. Despite having the highest knowledge levels, the higher CRC-risk group exhibited cancer-preventive behaviors comparable to the average and no-risk groups. Risk factor knowledge did not influence adherence to healthy dietary habits but was positively associated with increased physical activity. Few were aware of a CRC screening program (29%) and the recommended screening age (7%). Only 10.1% of screening-eligible participants had undergone CRC screening. Knowledge on CRC in the UAE is relatively low, with a gap between the public's awareness and their lifestyle practices. This calls for targeted educational campaigns and early detection strategies, particularly among higher-risk groups.

Non-Hispanic Black and Hispanic men experience disproportionately high rates of chronic conditions and may use cannabis to manage symptoms. However, cannabis use patterns and correlates in these populations remain underexplored. This study assessed individual and health-related correlates of current (past 30-day) cannabis use among non-Hispanic Black and Hispanic men with chronic illness. Data were drawn from a national sample of 1,982 non-Hispanic Black and Hispanic men aged ≥ 40 with at least one chronic condition. Participants completed measures of cannabis use, health perceptions, and diagnoses of conditions commonly associated with medicinal cannabis use: chronic pain, depression/anxiety, arthritis/rheumatic disease, and cancer. Logistic regression analyses examined associations between cannabis use, chronic conditions, pain, and stress, adjusting for sociodemographics. Participants had a mean age of 56.6 (± 10) years; 58.2% were non-Hispanic Black, and 21.3% reported current cannabis use. Use was significantly more common among those with chronic pain, depression/anxiety, and arthritis (p < 0.001 for all). In adjusted models, greater pain (AOR = 1.11, 95% CI: 1.07-1.16, p < 0.001), higher stress (AOR = 1.06, 1.01-1.10, p < 0.05), and more chronic conditions (AOR = 1.23, 1.10-1.38, p < 0.001) were associated with increased odds of use. Among current users, those reporting both medicinal and recreational use used cannabis more frequently (p < 0.001). Cannabis use was higher among non-Hispanic Black and Hispanic men with chronic conditions who reported greater pain, stress, and poorer physical and mental health. Dual medicinal and recreational use may signal increased cannabis-related health risks. Routine communication and monitoring of cannabis use are recommended to mitigate potential harms.

Human Papillomavirus (HPV) is among the most common sexually transmitted infections (STIs), with almost all sexually active individuals likely to encounter it during their lifetime. It is essential for health science students to have a comprehensive understanding of HPV, as their knowledge, attitudes, and behaviors can greatly impact patient education and decisions about vaccination or their current infection. This study aims to assess the level of awareness and knowledge about HPV among health science students and recognize the factors that influence these levels. We distributed paper questionnaires to 268 students (18-42 years) across different fields of study. Validity and reliability were assessed with 40 participants. After removing unreliable questions, a 36-item questionnaire was finalized. Awareness scores were calculated from responses, and statistical analysis was performed using IBM SPSS-27. This study examined 268 students aged 18 to 42 years, with an average age of 24.4 years (± 4.02). The median age was 24 years. Among the participants, 70.5% were female (189 subjects) and 29.5% were male (79 subjects). Students with PhD degrees in biological sciences had the highest awareness scores, averaging 16 (± 10.34). MSc students in biological sciences followed with awareness scores averaging 15.9 (± 5.83). BSc students in biological sciences had the lowest awareness scores, averaging 11.9 (± 6.43). Statistical analysis indicated that basic characteristics like sex, marital status, or having a partner did not significantly impact awareness levels among the subjects. However, the level of education was identified as a significant factor affecting awareness (p-value = 0.043). The majority of the study participants demonstrated a moderate level of knowledge about HPV. In this study awareness levels vary significantly across educational levels. However, the demographic factors such as gender, marital status, and relationship status did not notably influence the participants' levels of awareness. These findings underscore the need for targeted educational interventions to address this knowledge gap and improve HPV awareness, especially among BSc students in biological sciences.

