Public Health in Practice最新文献

{"title":"Digital screen exposure in infants, children and adolescents: a systematic review of existing recommendations","authors":"Viola Nuvoli ,&nbsp;Margherita Camanni ,&nbsp;Ilaria Mariani ,&nbsp;Simona Ponte ,&nbsp;Michelle Black ,&nbsp;Marzia Lazzerini","doi":"10.1016/j.puhip.2025.100653","DOIUrl":"10.1016/j.puhip.2025.100653","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100653"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265475","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}

{"title":"Missed opportunities: The unknown impact of the COVID-19 pandemic on early childhood development in the WHO European region","authors":"J.M. White ,&nbsp;C.L. Goodfellow ,&nbsp;A.O. Adeleke ,&nbsp;F.P. Awde ,&nbsp;Y.W. Chua ,&nbsp;A. Jovic ,&nbsp;E. Scott","doi":"10.1016/j.puhip.2025.100636","DOIUrl":"10.1016/j.puhip.2025.100636","url":null,"abstract":"<div><h3>Background</h3><div>Early childhood experiences can promote or adversely affect children's development and wellbeing with lifelong impact. The COVID-19 pandemic disrupted children's and families' lives worldwide. It is important to understand the effect on early childhood development. We aimed to examine what is known about the impact of the COVID-19 pandemic, and the related public health measures, on young children's development.</div></div><div><h3>Study design</h3><div>We carried out a mixed-method study which included a scoping review of review-level evidence about early childhood development over the course of the pandemic compared to beforehand and a web-based survey of early childhood development data published in the WHO European Region.</div></div><div><h3>Methods</h3><div>A systematic search of three databases was used to identify studies, published in English, up to November 2024. Findings were synthesised narratively by developmental domain. A web-based search was used to identify, routinely collected, national surveillance child development data in the WHO European Region. To illustrate the potential role of routine surveillance in the timely identification of developmental concerns, trend data from Scotland was examined.</div></div><div><h3>Results</h3><div>Seven reviews met the inclusion criteria. Most studies examined young children's mental health, while others assessed language development, mother-child bonding, and broader developmental outcomes. Findings were inconsistent, with some studies reporting adverse effects, with others finding no significant changes. There were significant gaps in the availability of national surveillance child development data in WHO European Region countries. Scottish surveillance data identified increases in developmental concerns, which affected disadvantaged groups more.</div></div><div><h3>Conclusions</h3><div>The available evidence about the effect of the COVID-19 pandemic, and related public health measures, on early childhood development is limited and inconclusive. Strengthening data collection and reporting across the WHO European Region is essential for timely and accurate assessment of developmental outcomes and to guide policy development.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100636"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580597","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}

{"title":"A systematic review of the pivotal role of environmental toxicant exposure on infectious diseases in low- and middle-income countries","authors":"Rehnuma Haque ,&nbsp;Md Shariful Islam ,&nbsp;Molly Hanson ,&nbsp;Md. Zamiur Rahaman ,&nbsp;Sadia Afrin ,&nbsp;Sristi Shome ,&nbsp;Mahbubur Rahman ,&nbsp;Syed Moshfiqur Rahman ,&nbsp;KM Saif-Ur-Rahman ,&nbsp;Rubhana Raqib","doi":"10.1016/j.puhip.2025.100631","DOIUrl":"10.1016/j.puhip.2025.100631","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this review is to identify which environmental toxicants are linked to infectious diseases in low- and middle-income countries (LMICs) by synthesizing available evidence. It aims to summarize key findings, identify research gaps and provide policy recommendations based on the associations between specific toxicants and disease outcomes.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search in PubMed, Scopus, Web of Science (core collection), and CENTRAL (the Cochrane Library) to identify studies on bacterial, viral, and parasitic pathogenic activity.</div></div><div><h3>Result</h3><div>This search yielded 11,468 studies, of which 55 met inclusion criteria after screening following the standard methods. A consistent association is found between particulate matter (PM2.5 and PM10) exposure and increased respiratory infection risk, with PM2.5 particularly linked to increased incidence and mortality in diseases like COVID-19 and tuberculosis. Heavy metals, including lead, cadmium, and mercury worsen chronic infections such as HIV/AIDS and hepatitis by increasing body burden and inflammation. The review highlights air pollutants’ substantial impact on infectious disease spread and severity while noting a research gap on other pollutants including persistent organic pollutants (POPs) and polycyclic aromatic hydrocarbons (PAHs). Bias assessment indicates around half the studies show low risk of bias; however, potential biases were noted in confounding variables and blinding of outcome assessment.</div></div><div><h3>Conclusion</h3><div>The systematic review emphasizes the need for research on biological mechanisms underlying these associations and the impacts of other pollutants. Findings advocate for reducing environmental pollution exposure in LMICs to mitigate infectious disease risk.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100631"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580596","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}

