Pub Date : 2025-12-01Epub Date: 2025-10-14DOI: 10.1016/j.puhip.2025.100673
Ma Elena Martínez-Ochoa , Pablo Moya-Martínez , Elisa Amo-Saus , María Ángeles Tortosa-Chuliá
Objectives
The aim of this study is to understand how different measures of loneliness affect the quality-of-life of older adults and their use of social and healthcare services.
Study design
An observational, cross-sectional study was conducted, administering a survey to 1003 non-institutionalized individuals aged 65 years or over in Spain.
Methods
Data on sociodemographic variables, quality-of-life, and the use of social and healthcare services were collected. The prevalence of loneliness was analyzed using various measures, while its relationship with quality-of-life and the use of social and healthcare services was assessed through linear and logistic regression models, adjusting for other factors.
Results
Loneliness reduced quality-of-life by between 11.1 % and 20.7 %. Of the social and health services analyzed, we found that loneliness increased the likelihood of using home help services by a factor of 1.75–2.36 and increased the number of visits to primary care/nursing services by a factor of 1.51–1.70.
Conclusions
Loneliness has detrimental effects on quality-of-life. Moreover, it may negatively impact health status, leading to increased use of social and healthcare services.
{"title":"Factors associated with quality of life and the use of public healthcare and social services in older adults experiencing loneliness","authors":"Ma Elena Martínez-Ochoa , Pablo Moya-Martínez , Elisa Amo-Saus , María Ángeles Tortosa-Chuliá","doi":"10.1016/j.puhip.2025.100673","DOIUrl":"10.1016/j.puhip.2025.100673","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study is to understand how different measures of loneliness affect the quality-of-life of older adults and their use of social and healthcare services.</div></div><div><h3>Study design</h3><div>An observational, cross-sectional study was conducted, administering a survey to 1003 non-institutionalized individuals aged 65 years or over in Spain.</div></div><div><h3>Methods</h3><div>Data on sociodemographic variables, quality-of-life, and the use of social and healthcare services were collected. The prevalence of loneliness was analyzed using various measures, while its relationship with quality-of-life and the use of social and healthcare services was assessed through linear and logistic regression models, adjusting for other factors.</div></div><div><h3>Results</h3><div>Loneliness reduced quality-of-life by between 11.1 % and 20.7 %. Of the social and health services analyzed, we found that loneliness increased the likelihood of using home help services by a factor of 1.75–2.36 and increased the number of visits to primary care/nursing services by a factor of 1.51–1.70.</div></div><div><h3>Conclusions</h3><div>Loneliness has detrimental effects on quality-of-life. Moreover, it may negatively impact health status, leading to increased use of social and healthcare services.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100673"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319580","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 : 2025-12-01Epub Date: 2025-09-12DOI: 10.1016/j.puhip.2025.100651
Workneh Wondimagegn Azalu , Sefinew Alemu Mekonnen , Ambaye Kenubih , Araya Mengistu Kassa , Wassie Abebe Molla , Wudu Temesgen Jemberu
Objectives
The study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and its associated risk factors.
Study design
A retrospective cohort study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and associated risk factors.
Method
A total of 642 study participants were selected using multistage cluster sampling from seven districts in Gondar zones in northwest Ethiopia. Data was collected using a questionnaire by face-to-face interviews. Logistic regression analysis was used to identify associations between rabies exposure and potential risk factors.
Results
The incidence of rabies exposure in the current study was estimated to be 20.95 % per year. Almost all (99.68 %) of respondents were aware of the existence of rabies, and 98.44 % of them know that rabies is a zoonotic disease. Residents of Genda Wuha (OR = 7.68) and Metema districts (OR = 7.12) had a greater risk of rabies exposure compared to those living in Debre Tabor district. Dog ownership (OR = 1.61) was greater risk for rabies exposure than non-dog ownership, larger family size (≥7 members) (OR = 2.23) had greater risk for rabies exposure.
Conclusion
The study outlined that although awareness of existence of rabies and its zoonotic risk was high, taking post-exposure prophylaxis was low. Therefore, use post exposure rabies vaccine of should be promoted.
{"title":"Human rabies exposure and associated risk factors in North-West Ethiopia","authors":"Workneh Wondimagegn Azalu , Sefinew Alemu Mekonnen , Ambaye Kenubih , Araya Mengistu Kassa , Wassie Abebe Molla , Wudu Temesgen Jemberu","doi":"10.1016/j.puhip.2025.100651","DOIUrl":"10.1016/j.puhip.2025.100651","url":null,"abstract":"<div><h3>Objectives</h3><div>The study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and its associated risk factors.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and associated risk factors.</div></div><div><h3>Method</h3><div>A total of 642 study participants were selected using multistage cluster sampling from seven districts in Gondar zones in northwest Ethiopia. Data was collected using a questionnaire by face-to-face interviews. Logistic regression analysis was used to identify associations between rabies exposure and potential risk factors.</div></div><div><h3>Results</h3><div>The incidence of rabies exposure in the current study was estimated to be 20.95 % per year. Almost all (99.68 %) of respondents were aware of the existence of rabies, and 98.44 % of them know that rabies is a zoonotic disease. Residents of Genda Wuha (OR = 7.68) and Metema districts (OR = 7.12) had a greater risk of rabies exposure compared to those living in Debre Tabor district. Dog ownership (OR = 1.61) was greater risk for rabies exposure than non-dog ownership, larger family size (≥7 members) (OR = 2.23) had greater risk for rabies exposure.</div></div><div><h3>Conclusion</h3><div>The study outlined that although awareness of existence of rabies and its zoonotic risk was high, taking post-exposure prophylaxis was low. Therefore, use post exposure rabies vaccine of should be promoted.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100651"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095294","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}
Human Papillomavirus (HPV) is a prevalent sexually transmitted infection and a leading cause of cervical cancer. In Georgia, cervical cancer ranks as the fifth most common cancer among women, with approximately 330 new cases and 200 deaths reported annually. Despite the availability of effective HPV vaccines, national vaccination coverage remains low. This study aimed to evaluate HPV vaccination coverage, analyze cervical cancer incidence trends, and model the potential impact of increased vaccination uptake on cancer prevention outcomes in Georgia.
