Public Health最新文献_第7页

How is health considered in urban transport planning? A review of the literature

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-22 DOI: 10.1016/j.puhe.2024.12.052

J. O'Connell

Objectives

Urban transport is an important determinant of population health. Ensuring health is well considered in urban transport planning is important to create healthy cities, healthy populations and sustainable societies. This review aimed to describe how health is considered in urban transport planning.

Study design

A narrative literature review was conducted.

Methods

Eligible literature included research articles, review articles, perspective articles, policy reports and technical reports published in English since 2013. PubMed, the Transport Research Integrated Database and grey literature sources were searched.

Results

Seventy articles were included, predominantly from high-income countries. Findings indicated that while urban transport is well recognised as a determinant of health, health considerations are often underprioritized in urban transport planning. Key issues identified included systemic power imbalances favouring car-orientated planning, insufficient legislative frameworks to promote health, the non-holistic assessment of health impacts in established environmental assessment processes, transport appraisal methodologies which undervalued health and differences between the health and planning professions in their preferred sources of evidence with associated challenges in knowledge translation. A consistent theme in the literature was that a strategic approach needed to be taken to improve how health is considered in urban transport planning and central to this was building relationships to enable collaborative and partnership working.

Conclusion

Health was poorly considered in urban transport planning. Contributing issues related to power, legislation, impact assessment and knowledge translation. A strategic approach is important to address these issues.

{"title":"How is health considered in urban transport planning? A review of the literature","authors":"J. O'Connell","doi":"10.1016/j.puhe.2024.12.052","DOIUrl":"10.1016/j.puhe.2024.12.052","url":null,"abstract":"<div><h3>Objectives</h3><div>Urban transport is an important determinant of population health. Ensuring health is well considered in urban transport planning is important to create healthy cities, healthy populations and sustainable societies. This review aimed to describe how health is considered in urban transport planning.</div></div><div><h3>Study design</h3><div>A narrative literature review was conducted.</div></div><div><h3>Methods</h3><div>Eligible literature included research articles, review articles, perspective articles, policy reports and technical reports published in English since 2013. PubMed, the Transport Research Integrated Database and grey literature sources were searched.</div></div><div><h3>Results</h3><div>Seventy articles were included, predominantly from high-income countries. Findings indicated that while urban transport is well recognised as a determinant of health, health considerations are often underprioritized in urban transport planning. Key issues identified included systemic power imbalances favouring car-orientated planning, insufficient legislative frameworks to promote health, the non-holistic assessment of health impacts in established environmental assessment processes, transport appraisal methodologies which undervalued health and differences between the health and planning professions in their preferred sources of evidence with associated challenges in knowledge translation. A consistent theme in the literature was that a strategic approach needed to be taken to improve how health is considered in urban transport planning and central to this was building relationships to enable collaborative and partnership working.</div></div><div><h3>Conclusion</h3><div>Health was poorly considered in urban transport planning. Contributing issues related to power, legislation, impact assessment and knowledge translation. A strategic approach is important to address these issues.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"240 ","pages":"Pages 21-26"},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of the COVID-19 pandemic on alcohol consumption in young adults: A systematic review

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-22 DOI: 10.1016/j.puhe.2025.01.004

Lorena Botella-Juan , Daniela Vargas-Caraballo , Antonio José Molina , Natalia Hernández-Segura , Tania Fernández-Villa

Objectives

The COVID-19 pandemic caused unprecedented restrictions, leading to differences in the frequency and patterns of alcohol consumption, especially among young adults. This systematic review aims to investigate the overall evidence concerning changes in alcohol consumption in this period.

Study design

Systematic review.

Methods

Adhering to PRISMA and SWiM guidelines, this study's review protocol is registered in PROSPERO (CRD42023464591). The studies research was carried out in PubMed, Scopus, and Web of Science. Inclusion criteria involved observational studies focusing on participants aged 18 to 35, exploring alcohol consumption during at least the first wave of COVID-19, and publications in English or Spanish.

Results

A total of 28 studies conducted in different countries were included, European (18), North American (9), and Latin American (1). Although in many studies the overall prevalence of alcohol use was reduced, it was mainly among occasional users, in which the main motivation was the lack of social contact. It was exposed that participants with a high risk of problematic use increased their alcohol consumption, showing associated factors such as poor mental health, depressive symptoms, stress, and coping motivations. Males generally exhibited a higher risk of problem use and risky behaviours than females.

Conclusions

During COVID-19, youth alcohol consumption decreased overall, especially among social drinkers, but increased among high-risk users due to factors like distress and loneliness. Similar trends during other disasters emphasize the importance of addressing high-risk drinking in disaster planning. Also, preventing high-risk drinking from adolescence and youth could be helpful in reducing the global burden and impact of alcohol consumption.

