Pub Date : 2026-01-11DOI: 10.1016/j.puhip.2026.100722
Fauzi Elamouri , Amera Muftah A Alamori , Jürgen Kurt Rockstroh
Objectives
This qualitative study among internally displaced heterosexual men in post-conflict Libya investigates the attitudes, experiences, and barriers related to condom use within this vulnerable population.
Study design
Qualitative study using semi-structured, face-to-face in-depth interviews.
Methods
Semi-structured, face-to-face in-depth interviews were conducted with 21 internally displaced (IDPs) male participants, aged 18–35. Participants were selected through purposive sampling, focusing on their displacement status and willingness to discuss sexual health practices. The interviews explored knowledge, experiences, and challenges related to condom use using a guided protocol. Braun and Clarke's thematic analysis framework was used to analyse the data.
Results
A total of 21 male heterosexual IDPs, aged 18–35, residing in IDP camps in Tripoli were recruited for the study. Only 9.5 % (n = 2) ever used a condom. Key barriers to condom use included financial constraints, geographic inaccessibility, cultural taboos, and stigma. Risk factors for condomless sex included lower knowledge about HIV and STIs, misconceptions about condom efficacy, lack of sexual health education, fear of social judgment, and negative perceptions about reduced pleasure. The theme of basic needs overriding safer sex practices was highlighted.
Conclusions
This study reveals significant gaps in sexual health knowledge and condom use among young displaced men in Libya. Targeted, culturally sensitive interventions are urgently needed to improve sexual health education, promote positive attitudes towards condom use, and enhance access to contraceptives, particularly in post-conflict settings.
{"title":"“Condoms don't cross your mind when you're hungry”: Challenges to safe sex in Libyan IDP camps; A qualitative study","authors":"Fauzi Elamouri , Amera Muftah A Alamori , Jürgen Kurt Rockstroh","doi":"10.1016/j.puhip.2026.100722","DOIUrl":"10.1016/j.puhip.2026.100722","url":null,"abstract":"<div><h3>Objectives</h3><div>This qualitative study among internally displaced heterosexual men in post-conflict Libya investigates the attitudes, experiences, and barriers related to condom use within this vulnerable population.</div></div><div><h3>Study design</h3><div>Qualitative study using semi-structured, face-to-face in-depth interviews.</div></div><div><h3>Methods</h3><div>Semi-structured, face-to-face in-depth interviews were conducted with 21 internally displaced (IDPs) male participants, aged 18–35. Participants were selected through purposive sampling, focusing on their displacement status and willingness to discuss sexual health practices. The interviews explored knowledge, experiences, and challenges related to condom use using a guided protocol. Braun and Clarke's thematic analysis framework was used to analyse the data.</div></div><div><h3>Results</h3><div>A total of 21 male heterosexual IDPs, aged 18–35, residing in IDP camps in Tripoli were recruited for the study. Only 9.5 % (n = 2) ever used a condom. Key barriers to condom use included financial constraints, geographic inaccessibility, cultural taboos, and stigma. Risk factors for condomless sex included lower knowledge about HIV and STIs, misconceptions about condom efficacy, lack of sexual health education, fear of social judgment, and negative perceptions about reduced pleasure. The theme of basic needs overriding safer sex practices was highlighted.</div></div><div><h3>Conclusions</h3><div>This study reveals significant gaps in sexual health knowledge and condom use among young displaced men in Libya. Targeted, culturally sensitive interventions are urgently needed to improve sexual health education, promote positive attitudes towards condom use, and enhance access to contraceptives, particularly in post-conflict settings.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100722"},"PeriodicalIF":1.9,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.puhip.2026.100726
Jacqueline P. Duncan , Marshall K. Tulloch-Reid , Trevor S. Ferguson , Mary-Anne Land , Bruce Neal
{"title":"Lower-sodium, potassium-enriched salt substitution: An opportunity for improving blood pressure in Jamaica?","authors":"Jacqueline P. Duncan , Marshall K. Tulloch-Reid , Trevor S. Ferguson , Mary-Anne Land , Bruce Neal","doi":"10.1016/j.puhip.2026.100726","DOIUrl":"10.1016/j.puhip.2026.100726","url":null,"abstract":"","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100726"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.puhip.2026.100724
Loveline Nzenria Aboki , Nfor Omarine Nlinwe , Calvin Bisong Ebai , Loveline Lum Niba , Mary Bi Suh Atanga
Objectives
Malaria continues to be a major health burden in sub-Saharan Africa, prompting the introduction of malaria vaccines such as RTS,S/AS01 (Mosquirix™) and R21/Matrix-M to reduce disease incidence. Understanding caregivers’ acceptance is critical for successful vaccine deployment. This study assessed factors influencing malaria vaccine acceptance among caregivers in Bamenda and Bamenda III Health Districts of Cameroon.