Study design
A retrospective observational study was conducted using national health registry data and modeling projections to assess the burden of cervical cancer and estimate the effect of scaled vaccination coverage.
Methods
National health databases were used to analyze HPV vaccination rates and cervical cancer incidence. Descriptive statistics, chi-square tests, and linear regression were applied to identify trends and disparities. Additionally, a dynamic transmission model was developed to simulate the 10-year impact of increasing HPV vaccination coverage on cervical cancer incidence.
Results
The crude cervical cancer incidence rate was 15.7 per 100,000 women, with an age-standardized rate of 10.6 per 100,000. In 2022, only 38 % of eligible girls aged 13–18 received the first HPV vaccine dose, and 26 % completed the second dose. Regional disparities in vaccination and screening were noted, and overall screening coverage declined to 13,890 women screened in 2022. Modeling showed that increasing vaccine coverage to 60 % could reduce cervical cancer incidence by 50 % (preventing ∼163 cases); coverage of 80 % and 90 % could reduce incidence by 70 % and 85 %, preventing 228 and 276 cases, respectively.
Conclusion
Low HPV vaccination uptake in Georgia (38 % first dose and 26 % dull coverage) and declining screening limit cervical cancer prevention. Modeling shows that increasing vaccination coverage to 60–90 % could prevent 163–276 cases over the next decade. Strengthening vaccination and screening strategies is essential to move forward elimination.
{"title":"Strategic implementation of HPV vaccination to eliminate cervical cancer in Georgia","authors":"Irakli Khuntsaria , Konstantine Gachechiladze , Elene Liparta , Tamar Kobulashvili , Mariam Jorbenadze , Tamaz Revazishvili , Ana Mamiseishvili , Elene Kekelia , Marina Topuridze , Lela Sturua , Thomas Schrader , Ekaterina Kldiashvili","doi":"10.1016/j.puhip.2025.100679","DOIUrl":"10.1016/j.puhip.2025.100679","url":null,"abstract":"<div><h3>Objectives</h3><div>Human Papillomavirus (HPV) is a prevalent sexually transmitted infection and a leading cause of cervical cancer. In Georgia, cervical cancer ranks as the fifth most common cancer among women, with approximately 330 new cases and 200 deaths reported annually. Despite the availability of effective HPV vaccines, national vaccination coverage remains low. This study aimed to evaluate HPV vaccination coverage, analyze cervical cancer incidence trends, and model the potential impact of increased vaccination uptake on cancer prevention outcomes in Georgia.</div></div><div><h3>Study design</h3><div>A retrospective observational study was conducted using national health registry data and modeling projections to assess the burden of cervical cancer and estimate the effect of scaled vaccination coverage.</div></div><div><h3>Methods</h3><div>National health databases were used to analyze HPV vaccination rates and cervical cancer incidence. Descriptive statistics, chi-square tests, and linear regression were applied to identify trends and disparities. Additionally, a dynamic transmission model was developed to simulate the 10-year impact of increasing HPV vaccination coverage on cervical cancer incidence.</div></div><div><h3>Results</h3><div>The crude cervical cancer incidence rate was 15.7 per 100,000 women, with an age-standardized rate of 10.6 per 100,000. In 2022, only 38 % of eligible girls aged 13–18 received the first HPV vaccine dose, and 26 % completed the second dose. Regional disparities in vaccination and screening were noted, and overall screening coverage declined to 13,890 women screened in 2022. Modeling showed that increasing vaccine coverage to 60 % could reduce cervical cancer incidence by 50 % (preventing ∼163 cases); coverage of 80 % and 90 % could reduce incidence by 70 % and 85 %, preventing 228 and 276 cases, respectively.</div></div><div><h3>Conclusion</h3><div>Low HPV vaccination uptake in Georgia (38 % first dose and 26 % dull coverage) and declining screening limit cervical cancer prevention. Modeling shows that increasing vaccination coverage to 60–90 % could prevent 163–276 cases over the next decade. Strengthening vaccination and screening strategies is essential to move forward elimination.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100679"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416103","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 : 2025-12-01Epub Date: 2025-10-10DOI: 10.1016/j.puhip.2025.100667
Junying Zhao , Ahmed El Fatmaoui , Mahla Shourian , Bethanie Lor , Pallab K. Ghosh
Objectives
This paper focuses on the national-level, inexpensive, demand-side vaccine policy—federal recommendations. It evaluates the effectiveness of 2008 and 2010 influenza vaccine recommendations, the spillover effect of the 2009 H1N1 vaccine recommendation on influenza vaccination, and heterogeneous policy effects across individual characteristics.
