Journal of Community Health最新文献

Cashew processing is a labor-intensive work, which requires physical demand exposing workers to various occupational health problems. This study aims to identify the occupational health issues faced by cashew workers, evaluate their working environment and assess their quality of life. A cross-sectional study was conducted among 280 cashew factory workers in South Kerala. Data was collected using a semi structured questionnaire which includes sociodemographic characteristics, working environment, and system related health issues. The WHOQOL-BREF questionnaire was used to assess Quality of life among workers. The collected data was entered and coded into Microsoft Excel (Version 2016) and analyzed via SPSS Version16.0. Prevalence of musculoskeletal pain (96.8%) was high, followed by central nervous system-related symptoms (68.2%) and dermatological issues (58.5%).Of the ten factories surveyed, one-third (33.3%) did not have a proper system for fumes and dust extraction, provision of personal protective equipment, appointment of welfare officers and accessible washing facilities. Participants above 45 yrs of age were found to have 1.7 times higher odds of experiencing occupational health issues compared to those aged less than 45 years, as per multivariate analysis(p < 0.05). With respect to Quality of life, workers had higher social health mean score of 65.11 ± 15.02 and lower psychological health mean score of 46.93 ± 10.61. Musculoskeletal pain was the most prevalent health issue among cashew workers. The working environment among cashew workers is generally poor, which, along with occupational hazards, contributes to compromised quality of life in multiple domains.

This scoping review synthesizes evidence on the physical health, mental well-being, health behaviors, and overall quality of life of middle-aged adults living alone, highlighting its significance from a community health perspective. Recognizing the rapid growth of this demographic, this review evaluates the current research landscape, identifies critical gaps, and explores opportunities for targeted interventions. Following the JBI Scoping Review Guidelines, comprehensive searches were conducted in Ovid-Medline, Ovid-EMBASE, APA PsycInfo, and CINAHL Complete for studies published between 2000 and 2024 on middle-aged adults (45-64 years) living alone. Randomized and non-randomized trials and quantitative and qualitative studies were considered. Two reviewers independently screened titles and abstracts before performing full-text reviews of the articles. Data on study characteristics, participant profiles, and health-related outcomes were extracted. Of the 19,519 studies initially identified, 44 were included. The studies were categorized based on design, population characteristics, and health outcomes. The results indicate that middle-aged adults living alone experience poorer physical and mental health and engage in less favorable health behaviors than their counterparts in multi-person households. Key determinants, such as socioeconomic status, geographic location, and healthcare access, contribute to these disparities. These findings underscore the urgent need for community-based strategies to reduce social isolation, improve healthcare accessibility, and promote healthier lifestyles, thereby addressing the critical public health gaps faced by this vulnerable population.

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.

The Generation End Game (GEG) policy plan represents a groundbreaking initiative by the Malaysian government aimed at creating a smoke-free generation. This cross-sectional study aims to explore the factors influencing knowledge, attitude and perception of Malaysian adolescents towards the policy. A quantitative pre- and post-test survey was conducted among 731 adolescents born in 2007 and above across Malaysia, following a brief informational introduction to the GEG policy. This study utilized ANCOVA and binomial logistic regression to assess the association between various sociodemographic factors with knowledge, attitude and perceptions of the GEG. The results reveal that gender, tobacco-related experiences, peer influences, and health-related beliefs significantly impacted perception outcomes (p < 0.05). Female participants were significantly more likely to express supportive perceptions compared to male participants (unadjusted OR = 2.538, 95% CI = 1.598-4.030, p < 0.001). Non-smokers/vapers were more supportive of the GEG than smokers/vapers (unadjusted OR = 3.308, 95% CI = 2.032-5.384, p < 0.001). Participants who identified tobacco use as "definitely harmful" exhibited significantly greater support (unadjusted OR = 2.563, 95% CI = 1.522-4.315, p < 0.001). Individuals who reported no prior tobacco education were significantly less supportive (unadjusted OR = 0.321, 95% CI = 0.114-0.90, p = 0.031). The findings underline the need for targeted educational campaigns to address knowledge gaps and improve public understanding of the policy. Efforts to enhance perceptions of the harmfulness of tobacco use and its broader societal impacts could further bolster support for the GEG policy.

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.