{"title":"Creating a healthier economy: A rapid evidence review of inequalities in flexible working arrangements in the UK","authors":"A. Barnes ,&nbsp;C. Cartwright ,&nbsp;K. Kennedy ,&nbsp;A. Formby","doi":"10.1016/j.puhip.2025.100649","DOIUrl":"10.1016/j.puhip.2025.100649","url":null,"abstract":"<div><h3>Objectives</h3><div>Flexible working – the control people have over work scheduling to meet wellbeing needs – is one way to help create a healthier economy. We sought to identify and summarise evidence about inequalities in access to flexible working arrangements in the UK and implications for health and wellbeing to inform policy development.</div></div><div><h3>Study design</h3><div>Rapid evidence review.</div></div><div><h3>Methods</h3><div>A rapid review of peer-reviewed articles and reports from trusted sources was completed on inequalities in access to UK flexible working arrangements to inform regional and local policy development. Published articles were identified through database searches (OVID-Embase, Scopus, Cochrane, Assia-Proquest) in September–October 2024. Data was extracted directly into a table and findings synthesised narratively by theme.</div></div><div><h3>Results</h3><div>Evidence identified was limited in detail, but consistent in reporting inequalities in access to flexible working by occupational status, with some evidence of inequalities by gender, disability, geography and ethnicity; with implications for health promotion. There was limited detail on specific health outcomes or pathways to impacts, though the significance of flexible working for women's well-being and Disabled people was highlighted. Included evidence noted systemic issues in the UK economy (e.g. occupational hierarchies, gendered norms about caring, racism, disability discrimination, ‘ideal worker’ culture that values overwork, flexibility stigma) that contribute to flexible working inequalities.</div></div><div><h3>Conclusions</h3><div>Further research and multi-level policy action is needed to address flexible working inequalities to promote health. Research could usefully focus on intersectional inequality, including systemic societal processes (i.e. stigma, racism, discrimination) shaping flexible working in practice. Policy action could include: evaluating the implementation of existing flexible working legislation in relation to inequality; national-regional-local action to support inclusive business models in which the bargaining positions of employees around flexibility are more equalised (e.g. cooperatives); evaluation and strengthening of Fair Work Charters; and funding and showcasing of flexible working pilots focused on addressing unequal flexible working access.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100649"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890449","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}

{"title":"Leveraging blue spaces for public health: Co-creating a whole-system action plan","authors":"Niamh Smith ,&nbsp;Michail Georgiou ,&nbsp;Deryck Irving ,&nbsp;Sebastien Chastin","doi":"10.1016/j.puhip.2025.100665","DOIUrl":"10.1016/j.puhip.2025.100665","url":null,"abstract":"<div><h3>Objectives</h3><div><ul><li><span>•</span><span><div>To co-create evidence-based, whole-system recommendations for leveraging blue spaces to enhance public health.</div></span></li><li><span>•</span><span><div>To highlight the salutogenic and equigenic benefits of blue spaces.</div></span></li><li><span>•</span><span><div>To guide decision-makers and practitioners in preserving, revitalising and using urban blue spaces for synergistic benefits to people and the planet.</div></span></li></ul></div></div><div><h3>Study design</h3><div>Systems based co-creation.</div></div><div><h3>Methods</h3><div><ul><li><span>1)</span><span><div>Establish an evidence base through extensive mixed-methods academic research over six years on the health benefits of urban blue spaces.</div></span></li><li><span>2)</span><span><div>Partner with a water-focused national research and innovation program to incorporate policy expertise and reduce siloed working.</div></span></li><li><span>3)</span><span><div>Co-create an action plan with stakeholders using system-based participatory research, following the DISCOVER framework.</div></span></li></ul></div></div><div><h3>Results</h3><div>The full system map consists of 137 variables and 220 causal linkages. The system map is structured around four core mechanisms that illustrate how urban blue spaces influence health: promoting physical activity, fostering social interaction, supporting a healthy environment, and reducing population stress.</div></div><div><h3>Conclusions</h3><div>Four strategic objectives identified, achievable through 12 policy actions. Blue spaces offer significant health benefits that have historically been overlooked in regeneration projects. The co-created recommendations provide a comprehensive guide for decision-makers and practitioners to maximise the health benefits of blue spaces. Implementing these recommendations can lead to synergistic benefits for both people and the planet.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100665"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319578","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}

{"title":"The changing epidemiology of child and adolescent mental health requires an immediate policy response","authors":"Alina Cosma ,&nbsp;Michelle Black ,&nbsp;Stanislava Vuckovic ,&nbsp;Ivana Pavic ,&nbsp;Helena Fonseca ,&nbsp;Marzia Lazzerini","doi":"10.1016/j.puhip.2025.100655","DOIUrl":"10.1016/j.puhip.2025.100655","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100655"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218997","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}