Study design
This was a cross-sectional survey conducted among 1000 caregivers of children aged five years and below, using a structured questionnaire.
Methods
Data on socio-demographics, perceptions, sources of information, and vaccine acceptance were collected. Associations between variables and vaccine acceptance were analyzed using Chi-square tests, with significant factors further explored through post-hoc analysis and odds ratios.
Results
Overall, 89.6 % of caregivers indicated their willingness to vaccinate their children. Significant factors associated with vaccine acceptability included source of information (community health events vs. social media, p = 0.037; OR = 1.663, 95 % CI: 1.032–2.68), individual perception (very rejecting vs. very accepting, p = 0.000; OR = 0.098, 95 % CI: 0.05–0 0.193), Sex (male vs. female, p = 0.028; OR = 0.704, 95 % CI: 0.515–0 0.963), religion (other religion vs. Christian, p = 0.001; OR = 0.386, 95 % CI: 0.224–0.663), occupation (NGO employed vs. self-employed, p = 0.045; OR = 2.92, 95 % CI: 1.024–8.327).
Conclusions
Most caregivers demonstrated high acceptance of the malaria vaccine, influenced by positive perceptions and trust in healthcare sources. However, misinformation and limited awareness remain barriers. To improve vaccine uptake, targeted health communication strategies should focus on enhancing information accuracy, engaging trusted health professionals, and leveraging mobile health tools. Strengthening community engagement and addressing misconceptions are essential to achieving higher vaccine coverage and advancing malaria control efforts, especially in the Bamenda and Bamenda III Health Districts.
{"title":"Determinants of caregivers' acceptance of the malaria vaccine: The case of Bamenda and Bamenda III Health Districts in Cameroon","authors":"Loveline Nzenria Aboki , Nfor Omarine Nlinwe , Calvin Bisong Ebai , Loveline Lum Niba , Mary Bi Suh Atanga","doi":"10.1016/j.puhip.2026.100724","DOIUrl":"10.1016/j.puhip.2026.100724","url":null,"abstract":"<div><h3>Objectives</h3><div>Malaria continues to be a major health burden in sub-Saharan Africa, prompting the introduction of malaria vaccines such as RTS,S/AS01 (Mosquirix™) and R21/Matrix-M to reduce disease incidence. Understanding caregivers’ acceptance is critical for successful vaccine deployment. This study assessed factors influencing malaria vaccine acceptance among caregivers in Bamenda and Bamenda III Health Districts of Cameroon.</div></div><div><h3>Study design</h3><div>This was a cross-sectional survey conducted among 1000 caregivers of children aged five years and below, using a structured questionnaire.</div></div><div><h3>Methods</h3><div>Data on socio-demographics, perceptions, sources of information, and vaccine acceptance were collected. Associations between variables and vaccine acceptance were analyzed using Chi-square tests, with significant factors further explored through post-hoc analysis and odds ratios.</div></div><div><h3>Results</h3><div>Overall, 89.6 % of caregivers indicated their willingness to vaccinate their children. Significant factors associated with vaccine acceptability included source of information (community health events vs. social media, p = 0.037; OR = 1.663, 95 % CI: 1.032–2.68), individual perception (very rejecting vs. very accepting, p = 0.000; OR = 0.098, 95 % CI: 0.05–0 0.193), Sex (male vs. female, p = 0.028; OR = 0.704, 95 % CI: 0.515–0 0.963), religion (other religion vs. Christian, p = 0.001; OR = 0.386, 95 % CI: 0.224–0.663), occupation (NGO employed vs. self-employed, p = 0.045; OR = 2.92, 95 % CI: 1.024–8.327).</div></div><div><h3>Conclusions</h3><div>Most caregivers demonstrated high acceptance of the malaria vaccine, influenced by positive perceptions and trust in healthcare sources. However, misinformation and limited awareness remain barriers. To improve vaccine uptake, targeted health communication strategies should focus on enhancing information accuracy, engaging trusted health professionals, and leveraging mobile health tools. Strengthening community engagement and addressing misconceptions are essential to achieving higher vaccine coverage and advancing malaria control efforts, especially in the Bamenda and Bamenda III Health Districts.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100724"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.puhip.2025.100715
Luisa Silva , Mayuri Gogoi , Zainab Lal , Paul Bird , Nisha George , Daniel Pan , Rebecca F. Baggaley , Pip Divall , Holly Reilly , Laura Nellums , Manish Pareek
Objectives
Antimicrobial resistance (AMR) is a major global public health concern. Although low-income countries are disproportionately affected by AMR, certain underserved groups in high-income countries (HICs), such as migrants and ethnic minorities, disproportionately bear the burden of AMR. This may be driven by socio-cultural factors including differences in health literacy. This review aimed to investigate the level of antibiotic knowledge amongst different ethnic minority groups in HICs.