{"title":"Impact of the COVID-19 pandemic on alcohol consumption in young adults: A systematic review","authors":"Lorena Botella-Juan , Daniela Vargas-Caraballo , Antonio José Molina , Natalia Hernández-Segura , Tania Fernández-Villa","doi":"10.1016/j.puhe.2025.01.004","DOIUrl":"10.1016/j.puhe.2025.01.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The COVID-19 pandemic caused unprecedented restrictions, leading to differences in the frequency and patterns of alcohol consumption, especially among young adults. This systematic review aims to investigate the overall evidence concerning changes in alcohol consumption in this period.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>Adhering to PRISMA and SWiM guidelines, this study's review protocol is registered in PROSPERO (CRD42023464591). The studies research was carried out in PubMed, Scopus, and Web of Science. Inclusion criteria involved observational studies focusing on participants aged 18 to 35, exploring alcohol consumption during at least the first wave of COVID-19, and publications in English or Spanish.</div></div><div><h3>Results</h3><div>A total of 28 studies conducted in different countries were included, European (18), North American (9), and Latin American (1). Although in many studies the overall prevalence of alcohol use was reduced, it was mainly among occasional users, in which the main motivation was the lack of social contact. It was exposed that participants with a high risk of problematic use increased their alcohol consumption, showing associated factors such as poor mental health, depressive symptoms, stress, and coping motivations. Males generally exhibited a higher risk of problem use and risky behaviours than females.</div></div><div><h3>Conclusions</h3><div>During COVID-19, youth alcohol consumption decreased overall, especially among social drinkers, but increased among high-risk users due to factors like distress and loneliness. Similar trends during other disasters emphasize the importance of addressing high-risk drinking in disaster planning. Also, preventing high-risk drinking from adolescence and youth could be helpful in reducing the global burden and impact of alcohol consumption.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"240 ","pages":"Pages 1-11"},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to 'Medical expenses of patients with severe mental disorders in Beijing, China' [Publ Health 229 (2024) 50-56]. 《北京市严重精神障碍患者的医疗费用》的勘误表[公共卫生229(2024)50-56]。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-10 DOI: 10.1016/j.puhe.2024.12.040

Y Xin, J-L Zhu, Q-Z Huang, Y Chen, C Chen, W Lu

引用次数: 0

The impacts of noise and air pollution on breast cancer risk in European and East Asian populations: Insights from genetic evidence 噪音和空气污染对欧洲和东亚人群乳腺癌风险的影响：来自遗传证据的见解。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.11.021

Chengdong Yu , Jiawei Xu , Siyi Xu , Lei Tang , Xiaofang Zhang , Wen Chen , Ting Yu

Objectives

Previous studies have reported associations of noise and air pollution with breast cancer (BC) risk, but the causality remains unclear. This study aimed to explore the effects of noise and air pollution on BC from a genetic perspective.

Study design

Genetic association study.

Methods

We began our investigation by visualizing the development trends in this field through bibliometric analysis. Subsequently, we conducted Mendelian randomization analyses to assess the effects of noise (daytime and evening) and air pollution (NO₂, NO_x, PM_2.5, PM_2.5–10, and PM₁₀) on BC. Genetic variants extracted from genome-wide association studies (GWAS) robustly associated with noise and air pollution were used as instrumental variables. The GWAS data for BC in European and East Asian populations were obtained from the Breast Cancer Association Consortium and the Biobank Japan, respectively.

Results

The effects of noise and air pollution on BC are receiving increasing attention. In the European population, genetically predicted exposure to NO₂ (OR: 1.9381; 95% CI: 1.2873–2.9180; P = 0.0015) and PM₁₀ (OR: 1.4187; 95% CI: 1.0880–1.8500; P = 0.0098) were positively associated with overall BC risk. Subtype analyses showed that PM₁₀ was significantly related to the risks of both ER+ (OR: 1.6165; 95% CI: 1.1778–2.2186; P = 0.0030) and ER− (OR: 1.6228; 95% CI: 1.0175–2.5881; P = 0.0421) BC. Additionally, NO₂ only increased the risk of ER+ BC (OR: 1.7429; 95% CI: 1.0679–2.8444; P = 0.0262), but not ER− BC. In East Asians, genetically predicted NO₂ was positively related to BC risk (OR: 1.1394; 95% CI: 1.0082–1.2877; P = 0.0366).

Conclusions

Our study gave new evidence from a genetic standpoint underscoring that improving the environmental quality of residential areas is conducive to reducing BC risk.

目的：以前的研究报道了噪音和空气污染与乳腺癌（BC）风险的关联，但因果关系尚不清楚。本研究旨在从遗传学角度探讨噪声和空气污染对BC的影响。研究设计：遗传关联研究。方法：通过文献计量学分析，对该领域的发展趋势进行可视化分析。随后，我们进行了孟德尔随机分析，以评估噪音（白天和晚上）和空气污染（NO2、NOx、PM2.5、PM2.5-10和PM10）对BC的影响。从全基因组关联研究（GWAS）中提取的与噪声和空气污染密切相关的遗传变异被用作工具变量。欧洲和东亚人群中BC的GWAS数据分别来自乳腺癌协会联合会和日本生物银行。结果：噪声和空气污染对BC的影响越来越受到重视。在欧洲人群中，基因预测暴露于NO2 (OR: 1.9381；95% ci: 1.2873-2.9180；P = 0.0015)和PM10 (OR: 1.4187；95% ci: 1.0880-1.8500；P = 0.0098)与总体BC风险呈正相关。亚型分析显示，PM10与ER+ (OR: 1.6165；95% ci: 1.1778-2.2186；P = 0.0030)和ER- (OR: 1.6228；95% ci: 1.0175-2.5881；P = 0.0421) bc。此外，NO2仅增加ER+ BC的风险(OR: 1.7429；95% ci: 1.0679-2.8444；P = 0.0262)， ER- BC无明显差异。在东亚，遗传预测的NO2与BC风险呈正相关(OR: 1.1394；95% ci: 1.0082-1.2877；p = 0.0366)。结论：我们的研究从遗传学的角度提供了新的证据，强调改善住宅区的环境质量有助于降低BC的风险。