Study design
Observational study with before-after comparison assessing changes in vaccination following policy implementation.
Methods
We used nationally representative 2004–2015 NHIS data on 77,361, 23,653, and 238,866 individuals in age groups targeted by the 2008, 2009, and 2010 policies, respectively. Using the Linear Probability Model with fixed effects, we estimated policy effectiveness, spillover effects, and heterogeneous effects across individual characteristics.
Results
Both 2008 and 2010 influenza vaccine recommendations boosted influenza vaccination likelihood by 20.9–26.5 % among children and 5.2–6.6 % among older adults. The 2009 H1N1 vaccine recommendation had a positive spillover effect, with a 5.7–9.8 % increase in influenza vaccination likelihood among younger adults. Low influenza vaccination likelihoods exist across demographic and socioeconomic characteristics: Children uninsured or privately insured, White, and low-income; Adults uninsured or publicly insured, White, African and Hispanic American, male, childless, self-reported poor or excellent health, low-educated, and low-income.
Conclusions
Future policies may address the cost barriers faced by the uninsured, and multi-level non-cost barriers experienced by privately insured children and publicly insured adults. Future policies may consider extending beyond the federal recommendation, such as implementing simultaneous anti-poverty policies, to achieve minimum coverage and utilize the spillover effects of one vaccine policy to maximize coverage of other vaccines. Future research may investigate potential policy spillover effects among influenza, COVID-19, RSV, and new vaccines.
{"title":"Power of public health advice: Effectiveness and spillover effects of federal vaccine recommendations","authors":"Junying Zhao , Ahmed El Fatmaoui , Mahla Shourian , Bethanie Lor , Pallab K. Ghosh","doi":"10.1016/j.puhip.2025.100667","DOIUrl":"10.1016/j.puhip.2025.100667","url":null,"abstract":"<div><h3>Objectives</h3><div>This paper focuses on the national-level, inexpensive, demand-side vaccine policy—federal recommendations. It evaluates the effectiveness of 2008 and 2010 influenza vaccine recommendations, the spillover effect of the 2009 H1N1 vaccine recommendation on influenza vaccination, and heterogeneous policy effects across individual characteristics.</div></div><div><h3>Study design</h3><div>Observational study with before-after comparison assessing changes in vaccination following policy implementation.</div></div><div><h3>Methods</h3><div>We used nationally representative 2004–2015 NHIS data on 77,361, 23,653, and 238,866 individuals in age groups targeted by the 2008, 2009, and 2010 policies, respectively. Using the Linear Probability Model with fixed effects, we estimated policy effectiveness, spillover effects, and heterogeneous effects across individual characteristics.</div></div><div><h3>Results</h3><div>Both 2008 and 2010 influenza vaccine recommendations boosted influenza vaccination likelihood by 20.9–26.5 % among children and 5.2–6.6 % among older adults. The 2009 H1N1 vaccine recommendation had a positive spillover effect, with a 5.7–9.8 % increase in influenza vaccination likelihood among younger adults. Low influenza vaccination likelihoods exist across demographic and socioeconomic characteristics: Children uninsured or privately insured, White, and low-income; Adults uninsured or publicly insured, White, African and Hispanic American, male, childless, self-reported poor or excellent health, low-educated, and low-income.</div></div><div><h3>Conclusions</h3><div>Future policies may address the cost barriers faced by the uninsured, and multi-level non-cost barriers experienced by privately insured children and publicly insured adults. Future policies may consider extending beyond the federal recommendation, such as implementing simultaneous anti-poverty policies, to achieve minimum coverage and utilize the spillover effects of one vaccine policy to maximize coverage of other vaccines. Future research may investigate potential policy spillover effects among influenza, COVID-19, RSV, and new vaccines.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100667"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416102","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 : 2025-12-01Epub Date: 2025-08-06DOI: 10.1016/j.puhip.2025.100647
Asma Mahamoud Abdillahi , Omer Adam Farih , Mustafe Abdillahi Ali , Abdirizak Hassan Abokor , Hodo Abdikarim , Saeed Hassan Mohamed , Awale Ali Omer , Shabcan Mohamed Ali , Abdisalam Hassan Muse
Objectives
Maternal health is a fundamental human right, yet significant inequities persist in low-resource settings like Somalia. This study investigates the nexus between socioeconomic status and maternal healthcare utilization, specifically examining the determinants of antenatal care (ANC) visits and place of delivery, to inform strategies aimed at achieving health equity.
Study design
A quantitative, cross-sectional study.
Methods
We used data from the 2020 Somalia Health and Demographic Survey (SHDS), a nationwide survey. The final analytical sample included 8248 women with a recent birth. We analyzed two dependent variables: number of ANC visits and place of delivery (home vs. health facility). Independent variables included wealth index, maternal education, residence, region, and other social determinants. Zero-inflated Negative Binomial (ZINB) regression was used for ANC visits, and binary logistic regression was used for place of delivery, with all analyses adjusted for the complex survey design.
