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Black US women share their experiences with follow-up after abnormal cervical cancer screening 美国黑人妇女分享她们在异常宫颈癌筛查后的随访经验
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-01 DOI: 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.
黑人女性筛查率高,癌症发病率高,这表明在筛查异常后缺乏适当的随访。我们的混合方法研究探讨了密歇根州黑人妇女宫颈癌筛查结果异常的经历。研究设计:顺序混合方法研究设计。方法:我们从汇总的当地医疗保健系统中随机选取72名近期筛查结果异常需要阴道镜随访的黑人妇女,并邀请她们参与。我们设计了一个基于有效的国家健康调查模块的定量调查和一个基于理论领域框架(TDF)的定性访谈,并使用应用主题分析(ATA)对其进行分析。我们根据定量结果计算了每个人的社会剥夺指数(SDI)。结果14名女性完成了调查和访谈。分别有5名、7名和2名妇女选择不进行阴道镜检查、适当进行阴道镜检查和未进行阴道镜检查,但又返回进行密切的间隔监测。定性主题提供了一个强有力的新兴主题:人类乳头瘤病毒(HPV)不确定性的永恒循环,这为其他确定的主题提供了背景,这些主题以缺乏知识导致情感负担为中心,与被视为黑人女性相交。我们发现了类似的筛查障碍,如积极和消极的关系,对后续行为有一定影响。结论:随着向初级HPV筛查的转变,必须创建新的教育平台,并针对每个种族/民族社区解释HPV周期。对HPV不确定性的永恒周期缺乏了解导致黑人女性缺乏阴道镜随访。
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引用次数: 0
A theory- and evidence-based holistic intervention to enhance the uptake of preventive eye examination among the elderly centre members 一项以理论及证据为基础的整体干预措施,以提高长者中心成员接受预防性眼科检查的机会
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-01 DOI: 10.1016/j.puhip.2025.100660
Wing Yan Lau , Jinxiao Lian , Andrew Lam , Maurice Yap

Objective

To develop a theory-driven and evidence-based intervention to enhance the uptake of preventive eye examinations of older adults in Hong Kong.

Study design

A cross-sectional study to inform the development of intervention.

Methods

Intervention development was informed by the Capability-Opportunity-Motivation Behaviour (COM-B) Model and the Behaviour Change Wheel through an eight-step approach. Key stages included identifying the missing behavioural drivers and considering the intervention options and implementation options to improve service uptake. Findings were evaluated against APEASE criteria and supplemented by the feedback from advisory group consultations.

Results

The barriers deterring preventive eye examination uptakes reflected deficits in psychological capability, social opportunity, physical opportunity, reflective motivation, and automatic motivation. An intervention requires seven intervention functions to address these deficits, including Education, Persuasion, Incentivisation, Training, Environmental Restructuring, Modelling and Enablement. The intervention aims to create a supportive environment in the elderly centre and lay referral networks to empower older adults to access health-related and service-related information, allowing access to appropriate social support. Better health communication of service-related information, more effective communication of appointment booking, and mobile service provision modes were proposed to enable older adults to attend future appointments.