Study design
This was a mixed-methods systematic literature review.
Methods
We searched four databases (MEDLINE, EMBASE, the Cochrane library, CINAHL) to May 5, 2023, for primary studies on knowledge of antibiotics in different ethnic groups in HICs. We included studies in English using qualitative, quantitative and/or mixed-methods approaches and reporting on antibiotic knowledge by ethnicity. We used the convergent integrated approach for data synthesis and the Mixed-Methods Appraisal tool for quality assessment.
Results
3935 articles were screened and 24 studies (17 quantitative, 5 qualitative, and 2 mixed-methods) were included, comprising 52778 participants from 8 countries (USA, UK, Australia, New Zealand, Netherlands, Greece, Sweden, Germany). Overall, participants from ethnic minority groups were able to identify common names of antibiotics and were aware of risks of antibiotics and side effects. However, participants thought antibiotics would treat viral-type illnesses. Ethnic minority groups generally had lower levels of knowledge compared to ethnic majority groups.
Conclusions
Although ethnic minority communities possessed good levels of knowledge on certain aspects of antibiotics (e.g. being able to identify names of antibiotics), there were gaps in other areas (e.g. misperception that antibiotics are used for viral infections). The lower level of knowledge in ethnic minority groups compared to majority groups may be a contributing factor to health inequalities, which calls for co-designed, culturally competent, educational interventions.
{"title":"Antibiotic knowledge among ethnic minority groups in high-income countries: A mixed–methods systematic review","authors":"Luisa Silva , Mayuri Gogoi , Zainab Lal , Paul Bird , Nisha George , Daniel Pan , Rebecca F. Baggaley , Pip Divall , Holly Reilly , Laura Nellums , Manish Pareek","doi":"10.1016/j.puhip.2025.100715","DOIUrl":"10.1016/j.puhip.2025.100715","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial resistance (AMR) is a major global public health concern. Although low-income countries are disproportionately affected by AMR, certain underserved groups in high-income countries (HICs), such as migrants and ethnic minorities, disproportionately bear the burden of AMR. This may be driven by socio-cultural factors including differences in health literacy. This review aimed to investigate the level of antibiotic knowledge amongst different ethnic minority groups in HICs.</div></div><div><h3>Study design</h3><div>This was a mixed-methods systematic literature review.</div></div><div><h3>Methods</h3><div>We searched four databases (MEDLINE, EMBASE, the Cochrane library, CINAHL) to May 5, 2023, for primary studies on knowledge of antibiotics in different ethnic groups in HICs. We included studies in English using qualitative, quantitative and/or mixed-methods approaches and reporting on antibiotic knowledge by ethnicity. We used the convergent integrated approach for data synthesis and the Mixed-Methods Appraisal tool for quality assessment.</div></div><div><h3>Results</h3><div>3935 articles were screened and 24 studies (17 quantitative, 5 qualitative, and 2 mixed-methods) were included, comprising 52778 participants from 8 countries (USA, UK, Australia, New Zealand, Netherlands, Greece, Sweden, Germany). Overall, participants from ethnic minority groups were able to identify common names of antibiotics and were aware of risks of antibiotics and side effects. However, participants thought antibiotics would treat viral-type illnesses. Ethnic minority groups generally had lower levels of knowledge compared to ethnic majority groups.</div></div><div><h3>Conclusions</h3><div>Although ethnic minority communities possessed good levels of knowledge on certain aspects of antibiotics (e.g. being able to identify names of antibiotics), there were gaps in other areas (e.g. misperception that antibiotics are used for viral infections). The lower level of knowledge in ethnic minority groups compared to majority groups may be a contributing factor to health inequalities, which calls for co-designed, culturally competent, educational interventions.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100715"},"PeriodicalIF":1.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.puhip.2025.100721
Shayna D. Cunningham, Jennifer Sussman, Sydney Tabor, Alison Wiser, Megan A. O'Grady
Objectives
Connecticut consistently reports higher rates of alcohol and cannabis use than national averages. To inform equitable and data-driven prevention planning, this study assessed statewide substance use primary prevention resources and developed an interactive map to visualize and optimize prevention capacity across the state.