Results
Marked disparities were found based on wealth. A significantly larger proportion of poorer women delivered at home (87.6 %) compared to richer women (55 %). Richer women had higher rates of ANC visits (Adjusted Incidence Rate Ratio [aIRR] = 1.41, p < 0.001) and were more likely to have facility-based deliveries (Adjusted Odds Ratio [AOR] = 1.57, p < 0.001). Higher maternal education, mobile phone ownership, and not wanting to go alone to a facility were also associated with better utilization. Significant regional disparities were observed.
Conclusions
Socioeconomic status is a primary driver of maternal healthcare utilization in Somalia, leading to substantial health inequities. Addressing these disparities requires multisectoral, targeted interventions that tackle poverty, enhance education, improve access to technology, and address cultural barriers to care.
产妇保健是一项基本人权，但在索马里等资源匮乏的环境中，严重的不平等现象依然存在。本研究调查了社会经济地位与孕产妇保健利用之间的关系，特别是检查了产前保健（ANC）访问和分娩地点的决定因素，为旨在实现健康公平的战略提供信息。研究设计定量、横断面研究。方法我们使用了2020年索马里健康和人口调查（SHDS）的数据，这是一项全国性调查。最终的分析样本包括8248名刚出生的女性。我们分析了两个因变量：ANC就诊次数和分娩地点（家庭vs.卫生机构）。自变量包括财富指数、母亲教育程度、居住地、地区和其他社会决定因素。ANC访问使用零膨胀负二项回归（ZINB），分娩地点使用二元逻辑回归，所有分析都针对复杂的调查设计进行了调整。结果根据财富发现了明显的差异。较贫穷妇女在家分娩的比例（87.6%）明显高于较富裕妇女（55%）。较富裕的妇女ANC就诊率较高（调整发病率比[aIRR] = 1.41, p < 0.001），更有可能在医院分娩（调整优势比[AOR] = 1.57, p < 0.001）。更高的母亲教育程度、拥有移动电话以及不愿独自前往医疗机构也与更好的利用有关。观察到显著的地区差异。社会经济地位是索马里孕产妇保健利用的主要驱动因素，导致严重的卫生不平等。要解决这些差异，就需要采取多部门、有针对性的干预措施，解决贫困问题，加强教育，改善获得技术的机会，并消除获得护理的文化障碍。
{"title":"Maternal health inequity in Somalia: A multivariate analysis of poverty and service utilization using nationwide cross-sectional survey data","authors":"Asma Mahamoud Abdillahi , Omer Adam Farih , Mustafe Abdillahi Ali , Abdirizak Hassan Abokor , Hodo Abdikarim , Saeed Hassan Mohamed , Awale Ali Omer , Shabcan Mohamed Ali , Abdisalam Hassan Muse","doi":"10.1016/j.puhip.2025.100647","DOIUrl":"10.1016/j.puhip.2025.100647","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal health is a fundamental human right, yet significant inequities persist in low-resource settings like Somalia. This study investigates the nexus between socioeconomic status and maternal healthcare utilization, specifically examining the determinants of antenatal care (ANC) visits and place of delivery, to inform strategies aimed at achieving health equity.</div></div><div><h3>Study design</h3><div>A quantitative, cross-sectional study.</div></div><div><h3>Methods</h3><div>We used data from the 2020 Somalia Health and Demographic Survey (SHDS), a nationwide survey. The final analytical sample included 8248 women with a recent birth. We analyzed two dependent variables: number of ANC visits and place of delivery (home vs. health facility). Independent variables included wealth index, maternal education, residence, region, and other social determinants. Zero-inflated Negative Binomial (ZINB) regression was used for ANC visits, and binary logistic regression was used for place of delivery, with all analyses adjusted for the complex survey design.</div></div><div><h3>Results</h3><div>Marked disparities were found based on wealth. A significantly larger proportion of poorer women delivered at home (87.6 %) compared to richer women (55 %). Richer women had higher rates of ANC visits (Adjusted Incidence Rate Ratio [aIRR] = 1.41, p < 0.001) and were more likely to have facility-based deliveries (Adjusted Odds Ratio [AOR] = 1.57, p < 0.001). Higher maternal education, mobile phone ownership, and not wanting to go alone to a facility were also associated with better utilization. Significant regional disparities were observed.</div></div><div><h3>Conclusions</h3><div>Socioeconomic status is a primary driver of maternal healthcare utilization in Somalia, leading to substantial health inequities. Addressing these disparities requires multisectoral, targeted interventions that tackle poverty, enhance education, improve access to technology, and address cultural barriers to care.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100647"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893561","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 : 2025-12-01Epub Date: 2025-10-08DOI: 10.1016/j.puhip.2025.100666
Josivaldo de Souza-Lima , Maribel Parra-Saldías , Sandra Mahecha Matsudo , Gerson Ferrari , Andrés Godoy-Cumillaf , Claudio Farias-Valenzuela , Pedro Valdivia-Moral
Objectives
This study examines the association between socioeconomic factors, gender, physical activity, and health satisfaction among Chilean adolescents. It aims to identify key disparities and their implications for public health policies.
Study design
Cross-sectional study based on the third wave (2016–2019) of the international Children's Worlds survey.
Methods
A total of 911 adolescents aged 12–13 years from Santiago, Chile, participated. Physical activity levels, socioeconomic indicators, and health satisfaction were assessed. Statistical analyses included t-tests, chi-square tests, ANOVA, and multiple linear regression models stratified by gender.