Conclusions

Informed by the Behaviour Change Wheel framework, a holistic intervention to address the multiple barriers to preventive eye examination uptake was developed. The findings indicated that strategies beyond health education and service provision should be considered. A multi-component intervention, including service providers, service recipients and community social workers, should be considered to effectively address the barriers to service uptake.
目的发展以理论为导向和循证为基础的干预措施,以提高香港老年人对预防性眼科检查的接受程度。研究设计一项横断面研究,为干预措施的制定提供信息。方法采用能力-机会-动机行为(COM-B)模型和行为改变轮,分八步进行干预。关键阶段包括确定缺失的行为驱动因素,并考虑干预方案和实施方案,以改善服务的吸收。根据亚太经合组织的标准对调查结果进行了评价,并辅以咨询小组协商的反馈意见。结果妨碍青少年进行预防性眼科检查的障碍主要表现在心理能力、社会机会、身体机会、反思动机和自动动机方面。干预需要七个干预功能来解决这些缺陷,包括教育、说服、激励、培训、环境重组、建模和实现。干预措施的目的是在老年人中心创造一个支持性环境,并建立转诊网络,使老年人能够获得与健康和服务有关的信息,从而获得适当的社会支持。建议改善服务相关信息的健康沟通,更有效的预约沟通,以及移动服务提供模式,使老年人能够参加未来的预约。结论在行为改变之轮框架的指导下,制定了一种整体干预措施,以解决预防眼科检查的多重障碍。调查结果表明,应考虑健康教育和提供服务以外的战略。应考虑采取包括服务提供者、服务接受者和社区社会工作者在内的多成分干预措施,以有效解决接受服务的障碍。
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引用次数: 0
Age verification in alcohol online sales and delivery: results from a mystery shopping study in Estonia 酒精在线销售和配送中的年龄验证:爱沙尼亚神秘购物研究的结果
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-30 DOI: 10.1016/j.puhip.2025.100656
Rainer Reile , Tiina Kuusik , Triin Mäll , Krista Tarlap , Anneli Sammel

Objectives

As the current evidence on the adherence to age verification requirement in alcohol online sale and delivery is scarce and inconclusive, we studied the age verification rate of alcohol deliveries via courier and parcel machine services to evaluate the accessibility of alcohol to the minors in Estonia.

Study design

Experimental study.

Methods

We adapted the mystery shopping methodology to the context of alcohol distance sale in Estonia to study the age verification ratio defined as ID requests during alcohol distance sale deliveries via couriers and parcel machines. A stratified random sample of 110 test purchases was created based on mapping of alcohol vendors offering alcohol distance sales in Estonia. Test purchasers (n = 7) aged 18–19 years old were recruited for the study. In total, 91 test purchases were conducted in between August and September 2024. Descriptive statistics and prevalence ratio from crude and adjusted log-binomial regression models were used to compare the ID validation by key test purchase characteristics.

Results

In total, 81.3 % of orders were delivered without ID validation. Although crude proportions of ID validation at the delivery varied for several test purchase characteristics, statistically significantly (p = 0.038) difference was only found for the delivery method. Courier deliveries had substantially lower age verification rate with 87.5 % of orders delivered without ID validation compared to 66.7 % in parcel machine deliveries. After adjustment to other test purchase characteristics, the corresponding prevalence ratio was 1.36 (95 % CI 1.02–1.82).

Conclusions

The findings indicate that online alcohol sales are accompanied with inconsistent and ineffective age verification practices that may increase alcohol availability to minors. The study highlights the need for stricter regulations and enforcement to prevent minors from accessing alcohol through online sales and delivery services.
由于目前关于酒精在线销售和配送中遵守年龄验证要求的证据很少且不确定,我们研究了通过快递和包裹机服务的酒精配送的年龄验证率,以评估爱沙尼亚未成年人获得酒精的可能性。研究设计:实验研究。方法将神秘购物方法应用于爱沙尼亚酒类远程销售的背景下,研究通过快递员和包裹机进行酒类远程销售交付时的年龄验证比率(定义为ID请求)。根据爱沙尼亚提供酒类远程销售的酒类供应商的地图,创建了110个测试购买的分层随机样本。测试购买者(n = 7)年龄在18-19岁。在2024年8月到9月之间总共进行了91次测试采购。采用粗糙和调整后的对数二项回归模型的描述性统计和患病率来比较关键测试购买特征的ID验证。结果81.3 %的订单在未验证ID的情况下发货。虽然交付时ID验证的粗比例在几个测试购买特征中有所不同,但仅在交付方法中发现了统计学上显著(p = 0.038)的差异。快递投递的年龄验证率要低得多,没有身份验证的订单中有87.5% %,而包裹机器投递的订单中有66.7% %。调整其他测试购买特征后,相应的患病率为1.36(95 % CI 1.02-1.82)。研究结果表明,在线酒精销售伴随着不一致和无效的年龄验证实践,这可能会增加未成年人获得酒精的机会。该研究强调需要更严格的法规和执法,以防止未成年人通过在线销售和送货服务获得酒精。
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引用次数: 0
Disparities in cardiovascular disease prevalence among people living with HIV in South Carolina from 2005 to 2020 2005年至2020年南卡罗来纳州艾滋病毒感染者心血管疾病患病率的差异
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-30 DOI: 10.1016/j.puhip.2025.100662
Haoyuan Gao , Junxiu Liu , Xueying Yang , Bankole Olatosi , Sharon Weissman , Jiajia Zhang