Study design
Descriptive cross-sectional study.
Methods
Surveys of Regional Behavioral Health Action Organizations (RBHAOs) and Local Prevention Councils (LPCs) assessed prevention strategies, funding sources, target populations, and implementation settings. Data were supplemented with web searches of public prevention resources and analyzed descriptively to identify geographic and community-type disparities. Findings informed the design of an interactive ArcGIS map to support planning and resource allocation.
Results
Data were collected from all five RBHAOs and 81 % of LPCs, representing 78 % of Connecticut towns. Most towns (92 %) received LPC prevention funding, and 77 % reported at least one additional funding source. The most common prevention strategies were information dissemination (85 %), education (80 %), and social marketing (64 %), primarily implemented in community and school settings. Rural and eastern regions reported fewer prevention resources and lower participation rates.
Conclusions
Connecticut's prevention infrastructure employs a comprehensive, multi-strategy approach but shows regional disparities in funding and strategy implementation. The interactive prevention map provides an actionable and adaptable framework for other jurisdictions to assess, visualize, and strengthen substance use prevention systems using standardized, data-driven approaches. Because many existing efforts rely heavily on educational and informational strategies, which alone have limited capacity to produce sustained, population-level change, expanding systems-level and environmental prevention strategies is important for long-term impact and equity.
{"title":"Connecticut's substance use primary prevention resource assessment and interactive map initiative","authors":"Shayna D. Cunningham, Jennifer Sussman, Sydney Tabor, Alison Wiser, Megan A. O'Grady","doi":"10.1016/j.puhip.2025.100721","DOIUrl":"10.1016/j.puhip.2025.100721","url":null,"abstract":"<div><h3>Objectives</h3><div>Connecticut consistently reports higher rates of alcohol and cannabis use than national averages. To inform equitable and data-driven prevention planning, this study assessed statewide substance use primary prevention resources and developed an interactive map to visualize and optimize prevention capacity across the state.</div></div><div><h3>Study design</h3><div>Descriptive cross-sectional study.</div></div><div><h3>Methods</h3><div>Surveys of Regional Behavioral Health Action Organizations (RBHAOs) and Local Prevention Councils (LPCs) assessed prevention strategies, funding sources, target populations, and implementation settings. Data were supplemented with web searches of public prevention resources and analyzed descriptively to identify geographic and community-type disparities. Findings informed the design of an interactive ArcGIS map to support planning and resource allocation.</div></div><div><h3>Results</h3><div>Data were collected from all five RBHAOs and 81 % of LPCs, representing 78 % of Connecticut towns. Most towns (92 %) received LPC prevention funding, and 77 % reported at least one additional funding source. The most common prevention strategies were information dissemination (85 %), education (80 %), and social marketing (64 %), primarily implemented in community and school settings. Rural and eastern regions reported fewer prevention resources and lower participation rates.</div></div><div><h3>Conclusions</h3><div>Connecticut's prevention infrastructure employs a comprehensive, multi-strategy approach but shows regional disparities in funding and strategy implementation. The interactive prevention map provides an actionable and adaptable framework for other jurisdictions to assess, visualize, and strengthen substance use prevention systems using standardized, data-driven approaches. Because many existing efforts rely heavily on educational and informational strategies, which alone have limited capacity to produce sustained, population-level change, expanding systems-level and environmental prevention strategies is important for long-term impact and equity.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100721"},"PeriodicalIF":1.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.puhip.2025.100714
Olivier Droulers , Sophie Lacoste-Badie
Introduction
In 2006, France passed a regulation requiring all alcoholic beverage bottles to carry a health warning aimed at pregnant women. The regulation stated that the pregnancy warning label (PWL) must appear on a contrasting background in a way that is visible, legible, clearly understandable, and indelible. It must not be concealed, obscured, or separated by any other text or image. The current study aims to assess whether current PWLs comply with the legal requirements.
