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.

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.

Men who have sex with men (MSM) have an elevated risk of adverse health outcomes associated with alcohol use and smoking. Although substantial studies have been conducted globally, little is known about alcohol use and smoking among MSM in Nepal. Therefore, the present study aimed to examine the prevalence and patterns of alcohol use and daily smoking among MSM in Nepal. A cross-sectional respondent-driven survey was conducted among MSM in Kathmandu, Nepal, between October and December 2022. Bivariate and multivariate logistic regression analyses were used to evaluate independent correlates of alcohol use in the past 12 months and daily smoking. Among 250 participants (mean age 27.6 ± 8.9 years), 71.6% had consumed alcohol in the past 12 months, and 42% smoked daily in the last 30 days. MSM who had an income of less than NRs 20,000 (aOR: 2.1; 95% CI: 1.1-3.8), were single (aOR: 2.0; 95% CI: 1.1-3.8), employed (aOR: 2.1; 95% CI: 1.1-4.1), engaged in sex work (aOR: 3.5; 95% CI: 1.1-11.1), ever smoked (aOR: 5.1; 95% CI: 2.6-9.7), and who did not engage in condomless sex (aOR: 2.1; 95% CI: 1.1-4.5) were more likely to use alcohol in the past 12 months. Similarly, participants who were born in Bagmati province (aOR: 3.7; 95% CI: 1.8-7.6), and had a history of drug use (aOR: 2.8; 95% CI: 1.3-5.7), and police detention (aOR: 3.2; 95% CI: 1.3-9.2) were more likely to be involved in daily smoking. The findings underscore the necessity of MSM-specific alcohol and smoking cessation programs in Nepal.

Hookah smoking among young adults is a growing public health concern, especially in low- and middle-income countries (LMICs). Despite its prevalence, comprehensive reviews evaluating theoretical frameworks used to study this behavior are lacking. This scoping review synthesized studies examining hookah smoking behaviors among young adults in LMICs. A systematic search was conducted in PubMed, Embase, Google Scholar, and CINAHL using keywords such as "Hookah OR Waterpipe OR Shisha," "Adverse effects OR Harmful Effects," "Young adults OR Adolescents," "Theory," and "Low-middle-income countries." Articles meeting predefined inclusion and exclusion criteria were screened using Covidence, and data on prevalence, predictors, and theoretical frameworks were extracted. The review included 28 studies involving 13,150 young adults with an average age of 19.2 years. Hookah use prevalence ranged from 2.6 to 89.4%, with a pooled prevalence of 26.4%. Frequently applied theoretical frameworks included the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT), along with the Protection Motivation Theory and PRECEDE-PROCEED. Facilitators of hookah use included subjective norms, favorable attitudes, perceived low risk, environmental influences, and limited awareness of health risks. Protective factors included self-efficacy, perceived risks, awareness of harmful effects, and anti-smoking attitudes. Interventions based on TPB and SCT showed positive outcomes, though some failed, highlighting the need for culturally sensitive approaches. The findings emphasize the importance of education and policy measures targeting both individual and environmental factors to reduce hookah smoking prevalence and its associated risks in LMICs.

The prevalence of obesity in Saudi Arabia has increased dramatically, with approximately 35% of the population estimated to be obese. This study assessed the patterns of carbonated beverage consumption and the factors and attitudes influencing consumption before and after implementing new soft drink taxes among Saudi adults. A secondary analysis was conducted on two cross-sectional studies involving Saudi adults aged over 18 years. The studies were conducted in July-September 2016 (Pre taxation, n = 964) and October 2022-March 2023 (post taxation, n = 1931). Data were collected using a validated questionnaire that included sociodemographic information, consumption patterns, influencing factors, and attitudes. A chi-square test compared frequency changes between the two periods, while a linear regression model assessed the impact of taxation on consumption frequency and quantity, along with associated factors and attitudes. Daily carbonated beverage consumption increased from 6% pre-taxation to 8% post-taxation. Significant changes were observed in factors and attitudes toward consumption (P < 0.05). The perceived influence of advertising decreased significantly (-0.320, P < 0.0001), while consumption during meals at home (0.430, P < 0.0001) and while watching TV or using electronic devices (0.231, P < 0.0001) increased post-taxation. The findings indicate that despite taxation, carbonated beverage consumption did not decrease among Saudi adults. These results underscore the need for comprehensive health promotion and intervention programs to address the high consumption of sugar-sweetened beverages and mitigate their health impacts.