{"title":"The impacts of noise and air pollution on breast cancer risk in European and East Asian populations: Insights from genetic evidence","authors":"Chengdong Yu , Jiawei Xu , Siyi Xu , Lei Tang , Xiaofang Zhang , Wen Chen , Ting Yu","doi":"10.1016/j.puhe.2024.11.021","DOIUrl":"10.1016/j.puhe.2024.11.021","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies have reported associations of noise and air pollution with breast cancer (BC) risk, but the causality remains unclear. This study aimed to explore the effects of noise and air pollution on BC from a genetic perspective.</div></div><div><h3>Study design</h3><div>Genetic association study.</div></div><div><h3>Methods</h3><div>We began our investigation by visualizing the development trends in this field through bibliometric analysis. Subsequently, we conducted Mendelian randomization analyses to assess the effects of noise (daytime and evening) and air pollution (NO<sub>2</sub>, NO<sub>x</sub>, PM<sub>2.5</sub>, PM<sub>2.5–10</sub>, and PM<sub>10</sub>) on BC. Genetic variants extracted from genome-wide association studies (GWAS) robustly associated with noise and air pollution were used as instrumental variables. The GWAS data for BC in European and East Asian populations were obtained from the Breast Cancer Association Consortium and the Biobank Japan, respectively.</div></div><div><h3>Results</h3><div>The effects of noise and air pollution on BC are receiving increasing attention. In the European population, genetically predicted exposure to NO<sub>2</sub> (OR: 1.9381; 95% CI: 1.2873–2.9180; <em>P</em> = 0.0015) and PM<sub>10</sub> (OR: 1.4187; 95% CI: 1.0880–1.8500; <em>P</em> = 0.0098) were positively associated with overall BC risk. Subtype analyses showed that PM<sub>10</sub> was significantly related to the risks of both ER+ (OR: 1.6165; 95% CI: 1.1778–2.2186; <em>P</em> = 0.0030) and ER− (OR: 1.6228; 95% CI: 1.0175–2.5881; <em>P</em> = 0.0421) BC. Additionally, NO<sub>2</sub> only increased the risk of ER+ BC (OR: 1.7429; 95% CI: 1.0679–2.8444; <em>P</em> = 0.0262), but not ER− BC. In East Asians, genetically predicted NO<sub>2</sub> was positively related to BC risk (OR: 1.1394; 95% CI: 1.0082–1.2877; <em>P</em> = 0.0366).</div></div><div><h3>Conclusions</h3><div>Our study gave new evidence from a genetic standpoint underscoring that improving the environmental quality of residential areas is conducive to reducing BC risk.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 197-205"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review of historic neighborhood redlining and contemporary health outcomes 对历史上的邻里红线和当代健康结果进行系统回顾。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.10.022

S.J. Bauer , B.R. Spoer , R. Ehrman , I. Nnodim Opara , H. Wei , R.S. Ellendula , A.H. Haidar , M. Hardeman , P.D. Levy , S.J. Korzeniewski

Objectives

Historic redlining grades that were assigned to US neighborhoods based largely on minority race or ethnicity by the Home Owners Loan Corporation (HOLC) during the 1930s have been linked with adverse health outcomes among neighborhood residents. This review aimed to summarize the quantitative evidence, so we could determine if any findings are replicated and otherwise identify research gaps.

Study design

Systematic review.

Methods

We conducted a systematic review by searching the PubMed® MEDLINE database for observational studies that reported on health outcomes among people who resided in neighborhoods that were assigned HOLC grades. We assessed quality by allocating points based on whether studies reported the sample size or count of people affected by outcomes (yes = 1 point, no = 2 points), and whether unadjusted magnitudes of association were reported alongside adjusted estimates (yes = 1 point, no = 2 points). The sum score was used to classify each study as high (2 points), average (3 points) or low quality (4 points).

Results

Among the 89 articles identified, 32 met inclusion criteria; 15 were deemed high-quality. The most frequently studied health conditions in order of descending frequency were: i) injury or violence (n = 8), ii) cancer (n = 7), iii) cardiometabolic (n = 6), iv) perinatal (n = 5), v) asthma (n = 2).

Conclusion

People who lived in areas with less desirable HOLC grades tended to suffer higher than expected rates of injury or violence, asthma, adverse pregnancy outcomes, and some cardiometabolic disorders; associations with cancer were mostly null. Methodological differences limited opportunities for direct comparison across studies, and there was significant heterogeneity among the few estimates that were generally comparable. While robust data are lacking, the limited existing evidence supports a possible association between historically redlined areas and heightened risk of adverse health outcomes. Why this association may exist remains unknown.

目的：在20世纪30年代，房屋所有者贷款公司（HOLC）根据少数民族或族裔划分的美国社区的历史红线等级与社区居民的不良健康结果有关。本综述旨在总结定量证据，以便我们可以确定是否有任何发现被复制，或者确定研究空白。研究设计：系统评价。方法：我们通过搜索PubMed®MEDLINE数据库，对居住在被分配为HOLC等级的社区的人们的健康结果进行了系统回顾。我们根据研究是否报告了样本量或受结果影响的人数（是= 1分，否= 2分）以及未调整的关联程度是否与调整后的估计值一起报告（是= 1分，否= 2分），通过分配分数来评估质量。总得分用于将每个研究分为高（2分），平均（3分）或低质量（4分）。结果：89篇文献中，32篇符合纳入标准；15个被认为是高质量的。最常被研究的健康状况（按频率降序排列）是：i)伤害或暴力（n = 8）， ii)癌症（n = 7）， iii)心脏代谢（n = 6）， iv)围产期（n = 5）， v)哮喘（n = 2）。结论：生活在HOLC等级较差地区的人往往遭受的伤害或暴力、哮喘、不良妊娠结局和一些心脏代谢疾病的发生率高于预期；与癌症的关联基本为零。方法上的差异限制了直接比较研究的机会，并且在少数具有一般可比性的估计中存在显著的异质性。虽然缺乏可靠的数据，但有限的现有证据支持历史上红线地区与不良健康结果风险增加之间可能存在关联。这种关联可能存在的原因尚不清楚。