Methods
Conducted between January and April 2025, the study is based on observations of PWLs displayed on alcoholic beverage bottles in supermarkets and wine shops across France.
Results
The study reveals widespread non-compliance with French regulations regarding PWLs on wine bottles. Common issues include inadequate label size, poor colour contrast, unclear designs, and placement that impairs visibility such as positioning the PWL at the edge of the label, on transparent backgrounds, or among competing logos and text.
Conclusion
The findings highlight the limitations of relying solely on general principles like visibility and legibility in health warning legislation. Effective implementation requires clear, detailed, and enforceable regulatory standards.
{"title":"Fifty shades of pregnancy warning labels on wine bottles: An observational study in France","authors":"Olivier Droulers , Sophie Lacoste-Badie","doi":"10.1016/j.puhip.2025.100714","DOIUrl":"10.1016/j.puhip.2025.100714","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2006, France passed a regulation requiring all alcoholic beverage bottles to carry a health warning aimed at pregnant women. The regulation stated that the pregnancy warning label (PWL) must appear on a contrasting background in a way that is visible, legible, clearly understandable, and indelible. It must not be concealed, obscured, or separated by any other text or image. The current study aims to assess whether current PWLs comply with the legal requirements.</div></div><div><h3>Methods</h3><div>Conducted between January and April 2025, the study is based on observations of PWLs displayed on alcoholic beverage bottles in supermarkets and wine shops across France.</div></div><div><h3>Results</h3><div>The study reveals widespread non-compliance with French regulations regarding PWLs on wine bottles. Common issues include inadequate label size, poor colour contrast, unclear designs, and placement that impairs visibility such as positioning the PWL at the edge of the label, on transparent backgrounds, or among competing logos and text.</div></div><div><h3>Conclusion</h3><div>The findings highlight the limitations of relying solely on general principles like visibility and legibility in health warning legislation. Effective implementation requires clear, detailed, and enforceable regulatory standards.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100714"},"PeriodicalIF":1.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.puhip.2025.100713
Sua Amaya-Santos , Carlos Vargas , Clara Bermúdez-Tamayo
Objectives
This study systematically evaluates how existing AI frameworks in healthcare address intersectional bias across the AI lifecycle and explores the mitigation strategies proposed.
Study design
Scoping review.
Methods
A scoping review was conducted per PRISMA-ScR guidelines, analyzing studies from 2014 to 2024. Searches included MEDLINE (Ovid), PubMed, EMBASE (Ovid), SCOPUS, ESCI, IEEE Xplore, and Google Scholar. Data were extracted on bias-related challenges and mitigation strategies across AI lifecycle phases (development, validation, implementation, monitoring). Studies were ranked by inclusivity (high, medium, or low).
Results
Of 374 records, 43 studies met inclusion criteria, primarily from high-income countries. Gender/sex (51.2 %) and race/ethnicity (44.2 %) were the most addressed dimensions, while disability (14 %) and citizenship (9.3 %) were least addressed. Inclusivity was categorized as high (21 studies, 48.8 %), medium (23.2 %), or low (27.9 %). Overall, 14 biases and 21 mitigation strategies were identified.
Conclusions
Significant gaps remain in addressing intersectional biases in AI frameworks, particularly for underrepresented groups such as individuals with disabilities and non-citizens. Despite many frameworks demonstrating efforts toward inclusivity, attention to intersectionality remains uneven and largely inconsistent. Mapping biases to lifecycle phases highlights actionable strategies to improve equity and inclusivity in AI-driven healthcare. These findings provide valuable guidance for researchers, policymakers, and developers to create equitable and responsible AI systems.
