Journal of Public Health Research最新文献

Community-Based Participatory Research (CBPR) is a critical component in building trust and trustworthiness, as well as mitigating power differentials - all of which are essential for building and sustaining community-academic partnerships. Since 2017, the University of Rochester Medical Center has co-created and co-facilitated a CBPR Training Program with community partners and academics to address these dynamics through didactic modules and group conversations. Innovations and pivots such as adding additional educational modules on grant writing and dissemination and implementation, plus redefining meeting times and locations have occurred in response to evaluation data and continuous quality improvement. Annual program evaluation, measured through surveys and focus groups, found program participants demonstrated a statistically significant increase in CBPR knowledge, CBPR skills, and ability to partner in a CBPR context before and after the program (<0.05), a result that was sustained when stratified by several program years. Qualitative results highlighted the importance of building and nurturing relationships built on trust, sharing resources, and ensuring students end the course ready to engage in CBPR. This project provides a model of teaching CBPR within a milieu that breaks down barriers to effective and meaningful CBPR.

Introduction: Public stigma of Alzheimer's disease (AD) can delay help-seeking and be a barrier to research participation. This study aimed to understand what, if any, patterns exist among aspects of AD stigma. Knowing this may advance opportunities to reduce AD stigma.

Methods: Adult respondents (N = 317) read a vignette about a man with mild stage AD dementia. Afterward, respondents answered the modified Family Stigma in Alzheimer's Disease Scale (FS-ADS), which measures: Structural Discrimination, Negative Severity Attributions, Negative Aesthetic Attributions, Antipathy, Supportiveness, Pity, and Social Distance. In this correlational study, latent class analyses were used to derive response profiles. Regression models were used to assess correspondence of personal characteristics with profile membership.

Results: Three profiles emerged from latent class analysis of four FS-ADS domains of: Structural Discrimination, Negative Severity Attributions, Supportiveness, and Social Distance. Two profiles characterized about 66.8% of respondents and were similar except for one distinguishing quality: beliefs that a person with AD would receive support from others. Additionally, membership in the "expecting higher support" profile was associated with identifying as White and having lower educational attainment, while membership in the "expecting lower support" profile was associated with relatively higher educational attainment.

Conclusions: Beliefs about a lack of support, worries about discrimination, and expectations of social distance may depict a topic cluster to leverage in public messaging campaigns intended to reduce AD stigma. In doing so, our findings suggest it will be essential to consider the age and education level of the intended audience.

Background: Community-Based Surveillance (CBS) refers to involving community members in the detection and reporting of diseases within their communities for timely and effective response. Hence, it is necessary to study the factors that influence community participation in CBS.

Objective: This study aims to utilize the Health Belief Model (HBM) to identify predictors of community engagement in CBS activities in Kelantan state, Malaysia.

Design and methods: Perceived Benefit (BEN), Perceived Barriers (BARR), Perceived Susceptibility (SUS), and Behavioral Likelihood (BL) were assessed using a validated questionnaire (KAP-CBS-ID). A Covariance-based Structural Equation Modeling (SEM) approach was used to understand the relationships between the study variables.

Results: The model demonstrated a good fit (RMSEA = 0.048, 90% CI [0.042, 0.054]; CFI = 0.935; TLI = 0.925; SRMR = 0.078) and explained 40.5% of the variance in the behavioral likelihood of engaging in CBS. Self-efficacy (SE) emerged as a strong direct predictor of participation. SUS showed both direct and indirect (mediated) effects on behavioral likelihood to participate in CBS, with the indirect effect occurring through SE. Similarly, BEN influenced BL indirectly through SE. The perceived barriers, on the other hand, had a significant negative direct effect on participation (BL). The effects of SE, BARR, and SUS on participation in CBS were substantial.

Conclusion: Public health interventions should focus on improving community self-efficacy to participate in CBS initiatives, as well as raising awareness of disease susceptibility, highlighting the benefits of CBS, and addressing participation barriers to increase community engagement in surveillance systems.

Background: The transition to motherhood is well-known as a significant event in the life span and improved mental health and emotional wellbeing are known to improve maternal and neonatal outcomes. Maternal mental health is reported to positively impact pregnancy health outcomes, elevating levels of public health overall. However, misalignment exists between women's perspectives and policy frameworks that govern healthcare. This study provides an opportunity to explore perspectives for the first time in Australia. The objective of the study was to explore women's knowledge of recognizing emotional wellbeing and experiences of focused promotion in the perinatal period.

Design and methods: A qualitative descriptive approach was adopted. Twenty-one women who were planning pregnancy, currently pregnant or raising children under 10 were recruited. Semi-structured interviews and focus groups were conducted and data analyzed using inductive thematic analysis.

Results: Five themes were generated: Emotional Wellbeing is something we feel; Emotional Wellbeing is a state of being; The Impact of Environment; What Women Want and Perinatal Mental Health Literacy.