{"title":"A systematic review of historic neighborhood redlining and contemporary health outcomes","authors":"S.J. Bauer , B.R. Spoer , R. Ehrman , I. Nnodim Opara , H. Wei , R.S. Ellendula , A.H. Haidar , M. Hardeman , P.D. Levy , S.J. Korzeniewski","doi":"10.1016/j.puhe.2024.10.022","DOIUrl":"10.1016/j.puhe.2024.10.022","url":null,"abstract":"<div><h3>Objectives</h3><div>Historic redlining grades that were assigned to US neighborhoods based largely on minority race or ethnicity by the Home Owners Loan Corporation (HOLC) during the 1930s have been linked with adverse health outcomes among neighborhood residents. This review aimed to summarize the quantitative evidence, so we could determine if any findings are replicated and otherwise identify research gaps.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>We conducted a systematic review by searching the PubMed® MEDLINE database for observational studies that reported on health outcomes among people who resided in neighborhoods that were assigned HOLC grades. We assessed quality by allocating points based on whether studies reported the sample size or count of people affected by outcomes (yes = 1 point, no = 2 points), and whether unadjusted magnitudes of association were reported alongside adjusted estimates (yes = 1 point, no = 2 points). The sum score was used to classify each study as high (2 points), average (3 points) or low quality (4 points).</div></div><div><h3>Results</h3><div>Among the 89 articles identified, 32 met inclusion criteria; 15 were deemed high-quality. The most frequently studied health conditions in order of descending frequency were: i) injury or violence (n = 8), ii) cancer (n = 7), iii) cardiometabolic (n = 6), iv) perinatal (n = 5), v) asthma (n = 2).</div></div><div><h3>Conclusion</h3><div>People who lived in areas with less desirable HOLC grades tended to suffer higher than expected rates of injury or violence, asthma, adverse pregnancy outcomes, and some cardiometabolic disorders; associations with cancer were mostly null. Methodological differences limited opportunities for direct comparison across studies, and there was significant heterogeneity among the few estimates that were generally comparable. While robust data are lacking, the limited existing evidence supports a possible association between historically redlined areas and heightened risk of adverse health outcomes. Why this association may exist remains unknown.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 181-187"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling relationships of human instinctive behaviors and blood pressure in Chinese adults: A network analysis 揭示人类本能行为与中国成年人血压的关系：一个网络分析。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.020

Bin Yu , Jianzhong Yin , Peng Yu , Yunzhe Fan , Jiqi Yang , Yao Fu , Sihan Wang , Tingting Yang , Bangjing Ma , Xianbin Ding , Shujuan Yang

Objectives

Human behaviors and blood pressure (BP) are closely intertwined, affecting health. However, few studies have demonstrated their complex relationships. Using network analysis, we aimed to untangle the intricate and potential causal relationships between BP and human instinctive behaviors, identifying potential action points for hypertension prevention and control.

Study design

Cohort study.

Methods

This study is based on two-wave data from 11,277 Chinese adults in the China Multi-Ethnic Cohort (CMEC) and an independent validation cohort of 21,947 adults from the Chinese Cohort of Working Adults (CCWA). We conducted a cross-sectional network analysis to estimate the interrelationships between measured BP and self-reported physical activity (PA), diet, and sleep. The centrality of each variable within the network was estimated using strength centrality index. Additionally, we performed a longitudinal network analysis to infer the potential causal relationships between BP and human instinctive behaviors in participants with normal or above-normal BP.

Results

The network models suggested that BP exhibited negative associations with the dietary score (edge weight: −0.09) and sleep duration (−0.05). Non-sedentary behavior and dietary score were the most central variables, strongly connecting BP and other lifestyles. Higher BP predicted a poorer dietary score (β = −0.21) in participants with above-normal BP. The effect of BP on dietary score was replicated in the validation cohort and validated by linear regression analysis.

Conclusions

Non-sedentary behaviors and dietary behaviors may be the potential action points in promoting healthy behaviors and contributing to BP management. It is essential to manage individuals’ BP status, non-sedentary behaviors, and dietary behaviors to disrupt malignant cycles.

目的：人的行为与血压（BP）密切相关，影响健康。然而，很少有研究证明它们之间的复杂关系。通过网络分析，我们旨在理清血压与人类本能行为之间复杂而潜在的因果关系，找出高血压预防和控制的潜在行动点。研究设计：队列研究。方法：本研究基于来自中国多民族队列（CMEC）的11,277名中国成年人的两波数据，以及来自中国工作成年人队列（CCWA）的21,947名成年人的独立验证队列。我们进行了横断面网络分析，以估计测量的血压与自我报告的身体活动（PA）、饮食和睡眠之间的相互关系。使用强度中心性指数估计网络中每个变量的中心性。此外，我们还进行了纵向网络分析，以推断血压正常或高于正常水平的参与者的血压与人类本能行为之间的潜在因果关系。结果：网络模型显示血压与饮食评分（边缘体重：-0.09）和睡眠时间（-0.05）呈负相关。非久坐行为和饮食评分是最核心的变量，与血压和其他生活方式密切相关。在血压高于正常值的参与者中，较高的血压预示着较差的饮食评分（β = -0.21）。BP对饮食评分的影响在验证队列中得到重复，并通过线性回归分析得到验证。结论：非久坐行为和饮食行为可能是促进健康行为和BP管理的潜在作用点。管理个人的血压状态、非久坐行为和饮食行为是打破恶性循环的必要条件。

