Ssm-Population Health最新文献_第6页

Changes in the association between county industrial composition and working-age mortality from 2000 to 2022. 2000 - 2022年县域产业构成与劳动年龄死亡率关系的变化。

IF 3.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-29 eCollection Date: 2025-09-01 DOI: 10.1016/j.ssmph.2025.101849

Xue Zhang, Iliya Gutin, Shannon M Monnat, Jennifer Karas Montez

Rising working-age mortality in recent decades was partly due to declines in the manufacturing industry. Less is known about how working-age mortality was associated with concurrent changes in other industries and whether those associations fluctuated over time alongside exogenous shocks to labor markets. This study draws on the precarious work literature to assess temporally specific associations between industry composition and mortality, which likely operate through direct effects on workers and spillover effects on communities. We estimate associations between county-level industry composition and mortality among working-age adults (ages 25-64) within multiple subperiods capturing shocks to labor markets and mortality (e.g., China Shock, Great Recession, opioid epidemic, and COVID-19) across 2000 to 2022. We use Bayesian Hierarchical Modeling to account for spatial and temporal patterns, net of other county-level characteristics. Results corroborate and extend prior findings that shares of certain industries are associated with mortality rates. Results further show that the size and direction of the associations fluctuated over time for some industries and causes of death. Higher shares of agricultural employment were associated with lower mortality across time, especially in latter periods, while the mortality benefits associated with higher shares of manufacturing employment waned in the latter period. Higher shares of service industry employment predicted higher mortality, especially during the pandemic. Associations between shares of employment in the professional service and mining/construction industries and mortality were mixed. The findings underscore the need to broaden the focus beyond the manufacturing industry to better understand trends and disparities in working-age mortality.

近几十年来，劳动年龄死亡率的上升部分是由于制造业的衰退。对于工作年龄死亡率与其他行业的同步变化之间的关系，以及这些关系是否会随着劳动力市场的外部冲击而波动，人们知之甚少。本研究利用不稳定工作文献来评估行业构成与死亡率之间的暂时特定关联，这种关联可能通过对工人的直接影响和对社区的溢出效应来运作。我们估计了2000年至2022年期间劳动力市场冲击和死亡率（如中国冲击、大衰退、阿片类药物流行和COVID-19）的多个子周期内县级行业构成与工作年龄成年人（25-64岁）死亡率之间的关联。我们使用贝叶斯层次模型来解释空间和时间模式，以及其他县级特征。结果证实并扩展了先前的发现，即某些行业的股份与死亡率有关。结果进一步表明，对于某些行业和死亡原因，这种关联的规模和方向随时间而波动。随着时间的推移，较高的农业就业份额与较低的死亡率相关，特别是在后期，而与较高的制造业就业份额相关的死亡率福利在后期减弱。服务业就业的较高份额预示着较高的死亡率，特别是在大流行期间。专业服务和采矿/建筑工业的就业份额与死亡率之间的关系好坏参半。研究结果强调，有必要将研究重点扩大到制造业以外，以便更好地了解工作年龄死亡率的趋势和差异。

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引用次数: 0

When conflict meets political exclusion: Ethnicity, governance, and child mortality 当冲突遇到政治排斥：种族、治理和儿童死亡率

IF 3.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-26 DOI: 10.1016/j.ssmph.2025.101842

SoYun Chang , Brandon Ives , Jieun Oh

Armed conflict poses a major threat to child health, and growing research highlights how political and social structures may moderate its effects, though the full range of relevant effect modifiers remains incompletely understood. This study examines how the relationship between conflict severity and under-5 mortality rates varies depending on patterns of ethnic political representation. Using data from 99 countries from 2000 to 2017 at the first administrative level (ADM1), it tests the hypothesis that conflict severity has a stronger adverse effect on child mortality where ethnic groups that lack political representation reside. Multivariate linear regression models with ADM1 and year fixed effects provide evidence that lack of ethnic political representation operates as an effect modifier of the conflict-mortality relationship. The results remain robust across alternative measurements, covariates, model specifications, and matching techniques. These findings contribute to understanding how political inequality shapes the health consequences of conflict, with implications for both conflict-affected health interventions and policies addressing political representation.