Results
Boys reported higher levels of electronic gaming (64.6 % vs. 35.4 %, p < 0.001), while girls engaged more in outdoor play at lower frequencies (52.8 % vs. 47.2 %, p = 0.045). Perceived safety was a stronger predictor of health satisfaction for girls (β = 0.252, p < 0.001) than for boys (β = 0.251, p < 0.001).
Conclusions
Socioeconomic and environmental factors significantly influence adolescent health satisfaction, with gender-specific differences. Policies should focus on improving access to recreational spaces and addressing economic barriers, particularly for girls.
目的探讨智利青少年社会经济因素、性别、身体活动和健康满意度之间的关系。它旨在确定主要的差距及其对公共卫生政策的影响。研究设计基于第三波（2016-2019）国际儿童世界调查的横断面研究。方法对来自智利圣地亚哥的911名12 ~ 13岁青少年进行调查。对身体活动水平、社会经济指标和健康满意度进行了评估。统计分析包括t检验、卡方检验、方差分析和按性别分层的多元线性回归模型。结果男孩报告了更高水平的电子游戏（64.6%对35.4%,p < 0.001），而女孩更多地参与户外游戏，频率较低（52.8%对47.2%,p = 0.045）。感知安全是女孩健康满意度的更强预测因子（β = 0.252, p < 0.001），而男孩（β = 0.251, p < 0.001）。结论社会经济和环境因素对青少年健康满意度有显著影响，且存在性别差异。政策应侧重于改善获得娱乐空间的机会和解决经济障碍，特别是对女孩而言。
{"title":"Analyzing health inequality among adolescents in Chile: Physical activity, socioeconomics, and play environments across genders","authors":"Josivaldo de Souza-Lima , Maribel Parra-Saldías , Sandra Mahecha Matsudo , Gerson Ferrari , Andrés Godoy-Cumillaf , Claudio Farias-Valenzuela , Pedro Valdivia-Moral","doi":"10.1016/j.puhip.2025.100666","DOIUrl":"10.1016/j.puhip.2025.100666","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the association between socioeconomic factors, gender, physical activity, and health satisfaction among Chilean adolescents. It aims to identify key disparities and their implications for public health policies.</div></div><div><h3>Study design</h3><div>Cross-sectional study based on the third wave (2016–2019) of the international Children's Worlds survey.</div></div><div><h3>Methods</h3><div>A total of 911 adolescents aged 12–13 years from Santiago, Chile, participated. Physical activity levels, socioeconomic indicators, and health satisfaction were assessed. Statistical analyses included t-tests, chi-square tests, ANOVA, and multiple linear regression models stratified by gender.</div></div><div><h3>Results</h3><div>Boys reported higher levels of electronic gaming (64.6 % vs. 35.4 %, p < 0.001), while girls engaged more in outdoor play at lower frequencies (52.8 % vs. 47.2 %, p = 0.045). Perceived safety was a stronger predictor of health satisfaction for girls (β = 0.252, p < 0.001) than for boys (β = 0.251, p < 0.001).</div></div><div><h3>Conclusions</h3><div>Socioeconomic and environmental factors significantly influence adolescent health satisfaction, with gender-specific differences. Policies should focus on improving access to recreational spaces and addressing economic barriers, particularly for girls.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100666"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265480","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 : 2025-12-01Epub Date: 2025-10-01DOI: 10.1016/j.puhip.2025.100658
Ariel Washington , Kassidy F. Houck , Bridget W. Nelson , Diane M. Harper
Objectives
Black women have both high screening and high cancer rates, indicating a lack of appropriate follow-up after an abnormal screening. Our mixed methods study explores the experiences of Black women who had abnormal cervical cancer screening results in Michigan.
Study design
Sequential mixed-method study design.
Methods
We identified a random group of 72 Black women with recent abnormal screening results requiring colposcopy follow-up from the aggregated local healthcare systems and invited them to participate. We designed a quantitative survey based on validated national health survey modules and a qualitative interview structured on the Theoretical Domains Framework (TDF), which was analyzed using Applied Thematic Analysis (ATA). We calculated each person's social deprivation index (SDI) based on quantitative results.
Results
Fourteen women completed the survey and interview. Five, seven, and two women chose no colposcopy, appropriate colposcopy, and missed colposcopy, but returned for close interval surveillance, respectively. The qualitative themes provided a potent emerging theme: the eternal cycle of human papillomavirus (HPV) uncertainty, which provided context for the other identified themes centered around lack of knowledge leading to emotional burdens, which intersected with being seen as a Black woman. We found similar barriers that have been noted for screening, such as relationships, positive and negative, having some influence on follow-up behavior.
Conclusions
With the shift to primary HPV screening, new educational platforms must be created and tailored to explain the HPV cycle for each racial/ethnic community.
Precis
The lack of knowledge about the eternal cycle of HPV uncertainty leads to Black women's lack of colposcopy follow-up.