Pre-exposure prophylaxis (PrEP) is an evidence-based strategy for HIV prevention, particularly for high-risk populations such as people who inject drugs and engage in chemsex. In Italy, there is no data on the actual knowledge of PrEP among Healthcare professionals (HCPs) in substance use disorder services (SerDs). This study aimed to assess PrEP awareness among SerD HCPs, also exploring their level of knowledge, practice, training, and perceived barriers. A cross-sectional study was conducted using a convenience sample of HCPs from SerDs across Italy (2023-2024). The questionnaire addressed sociodemographic and work-related information, PrEP awareness, knowledge scores (i.e. percentage of correct answers) on when proposing PrEP and reimbursement criteria, practice, and training received. Multiple logistic regression was performed to explore associations with PrEP awareness. The sample consisted of 306 professionals (26.8% physicians). Only 44.8% were aware of PrEP, with lower awareness among non-physicians (p < 0.001). As for knowledge scores on when proposing PrEP and on reimbursement, the median was 57.14% (IQR: 42.86-71.43%) and 55.56% (IQR: 33.33-66.67%), respectively. No differences were reported across professional roles. Only 10.36% reported PrEP is offered at their workplace and 87.9% highlighted a lack of training. Additionally, 96.79% believed it would be appropriate for HCPs to receive PrEP training; however, nurses were the most likely to state it is not appropriate (p = 0.046). The study identified gaps in PrEP knowledge and training among SerD professionals, including physicians. The strong interest in training suggests that SerD HCPs, though with varying perceptions, may be a receptive group for interventions for improving PrEP implementation.

Adequate access to healthy food is crucial for preventing and managing diet-related chronic diseases, especially for vulnerable populations. In neighborhoods lacking supermarkets, lower-income residents tend to source food in small independently-owned stores. To understand how retail food environments are associated with healthy food availability, we examined associations between in-store features and Healthy Food Availability Index (HFAI) scores in Baltimore and Charles County, Maryland stores. Cross-sectional data were collected from 2022 to 2024 across 18 stores. Observational Store Environmental Checklists assessed in-store features, food assistance program authorization, and targeted point-of-purchase promotions. An adapted HFAI scale was used to score each store from 0 to 27 with a higher score indicating greater healthy food availability. Linear regression models analyzed associations between in-store features and HFAI scores using R software. Across all urban and rural stores, the average HFAI score was low (M = 9.16, SD = 4.38). Unsurprisingly, rural stores were more likely to have a larger retail space (2.60 more aisles, on average) than urban stores. Urban vs. rural location and other store characteristics were not found to be significantly associated with HFAI scores. However, the presence of point-of-purchase promotions was associated with a 6.74-point higher HFAI score (CI: 2.40-11.08) after adjusting for number of aisles, food assistance program authorization, and location. Our sample of small Maryland stores generally had low healthy food availability regardless of urban or rural location. This suggests a need for further research to scale-up and evaluate retail food environment interventions that reach both urban and rural settings, nationwide.

This study explores the impact of serious neighborhood crime on levels of stress and prevalence of depression. The target population was adults residing in affected communities, specifically within North Philadelphia. A cross-sectional study was conducted to examine the relationship between serious crimes in North Philadelphia and stress/depression among community residents. All participants (n = 577) resided within one of ten zip codes in North Philadelphia. Individual exposure to serious neighborhood crime over four years (2016-2019) was quantified. Levels of stress and prevalence of depression served as outcome measures of mental health. The study results did not support an association between exposure to neighborhood crime and stress/depression as measured by validated instruments. Resilience was identified to have a positive and statistically significant independent impact on both stress (p < 0.0001) and depression (p < 0.0001), serving as a mediator in the association between crime exposure and levels of stress and prevalence of depression. Results from this study can be used as a framework in targeting the needs of Philadelphia residents and improving their overall stress and depression.

Native Americans serve in the U.S. military at the highest rate per capita of any ethnoracial group and have elevated rates of mental health (MH) difficulties compared to other ethnoracial groups, including posttraumatic stress disorder, alcohol use disorders, and suicide. Almost half of Native Veterans live in rural areas; rurality is associated with significant barriers to MH services. Engaging in outreach with Native Veterans is an important pathway for connecting them with MH care, but the outreach process and educational materials must be culturally aligned to be more effective. We collaborated with partners at a rural Department of Veterans Affairs medical center (VAMC) to develop and refine a process for co-creating MH-focused outreach materials that are culturally centered on the needs, preferences, and values of rural Native Veterans. Our model of Co-creating Outreach for Rural Native Veterans' Engagement (CORE) involves five key steps: building strong partnerships with rural VAMC partners (Connect), conducting a needs assessment to identify VAMC partners' and Native Veterans' unique needs (Learn), engaging in ongoing synchronous and asynchronous dialogue during iterative development of materials (Collaborate), piloting materials during outreach (Pilot), and refining materials based on Veteran and partner feedback (Re-evaluate). The process of developing culturally centered outreach materials should involve iterative refinement, partnerships and consultation with cultural experts, and strong relationships founded on respect, trust, and a commitment to bidirectional learning.