武装冲突对儿童健康构成重大威胁，越来越多的研究强调政治和社会结构如何能够缓和其影响，尽管有关影响调节因素的全部范围仍未完全了解。这项研究考察了冲突严重程度与5岁以下儿童死亡率之间的关系如何因种族政治代表性的模式而异。该研究利用2000年至2017年99个国家一级行政层面（ADM1）的数据，检验了冲突严重程度对缺乏政治代表性的民族居住的儿童死亡率产生更大不利影响的假设。具有ADM1和固定年效应的多元线性回归模型提供了证据，表明缺乏种族政治代表性是冲突-死亡率关系的影响调节因子。结果在可选测量、协变量、模型规范和匹配技术中仍然是稳健的。这些发现有助于理解政治不平等如何影响冲突的健康后果，对受冲突影响的卫生干预措施和解决政治代表性问题的政策都有影响。

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引用次数: 0

Urban riverbank green spaces as therapeutic environments: Examining the psychosocial benefits of square dance in aging populations in China 城市河岸绿地作为治疗环境：广场舞在中国老年人群中的社会心理效益研究

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-24 DOI: 10.1016/j.ssmph.2025.101848

Song Wei , Hongli Yu , Chen Sun

Green spaces along urban rivers have become popular venues for promoting physical activity (PA), particularly among older adults. However, there is little research on how the timing (morning versus nighttime) and location (green versus non-green spaces) of square dancing (reflecting PA) influence psychosocial benefits for older adults. Furthermore, gender differences in these interactions remain unexplored. This study examines the psychosocial benefits (e.g., reducing anxiety and depression disorders, improving psychological well-being and quality of life, enhancing emotional well-being, and alleviating psychological stress) of square dancing for aging Chinese adults with gender-specific preferences. This study utilized a cross-sectional sampling method with older adults from urban riverbank green spaces in China (N = 536; 315 women and 221 men) in 2023. We collected demographics, preferences (both time and location), and psychosocial health outcomes using well-known tools. Statistical analyses included correlation assessments, Wald Chi-Square tests, and gender-specific comparisons. Results indicated that 71.08 % of participants preferred PA in green spaces and 60.82 % preferred nighttime activities, highlighting clear patterns of engagement. Among men, PA timing was more strongly related to anxiety levels (Wald χ² = 5.178). Conversely, PA location was significantly associated with emotional well-being (Wald χ² = 5.822) and quality of life (Wald χ² = 6.748) outcomes among women. Nighttime PA in urban riverside green spaces offers psychological benefits to older Chinese adults, highlighting distinct gender- and time-specific effects. Considering these findings, public health and community planning initiatives need to be customized to improve overall health and well-being among the aging population.

城市河流沿岸的绿地已成为促进身体活动（PA）的热门场所，尤其是在老年人中。然而，关于广场舞的时间（早上与晚上）和地点（绿色与非绿色空间）（反映PA）如何影响老年人的心理社会效益的研究很少。此外，这些相互作用中的性别差异仍未得到探索。本研究探讨了广场舞对具有性别偏好的中国老年人的心理社会效益（如减少焦虑和抑郁障碍、改善心理健康和生活质量、增强情绪健康和缓解心理压力）。本研究采用横断面抽样方法，对来自中国城市河岸绿地的老年人(N = 536；到2023年，女性为315人，男性为221人。我们使用众所周知的工具收集了人口统计数据、偏好（时间和地点）和心理健康结果。统计分析包括相关性评估、Wald卡方检验和性别比较。结果表明，71.08%的参与者更喜欢在绿地上的PA， 60.82%的参与者更喜欢夜间活动，突出了明确的参与模式。在男性中，PA时间与焦虑水平的相关性更强（Wald χ2 = 5.178）。相反，PA位置与女性的情绪幸福感（Wald χ2 = 5.822）和生活质量（Wald χ2 = 6.748）结果显著相关。城市滨江绿地的夜间PA为中国老年人提供了心理上的好处，突出了明显的性别和时间特异性效果。考虑到这些发现，需要定制公共卫生和社区规划举措，以改善老年人的整体健康和福祉。