Conclusions: Australian women define emotional wellbeing as the absence of illness, multidimensional and heavily shaped by the influence of social media, interpersonal relationships, and antenatal midwifery models of care. Findings show improving perinatal mental health literacy among women, families, and maternity care providers may enable earlier recognition and support for emotional wellbeing in the transition to motherhood. Further research is warranted to target knowledge and awareness of emotional wellbeing to support the development of a mentally healthy vocabulary for pregnant women and mothers.

Background: Neurodevelopmental disorders (NDDs) are chronic disorders considered an emerging public health problem. This condition can markedly impair the Health-related Quality of Life (HRQoL). This study aimed to examine the HRQoL among children with NDDs.

Design and methods: A cross-sectional study was conducted among 73 parents/caregivers of children with NDDs aged 2-12 years. Pediatric Quality of Life Inventory 4.0 Generic Core Scale was used to assess the HRQoL. A multiple linear regression model was performed to assess the association.

Results: Among the 73 parents/caregivers, majority of their children fell into 2-4 year age group, with 70% being male. In contrast to other NDDs, this study highlights that the mean HRQoL scores for Cerebral palsy (CP), Down syndrome, Intellectual disability (ID), Motor disorders, and Neurogenetic disorders were below 50 on the 0-100 scale. The analysis of variance revealed a significant effect of NDD categories on the physical domain of QoL. Findings from regression analysis highlight that the physical functioning domain of QoL was significantly influenced by factors including age [ß: 2.44; 95%CI: (0.07, 4.81)], various NDDs, such as Attention-deficit hyperactivity disorder [ß: -25.54, 95%CI: (-43.12, -7.96)], Autism [ß: -25.44, 95%CI: (-41.51, -9.37)], CP [ß: -46.52, 95%CI: (-65.41, -17.62)], Down syndrome [ß: -42.33, 95%CI: (-63.28, -21.37)], ID [ß: -46.14, 95%CI: (-82.61, -9.67)] and motor disorder [ß: -77.07, 95%CI: (-103.32, -50.82)] and stable family income [ß: 16.37; 95%CI: (3.44, 29.29)]. This study also underscores that emotional functioning was significantly influenced by sex [ß: 18.27; 95%CI: (4.57, 31.97)], motor disorders [ß: -36.15, 95%CI: (-67.14, -5.16)], and social functioning was influenced by birth order 3rd/more [ß: 32.24;95%CI: (7.43, 57.04)].

Conclusions: This exploratory study highlights that multiple factors may influence various domains of HRQoL, including physical, emotional, social, and school functioning in children, providing a foundation for future studies.

Background: Respiratory-related mortality in Bangladesh exhibits pronounced seasonal trends, yet systematic forecasting to guide public health interventions remains limited. This study analyzes temporal patterns and projects future mortality using nationally certified cause-of-death data.

Methods: We applied a Seasonal Autoregressive Integrated Moving Average (SARIMA) model to monthly respiratory mortality records (January 2018-December 2024, 84 data points). Model selection was guided by AIC/BIC criteria, with performance evaluated via fivefold time-series cross-validation (training/test splits: Fold 1: 24/12, Fold 2: 36/12, Fold 3: 48/12, Fold 4: 60/12, Fold 5: 72/12). Seasonality was quantified through decomposition, and 18-month forecasts were generated with 95% prediction intervals.

Results: Mortality demonstrated strong seasonal peaks in July, August (79.5% of death counts in July), and January (66.2% of death counts in July), aligning with monsoon and winter periods. The optimal SARIMA(1,2,3)(0,1,1)[12] model achieved robust accuracy: mean absolute scaled error (MASE) = 0.41, MAE = 259.123, and RMSE = 337.238 (cross-validation mean: MASE = 0.58, MAE = 520.13). Forecasts projected stable monthly averages of 1724 (95% CI: 782-2667) deaths in 2025 and 1711 (593-2830) in 2026, with highest occurrence in July, August then January. Residual diagnostics confirmed model adequacy (Ljung-Box p = 0.971), though non-normality (Shapiro-Wilk p < 0.001) was present, it was negligible.

Conclusion: Respiratory mortality in Bangladesh follows predictable seasonal patterns, with monsoon and winter peaks demanding targeted interventions. The SARIMA model provides actionable forecasts for preemptive public health measures, such as pre-monsoon vaccination campaigns and pollution control. Future research should explore environmental covariates to enhance precision.

Background: In Ethiopia, most family planning users rely on short-acting contraceptives, despite the greater effectiveness of long-acting and permanent methods (LAPCMs). Previous studies on users' intention to adopt LAPCMs have reported inconsistent findings. This study aimed to determine the pooled prevalence of intention to use LAPCMs and identify associated factors among Ethiopian family planning users.