Objective

We investigated the trends and disparities in cardiovascular disease (CVD) among people with HIV (PWH) in South Carolina (SC).

Study design

This is a statewide cohort study.

Methods

A comprehensive electronic health records database in SC assessed CVD prevalence trends among PWH overall and within two age groups (<50 and ≥ 50 years) from 2005 to 2020. Additionally, we explored disparities in CVD prevalence across subgroups by sex, race and ethnicity, rurality, and HIV transmission mode.

Results

This study included 31,984 PWH aged 18 and older. From 2005 to 2020, the prevalence of CVD among PWH in SC increased from 19.9 % to 24.4 % overall (P-trend<0.001) and from 18.1 % to 22.6 % for those aged <50 years (P-trend<0.001) but remained stable from 41.0 to 40.8 among those aged ≥50 years (P-trend = 0.26). Disparities in CVD prevalence by sex, race and ethnicity, rurality, and HIV transmission mode were observed among PWH across both ages <50 years and ≥50 years. For example, among individuals aged<50 years, the prevalence of CVD increased from 23.1 % to 31.2 % for females (P-trend<0.001) while it increased from 15.8 % to 19.6 % for males (P-trend<0.001) (P-interaction<0.001). The corresponding values for aged ≥50 years were from 48.3 % to 50.4 % for females (P-trend = 0.08) and from 35.6 % to 37.5 % for males (P-trend = 0.02) (P-interaction = 0.003).

Conclusion

As PWH experience improved and extended life expectancy, this study revealed the prevalence and associated disparities in CVD prevalence across demographics and HIV transmission mode in SC, emphasizing the need for targeted interventions to enhance cardiovascular health in this vulnerable population.
目的调查南卡罗来纳州HIV感染者(PWH)心血管疾病(CVD)的趋势和差异。研究设计这是一项全州范围的队列研究。方法利用SC综合电子健康档案数据库评估2005 - 2020年PWH患者总体及两个年龄组(50岁和≥50岁)的心血管疾病流行趋势。此外,我们还探讨了按性别、种族和民族、农村和艾滋病毒传播方式划分的不同亚组中心血管疾病患病率的差异。结果本研究纳入18岁及以上PWH 31984例。从2005年到2020年,SC中PWH的CVD患病率总体从19.9%上升到24.4% (P-trend<0.001), 50岁人群从18.1%上升到22.6% (P-trend<0.001),而≥50岁人群的CVD患病率稳定在41.0 ~ 40.8% (P-trend = 0.26)。在年龄≥50岁和≥50岁的PWH人群中,CVD患病率在性别、种族和民族、农村地区和HIV传播方式方面存在差异。例如,在50岁的人群中,女性心血管疾病患病率从23.1%增加到31.2% (P-trend<0.001),而男性心血管疾病患病率从15.8%增加到19.6% (P-trend<0.001) (P-interaction<0.001)。年龄≥50岁女性相应值为48.3% ~ 50.4% (P-trend = 0.08),男性相应值为35.6% ~ 37.5% (P-trend = 0.02) (P-interaction = 0.003)。结论:随着PWH患者的预期寿命得到改善和延长,本研究揭示了SC中不同人口统计学和HIV传播方式的心血管疾病患病率及其相关差异,强调需要有针对性的干预措施来改善这一弱势人群的心血管健康。
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引用次数: 0
Healthcare professionals’ perspectives on the implementation and purposefulness of a new alcohol recovery Navigator role in the North East of England – preliminary qualitative findings 医疗保健专业人员的观点,在英格兰东北部的一个新的酒精恢复导航作用的实施和目的-初步定性的发现
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-30 DOI: 10.1016/j.puhip.2025.100661
Michael Cave , Ryan Swiers , Domna Salonen , Sarah Hulse , James Crosbie , Amy O'Donnell , Katherine Jackson , Emma-Joy Holland , Floor Christie-de Jong