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引用次数: 0

Understanding the dynamics and interplay of public support and adherence to five key mitigation behaviors over the course of the evolving COVID-19 pandemic 了解在COVID-19大流行演变过程中公众支持和遵守五种关键缓解行为的动态和相互作用

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-24 DOI: 10.1016/j.ssmph.2025.101847

Frank C. Gootjes , John B.F. de Wit , Denise D.T. de Ridder , F. Marijn Stok , Floor M. Kroese , Marijn de Bruin

Behavioral measures played a critical role in mitigating the COVID-19 pandemic, and their success hinged on continued public support and adherence. This study provides novel evidence on changes in support and adherence to behavioral mitigation measures and appraises the role of pandemic fatigue to provide robust guidance for effective governance of future public health and safety crises. Data were collected from a population cohort study in the Netherlands. This study used data from six assessments (December 2020–March 2022) at 12-week intervals, aligned with differences in pandemic severity and policy stringency. The analytic sample consisted of participants (N = 20,475) randomly allocated to answer questions on support and adherence to measures, focusing on physical distancing, avoiding crowds, mask-wearing on public transport, COVID-19 testing when symptomatic, and staying home when symptomatic. Changes in adherence and support and their interplay across time were assessed using random intercept cross-lagged panel models, controlling for age, gender and education. At the end of 2020, support for mitigation measures was found to be high, with little difference between measures. Subsequent changes in support for most measures broadly paralleled changes in pandemic severity and policy stringency. Adherence was less responsive to pandemic severity and policy stringency, and was mostly stable, albeit with differences between behavioral measures. Support and adherence to COVID-19 testing steadily increased after this was recommended as of early 2021. Changes in support and adherence did not reflect the notion of pandemic fatigue as a monotonic decline in support and adherence across behaviors. Findings highlight the need to better understand and address the factors influencing differing dynamics in support and adherence to specific protective behaviors.

行为措施在缓解COVID-19大流行方面发挥了关键作用，其成功取决于公众的持续支持和坚持。本研究为支持和遵守行为缓解措施方面的变化提供了新的证据，并评估了大流行疲劳的作用，为有效治理未来的公共卫生和安全危机提供了强有力的指导。数据收集自荷兰的一项人口队列研究。该研究使用了6次评估（2020年12月至2022年3月）的数据，每隔12周进行一次，与大流行严重程度和政策严格程度的差异保持一致。分析样本由随机分配的参与者（N = 20475）组成，他们被要求回答有关支持和遵守措施的问题，重点是保持身体距离、避开人群、在公共交通工具上戴口罩、出现症状时进行COVID-19检测、出现症状时待在家里。在控制年龄、性别和教育程度的情况下，使用随机截距交叉滞后面板模型评估依从性和支持性的变化及其相互作用。到2020年底，对缓解措施的支持度很高，各项措施之间的差异不大。随后在支持大多数措施方面的变化大致与大流行严重程度和政策严格程度的变化相一致。依从性对大流行的严重程度和政策的严格程度反应较弱，并且基本稳定，尽管行为措施之间存在差异。自2021年初提出这一建议后，对COVID-19检测的支持和坚持度稳步上升。支持和依从性的变化并没有反映出大流行疲劳是各种行为的支持和依从性单调下降的概念。研究结果强调需要更好地理解和解决影响支持和坚持特定保护行为的不同动态的因素。

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引用次数: 0

Daughter's college completion and parents' psychosocial wellbeing: quasi-experimental evidence from South Korea 女儿大学毕业与父母心理健康：来自韩国的准实验证据

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-23 DOI: 10.1016/j.ssmph.2025.101846