{"title":"Unveiling relationships of human instinctive behaviors and blood pressure in Chinese adults: A network analysis","authors":"Bin Yu , Jianzhong Yin , Peng Yu , Yunzhe Fan , Jiqi Yang , Yao Fu , Sihan Wang , Tingting Yang , Bangjing Ma , Xianbin Ding , Shujuan Yang","doi":"10.1016/j.puhe.2024.12.020","DOIUrl":"10.1016/j.puhe.2024.12.020","url":null,"abstract":"<div><h3>Objectives</h3><div>Human behaviors and blood pressure (BP) are closely intertwined, affecting health. However, few studies have demonstrated their complex relationships. Using network analysis, we aimed to untangle the intricate and potential causal relationships between BP and human instinctive behaviors, identifying potential action points for hypertension prevention and control.</div></div><div><h3>Study design</h3><div>Cohort study.</div></div><div><h3>Methods</h3><div>This study is based on two-wave data from 11,277 Chinese adults in the China Multi-Ethnic Cohort (CMEC) and an independent validation cohort of 21,947 adults from the Chinese Cohort of Working Adults (CCWA). We conducted a cross-sectional network analysis to estimate the interrelationships between measured BP and self-reported physical activity (PA), diet, and sleep. The centrality of each variable within the network was estimated using strength centrality index. Additionally, we performed a longitudinal network analysis to infer the potential causal relationships between BP and human instinctive behaviors in participants with normal or above-normal BP.</div></div><div><h3>Results</h3><div>The network models suggested that BP exhibited negative associations with the dietary score (edge weight: −0.09) and sleep duration (−0.05). Non-sedentary behavior and dietary score were the most central variables, strongly connecting BP and other lifestyles. Higher BP predicted a poorer dietary score (β = −0.21) in participants with above-normal BP. The effect of BP on dietary score was replicated in the validation cohort and validated by linear regression analysis.</div></div><div><h3>Conclusions</h3><div>Non-sedentary behaviors and dietary behaviors may be the potential action points in promoting healthy behaviors and contributing to BP management. It is essential to manage individuals’ BP status, non-sedentary behaviors, and dietary behaviors to disrupt malignant cycles.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 289-297"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neighborhood contributions in influencing overweight and obesity among Chinese children and adolescents: Temporal, geographical and gender variations 社区对中国儿童和青少年超重和肥胖的影响：时间、地理和性别差异

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.11.024

Lijuan Gu

Objective

The precise extent to which neighborhood influences childhood overweight and obesity (O/O) remains unknown. We investigated the magnitudes of neighborhood contributions to childhood O/O and explored potential temporal, geographical and gender variations.

Study design

This was a pooled analysis using secondary survey data from six China Family Panel Studies from 2010 to 2020.

Methods

26 262 children and adolescents aged 6–16 years residing in the low, medium and high O/O prevalence areas were included. Multilevel logistic analyses with random slopes were utilized to regress O/O on various individual and neighborhood covariates. Intraclass Correlation Coefficients were applied to quantify neighborhood contributions and 80 % Interval Odds Ratio and Proportions of Opposed Odds Ratios were used to evaluate between-neighborhood discrepancies in specific neighborhood factors.

Results

Overall, neighborhood accounted for 2%–8% of O/O variations. Temporally, neighborhood contributions declined from 2010 to 2016 but increased thereafter. Geographically, they were higher in medium/low prevalence areas than high prevalence areas (4%–10 % vs. 2%–6%). Compared to males, they were greater among females (3%–9% vs. 1%–7%). Neighborhood contributions in high prevalence areas have rapidly increased recently with those among males growing faster. Besides O/O prevalence areas, residence (OR: 1.12, CIs: 1.01–1.23)) and percentage of households with minimum living allowance (1.01, 1.00–1.01) were significant neighborhood factors with the effects of residence exhibited lower between-neighborhood variations (32%–43 % vs. 48%–50 %).

Conclusion

This study empirically suggests the importance of neighborhood and supports the potential of governmental policies aiming at curbing childhood overweight/obesity through tailored neighborhood-based interventions.

目的：邻里关系对儿童超重和肥胖（O/O）影响的确切程度尚不清楚。我们调查了邻里对儿童O/O的贡献程度，并探讨了潜在的时间、地理和性别差异。研究设计：本研究采用2010年至2020年6项中国家庭小组研究的二次调查数据进行汇总分析。方法：选取生活在O/O低、中、高流行地区的6 ~ 16岁儿童和青少年26262例。采用随机斜率的多水平逻辑分析对不同个体和邻域协变量的O/O进行回归。类内相关系数用于量化邻域贡献，80%区间优势比和相对优势比用于评估特定邻域因素的邻域间差异。结果：总体而言，邻域占O/O变化的2%-8%。从时间上看，社区贡献从2010年到2016年有所下降，但此后有所增加。从地理上看，中/低流行地区的死亡率高于高流行地区（4%- 10%对2%-6%）。与男性相比，女性患病率更高（3%-9% vs. 1%-7%）。在高流行地区，社区贡献最近迅速增加，其中男性贡献增长更快。除O/O患病率外，居住地（OR: 1.12, ci: 1.01 ~ 1.23）和领取最低生活保障家庭百分比（1.01,1.00 ~ 1.01）是显著的社区因素，居住地的影响在社区间差异较小（32% ~ 43% vs. 48% ~ 50%）。结论：本研究从经验上表明了社区的重要性，并支持政府通过量身定制的社区干预措施来遏制儿童超重/肥胖的政策潜力。