The Immigration Medical Examination (IME) is a mandatory step in obtaining U.S. permanent residency, yet its high cost and limited accessibility pose significant barriers for low-income immigrants. Addressing these challenges is critical to ensuring equitable healthcare access for underserved populations. To present the benefits and process of integrating IME services into a student-run free clinic serving low-income immigrant populations. A review of IME requirements, cost barriers, and existing student-run clinic models informed the development of an IME program at the Knights Landing One Health Center (KLOHC). The implementation process involved four key steps: assessing community needs, securing qualified personnel, establishing clinic logistics, and implementing a structured training model for student volunteers. A retrospective chart review of patients receiving IME services from May 2022 to May 2024 was conducted to analyze patient demographics, service utilization, and health screening outcomes. KLOHC provided IME services to 204 patients, with 177 adult records analyzed. The majority were Hispanic/Latino (84%) and Spanish-speaking (79%), highlighting the importance of culturally and linguistically competent care. Patient volume steadily increased, with a consistent waitlist of 14-20 individuals per session. Cost reduction was significant, with services provided at no cost for selected cities already served by KLOHC. These cities include Knights Landing, Davis, Winters, Woodland (Yolo County), Yuba City (Sutter County), and Sacramento (Sacramento County). A $250 was charged to non-target community patients, compared to the private sector's $400-$900 range. IME health screenings identified cases of tuberculosis and sexually transmitted infections, enabling timely treatment. The structured student leadership model ensured continuity, training, and sustainability. Integrating IME services into student-run clinics is a feasible and effective strategy to expand access to essential health evaluations for immigrant populations. Funds collected from non-target communities were used to pay for vaccines, x-rays, and transportation for target community members which eased the financial burden of the already expensive immigration process. KLOHC's model demonstrates a cost-effective service for patients, improves healthcare accessibility, and provides hands-on training for future healthcare professionals. This initiative serves as a replicable framework for other student-run clinics nationwide, addressing a critical gap in immigrant healthcare and promoting a more equitable healthcare system.

Recent advancements in childhood cancer treatment have significantly improved survival rates, yet survivors continue to face considerable morbidity and mortality, rendering them a vulnerable population. Tobacco use, linked to heightened cancer risk, is discouraged among survivors for long-term health preservation; however, many persist in its use, mirroring rates among their non-cancer peers. Through 25 in-depth interviews, we explored the interplay of perceived risk and social integration on tobacco use post-treatment among both Latine and non-Latine young adult survivors. Sixty percent of respondents were male, 44% identified as Latine, with ages ranging from 22 to 38 years (mean age 30 years; mean age at diagnosis 9 years), representing diverse cancer types. Despite awareness of tobacco-related health hazards, including general and respiratory health impacts, addiction potential, and financial burdens, survivors consistently cited stress alleviation as a primary motive for tobacco use. Fearof cancer recurrence was seldom cited as a deterrent, rather survivors identified tobacco as a means to foster peer connections, particularly in workplace settings, where smoking norms prevailed. Co-workers influenced initiation, and smoking breaks served as crucial socializing opportunities, endorsed as acceptable coping mechanisms. Notably, generational factors overshadowed cultural influences on tobacco use. These insights underscore the need for targeted interventions, in which clinicians can emphasize alternative stress management strategies over risk-centric messaging, prioritize social skill development, and address workplace environments as high-risk settings.

Evidence on the association between dialysis facility accessibility and mortality in small countries is limited. This study evaluated the association between travel distance and one- and two-year mortality among Israeli end-stage renal disease (ESRD) patients. Data were obtained from the National Renal Replacement Therapy Registry, encompassing all Israeli ESRD patients aged ≥ 45 years who initiated hemodialysis in 2010-2021. Sociodemographic (age, sex, population group), treatment-related (hospital/community treatment, primary renal disease, incident-year cohort), and geographic (residency socioeconomic and peripherality indices) data were collected. Travel distances from the most recent address to the initial treating facility were categorized into three groups based on the 50th and 90th percentiles, excluding outliers (> 100 km). Adjusted Cox regressions assessed associations between travel distances and mortality, with incident-year cohort-specific models evaluating temporal hazard variations. Analyses included 15,606 patients. The long-distance group (> 26.39 km) was characterized by younger age, Arab ethnicity, peripheral residence, and lower socioeconomic status. Compared to the short-distance group (≤ 6.80 km), the hazard ratios (HRs) in the intermediate-distance group (> 6.80 and ≤ 26.39 km) were 1.216 (1.106-1.337) for one-year and 1.181 (1.093-1.275) for two-year mortality. In the long-distance group, the HRs were 1.718 (1.460-2.021) for one-year and 1.554 (1.351-1.787) for two-year mortality (P-for-trend between travel distances <.001). Sensitivity and temporal analyses confirmed consistent associations across incident-year cohorts, alternative cut-offs, and outlier inclusion. The association between travel distance and mortality highlights the need to improve geographic accessibility to healthcare to reduce inequities, especially for life-sustaining chronic treatments such as hemodialysis.

The purpose of this study was to measure the HPV vaccine behaviors and intentions of college-aged men. 493 participants, who identified as "male" or "trans man", from a large university in the Mid-Atlantic were included in this study. An online survey measured several independent variables as well as variables related to HPV and HPV vaccine knowledge, perceptions, and behaviors. Descriptive statistics were used to evaluate each variable after filtering the participants by vaccination status. A binomial logistic regression was used to analyze and predict the effect of each variable on college men's vaccination status. The academic year in which participants completed the survey, home location, and HPV knowledge were significant predictors of HPV vaccination status. Lack of inclusion of males during conversations about the HPV vaccine could be the source of the differences between male and female HPV vaccination behavior and intention.