Objectives

This study aimed to explore clinicians’ perspectives in a single acute hospital regarding the introduction and perceived impact of an Alcohol Recovery Navigator role. The role was implemented within a hospital setting in North-East England to improve uptake of treatment in the community post-discharge and thereby help to reduce alcohol-related repeat admissions.

Study design

A qualitative study was conducted.

Methods

Semi-structured interviews were conducted with hospital clinicians (n = 8) recruited via purposive and snowball sampling. Interviews were transcribed verbatim, analysed using thematic analysis, with themes subsequently mapped onto Normalisation Process Theory constructs: coherence, cognitive participation, collective action, and reflexive monitoring.

Results

Participants reported high levels of knowledge and understanding (coherence) of the Alcohol Recovery Navigator role and valued having this service as part of patients’ recovery pathway. Staff appeared committed to engaging with the role (cognitive participation), which was perceived to have aided implementation and embedding of the role into patient care pathways. Participants were able to make the role work (collective action) by building relationships with hospital staff and patients to improve continuity of care. Staff appraisal (reflexive monitoring) observed increased engagement from patients with Navigators and perceived that the role contributed to patients making changes towards better health.

Conclusion

Participants’ perspectives support the continued provision of the Alcohol Recovery Navigator role. Implementation was viewed to have been successful, with Navigators imperative in bridging the gap between hospital and community care. Future research is required to assess the effectiveness of the wider programme.
目的:本研究旨在探讨一家急性医院临床医生对酒精恢复导航员角色的引入和感知影响的看法。该项目是在英格兰东北部的一家医院实施的,目的是改善社区出院后接受治疗的情况,从而帮助减少与酒精有关的再次入院。研究设计进行定性研究。方法采用目的抽样和滚雪球抽样的方法,对8名医院临床医生进行半结构化访谈。访谈被逐字记录下来,使用主题分析进行分析,随后将主题映射到正常化过程理论结构上:连贯性、认知参与、集体行动和反身性监测。结果参与者报告了酒精恢复导航员角色的高水平知识和理解(一致性),并重视将这项服务作为患者恢复途径的一部分。工作人员似乎致力于参与角色(认知参与),这被认为有助于实施和嵌入角色到患者护理途径中。参与者能够通过与医院工作人员和患者建立关系来提高护理的连续性,从而发挥作用(集体行动)。工作人员评价(反射性监测)观察到,患者对导航员的参与有所增加,并认为该角色有助于患者做出改变,改善健康状况。结论:参与者的观点支持继续提供酒精恢复导航员的角色。执行工作被认为是成功的,导航员在弥合医院和社区护理之间的差距方面是必不可少的。今后需要进行研究,以评估更广泛方案的有效性。
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引用次数: 0
Reducing health inequalities through work-a public health emergency? 通过工作减少健康不平等——突发公共卫生事件?
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-29 DOI: 10.1016/j.puhip.2025.100659
N. Amedzro, S. Boorman, G. Allsopp
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引用次数: 0
Needle length selection for intramuscular vaccine administration: Time for an evidence-based approach 肌注疫苗注射针头长度的选择:循证方法的时机
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-29 DOI: 10.1016/j.puhip.2025.100657
Marjan Doppen , Ciléin Kearns , Nethmi Kearns , Thomas Hills , Gabrielle Shortt , Lesley Gray , Mark Weatherall , Nicole J. Moreland , Ali Mirjalili , Richard Beasley
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引用次数: 0
Digital screen exposure in infants, children and adolescents: a systematic review of existing recommendations 婴儿、儿童和青少年接触数字屏幕:对现有建议的系统审查
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-26 DOI: 10.1016/j.puhip.2025.100653
Viola Nuvoli , Margherita Camanni , Ilaria Mariani , Simona Ponte , Michelle Black , Marzia Lazzerini