{"title":"Black US women share their experiences with follow-up after abnormal cervical cancer screening","authors":"Ariel Washington , Kassidy F. Houck , Bridget W. Nelson , Diane M. Harper","doi":"10.1016/j.puhip.2025.100658","DOIUrl":"10.1016/j.puhip.2025.100658","url":null,"abstract":"<div><h3>Objectives</h3><div>Black women have both high screening and high cancer rates, indicating a lack of appropriate follow-up after an abnormal screening. Our mixed methods study explores the experiences of Black women who had abnormal cervical cancer screening results in Michigan.</div></div><div><h3>Study design</h3><div>Sequential mixed-method study design.</div></div><div><h3>Methods</h3><div>We identified a random group of 72 Black women with recent abnormal screening results requiring colposcopy follow-up from the aggregated local healthcare systems and invited them to participate. We designed a quantitative survey based on validated national health survey modules and a qualitative interview structured on the Theoretical Domains Framework (TDF), which was analyzed using Applied Thematic Analysis (ATA). We calculated each person's social deprivation index (SDI) based on quantitative results.</div></div><div><h3>Results</h3><div>Fourteen women completed the survey and interview. Five, seven, and two women chose no colposcopy, appropriate colposcopy, and missed colposcopy, but returned for close interval surveillance, respectively. The qualitative themes provided a potent emerging theme: the eternal cycle of human papillomavirus (HPV) uncertainty, which provided context for the other identified themes centered around lack of knowledge leading to emotional burdens, which intersected with being seen as a Black woman. We found similar barriers that have been noted for screening, such as relationships, positive and negative, having some influence on follow-up behavior.</div></div><div><h3>Conclusions</h3><div>With the shift to primary HPV screening, new educational platforms must be created and tailored to explain the HPV cycle for each racial/ethnic community.</div></div><div><h3>Precis</h3><div>The lack of knowledge about the eternal cycle of HPV uncertainty leads to Black women's lack of colposcopy follow-up.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100658"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265479","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 : 2025-12-01Epub Date: 2025-11-01DOI: 10.1016/j.puhip.2025.100678
Christiana Lokko, Jonathan Sackey, E.A. Aboagye
Objectives
This study examines the prevalence and determinants of CS deliveries in Ghana, with a focus on institutional, health-related, and contextual factors.
Study design
Stratified two-stage cluster design, selecting 618 clusters using probability proportional to size (PPS) and systematic random sampling.
Methods
A population-based cross-sectional study was conducted on 4649 women who had given birth within the past five years. The respondents were interviewed using a standardised structured questionnaire and samples were obtained through stratified random sampling. Therefore, bivariate analysis and logistic regression were applied to the data in IBM SPSS version 21 to ascertain the prevalence, association and determinants of CS delivery at a p-value of 0.005.
Results
The prevalence of CS found in this current study is 20.1 %, which is higher than the recommended global benchmark range (10 %–15 %). Age, educational level, wealth index, religion, parity, twin status, access to healthcare, self-reported health status, and region significantly determined the likelihood of caesarean section delivery.
Conclusion
The caesarean section rate in Ghana has risen to 20.1 %, reflecting both overuse among privileged groups and underuse among disadvantaged populations. Addressing these disparities with targeted, evidence-based interventions is crucial to ensure equitable and medically appropriate CS delivery.
目的：本研究考察了加纳CS分娩的患病率和决定因素，重点关注制度、健康相关和环境因素。研究设计分层两阶段聚类设计，采用概率与大小成比例（PPS）和系统随机抽样方法选择618个聚类。方法对近5年内生育的4649名妇女进行了人口横断面研究。采用标准化的结构化问卷对受访者进行访谈，采用分层随机抽样的方式获取样本。因此，在IBM SPSS version 21中对数据进行双变量分析和逻辑回归，以确定CS交付的患病率，相关性和决定因素，p值为0.005。结果本研究中发现的CS患病率为20.1%，高于推荐的全球基准范围（10% - 15%）。年龄、教育程度、财富指数、宗教、胎次、双胞胎状况、获得医疗保健的机会、自我报告的健康状况和地区显著决定了剖腹产分娩的可能性。结论加纳剖宫产率已上升至20.1%，反映了特权群体的过度使用和弱势群体的使用不足。通过有针对性的、以证据为基础的干预措施来解决这些差异，对于确保公平和医学上适当的CS提供至关重要。
{"title":"Prevalence and Determinants of Caesarean Section Deliveries in Ghana: A Population-Based Cross-sectional Study","authors":"Christiana Lokko, Jonathan Sackey, E.A. Aboagye","doi":"10.1016/j.puhip.2025.100678","DOIUrl":"10.1016/j.puhip.2025.100678","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the prevalence and determinants of CS deliveries in Ghana, with a focus on institutional, health-related, and contextual factors.</div></div><div><h3>Study design</h3><div>Stratified two-stage cluster design, selecting 618 clusters using probability proportional to size (PPS) and systematic random sampling.</div></div><div><h3>Methods</h3><div>A population-based cross-sectional study was conducted on 4649 women who had given birth within the past five years. The respondents were interviewed using a standardised structured questionnaire and samples were obtained through stratified random sampling. Therefore, bivariate analysis and logistic regression were applied to the data in IBM SPSS version 21 to ascertain the prevalence, association and determinants of CS delivery at a p-value of 0.005.</div></div><div><h3>Results</h3><div>The prevalence of CS found in this current study is 20.1 %, which is higher than the recommended global benchmark range (10 %–15 %). Age, educational level, wealth index, religion, parity, twin status, access to healthcare, self-reported health status, and region significantly determined the likelihood of caesarean section delivery.</div></div><div><h3>Conclusion</h3><div>The caesarean section rate in Ghana has risen to 20.1 %, reflecting both overuse among privileged groups and underuse among disadvantaged populations. Addressing these disparities with targeted, evidence-based interventions is crucial to ensure equitable and medically appropriate CS delivery.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100678"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464872","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 : 2025-12-01Epub Date: 2025-10-30DOI: 10.1016/j.puhip.2025.100677
Abram L. Wagner , Marie Jacobson , Renie Cuyno Mellen , Widia Adiratna , Emily Treleaven , Aditya L. Ramadona , Retna Siwi Padmawati , Yayi Suryo Prabandari
Objective
This study examines the relationship between gotong royong participation and COVID-19 vaccine uptake in Yogyakarta, Indonesia.
