Journal of Community Health最新文献

The Harijan sanitary workers are the most vulnerable group in our society and suffer from several kinds of occupational health problems due to their low level of education, dirty jobs and misunderstanding of occupational health concerns. The purpose of this study was to determine the level of awareness about personal hygiene and occupational health to assess the impact of the occupational health intervention on the Harijan sanitary workers in the Rajshahi district of Bangladesh. A pre-post mixed-methods study was conducted from January to June 2025 in four sweeper colonies of Rajshahi to measure how a culturally adapted health education initiative influenced Harijan sanitary workers' knowledge, attitudes, and practices. Data gathered from 110 participants, along with qualitative inputs from FGDs, KIIs, and in-depth interviews, offered both numerical insights and real-life context. Statistical and thematic analyses using SPSS and NVivo examined shifts in safety habits and skin-related issues, reinforced through cross-validation of findings across multiple qualitative sources. A total of 110 Harijan sanitary workers (52.7% male, 47.3% female) in Rajshahi averaged 6.7 years of service and 6.8 household members, with over 30% lacking formal education and only 6.4% completing secondary school. After the awareness program, pulmonary symptoms showed mixed, non-significant changes and skin disease rates trended downward without statistical significance, while organ pain complaints (back and muscle) significantly declined (χ²=11.64, p = 0.003). Occupational health knowledge scores nearly doubled from 6.8 to 13.2 (94.1% increase, p < 0.001) three months after training. Attitudes toward PPE use and self-care improved by 27.7% (from 27.1 to 34.6, p < 0.001), and adoption of safety practices-glove use, mask wearing, boots, handwashing, and sanitizer-rose substantially (all p < 0.001). Years of service showed no meaningful correlation with gains in knowledge, attitude, or practice, underscoring the importance of structured training regardless of experience. The study revealed that the Harijan sanitary workers of Rajshahi benefited from occupational health interventions that raised their knowledge levels and may influence their health-related behaviours.

Student-run clinics (SRCs) serve dual roles of providing essential healthcare services for underserved patients and in facilitating critical learning opportunities for students. However, the goals of service can conflict with the goals of learning. In the context of SRCs, this raises numerous dilemmas whose unintended consequences can have far-reaching effects. Similarly, while systemic inequities fuel the impetus for SRCs, they also simultaneously expose the operational vulnerabilities of these organizations. These can generate difficulties navigating the fine line between providing for our society's vulnerable patients and subjecting these patients to an enterprise that prioritizes training in ways that burden patients. Without an emphasis on sustainable reforms and continued resource investment to support changes, SRCs risk not only failing to meaningfully impact their patient populations but also unintentionally reinforcing the very inequities they aim to address. While some of these challenges have been individually addressed in the literature, attempts to characterize the range of potential conflicts and approaches to formulating best practices for addressing them remain limited.

Cutaneous leishmaniasis (CL) is an endemic disease prevalent in many parts of Iran, including Ilam Province. Conducted in Dehloran City from April 12 to 24, 2025, this study aimed to assess the determinants of the disease, particularly among schoolchildren, as the most vulnerable societal stratum. This descriptive-analytical study included 1,302 schoolchildren selected using a random cluster sampling method. Data was collected based on self-reporting using a validated (by an expert panel) and reliable (with a Cronbach's alpha of 78%) questionnaire. The data was analysed using SPSS version 22 software. Approximately 85% of participants had weak to average knowledge scores, with a mean of 1.88 ± 5.46. The average attitudes score of participants was 5.77 ± 20.97, with only 9.52% exhibiting positive preventive attitudes. More than 95% of participants had poor preventive behaviours. Most participants had weak or average knowledge, attitudes, and behaviours towards CL. There is an obvious shortcoming in health education in the elementary education system. Elementary schools should adopt CL educational intervention to control disease. This may be achieved by applying the theory and models of behaviour change.