Objectives

This review aimed to synthesise existing recommendations - issued by either United Nations agencies, scientific societies, governmental health authorities, non-profit organisations, or others - on digital screen exposure in infants, children, and adolescents.

Study design

Systematic review.

Methods

A wide search strategy was utilised - including digital databases (PubMed, EMBASE, Web of Science), Google, ChatGPT, reference lists from and grey literature —up to July 2024. Identified documents were categorized by type, issuing institutions, audience, publication year, and age groups. A synthesis of recommendations on screen time quantity was provided, comparing recommendations from the World Health Organization (WHO) with those from other institutions/bodies.

Results

Out of 85,425 records retrieved, 41 documents were identified. Of these, 23 were published by scientific societies, 13 by government/health authorities, two by the WHO, and three by non-profit organisations. In relation to digital screen quantity, most documents aligned: i) for children under 2 years, most documents recommended zero exposure (n = 20/22); ii) for children aged 2–5 years, the majority recommended limiting screen time to 1 h per day (n = 17/21); iii) for children over 5 years and adolescents, the most permissive guidelines suggested a maximum of 2 h per day (n = 8/10). Existing recommendations were either equally strict or more restrictive than WHO guidelines. In regard to the quality of digital screen exposure, 10 key points emerged, along with additional guidance for parents, schools, healthcare professionals, researchers, and industry.