{"title":"Disparities in cardiovascular disease prevalence among people living with HIV in South Carolina from 2005 to 2020","authors":"Haoyuan Gao ,&nbsp;Junxiu Liu ,&nbsp;Xueying Yang ,&nbsp;Bankole Olatosi ,&nbsp;Sharon Weissman ,&nbsp;Jiajia Zhang","doi":"10.1016/j.puhip.2025.100662","DOIUrl":"10.1016/j.puhip.2025.100662","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated the trends and disparities in cardiovascular disease (CVD) among people with HIV (PWH) in South Carolina (SC).</div></div><div><h3>Study design</h3><div>This is a statewide cohort study.</div></div><div><h3>Methods</h3><div>A comprehensive electronic health records database in SC assessed CVD prevalence trends among PWH overall and within two age groups (&lt;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.</div></div><div><h3>Results</h3><div>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&lt;0.001) and from 18.1 % to 22.6 % for those aged &lt;50 years (P-trend&lt;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 &lt;50 years and ≥50 years. For example, among individuals aged&lt;50 years, the prevalence of CVD increased from 23.1 % to 31.2 % for females (P-trend&lt;0.001) while it increased from 15.8 % to 19.6 % for males (P-trend&lt;0.001) (P-interaction&lt;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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100662"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264882","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}

{"title":"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","authors":"M. Limburg ,&nbsp;M. Cronin ,&nbsp;M. Black ,&nbsp;J.C. Inchley ,&nbsp;D. Jourdan ,&nbsp;C. Jung-Sievers ,&nbsp;P. McHale ,&nbsp;E. Rehfuess ,&nbsp;M.-C. Tsai ,&nbsp;N.J. Gray","doi":"10.1016/j.puhip.2025.100654","DOIUrl":"10.1016/j.puhip.2025.100654","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;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","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100654"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265478","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}

{"title":"Upholding the right to health of forcibly displaced children in Europe","authors":"Amy Stevens ,&nbsp;Zeliha Öcek ,&nbsp;Sergey Sargsyan ,&nbsp;Michelle Black","doi":"10.1016/j.puhip.2025.100641","DOIUrl":"10.1016/j.puhip.2025.100641","url":null,"abstract":"<div><div>In 2023 Europe hosted an estimated 9 million children who had been forcibly displaced from their homes because of conflict, persecution, violence, natural or environmental disasters, climate crisis, human trafficking and extreme poverty. Their experiences pre, during and post migration impact their health, wellbeing and development. Countries across the European Region have a moral and legal duty to uphold the right to health of all children living within their borders, irrespective of immigration status. However, many countries are falling short of delivering on these obligations. The rise in populist radical right politics and anti-immigrant sentiment across the Region has led to an increase in potentially health-harming immigration policies and practices. Challenges to meeting the health needs of displaced children include underfunded health systems, limited specialist services, health and care workforce shortages, and lack of data to inform evidence-based policy and practice. Displaced children are often subjected to restrictions on service entitlements; systemic racism, xenophobia and discrimination in health systems; and language, cultural, social, financial, and administrative barriers to care. Cross-country collaboration is required to address the drivers of forced migration; increase availability of safe and legal routes for refugees; and ensure health systems across the Region have the data, resource and capacity required to respond to the needs of displaced children. Essential policies supporting a child's right to health include: provision of child and family-centred community alternatives to refugee camps and immigration detention; provision of healthcare and education entitlements equitable to children of the host nation; protection of children from violence and exploitation; and delivery of quality and inclusive trauma-informed healthcare that accounts for language needs, cultural diversity and safeguarding risks. With political commitment and coordinated efforts, ensuring the right to health for displaced children is achievable and should be prioritised.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100641"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595533","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}

{"title":"The health for hearts united dissemination Trial: Implementation costs to reduce cardiovascular risk in African Americans","authors":"Jon C. Mills ,&nbsp;Jeffrey Harman ,&nbsp;Pauline Muturi ,&nbsp;Christina Davis ,&nbsp;Iris Young-Clark ,&nbsp;Penny Ralston","doi":"10.1016/j.puhip.2025.100633","DOIUrl":"10.1016/j.puhip.2025.100633","url":null,"abstract":"<div><h3>Objectives</h3><div>We report on the implementation costs of disseminating Health for Hearts United (HH), a church-based intervention designed to reduce CVD in African Americans.</div></div><div><h3>Study design</h3><div>Cost analysis from dissemination trial of the CVD risk reducing, HH Intervention.</div></div><div><h3>Methods</h3><div>Total costs included materials purchased and labor hours contributed by the academic team to implement the intervention. Materials costs included supplies and printing calculated in total, as well as on a per-participant basis. Labor hours were tracked for each team member. Labor hours were further categorized by the phase of the intervention (Training, Planning &amp; Coaching, Delivery &amp; Recognition). Per-participant and per-church costs are reported as the cost measurement divided by the total health leaders that participated (reached).</div></div><div><h3>Results</h3><div>A total of n = 168 out of 173 health leader participants were reached (97 %). Total program costs were $87,207.66. Total material costs were $13,308.00, while labor costs accounted for 85 % of the total program costs ($87,207.66) at $73,899.66. The Training Phase comprised the largest portion (74 %) of the total labor costs ($54,598.29). Total per-health leader participant reached cost were $519.09.</div></div><div><h3>Conclusions</h3><div>In one of the first studies to report the costs of implementing a CVD risk reducing intervention among African Americans in a church setting, in partnership with a local academic institution, training was the main cost driver. Costs of implementing HH could be reduced by lowering hourly labor cost. Future research should examine costs associated with different methods of implementation (e.g., using more lay people).</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100633"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519173","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}