{"title":"Neighborhood contributions in influencing overweight and obesity among Chinese children and adolescents: Temporal, geographical and gender variations","authors":"Lijuan Gu","doi":"10.1016/j.puhe.2024.11.024","DOIUrl":"10.1016/j.puhe.2024.11.024","url":null,"abstract":"<div><h3>Objective</h3><div>The precise extent to which neighborhood influences childhood overweight and obesity (O/O) remains unknown. We investigated the magnitudes of neighborhood contributions to childhood O/O and explored potential temporal, geographical and gender variations.</div></div><div><h3>Study design</h3><div>This was a pooled analysis using secondary survey data from six China Family Panel Studies from 2010 to 2020.</div></div><div><h3>Methods</h3><div>26 262 children and adolescents aged 6–16 years residing in the low, medium and high O/O prevalence areas were included. Multilevel logistic analyses with random slopes were utilized to regress O/O on various individual and neighborhood covariates. Intraclass Correlation Coefficients were applied to quantify neighborhood contributions and 80 % Interval Odds Ratio and Proportions of Opposed Odds Ratios were used to evaluate between-neighborhood discrepancies in specific neighborhood factors.</div></div><div><h3>Results</h3><div>Overall, neighborhood accounted for 2%–8% of O/O variations. Temporally, neighborhood contributions declined from 2010 to 2016 but increased thereafter. Geographically, they were higher in medium/low prevalence areas than high prevalence areas (4%–10 % vs. 2%–6%). Compared to males, they were greater among females (3%–9% vs. 1%–7%). Neighborhood contributions in high prevalence areas have rapidly increased recently with those among males growing faster. Besides O/O prevalence areas, residence (OR: 1.12, CIs: 1.01–1.23)) and percentage of households with minimum living allowance (1.01, 1.00–1.01) were significant neighborhood factors with the effects of residence exhibited lower between-neighborhood variations (32%–43 % vs. 48%–50 %).</div></div><div><h3>Conclusion</h3><div>This study empirically suggests the importance of neighborhood and supports the potential of governmental policies aiming at curbing childhood overweight/obesity through tailored neighborhood-based interventions.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 173-180"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An ecological study on the correlation between sanitary vulnerability and air pollution with COVID-19 pandemic burden: What lessons can we learn? 关于卫生脆弱性和空气污染与 COVID-19 流行病负担之间相关性的生态学研究：我们可以吸取哪些经验教训？

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.002

Manuela Bullo , Gabriela Lakkis , Alejandro Enet , Juan Ignacio Bonfiglio , Ricardo Di Pasquale , Sol Represa , Luciana Marisol Gonzalez , Gabriela Gonzalez-Aleman , Maria Cristina Lamas , Agustin Salvia , Martín Langsam , Tomás Olego , Santiago Perez-Lloret

Objectives

Air quality, socioeconomic status, access to healthcare, genetic predispositions, among other factors impacted the COVID-19 pandemic burden. We explored the relationship between PM2.5 levels and sanitary vulnerability in COVID-19 pandemic health outcomes in Argentina.

Study design

Ecological study.

Methods

We used the Sanitary Vulnerability Index (SVI) to account for social determinants of health and distance to health centers. PM2.5 air concentration and human emissions were obtained from the Atmospheric Composition Analysis Group V5.GL.03 dataset and the inventory of anthropogenic gas-phase and particle emissions for Argentina (GEEA-AEIv3.0M), respectively. Finally, we extracted data from March 1, 2020, to January 1, 2021 from the official Argentinean database of COVID-19 (Argentine Ministry of Health).

Results

SVI correlated with the rate of positive COVID-19 tests per 100,000 people (r = −0.56, p < 0.01), Intensive Care Unit (ICU) admissions per 100,000 people (r = −0.52, p < 0.01), and deaths per 100,000 people (r = −0.58, p < 0.01). PM2.5 air concentration correlated with the rate of positive tests (r = −0.09, p = 0.03), ICU admissions (r = −0.16, p < 0.01), and mortality (r = −0.11, p = 0.01). PM2.5 human emissions did not show significant correlations with COVID-19 outcomes. There was a significant interaction between SVI and PM2.5 air concentration for the rate of positive COVID-19 tests and mortality. PM2.5 air quality showed a positive and significant association with the outcomes only in areas with high SVI. A machine-learning model including these variables accounted for 46 % of the variability.

Conclusions

The interplay between health vulnerability and air quality in human health is complex. Addressing the burden of COVID-19 pandemic requires the consideration of a comprehensive range of determinants.