Conclusions

There is consensus on the need to limit the quantity of digital screen time for infants, children and adolescents and to ensure good quality exposure. This alignment provides a strong basis for governments and other bodies to agree on local recommendations, as well as strategies to improve their implementation in practice.
本综述旨在综合联合国机构、科学学会、政府卫生当局、非营利组织或其他机构发布的关于婴儿、儿童和青少年接触数字屏幕的现有建议。研究设计:系统评价。方法采用广泛的检索策略,包括数字数据库(PubMed, EMBASE, Web of Science), b谷歌,ChatGPT,参考文献列表和灰色文献,截止到2024年7月。确定的文件按类型、发行机构、受众、出版年份和年龄组进行分类。提供了关于屏幕时间的综合建议,将世界卫生组织(卫生组织)的建议与其他机构/机构的建议进行了比较。结果在检索到的85,425条记录中,识别出41个文档。其中,23篇由科学学会发表,13篇由政府/卫生当局发表,2篇由世界卫生组织发表,3篇由非营利组织发表。关于数字屏幕的数量,大多数文件一致:i)对于2岁以下的儿童,大多数文件建议零暴露(n = 20/22);Ii)对于2-5岁的儿童,大多数人建议将屏幕时间限制在每天1小时(n = 17/21);Iii)对于5岁以上的儿童和青少年,最宽松的指南建议每天最多2小时(n = 8/10)。现有的建议要么与世卫组织的指导方针同样严格,要么更严格。关于数字屏幕暴露的质量,出现了10个关键点,以及对家长、学校、医疗保健专业人员、研究人员和行业的额外指导。结论限制婴儿、儿童和青少年使用数字屏幕的时间并确保高质量的接触已成为共识。这种一致性为各国政府和其他机构就地方建议以及在实践中改进其实施的战略达成一致提供了坚实的基础。
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引用次数: 0
The changing epidemiology of child and adolescent mental health requires an immediate policy response 儿童和青少年心理健康流行病学的变化要求立即作出政策反应
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-25 DOI: 10.1016/j.puhip.2025.100655
Alina Cosma , Michelle Black , Stanislava Vuckovic , Ivana Pavic , Helena Fonseca , Marzia Lazzerini
The epidemiology of child and adolescent mental health is rapidly evolving, necessitating urgent and coordinated responses across health, education, social services, and justice sectors. This commentary highlights key trends in adolescent mental health, emphasizing the shifting social, economic, and technological determinants shaping youth mental health. Recent evidence indicates a rise in mental health challenges, with increased gender disparities, heightened stress from academic pressures, social media exposure, and economic inequalities, among others, shaping adolescent mental health trajectories. Simultaneously, health systems are facing escalating demands for mental health care, compounded by workforce shortages and gaps in training to address emerging conditions such as digital addiction and societal withdrawal. The commentary underscores the importance of preventive, intersectoral, and life course approaches to mental health, advocating for increased investment in prevention, research, workforce development, and integrated care models. Addressing these issues requires evidence-based policies that consider cross-national differences and gendered trends while ensuring sustainable mental health systems for future generations. By prioritizing adolescent mental health within broader public health agendas, we can create a foundation for long-term well-being and social sustainability.
儿童和青少年心理健康的流行病学正在迅速发展,需要在卫生、教育、社会服务和司法部门采取紧急和协调的应对措施。本评论强调青少年心理健康的主要趋势,强调影响青少年心理健康的不断变化的社会、经济和技术决定因素。最近的证据表明,心理健康挑战有所增加,性别差距扩大,学业压力、社交媒体曝光和经济不平等等带来的压力加剧,这些都影响着青少年的心理健康轨迹。与此同时,卫生系统面临着对精神卫生保健不断升级的需求,再加上劳动力短缺和应对数字成瘾和社会退缩等新出现疾病的培训差距。评注强调了预防性、部门间和生命全程精神卫生方法的重要性,倡导增加对预防、研究、劳动力发展和综合护理模式的投资。解决这些问题需要基于证据的政策,考虑到跨国差异和性别趋势,同时确保为子孙后代提供可持续的精神卫生系统。通过在更广泛的公共卫生议程中优先考虑青少年心理健康,我们可以为长期福祉和社会可持续性奠定基础。
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引用次数: 0
School is more than a place to learn: An intersectoral assessment of adolescent well-being prior to and after the COVID-19 pandemic in the WHO European Region 学校不仅仅是一个学习的地方:世卫组织欧洲区域2019冠状病毒病大流行前后青少年福祉的部门间评估
IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-25 DOI: 10.1016/j.puhip.2025.100654
M. Limburg , M. Cronin , M. Black , J.C. Inchley , D. Jourdan , C. Jung-Sievers , P. McHale , E. Rehfuess , M.-C. Tsai , N.J. Gray