Ah-Reum Lee, K. Renata Flores Romero, Jacqueline Torres

The educational achievements of offspring are reported to be positively associated with the wellbeing of older parents, although observational research on this topic is likely subject to residual confounding bias. We use data on over 7,000 older adults who responded to the Korean Longitudinal Study on Aging (KLoSA), a population-based study that captures data on the wellbeing and family dynamics of adults 45 years along with detailed rosters of respondents' living children, including their age and educational attainment. We use these rosters to characterize offspring exposure to a 1993 higher education reform that increased college enrollment rates, particularly for young women, by over 45 percentage points over a decade. Prior research has leveraged this reform to identify the causal effects of college completion on women's fertility and labor market outcomes; we similarly demonstrate its utility as a natural experiment in our study, showing a meaningful discontinuity in the college completion of respondents' daughters based on exposure to the reform. We show that college completion among daughters reduced the risk of depression for older parents by 6–25% (with variation by parents' gender and model specification) but had no effects on ratings of life satisfaction. The returns to offspring college completion were most pronounced for older mothers, parents in living urban regions and those with fewer of their own household assets. Daughter's college completion also had an impact on some domains of intergenerational support that could explain effects on depressive symptoms, including the frequency of parent-child contact.

据报道，子女的教育成就与老年父母的幸福呈正相关，尽管关于这一主题的观察性研究可能存在残留混淆偏差。我们使用了7000多名老年人的数据，他们对韩国老龄化纵向研究（KLoSA）做出了回应，这是一项基于人口的研究，收集了45岁成年人的幸福和家庭动态数据，以及受访者在世子女的详细名单，包括他们的年龄和受教育程度。我们用这些名单来描述后代对1993年高等教育改革的影响，这项改革使大学入学率，特别是年轻女性的入学率在十年内提高了45个百分点以上。先前的研究利用这一改革来确定大学毕业对女性生育能力和劳动力市场结果的因果影响；在我们的研究中，我们同样证明了它作为一个自然实验的效用，显示了基于改革暴露的受访者女儿的大学完成度有意义的不连续性。我们发现，女儿完成大学学业使年长父母患抑郁症的风险降低了6-25%（随父母性别和模型规格的变化而变化），但对生活满意度评分没有影响。对于年龄较大的母亲、居住在城市地区的父母以及家庭资产较少的人来说，子女完成大学学业的回报最为明显。女儿的大学毕业也对代际支持的某些领域产生了影响，这可以解释对抑郁症状的影响，包括亲子接触的频率。

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引用次数: 0

Does regular engagement with arts and creative activities improve adolescent mental health and wellbeing? A systematic review and assessment of causality 经常参加艺术和创造性活动能改善青少年的心理健康和幸福吗？对因果关系的系统回顾和评估

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-22 DOI: 10.1016/j.ssmph.2025.101845

Sam Hugh-Jones , Stephanie Ray , Anna Wilding , Matt Sutton , Neil Humphrey , Luke Munford

Background

There is a growing body of evidence on the relationship between arts and creative activities and adolescent mental health and wellbeing. However, most research has focused on short, sharp creative arts interventions, and not on regular, day-to-day engagement with arts and creative activities. It is unclear the extent to which this complex relationship can be considered causal. This systematic review aimed to summarise the quantitative evidence on engagement with arts and creative activities and assess whether it supports causal conclusions.

Methods

We systematically searched 10 databases. We included any quantitative studies (cross-sectional and longitudinal observational studies, natural and quasi-experimental designs, and controlled trials) assessing the link between regular engagement (multiple instances over a period of more than one week) with arts and creative activities, and adolescent (10-19y) mental health and wellbeing. We included studies published in English from 2014 to 2024. Methodological quality was assessed using JBI critical appraisal tools. Support for causal conclusions was assessed using the Bradford Hill Viewpoints.

Results

Of 7769 records screened, 28 were selected for inclusion. Most studies suggested a positive association between arts engagement and adolescent mental health and wellbeing. We found some support for all Bradford Hill viewpoints, but less support for experimental evidence and a dose-response relationship.

Discussion

This review provides moderate support for a causal relationship between arts engagement and adolescent mental health and wellbeing. More evidence from randomised experiments or generated by applying causal inference methods to observational data is needed to better account for selection, confounding, and reverse-causality.