目标：空气质量、社会经济地位、获得医疗保健、遗传易感等因素影响了COVID-19大流行负担。我们探讨了PM2.5水平与阿根廷COVID-19大流行健康结果中卫生脆弱性之间的关系。研究设计：生态学研究。方法：我们使用卫生脆弱性指数（SVI）来解释健康和卫生中心距离的社会决定因素。PM2.5空气浓度和人类排放数据来自大气成分分析小组V5.GL。03数据集和阿根廷人为气相和颗粒排放清单（GEEA-AEIv3.0M）。最后，我们从阿根廷官方COVID-19数据库（阿根廷卫生部）中提取了2020年3月1日至2021年1月1日的数据。结果：SVI与每10万人COVID-19检测阳性率相关（r = -0.56, p）。结论：健康脆弱性与人类健康空气质量之间的相互作用是复杂的。解决COVID-19大流行的负担需要考虑一系列全面的决定因素。

{"title":"An ecological study on the correlation between sanitary vulnerability and air pollution with COVID-19 pandemic burden: What lessons can we learn?","authors":"Manuela Bullo , Gabriela Lakkis , Alejandro Enet , Juan Ignacio Bonfiglio , Ricardo Di Pasquale , Sol Represa , Luciana Marisol Gonzalez , Gabriela Gonzalez-Aleman , Maria Cristina Lamas , Agustin Salvia , Martín Langsam , Tomás Olego , Santiago Perez-Lloret","doi":"10.1016/j.puhe.2024.12.002","DOIUrl":"10.1016/j.puhe.2024.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Air quality, socioeconomic status, access to healthcare, genetic predispositions, among other factors impacted the COVID-19 pandemic burden. We explored the relationship between PM2.5 levels and sanitary vulnerability in COVID-19 pandemic health outcomes in Argentina.</div></div><div><h3>Study design</h3><div>Ecological study.</div></div><div><h3>Methods</h3><div>We used the Sanitary Vulnerability Index (SVI) to account for social determinants of health and distance to health centers. PM2.5 air concentration and human emissions were obtained from the Atmospheric Composition Analysis Group V5.GL.03 dataset and the inventory of anthropogenic gas-phase and particle emissions for Argentina (GEEA-AEIv3.0M), respectively. Finally, we extracted data from March 1, 2020, to January 1, 2021 from the official Argentinean database of COVID-19 (Argentine Ministry of Health).</div></div><div><h3>Results</h3><div>SVI correlated with the rate of positive COVID-19 tests per 100,000 people (r = −0.56, p < 0.01), Intensive Care Unit (ICU) admissions per 100,000 people (r = −0.52, p < 0.01), and deaths per 100,000 people (r = −0.58, p < 0.01). PM2.5 air concentration correlated with the rate of positive tests (r = −0.09, p = 0.03), ICU admissions (r = −0.16, p < 0.01), and mortality (r = −0.11, p = 0.01). PM2.5 human emissions did not show significant correlations with COVID-19 outcomes. There was a significant interaction between SVI and PM2.5 air concentration for the rate of positive COVID-19 tests and mortality. PM2.5 air quality showed a positive and significant association with the outcomes only in areas with high SVI. A machine-learning model including these variables accounted for 46 % of the variability.</div></div><div><h3>Conclusions</h3><div>The interplay between health vulnerability and air quality in human health is complex. Addressing the burden of COVID-19 pandemic requires the consideration of a comprehensive range of determinants.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 206-213"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Positive associations between dietary potential acid load and renal cancer incidence and mortality: Results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial 饮食潜在酸负荷与肾癌发病率和死亡率之间的正相关：来自前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验的结果

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.004

Xiaorui Ren , Shijiang Deng , Ling Xiang , Haitao Gu , Yunhao Tang , Yaxu Wang , Shiwen Tong , Linglong Peng , Dengliang Liu

Objectives

To explore the relationships between dietary potential acid load and renal cancer (RC) incidence and mortality.

Study design

A prospective cohort study involving 97,166 U S. adults aged 55–74 years.

Methods

Data utilized in this study were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Dietary potential acid load was assessed by dietary acid load (DAL), potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores using a validated Diet History Questionnaire (DHQ). Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for RC incidence and mortality with adjustment for potential confounders. Restricted cubic spline (RCS) plots were utilized to reveal whether there were nonlinear associations between the DAL, PRAL, and NEAP scores and RC incidence and mortality.

Results

During a follow-up period of 859,907 and 1,467,573 person-years, 423 RC cases and 221 mortality cases were documented. DAL, PRAL, and NEAP scores were positively associated with RC incidence (DAL: HR 1.41; 95% CI 1.05, 1.90; P-trend = 0.010; PRAL: HR 1.45; 95% CI 1.10, 1.91; P-trend = 0.010; NEAP: HR 1.39; 95% CI 1.04, 1.85; P-trend = 0.029). Similar associations were observed between DAL, PRAL, and NEAP scores and RC mortality. The RCS plots demonstrated a nonlinear association between DAL score and RC risk, while a linear association was observed between DAL score and RC mortality. Similar linear associations were found between PRAL and NEAP scores and RC incidence and mortality.

Conclusion

A higher dietary potential acid load was associated with higher risk of RC incidence and mortality in American adults.

目的：探讨膳食潜在酸负荷与肾癌（RC）发病率和死亡率的关系。研究设计：一项前瞻性队列研究，涉及97,166名年龄在55-74岁的美国成年人。方法：本研究使用的数据来自前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验（PLCO）。采用经验证的饮食史问卷（DHQ），通过膳食酸负荷（DAL）、潜在肾酸负荷（PRAL）和净内源性酸生成（NEAP）评分评估膳食潜在酸负荷。Cox比例风险回归用于估计RC发病率和死亡率的风险比（hr）和95%置信区间（ci），并对潜在混杂因素进行调整。利用限制性三次样条（RCS）图揭示DAL、PRAL和NEAP评分与RC发病率和死亡率之间是否存在非线性关联。结果：在859,907和1,467,573人年的随访期间，记录了423例RC病例和221例死亡病例。DAL、PRAL和NEAP评分与RC发病率呈正相关(DAL: HR 1.41；95% ci 1.05, 1.90；P-trend = 0.010；平均：小时1.45；95% ci 1.10, 1.91；P-trend = 0.010；小潮：小时1.39；95% ci 1.04, 1.85；p趋势= 0.029)。在DAL、PRAL和NEAP评分与RC死亡率之间观察到类似的关联。RCS图显示DAL评分与RC风险之间存在非线性关联，而DAL评分与RC死亡率之间存在线性关联。PRAL和NEAP评分与RC发病率和死亡率之间也存在类似的线性关联。结论：在美国成年人中，较高的饮食潜在酸负荷与较高的RC发病率和死亡率相关。