{"title":"Frameworks encompassing intersectional perspective of artificial intelligence in healthcare. Scoping review","authors":"Sua Amaya-Santos , Carlos Vargas , Clara Bermúdez-Tamayo","doi":"10.1016/j.puhip.2025.100713","DOIUrl":"10.1016/j.puhip.2025.100713","url":null,"abstract":"<div><h3>Objectives</h3><div>This study systematically evaluates how existing AI frameworks in healthcare address intersectional bias across the AI lifecycle and explores the mitigation strategies proposed.</div></div><div><h3>Study design</h3><div>Scoping review.</div></div><div><h3>Methods</h3><div>A scoping review was conducted per PRISMA-ScR guidelines, analyzing studies from 2014 to 2024. Searches included MEDLINE (Ovid), PubMed, EMBASE (Ovid), SCOPUS, ESCI, IEEE Xplore, and Google Scholar. Data were extracted on bias-related challenges and mitigation strategies across AI lifecycle phases (development, validation, implementation, monitoring). Studies were ranked by inclusivity (high, medium, or low).</div></div><div><h3>Results</h3><div>Of 374 records, 43 studies met inclusion criteria, primarily from high-income countries. Gender/sex (51.2 %) and race/ethnicity (44.2 %) were the most addressed dimensions, while disability (14 %) and citizenship (9.3 %) were least addressed. Inclusivity was categorized as high (21 studies, 48.8 %), medium (23.2 %), or low (27.9 %). Overall, 14 biases and 21 mitigation strategies were identified.</div></div><div><h3>Conclusions</h3><div>Significant gaps remain in addressing intersectional biases in AI frameworks, particularly for underrepresented groups such as individuals with disabilities and non-citizens. Despite many frameworks demonstrating efforts toward inclusivity, attention to intersectionality remains uneven and largely inconsistent. Mapping biases to lifecycle phases highlights actionable strategies to improve equity and inclusivity in AI-driven healthcare. These findings provide valuable guidance for researchers, policymakers, and developers to create equitable and responsible AI systems.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100713"},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.puhip.2025.100717
Julian Matthewman , Sinéad Langan , Reecha Sofat , James Galloway , Mark Russell
Objectives
To examine regional variation in the prescribing of targeted therapies for chronic inflammatory disorders in England between 2019 and 2025.
Study design
Retrospective observational study.
Methods
This study analysed Secondary Care Medicines Data from all NHS hospitals in England to evaluate time-trends in prescribing rates of targeted therapies by Integrated Care Board (ICB).
Results
Substantial and increasing regional variation in prescribing rates for targeted therapies was observed between 2019 and 2025. The disparity between the highest and lowest prescribing ICBs increased over time, with rates ranging from 2.0 to 6.5 per 1000 people in 2019 and 3.4 to 14.2 per 1000 people in 2025.
Conclusions
There is marked and growing regional variation in the prescribing of targeted therapies across England. Further research should explore the reasons for this divergence to ensure equitable access to these highly effective treatments for patients with chronic inflammatory disorders, irrespective of geography.
{"title":"Prescribing of high-cost targeted therapies in England is diverging by region","authors":"Julian Matthewman , Sinéad Langan , Reecha Sofat , James Galloway , Mark Russell","doi":"10.1016/j.puhip.2025.100717","DOIUrl":"10.1016/j.puhip.2025.100717","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine regional variation in the prescribing of targeted therapies for chronic inflammatory disorders in England between 2019 and 2025.</div></div><div><h3>Study design</h3><div>Retrospective observational study.</div></div><div><h3>Methods</h3><div>This study analysed Secondary Care Medicines Data from all NHS hospitals in England to evaluate time-trends in prescribing rates of targeted therapies by Integrated Care Board (ICB).</div></div><div><h3>Results</h3><div>Substantial and increasing regional variation in prescribing rates for targeted therapies was observed between 2019 and 2025. The disparity between the highest and lowest prescribing ICBs increased over time, with rates ranging from 2.0 to 6.5 per 1000 people in 2019 and 3.4 to 14.2 per 1000 people in 2025.</div></div><div><h3>Conclusions</h3><div>There is marked and growing regional variation in the prescribing of targeted therapies across England. Further research should explore the reasons for this divergence to ensure equitable access to these highly effective treatments for patients with chronic inflammatory disorders, irrespective of geography.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100717"},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.puhip.2025.100716
Evy Present , Els Driessen , Yvonne Kuipers
Objective
To examine and describe the current practices and perspectives regarding human milk donation in Belgium.