<div><h3>Objectives</h3><div>Adolescents' lives around the world were significantly disrupted during school closures to contain the COVID-19 pandemic. As well as the learning losses that ensued, commentators have noted the pandemic's often negative impact on a wide range of issues including mental health and nutrition. This study sought to understand how adolescent well-being changed following the pandemic period across the WHO European region.</div></div><div><h3>Study design</h3><div>Using data from two international surveys for countries in the WHO European region, Health Behaviour in School-aged Children (HBSC) and Programme for International Student Assessment (PISA), this secondary analysis examines adolescent well-being pre- and post-pandemic, as well as associations with socioeconomic status (SES) and school closure duration.</div></div><div><h3>Methods</h3><div>The UN H6+ framework for adolescent well-being informed selection of indicators from both surveys, mapped against its five domains: 1) Good health and optimum nutrition, 2) Connectedness, positive values and contribution to society, 3) Safety and a supportive environment, 4) Learning, competence, education, skills and employability, and 5) Agency and resilience.</div><div>Following selection of one indicator per domain for analysis, overall trends between 2018-2022 and 2014–2018 were described, and outcomes by most and least deprived quintiles of SES compared. Logistic fixed effect regression models were employed to analyse the change between 2018 and 2022 for the binary variables in domains 1,2,3 and 5. Linear fixed effect regression models were used for continuous variables in domain 4. Finally, measures of SES and school closure duration were added as interaction terms to the models.</div></div><div><h3>Results</h3><div>A decrease in adolescent well-being was seen across all domains between 2018 and 2022, apart from domain 1 (physical activity) which showed an increase. These changes were statistically significant for all except domain 3 (bullying). High family support decreased by 17% (OR: 0.827; 95% CI: 0.720 to 0.949) and feeling pressured by schoolwork increased by 40% (OR: 1.402; 95% CI: 1.242 to 1.581). PISA average scores for maths and reading decreased, by 15.153 (95% CI: −22.229 to −8.078) and 12.482 (95% CI: −20.184 to −4.779), respectively. SES had a greater association with assessment scores for maths (p = 0.027), and science (p = 0.002) in 2022 than in 2018, resulting in a growing inequity gap. None of the included well-being indicators showed a statistically significant association for every 30 days of school closure duration.</div></div><div><h3>Conclusions</h3><div>Adolescent well-being declined during the pandemic; this was especially seen in education outcomes for adolescents from the most deprived backgrounds. Leveraging existing health and education datasets enables an intersectoral approach to support those who have fallen behind. Future pandemic response d
为遏制COVID-19大流行而停课期间,世界各地青少年的生活受到严重干扰。除了随之而来的学习损失外,评论人士还注意到,大流行往往对包括心理健康和营养在内的一系列广泛问题产生负面影响。本研究旨在了解世卫组织欧洲区域大流行期间青少年福祉的变化情况。研究设计利用世卫组织欧洲区域国家的两项国际调查——学龄儿童健康行为(HBSC)和国际学生评估项目(PISA)——的数据,这项二级分析检查了大流行前后青少年的健康状况,以及与社会经济地位(SES)和学校关闭时间的关系。方法联合国H6+青少年福祉框架为两项调查的指标选择提供了信息,并根据其五个领域绘制了指标图:1)良好健康和最佳营养;2)连通性、积极价值观和对社会的贡献;3)安全和支持性环境;4)学习、能力、教育、技能和就业能力;5)机构和复原力。在每个领域选择一个指标进行分析后,描述了2018-2022年和2014-2018年之间的总体趋势,并比较了最贫困和最不贫困的SES五分位数的结果。采用Logistic固定效应回归模型分析域1、域2、域3、域5二元变量2018 - 2022年的变化。连续变量在域4中采用线性固定效应回归模型。最后,在模型中加入社会经济地位和学校停课时间作为交互项。结果2018年至2022年期间,青少年幸福感在所有领域都有所下降,除了领域1(身体活动)有所增加。这些变化在除领域3(欺凌)外的所有领域都具有统计学意义。高家庭支持减少了17% (OR: 0.827; 95% CI: 0.720至0.949),学业压力感增加了40% (OR: 1.402; 95% CI: 1.242至1.581)。PISA的数学和阅读平均分分别下降了15.153分(95% CI: - 22.229至- 8.078)和12.482分(95% CI: - 20.184至- 4.779)。与2018年相比,2022年社会经济地位与数学(p = 0.027)和科学(p = 0.002)的评估分数之间的关联更大,导致不平等差距日益扩大。所包括的福祉指标都没有显示出每30天的学校关闭时间与统计上显著的关联。结论流感大流行期间青少年幸福感下降;这在来自最贫困背景的青少年的教育结果中尤为明显。利用现有的卫生和教育数据集,可以采取跨部门办法,为落后的人提供支持。未来的大流行应对决策,如关闭学校,必须仔细平衡预防传染病与对教育和学生福祉的影响。
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Public Health in Practice
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