There is potential value in combining education with policy, systems, and environmental (PSE) change strategies in school-based dietary and physical activity (PA) interventions. We investigated the impact of different combinations of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions on diet and PA and determined if student and school characteristics modified these impacts. A quasi-experimental, two-group (intervention (I) and comparison (C)), pre-post design examined the impact of interventions on diet and PA of 4th /5th grade students (n_I=2,115;n_C=1,102) in SNAP-Ed-eligible California public schools (n_I=51;n_C=18). Compared to students receiving no intervention, students receiving education + PSE decreased soda intake by 0.08 times/day [95% CI: -0.15, -0.02], increased whole fruit intake by 0.17 times/day [95% CI: 0.03-0.32], and increased total vegetable intake by 0.46 times/day [95% CI: 0.18-0.75]. Among students who received education only, sport and energy drink intake increased by 0.11 times/day [95% CI: 0.03-0.19] and 0.05 times/day [95% CI: 0.01-1.10] respectively, compared to students receiving no intervention, and fruit juice intake increased by 0.11 times/day [95% CI: 0.03, 0.20]. School urbanicity and Free and Reduced-Price Meal (FRPM) eligibility level modified intervention impacts. Compared to students from no intervention schools, students in urban schools receiving education only increased intake frequency of sweetened fruit drinks (β_interaction[95% CI] = 0.12[0.01-0.23], and students from schools with FRPM above the state average receiving education + PSE significantly increased intake frequency of beans (β_interaction[95% CI] = 0.14[0.04-0.24]. Findings highlight the benefit of coupling nutrition education with PSE changes and identify key areas for refining dietary and PA interventions in schools.

Hookah use is a growing global health concern, particularly among young adults, with significant misconceptions about its safety. This study aimed to investigate the prevalence of hookah use and its association with knowledge of harmful substances and future susceptibility among university students in Iran. A cross-sectional study was conducted among 561 undergraduate students from Golestan University of Medical Sciences in Iran between April and June 2024. Data were collected using a questionnaire assessing demographics, hookah and cigarette use patterns, future susceptibility, and knowledge of harmful substances in hookah versus cigarettes. Statistical analyses included descriptive statistics, chi-square tests, and logistic regression. The lifetime prevalence of hookah use was 44.4%, with 16% reporting use in the past month. A significant portion of students (38.7%) were susceptible to future hookah use. Most participants demonstrated good knowledge regarding the harmful substances in hookah compared to cigarettes. However, knowledge of carbon monoxide and heavy metal content was associated with a lower risk of future hookah use susceptibility (AOR = 0.498 and AOR = 0.490, respectively). Prior hookah use (lifetime, past year, past month) was significantly associated with increased susceptibility to future use (p < 0.0001). Hookah use is prevalent among Iranian university students, and prior use significantly predicts future susceptibility. While knowledge of hookah's harmful effects is relatively high, it does not fully mitigate the risk of future use. Interventions should focus on addressing attitudes and social influences that promote hookah use, alongside enhancing knowledge about specific harmful components.

Precision social medicine (PSM) represents a transformative approach to advancing community health by leveraging predictive analytics to deliver the right resources to the right individuals at the right time. The PSM framework integrates multi-level data on social drivers of health to align community-based interventions with populations most likely to benefit. By optimizing the allocation of scarce resources, PSM aims to reduce health disparities, strengthen community health systems, and address upstream drivers of inequity. This paper explores the potential and challenges of applying PSM within community health settings and proposes an implementation framework designed to support equitable and sustainable adoption of such strategies.

Tobacco use is disproportionately high among Indigenous populations globally. However, the information regarding smoking prevalence among Orang Asli (Indigenous population in Peninsular Malaysia), remained scarce. This cross-sectional study assessed the prevalence and associated factors of tobacco use among 341 Orang Asli individuals aged 15 years and above across four states in Peninsular Malaysia. Data were collected through home visits using a validated and culturally adapted questionnaire from the Global Adult Tobacco Survey (GATS). The results show that the prevalence of tobacco use was 30.5%, with cigarette smoking at 26.7%, e-cigarette use at 7.3%, and smokeless tobacco use at 2.9%. Multiple logistic regression (MLR) identified male gender and self-employment as significant predictors of cigarette use. Additionally, males and younger Orang Asli (aged 15-17) were more likely to use e-cigarettes, while religious affiliation was associated with lower odds of smokeless tobacco use. These findings highlight the need to strengthen tobacco control frameworks by incorporating targeted interventions that engage Orang Asli leaders, integrate health promotion within community structures, and implement stricter policy regulation of tobacco products to effectively reduce tobacco use and health disparities within this marginalized population.