Study design
A cross-sectional study was conducted, utilising an online survey distributed to women and their partners or co-parents.
Methods
Demographic and personal details and responses related to awareness, information resources, milk transfer, and donor-recipient and recipient-donor contact were obtained. We measured factors influencing the intention to donate and receive human milk (0–5 scale), attitudes toward human milk donation (1–4 scale) and donation practices (dichotomous responses). Descriptive statistics were used to analyse the data.
Results
The analysis included 873 respondents. A surplus (4.6 ± 1.0) or shortage (3.9 ± 1.7) of milk is the primary factor influencing the intention to donate or receive human milk, reported by 88 % and 78 % of respondents, respectively. Most donations (85.7 %) occur through social media (50 %) and personal networks (47.6 %). Key perspectives of milk donation include healthcare providers’ familiarity (3.7 ± 0.5), public awareness (3.6 ± 0.5), mandatory blood testing (3.5 ± 0.7), and donor screening (3.5 ± 0.6). Human milk banks are perceived as valuable resources (3.5 ± 0.6), while altruism (3.4 ± 0.6) is key to donating. There is broad support for making human milk accessible to all infants, not just those who are premature or ill (3.4 ± 0.6).
Conclusions
Personal attitudes and intentions shape informal, self-regulated milk donation. Healthcare providers should consider these perspectives when advising on milk donation practices.
{"title":"Exploring human milk donation: A cross-sectional study","authors":"Evy Present , Els Driessen , Yvonne Kuipers","doi":"10.1016/j.puhip.2025.100716","DOIUrl":"10.1016/j.puhip.2025.100716","url":null,"abstract":"<div><h3>Objective</h3><div>To examine and describe the current practices and perspectives regarding human milk donation in Belgium.</div></div><div><h3>Study design</h3><div>A cross-sectional study was conducted, utilising an online survey distributed to women and their partners or co-parents.</div></div><div><h3>Methods</h3><div>Demographic and personal details and responses related to awareness, information resources, milk transfer, and donor-recipient and recipient-donor contact were obtained. We measured factors influencing the intention to donate and receive human milk (0–5 scale), attitudes toward human milk donation (1–4 scale) and donation practices (dichotomous responses). Descriptive statistics were used to analyse the data.</div></div><div><h3>Results</h3><div>The analysis included 873 respondents. A surplus (4.6 ± 1.0) or shortage (3.9 ± 1.7) of milk is the primary factor influencing the intention to donate or receive human milk, reported by 88 % and 78 % of respondents, respectively. Most donations (85.7 %) occur through social media (50 %) and personal networks (47.6 %). Key perspectives of milk donation include healthcare providers’ familiarity (3.7 ± 0.5), public awareness (3.6 ± 0.5), mandatory blood testing (3.5 ± 0.7), and donor screening (3.5 ± 0.6). Human milk banks are perceived as valuable resources (3.5 ± 0.6), while altruism (3.4 ± 0.6) is key to donating. There is broad support for making human milk accessible to all infants, not just those who are premature or ill (3.4 ± 0.6).</div></div><div><h3>Conclusions</h3><div>Personal attitudes and intentions shape informal, self-regulated milk donation. Healthcare providers should consider these perspectives when advising on milk donation practices.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100716"},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.puhip.2025.100719
Emily M. D'Agostino , Raha Manyara , Tyler Erickson , Angel Chen , Ashley Peters , Ashley Blakemore , Elena Maina , Cynthia Vargas , Kanecia O. Zimmerman
Objectives
School absenteeism predicts poor academic achievement and long-term health inequities. Chronic absenteeism increased dramatically during the COVID-19 pandemic, and both student attendance and achievement disparities widened. This study examined the association between participation in an intensive outside-of-school intervention, Student U, and school absenteeism, as well as changes in attendee academic performance during the pandemic.
Study design
Observational cohort study.