越来越多的证据表明，艺术和创造性活动与青少年心理健康和幸福之间存在关系。然而，大多数研究都集中在短期的、尖锐的创造性艺术干预上，而不是定期的、日常的艺术和创造性活动。目前尚不清楚这种复杂的关系在多大程度上可以被认为是因果关系。本系统综述旨在总结参与艺术和创造性活动的定量证据，并评估其是否支持因果结论。方法系统检索10个数据库。我们纳入了所有定量研究（横断面和纵向观察研究、自然和准实验设计以及对照试验），以评估定期参与（超过一周的时间内多次参与）艺术和创造性活动与青少年（10-19岁）心理健康和福祉之间的联系。我们纳入了2014年至2024年用英语发表的研究。使用JBI关键评估工具评估方法学质量。对因果结论的支持使用布拉德福德希尔观点进行了评估。结果从筛选的7769条记录中筛选出28条纳入。大多数研究表明，参与艺术与青少年心理健康和幸福之间存在积极联系。我们发现对布拉德福德·希尔的所有观点都有一些支持，但对实验证据和剂量-反应关系的支持较少。本综述为艺术参与与青少年心理健康和幸福之间的因果关系提供了适度的支持。需要更多来自随机实验或通过对观测数据应用因果推理方法产生的证据来更好地解释选择、混淆和反向因果关系。

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引用次数: 0

The biological consequences of grandparental death for children: An analysis of telomere length 祖父母死亡对儿童的生物学影响：端粒长度分析

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-21 DOI: 10.1016/j.ssmph.2025.101843

Michelle Sarah Livings , Emily Smith-Greenaway , Brandon G. Wagner , Ashton M. Verdery

Increasingly, health scholars acknowledge bereavement as a determinant of population health. Some research suggests that childhood health is especially affected by the deaths of family members. Although most research has focused on losing a parent or sibling in childhood, more recently, scholarship has established grandparental death as a source of poor mental health. We know less, however, about whether grandparental death affects children biologically, potentially imprinting them in a way that is consequential for their physical health and development. In this study, we offer the first analysis of the association between grandparental loss and U.S. children's telomere length—a common biomarker that reflects cumulative stress exposure. We use data from the Future of Families and Child Wellbeing Study to study grandparental death and children's telomere length at around age 9. Boys' telomere length is not associated with grandparental death; however, girls, and in particular girls who did not co-reside with their grandmother around age 5, had shorter telomere lengths following the death of their grandmother compared to girls whose grandmothers were still alive. Specifically, a non-co-resident grandmother's recent death corresponds with 11 % shorter telomeres among girls (p < 0.001), which persists net of covariates. This study demonstrates that grandparental death is a unique health risk factor for children, emphasizing the need to consider grandparental death as an underappreciated source of childhood health disparities.

越来越多的健康学者承认丧亲之痛是人口健康的决定因素。一些研究表明，儿童健康尤其受到家庭成员死亡的影响。虽然大多数研究都集中在童年时失去父母或兄弟姐妹，但最近，学术研究已经确定，祖父母去世是心理健康状况不佳的一个原因。然而，我们对祖父母的死亡是否会对孩子产生生物学上的影响知之甚少，是否会以一种对他们的身体健康和发展产生影响的方式给他们留下印记。在这项研究中，我们首次分析了祖父母丧失与美国儿童端粒长度之间的关系——端粒长度是一种反映累积压力暴露的常见生物标志物。我们使用来自未来家庭和儿童健康研究的数据来研究祖父母的死亡和9岁左右儿童的端粒长度。男孩端粒长度与祖父母死亡无关；然而，女孩，特别是那些在5岁左右没有和祖母住在一起的女孩，在祖母去世后的端粒长度比祖母还活着的女孩要短。具体来说，一位非共同居民的祖母最近去世，与女孩的端粒缩短11%相对应(p <；0.001)，这在协变量中仍然存在。这项研究表明，祖父母死亡是儿童的一个独特的健康风险因素，强调需要考虑祖父母死亡作为儿童健康差异的一个未被充分认识的来源。

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引用次数: 0

Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India 数字健康素养与对健康信息来源的信任：日本、美国和印度大学生的比较研究

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-20 DOI: 10.1016/j.ssmph.2025.101844

Hirono Ishikawa , Rina Miyawaki , Mio Kato , Jessica Legge Muilenburg , Yuki Azaad Tomar , Yoko Kawamura

The rapid expansion of the Internet and social media has transformed health communication, highlighting the critical importance for digital health literacy - particularly during the “infodemics” of the COVID-19 pandemic. This study examined digital health literacy and online health information–seeking behaviors among university students - the digital native generation - in Japan, the United States, and India. A cross-national comparison across these culturally and technologically diverse countries provides insights into global variations in digital health literacy.