Study design
Cross-sectional survey.
Methods
We conducted a cross-sectional survey of 804 adults across rural and urban subdistricts in Yogyakarta province. The survey assessed COVID-19 vaccination status, engagement in gotong royong activities, and demographic, experiential, and normative factors related to vaccination. Multivariable logistic regression models were used to identify associations between gotong royong involvement and vaccination outcomes.
Results
Participation in gotong royong was reported by 44.3 % of respondents, with the most common activity being support and assistance (39.2 %). Among all participants, 10.8 % were unvaccinated, 43.9 % completed the primary series, and 41.8 % had received a booster dose. Individuals involved in gotong royong were less likely to be unvaccinated (5.3 % vs. 15.2 %) and, in multivariable analysis, had significantly higher odds of receiving at least one vaccine dose (OR: 3.41; 95 % CI: 1.78–6.54). They were also more likely to report community encouragement for vaccination, including from religious leaders (55.6 % vs. 40.2 %, P < 0.0001) and peers (83.7 % vs. 77.0 %, P = 0.0027).
Conclusions
These findings highlight the importance of aligning vaccination campaigns with culturally embedded social structures. Leveraging communal values and trusted local actors may enhance vaccine uptake in collectivist settings and inform broader strategies for routine immunization and pandemic preparedness.
{"title":"Gotong royong and COVID-19 vaccination in Indonesia: Linking communal values to collective immunity","authors":"Abram L. Wagner , Marie Jacobson , Renie Cuyno Mellen , Widia Adiratna , Emily Treleaven , Aditya L. Ramadona , Retna Siwi Padmawati , Yayi Suryo Prabandari","doi":"10.1016/j.puhip.2025.100677","DOIUrl":"10.1016/j.puhip.2025.100677","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines the relationship between gotong royong participation and COVID-19 vaccine uptake in Yogyakarta, Indonesia.</div></div><div><h3>Study design</h3><div>Cross-sectional survey.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey of 804 adults across rural and urban subdistricts in Yogyakarta province. The survey assessed COVID-19 vaccination status, engagement in gotong royong activities, and demographic, experiential, and normative factors related to vaccination. Multivariable logistic regression models were used to identify associations between gotong royong involvement and vaccination outcomes.</div></div><div><h3>Results</h3><div>Participation in <em>gotong royong</em> was reported by 44.3 % of respondents, with the most common activity being support and assistance (39.2 %). Among all participants, 10.8 % were unvaccinated, 43.9 % completed the primary series, and 41.8 % had received a booster dose. Individuals involved in gotong royong were less likely to be unvaccinated (5.3 % vs. 15.2 %) and, in multivariable analysis, had significantly higher odds of receiving at least one vaccine dose (OR: 3.41; 95 % CI: 1.78–6.54). They were also more likely to report community encouragement for vaccination, including from religious leaders (55.6 % vs. 40.2 %, P < 0.0001) and peers (83.7 % vs. 77.0 %, P = 0.0027).</div></div><div><h3>Conclusions</h3><div>These findings highlight the importance of aligning vaccination campaigns with culturally embedded social structures. Leveraging communal values and trusted local actors may enhance vaccine uptake in collectivist settings and inform broader strategies for routine immunization and pandemic preparedness.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100677"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464902","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 : 2025-12-01Epub Date: 2025-07-01DOI: 10.1016/j.puhip.2025.100638
Karsten Keller , Ingo Sagoschen , Volker H. Schmitt , Stefano Barco , Visvakanth Sivanathan , Omar Hahad , Frank P. Schmidt , Christine Espinola-Klein , Stavros Konstantinides , Thomas Münzel , Lukas Hobohm
Objectives
To date, few large studies of clinical outcomes in pediatric COVID-19 patients have been reported.
Study design
Epidemiological study of the German nationwide inpatient study (GNIS).
Methods
We used the GNIS to analyze all hospitalized children ≤18 years with confirmed COVID-19 diagnosis in Germany between Jan 1st and December 31st, 2020.
Results
Overall, 3360 children aged ≤18 years were hospitalized with COVID-19 infection in Germany in 2020 (49.8 % females). Among these, 1640 (48.8 %) were aged ≤6 years, 504 (15.0 %) 7 - ≤12 years and 1216 (36.2 %) were aged 13 - ≤18 years. Among these 3360 patients, 3.3 % were treated with mechanical ventilation and 0.23 % died in the hospital. The frequency of venous thromboembolism (0.18 %), vasculopathy (0.68 %), multisystem inflammatory syndrome caused by COVID-19 (0.65 %), and diagnosis of myocarditis (0.60 %) were low. Besides pneumonia and acute respiratory distress syndrome, obesity (OR 6.1 [95 %CI 2.1–18.2], P = 0.001), heart failure (OR 17.0 [95 %CI 6.8–42.1], P < 0.001) and acute/chronic kidney failure (OR 9.5 [95 %CI 4.0–22.2], P < 0.001) were independently associated with mechanical ventilation. Acute or chronic kidney failure (OR 41.4 [95 %CI 7.8–218.6], P < 0.001), liver disease (OR 18.8 [95 %CI 2.5–143.3], P = 0.005), and necessity of mechanical ventilation (OR 7.6 [95 %CI 1.2–47.4], P = 0.031) were independent risk factors for case-fatality.