Methods
A simple linear regression model was performed testing the association between Student U attendance and schools absences. Paired t-tests and a global test for overall improvement using generalized estimating equations were performed to examine changes in pre- and post-test academic performance.
Results
The sample included 65 students (Hispanic/Latino, 56.9 %; Non-Hispanic Black/African American, 33.8 %; 80.0 % first-generation college-bound). For every day a 7th-grade student attended Student U, school absences decreased by 0.14 days (p = 0.02). Mean differences in overall improvement for 7th- and 10th-grade student test scores were 23.65 (95 % CI: 19.91, 27.39; p < 0.001) and 22.12 (95 % CI: 15.67, 28.58; p < 0.001), respectively.
Conclusions
We demonstrated the association between participation in Student U and lower school absenteeism, as well as improved academic performance across multiple subjects for underserved youth. Findings reinforce the potential for comprehensive and intensive outside-of-school programs to support underserved youth and mitigate inequities following pandemics and other public health emergencies.
目的学校缺勤预示着学习成绩差和长期健康不平等。在2019冠状病毒病大流行期间,长期缺勤率急剧上升,学生出勤率和成绩差距都扩大了。本研究调查了参与强化校外干预、学生U和学校缺勤之间的关系,以及大流行期间出席者学业成绩的变化。研究设计:观察性队列研究。方法采用简单线性回归模型检验学生出勤与缺勤之间的关系。使用广义估计方程进行配对t检验和总体改进的全球检验,以检查测试前和测试后学业成绩的变化。结果样本包括65名学生(西班牙裔/拉丁裔占56.9%;非西班牙裔黑人/非洲裔美国人占33.8%;第一代大学生占80.0%)。七年级学生每参加学生U一天,缺课天数减少0.14天(p = 0.02)。七年级和十年级学生考试成绩总体改善的平均差异分别为23.65 (95% CI: 19.91, 27.39; p < 0.001)和22.12 (95% CI: 15.67, 28.58; p < 0.001)。结论:我们证明了学生U的参与与较低的学校缺勤率之间的联系,以及缺勤青少年在多个科目上学习成绩的提高。研究结果表明,有可能开展全面和密集的校外项目,以支持得不到充分服务的青年,并缓解大流行和其他突发公共卫生事件后的不平等现象。
{"title":"A comprehensive outside-of-school intervention to promote school attendance and achievement during the COVID-19 pandemic","authors":"Emily M. D'Agostino , Raha Manyara , Tyler Erickson , Angel Chen , Ashley Peters , Ashley Blakemore , Elena Maina , Cynthia Vargas , Kanecia O. Zimmerman","doi":"10.1016/j.puhip.2025.100719","DOIUrl":"10.1016/j.puhip.2025.100719","url":null,"abstract":"<div><h3>Objectives</h3><div>School absenteeism predicts poor academic achievement and long-term health inequities. Chronic absenteeism increased dramatically during the COVID-19 pandemic, and both student attendance and achievement disparities widened. This study examined the association between participation in an intensive outside-of-school intervention, Student U, and school absenteeism, as well as changes in attendee academic performance during the pandemic.</div></div><div><h3>Study design</h3><div>Observational cohort study.</div></div><div><h3>Methods</h3><div>A simple linear regression model was performed testing the association between Student U attendance and schools absences. Paired t-tests and a global test for overall improvement using generalized estimating equations were performed to examine changes in pre- and post-test academic performance.</div></div><div><h3>Results</h3><div>The sample included 65 students (Hispanic/Latino, 56.9 %; Non-Hispanic Black/African American, 33.8 %; 80.0 % first-generation college-bound). For every day a 7th-grade student attended Student U, school absences decreased by 0.14 days (p = 0.02). Mean differences in overall improvement for 7th- and 10th-grade student test scores were 23.65 (95 % CI: 19.91, 27.39; p < 0.001) and 22.12 (95 % CI: 15.67, 28.58; p < 0.001), respectively.</div></div><div><h3>Conclusions</h3><div>We demonstrated the association between participation in Student U and lower school absenteeism, as well as improved academic performance across multiple subjects for underserved youth. Findings reinforce the potential for comprehensive and intensive outside-of-school programs to support underserved youth and mitigate inequities following pandemics and other public health emergencies.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100719"},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}