An online survey was administered to 1500 undergraduate students (500 per country) using the Digital Health Literacy Instrument (DHLI) to evaluate their ability in utilizing digital health information. DHLI scores were compared across countries, and associated factors were analyzed.

The mean age of participants was 20.6 years. DHLI scores were significantly higher in the US (3.10 ± 0.38) than in India (2.94 ± 0.38) and Japan (2.89 ± 0.42). While students generally demonstrated strong operational skills, many lacked sufficient ability to critically evaluate information and contribute self-generated content, indicating the need for targeted educational support. Importantly, trust in online health information sources, rather than mere usage, was strongly associated with higher DHLI scores.

These findings highlight the importance of enhancing individual skills in identifying credible sources and increasing the availability of trustworthy digital health content, particularly from public agencies and official social media platforms. Future research should explore cultural and systemic factors underlying cross-country differences to inform targeted strategies for improving digital health literacy globally.

互联网和社交媒体的迅速发展改变了卫生传播，凸显了数字卫生素养的至关重要性，特别是在2019冠状病毒病大流行的“信息流行病”期间。这项研究调查了日本、美国和印度的大学生（数字原生代）的数字健康素养和在线健康信息寻求行为。对这些文化和技术多样化的国家进行跨国比较，可以深入了解数字卫生素养的全球差异。使用数字健康素养工具（DHLI）对1500名本科生（每个国家500名）进行了在线调查，以评估他们利用数字健康信息的能力。DHLI得分在不同国家之间进行比较，并分析相关因素。参与者的平均年龄为20.6岁。DHLI评分在美国（3.10±0.38）明显高于印度（2.94±0.38）和日本（2.89±0.42）。虽然学生们普遍表现出很强的操作技能，但许多人缺乏足够的能力来批判性地评估信息和贡献自我生成的内容，这表明需要有针对性的教育支持。重要的是，对在线健康信息来源的信任，而不仅仅是使用，与较高的DHLI分数密切相关。这些发现强调了提高个人技能在识别可靠来源和增加可信赖的数字健康内容的可用性方面的重要性，特别是来自公共机构和官方社交媒体平台。未来的研究应探索跨国差异背后的文化和系统因素，为提高全球数字健康素养的有针对性战略提供信息。

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引用次数: 0

The impact of slow mobility and built environment characteristics on 12.5-year all-cause mortality among older women and men: A prospective cohort study from Poland 慢流动性和建筑环境特征对老年男女12.5年全因死亡率的影响：来自波兰的一项前瞻性队列研究

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-11 DOI: 10.1016/j.ssmph.2025.101841

Katarzyna Zawisza , Michalina Gajdzica , Alberto Raggi , Beata Tobiasz-Adamczyk

Worldwide initiatives promoting mobility modes such as walking or cycling as low-cost and zero-emission forms of transport, have highlighted the possible health benefits of slow mobility. Identifying crucial elements of the built environment (BE) for slow mobility users, especially older adults, is important.

The study aimed to: compare the mortality risk of slow mode users with other transport mode users in both men and women; verify, which aspects of subjective and objective assessment of the BE are relevant as risk factors of 12.5-year all-cause mortality across various mobility mode users; examine social participation as a mediator of the relationship.

The Polish part of the COURAGE in Europe cross-sectional baseline study was conducted in 2011. The analysis included 1166 face-to-face interviews with randomly selected community-dwelling individuals aged 65 years or older from Poland. Information about deaths was obtained from the State Systems Department on Mar 1, 2024. The outdoor BE was assessed by trained interviewers’ direct observations. The Cox proportional hazard models were used.

Higher quality of streetscapes (in women) and walkways (in men) for those who mainly walk in their neighborhood, and bikeways (in women who cycle) were found to be significant protective factors against mortality. Walkways and bikeways were associated with a higher risk of death in the fast mode of transportation group of men. Mediation effect of social participation was found in unadjusted models.

The findings underline the importance of planning and organizing the BE from an age–friendly perspective and the need for a holistic approach to urban planning.