Methods: A systematic search was conducted in PubMed, Scopus, the Cochrane Library, and Google Scholar. Data were extracted using Microsoft Excel and analyzed with STATA version 11. A random-effects model was applied to estimate pooled prevalence, while heterogeneity was assessed using the Cochrane Q test and I ² statistic.

Results: Six studies involving 2773 participants were included. The pooled prevalence of intention to use LAPCMs was 50.98% (95% CI: 43.57-58.40). Significant factors associated with intention included good knowledge (POR = 4.81, 95% CI: 2.01-11.52), positive attitude (POR = 3.15, 95% CI: 2.21-4.50), higher educational attainment (POR = 6.23, 95% CI: 2.71-14.35), and the absence of myths and misconceptions (POR = 2.19, 95% CI: 1.10-4.38).

Conclusion: Intention to use LAPCMs among Ethiopian family planning users is moderate, indicating suboptimal uptake. Knowledge, education, attitudes, and misconceptions strongly influence this intention. Interventions that improve awareness, dispel misconceptions, and foster supportive attitudes are critical for enhancing adoption. Policymakers and health organizations should prioritize targeted education and behavior change strategies to strengthen family planning outcomes.

Background: Drug and alcohol support workers play a vital role in addressing the growing burden of substance-related harm and mortality. The COVID-19 pandemic led to an abrupt and significant shift towards home working for many in this workforce. This study explores these workers' home working experiences, addressing a research gap and providing valuable insights for staff, organisations delivering public health services, and service users.

Design and methods: This qualitative study explores home working experiences of 30 drug and alcohol support workers in northern England during the COVID-19 pandemic. Data collection included innovative digital methods: (1) digital timelines (n = 16); (2) in-depth interviews (n = 17); (3) five focus groups (n = 12). Timeline text was treated as qualitative text data. Interviews and focus groups were recorded, transcribed, and coded. Data were subject to Framework Analysis.

Results: Seven themes were identified: (1) Difficulty balancing and separating work and home life; (2) Importance of setup, infrastructure and conducive work environment; (3) The move to remote/home working - a process; (4) Convenience and efficiency benefits; (5) Loss of the social: - reductions in social connectedness and feelings of isolation; (6) The importance of the 'office' for connection, communication, socialising, and information sharing; (7) Managing remotely - the development and implementation of strategies and ways of coping.

Conclusions: While home working offers some benefits for substance use support workers, providers, and service users, it also introduces significant challenges. Understanding these is critical for service optimisation. A hybrid (in-person/remote) deliver model, combining home and co-located, office-based working may be optimal.

Background: Communication is central to effective public health practice, with all roles and functions requiring proficiency in communication. A competency-based approach to public health enhances workforce development and helps ensure adaptability and collaboration by equipping professionals with the practical skills needed to address complex and evolving public health challenges, including through communication.

Methods: Semi-structured interviews and reflexive thematic analysis were conducted to explore the perspectives of public health communication experts (researchers and practitioners) regarding the importance of public health communication, the challenges and opportunities faced by the field of practice, and the specialized competencies required for strengthened communication in modernized public health practice.

Results: Twelve key informants were interviewed, and seven interrelated themes were generated from the data. The themes were organized in three main areas: the importance of public health communication, the various levels of influence on effective communication, and the support needed for strengthened communication capacity. Participants stressed the importance of partnerships and collaboration, dedicated resources, ongoing professional development, and tools to facilitate the implementation of the specialized competencies.

Conclusions: A competency-based approach, including specialized roles and education and training programs aligned with updated communication competencies, will empower public health to tackle modern challenges. This research contributes to a multi-step research project to develop a Canadian public health communication competency framework and supports ongoing efforts to strengthen the public health workforce in Canada.

Introduction: South Africa's National School Nutrition Programme (NSNP) was created in 1994 to reduce poverty and unemployment and improve children's learning. It aims to aid disadvantaged children and strengthen poor communities, especially in rural areas.

Objectives: The study examined challenges in implementing Total Quality Management (TQM) in the South African National School Nutrition Programme.

Methods: A qualitative case study design was used based on document analysis extracted through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The documents were analysed using thematic analysis.

Results: Key TQM challenges affecting the implementation of the NSNP include Customer focus-lack of funding from the Department of Basic Education to accommodate increased enrolment; Employee involvement-role ambiguity due to lack of communication, and at times, the roles of the NSNP players are not clearly defined; Process-centric approaches-lack of school-level infrastructure to store and cook for students, Continuous improvement and training-lack of education curriculum on nutrition education and Relationship management-lack of coordination of the stakeholders on funding, political landscape, nutrition policies, community involvement, programme adaptability.

Conclusion: Effective monitoring systems should be established to guarantee that students receive the necessary quality and quantity of food. These systems should also oversee food supply, storage, preparation, and hygiene. Additionally, the current targeting system, the quintile system, requires evaluation. This should involve assessing the school's location, available resources, and individual students' social context.