Conclusions
In Germany in 2020, hospitalized children aged ≤18 years with COVID-19 infection had a low case-fatality. Heart, liver and renal failure were associated with adverse COVID-19 complications, such as the need for mechanical ventilation or death. Myocarditis, vasculopathy and venous thromboembolism were rare complications in this patient group.
迄今为止，很少有关于儿童COVID-19患者临床结局的大型研究报道。研究设计：德国全国住院患者研究（GNIS）的流行病学研究。方法采用GNIS分析2020年1月1日至12月31日期间德国所有≤18岁确诊COVID-19住院儿童。结果2020年德国因COVID-19感染住院的儿童总数为3360人，其中女性占49.8%。其中年龄≤6岁1640例（48.8%），7 ~≤12岁504例（15.0%），13 ~≤18岁1216例（36.2%）。在3360例患者中，3.3%接受机械通气治疗，0.23%在医院死亡。静脉血栓栓塞（0.18%）、血管病变（0.68%）、新冠肺炎引起的多系统炎症综合征（0.65%）和心肌炎（0.60%）诊断率较低。除肺炎和急性呼吸窘迫综合征外，肥胖（OR为6.1 [95% CI 2.1-18.2], P = 0.001）、心力衰竭(OR为17.0 [95% CI 6.8-42.1], P <；0.001)和急性/慢性肾衰竭(OR 9.5 [95% CI 4.0-22.2], P <；0.001)与机械通气独立相关。急性或慢性肾衰竭(or 41.4 [95% CI 7.8-218.6], P <；0.001)、肝脏疾病（OR 18.8 [95% CI 2.5 ~ 143.3], P = 0.005）和是否需要机械通气（OR 7.6 [95% CI 1.2 ~ 47.4], P = 0.031）是病死率的独立危险因素。结论2020年德国≤18岁住院儿童COVID-19感染病死率低。心脏、肝脏和肾脏衰竭与COVID-19不良并发症相关，例如需要机械通气或死亡。心肌炎、血管病变和静脉血栓栓塞是少见的并发症。
{"title":"In-hospital course of children with COVID-19 infection - Results of the German nationwide inpatient sample","authors":"Karsten Keller , Ingo Sagoschen , Volker H. Schmitt , Stefano Barco , Visvakanth Sivanathan , Omar Hahad , Frank P. Schmidt , Christine Espinola-Klein , Stavros Konstantinides , Thomas Münzel , Lukas Hobohm","doi":"10.1016/j.puhip.2025.100638","DOIUrl":"10.1016/j.puhip.2025.100638","url":null,"abstract":"<div><h3>Objectives</h3><div>To date, few large studies of clinical outcomes in pediatric COVID-19 patients have been reported.</div></div><div><h3>Study design</h3><div>Epidemiological study of the German nationwide inpatient study (GNIS).</div></div><div><h3>Methods</h3><div>We used the GNIS to analyze all hospitalized children ≤18 years with confirmed COVID-19 diagnosis in Germany between Jan 1st and December 31st, 2020.</div></div><div><h3>Results</h3><div>Overall, 3360 children aged ≤18 years were hospitalized with COVID-19 infection in Germany in 2020 (49.8 % females). Among these, 1640 (48.8 %) were aged ≤6 years, 504 (15.0 %) 7 - ≤12 years and 1216 (36.2 %) were aged 13 - ≤18 years. Among these 3360 patients, 3.3 % were treated with mechanical ventilation and 0.23 % died in the hospital. The frequency of venous thromboembolism (0.18 %), vasculopathy (0.68 %), multisystem inflammatory syndrome caused by COVID-19 (0.65 %), and diagnosis of myocarditis (0.60 %) were low. Besides pneumonia and acute respiratory distress syndrome, obesity (OR 6.1 [95 %CI 2.1–18.2], P = 0.001), heart failure (OR 17.0 [95 %CI 6.8–42.1], P < 0.001) and acute/chronic kidney failure (OR 9.5 [95 %CI 4.0–22.2], P < 0.001) were independently associated with mechanical ventilation. Acute or chronic kidney failure (OR 41.4 [95 %CI 7.8–218.6], P < 0.001), liver disease (OR 18.8 [95 %CI 2.5–143.3], P = 0.005), and necessity of mechanical ventilation (OR 7.6 [95 %CI 1.2–47.4], P = 0.031) were independent risk factors for case-fatality.</div></div><div><h3>Conclusions</h3><div>In Germany in 2020, hospitalized children aged ≤18 years with COVID-19 infection had a low case-fatality. Heart, liver and renal failure were associated with adverse COVID-19 complications, such as the need for mechanical ventilation or death. Myocarditis, vasculopathy and venous thromboembolism were rare complications in this patient group.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100638"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633276","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}
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