This study aimed to assess knowledge, attitudes, and practices (KAP) related to snakebite first aid among residents of the Northern Border regoin and identify gaps for targeted interventions. A cross-sectional survey was conducted among 1236 adults using a structured, self-administered questionnaire covering demographics, knowledge, attitudes, behaviors, and sources of information. Data were analyzed descriptively and interpreted through the Health Belief Model (HBM) and COM-B framework to identify behavioral determinants and inform public health recommendations. Participants demonstrated moderate knowledge, with 43.2% aware of correct first aid steps and 39.8% recognizing limb immobilization as the first action. Misconceptions such as venom suction, tourniquet application, and incision were endorsed by 41.7%. While 68.0% acknowledged the importance of first aid, only 43.7% felt confident in responding, and 25.2% had formal training. Social media (32.5%) and educational institutions (23.8%) were the main information sources. HBM analysis revealed moderate perceived severity, limited perceived susceptibility, low self-efficacy, and significant barriers due to misinformation and lack of training. COM-B analysis highlighted gaps in capability, opportunity, and motivation. To conclude, Despite moderate awareness, substantial misconceptions and low confidence persist among the Northern Border population population. Structured, culturally tailored interventions, including social media campaigns, practical workshops, school curricula integration, and system-level preparedness, are urgently needed to improve community readiness and reduce snakebite morbidity.

After the COVID-19 pandemic, racial and ethnic minority groups experienced disproportionate delays in returning to breast cancer. The GW Cancer Center's Community Outreach and Engagement team developed a novel Neighborhood Health Ambassador (NHA) network to increase knowledge and access to breast cancer screening in the Washington, DC metropolitan region. First, we recruited NHAs to complete a paid 100-h Community Health Worker (CHW) training and 44-h practicum. We coached NHAs to conduct community outreach and breast cancer screening education in their neighborhoods. Second, we partnered with two community-based organizations to arrange direct screenings for Hispanic/Latina and African immigrant women. Twenty-six NHAs completed the CHW Curriculum. Nineteen NHAs completed the practicum. NHAs reached 2,189 direct beneficiaries at 108 events over a year. GW Cancer Center staff navigated 21 women to mammograms. Out-of-pocket costs were paid to allow an additional 102 uninsured women to obtain mammograms. This project piloted a community-based network to strengthen breast cancer screening in the GW Cancer Center catchment area. Creating a grassroots network of community health workers is feasible and impactful, but time-intensive. Directly partnering with longstanding community partners yielded faster screening uptake among priority groups for breast cancer screening.

Investing in a diverse public health workforce has implications for strengthening cultural humility and addressing health inequities within minoritized populations. First-generation (FG) students pursuing graduate level degrees are an important population with the potential to strengthen such efforts in their transition into the public health workforce. However, research on the factors influencing job satisfaction and job decisions is limited. The main objective of this study was to examine how personal, social, and economic resources influence job satisfaction among public health master's and doctoral level graduates, and to explore differences across education generation and racial/ethnic background. Drawing on Conservation of Resource and Intersectionality theories, we conducted secondary analysis using a recent national survey investigating factors that are associated with public health career choices (n = 751). Adjusted and weighted linear regression models, both with and without interaction terms, were analyzed to examine the associations between resource domains and job satisfaction. Our findings revealed significant moderating effects of FG status across personal, social, and economic resource domains in shaping job satisfaction, both within the full sample and among specific racial and ethnic subgroups. Further analysis revealed stronger influence of these resources among Black FG, White FG and total FG groups compared to non-FG groups, suggesting these resources may play a role in influencing job satisfaction among first-generation individuals. Therefore, public health graduate level academic programs and employers should consider strategies that improve access to resources to better support first-generation individuals' completion of degrees and transition into the workforce.