促进步行或骑自行车等低成本和零排放的交通方式的全球倡议强调了缓慢移动可能带来的健康益处。为行动缓慢的使用者（尤其是老年人）确定建筑环境的关键要素是很重要的。该研究的目的是：比较男性和女性慢速模式使用者与其他交通方式使用者的死亡风险；验证不同出行方式使用者12.5年全因死亡率的主观和客观评估的哪些方面是相关的风险因素；考察社会参与作为关系的中介。欧洲COURAGE横断面基线研究的波兰部分于2011年进行。分析包括1166个面对面访谈，随机选择来自波兰的65岁或以上的社区居民。有关死亡的信息于2024年3月1日从州系统部门获得。户外BE由训练有素的采访者直接观察评估。采用Cox比例风险模型。研究发现，对于那些主要在社区步行的人来说，较高质量的街景（女性）和人行道（男性）以及自行车道（骑自行车的女性）是降低死亡率的重要保护因素。在使用快速交通工具的人群中，人行道和自行车道与更高的死亡风险相关。在未调整的模型中发现了社会参与的中介效应。研究结果强调了从老年人友好的角度规划和组织BE的重要性，以及对城市规划采取整体方法的必要性。

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引用次数: 0

Effects of a participatory learning and action programme in women's groups on adolescent girls: a cluster-randomized controlled trial in Bihar, India 妇女团体参与性学习和行动方案对少女的影响：印度比哈尔邦的一项集群随机对照试验

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-07-10 DOI: 10.1016/j.ssmph.2025.101840

Lisa Bogler , Abhijeet Kumar , S.V. Subramanian , Sebastian Vollmer

Background

Adolescence is a critical development period where young people acquire health behaviours, making this a crucial time for interventions targeting health. Participatory learning and action programmes aimed at improving maternal and child health are usually delivered through women's groups but could potentially impact adolescent girls as well, either through their direct participation or through information sharing in the community.

Methods

We used a cluster-randomized controlled trial to evaluate the impact of a large-scale participatory learning and action programme called Gram Varta on attitudes and health-related knowledge of adolescent girls in rural Bihar. The programme was implemented between 2015 and 2016 by state-supported agencies in women's self-help groups and additionally targeted adolescent girls for programme participation. Using household survey data on almost 700 girls aged 13–19 years, we estimated the community-level intention-to-treat effect of Gram Varta on adolescent girls. Outcomes included female empowerment, outlook on the future, preferences regarding marriage and childbearing, care given by parents, and knowledge and practices regarding reproductive health and contraception.

Findings

Out of 53 indicators, only one was statistically significantly affected by Gram Varta across specifications, suggesting an increase in the share of girls engaging in unpaid housework by about 12 percentage points.

Conclusion

Our findings suggest that Gram Varta did not change attitudes and knowledge of adolescent girls on the community-level. This could be due to low participation of girls in programme meetings as well as low levels of information sharing between adults who took part in this programme and adolescent girls.

青少年时期是年轻人养成健康行为的关键发展时期，因此是开展针对健康的干预措施的关键时期。旨在改善孕产妇和儿童健康的参与性学习和行动方案通常是通过妇女团体提供的，但也可能通过少女的直接参与或通过在社区分享信息对她们产生潜在影响。方法我们采用一项集群随机对照试验来评估一项名为Gram Varta的大规模参与式学习和行动计划对比哈尔邦农村少女的态度和健康相关知识的影响。该方案在2015年至2016年期间由国家支持的妇女自助团体机构实施，并针对少女参与方案。利用近700名13-19岁女孩的家庭调查数据，我们估计了Gram Varta对青春期女孩的社区层面意向治疗效果。结果包括赋予妇女权力、对未来的展望、对婚姻和生育的偏好、父母的照顾以及有关生殖健康和避孕的知识和做法。在53个指标中，只有一个指标在统计上受到了格拉姆瓦尔塔的显著影响，这表明从事无偿家务劳动的女孩比例增加了约12个百分点。结论格兰·瓦尔塔在社区层面并没有改变少女的态度和知识。这可能是由于女孩很少参加方案会议，以及参加该方案的成年人与少女之间的信息交流程度较低。

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引用次数: 0