{"title":"Positive associations between dietary potential acid load and renal cancer incidence and mortality: Results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial","authors":"Xiaorui Ren , Shijiang Deng , Ling Xiang , Haitao Gu , Yunhao Tang , Yaxu Wang , Shiwen Tong , Linglong Peng , Dengliang Liu","doi":"10.1016/j.puhe.2024.12.004","DOIUrl":"10.1016/j.puhe.2024.12.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the relationships between dietary potential acid load and renal cancer (RC) incidence and mortality.</div></div><div><h3>Study design</h3><div>A prospective cohort study involving 97,166 U S. adults aged 55–74 years.</div></div><div><h3>Methods</h3><div>Data utilized in this study were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Dietary potential acid load was assessed by dietary acid load (DAL), potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores using a validated Diet History Questionnaire (DHQ). Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for RC incidence and mortality with adjustment for potential confounders. Restricted cubic spline (RCS) plots were utilized to reveal whether there were nonlinear associations between the DAL, PRAL, and NEAP scores and RC incidence and mortality.</div></div><div><h3>Results</h3><div>During a follow-up period of 859,907 and 1,467,573 person-years, 423 RC cases and 221 mortality cases were documented. DAL, PRAL, and NEAP scores were positively associated with RC incidence (DAL: HR 1.41; 95% CI 1.05, 1.90; P-trend = 0.010; PRAL: HR 1.45; 95% CI 1.10, 1.91; P-trend = 0.010; NEAP: HR 1.39; 95% CI 1.04, 1.85; P-trend = 0.029). Similar associations were observed between DAL, PRAL, and NEAP scores and RC mortality. The RCS plots demonstrated a nonlinear association between DAL score and RC risk, while a linear association was observed between DAL score and RC mortality. Similar linear associations were found between PRAL and NEAP scores and RC incidence and mortality.</div></div><div><h3>Conclusion</h3><div>A higher dietary potential acid load was associated with higher risk of RC incidence and mortality in American adults.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 229-238"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of prenatal intervention on neonatal hyperbilirubinemia management in rural Bangladesh: Results from a cluster-randomized trial 孟加拉国农村地区产前干预对新生儿高胆红素血症管理的效果：分组随机试验的结果。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.puhe.2024.12.018

Supta Sarker , Farjana Jahan , Sarker Masud Parvez , A.K.M. Shoab , Rezaul Hasan , Shams El Arifeen , Sk Masum Billah , Md Mahbubul Hoque , Mahbubur Rahman

Objectives

Nearly 80 % of severe neonatal hyperbilirubinemia cases are identified too late for medical treatment in lower-middle-income countries. Parents’ understanding of neonatal jaundice is crucial for early detection and effective treatment. This study evaluated the effectiveness of prenatal sensitization in improving maternal knowledge and attitude toward neonatal hyperbilirubinemia management in Bangladesh.

Study design

Cluster-randomized trial.

Methods

Between September 2019 and March 2021, a prospective home-based intervention trial on neonatal hyperbilirubinemia was conducted in 20 interventions and comparison clusters through community health workers (CHW). Participants were pregnant women in their second or third trimester of pregnancy. Proportion-based difference-in-difference (DID) was calculated to determine changes in the mother's knowledge and attitude towards newborn jaundice.

Results

A total of 539 pregnant women were enrolled, 273 in the intervention, and 266 in the comparison arm. Following the intervention, participant's overall knowledge level about neonatal hyperbilirubinemia increased significantly (DID: 24.9, 95%CI: 19.2, 30.7) from baseline (33.2 %) to endline (70.5 %). Knowledge of newborn jaundice management showed the most improvement (DID: 60), followed by danger signs detection (DID: 40.0). The intervention also enhanced participants' positive attitudes regarding neonatal hyperbilirubinemia (DID: 13.1, 95%CI: 8.1, 18.0). Mothers with improved knowledge of neonatal hyperbilirubinemia were nearly five times more likely to have a favorable attitude toward it than those with counterparts.

Conclusions

CHW-led home-based prenatal sensitization interventions substantially improved mothers' awareness and attitudes toward neonatal hyperbilirubinemia detection and management. Integrating such sensitization into prenatal care of the existing health system could be a practical approach to improve neonatal health outcomes in Bangladesh.

目标：在中低收入国家，近80%的严重新生儿高胆红素血症病例被发现得太晚，无法进行医疗治疗。家长对新生儿黄疸的了解对早期发现和有效治疗至关重要。本研究评估了产前敏化在提高孟加拉国产妇对新生儿高胆红素血症管理的知识和态度方面的有效性。研究设计：集群随机试验。方法：2019年9月至2021年3月，通过社区卫生工作者（CHW）在20个干预和比较集群中对新生儿高胆红素血症进行前瞻性家庭干预试验。参与者都是处于妊娠中期或晚期的孕妇。计算基于比例的差异（DID）来确定母亲对新生儿黄疸的知识和态度的变化。结果：共纳入539名孕妇，干预组273名，对照组266名。干预后，参与者对新生儿高胆红素血症的总体知识水平从基线（33.2%）到终点（70.5%）显著增加（DID: 24.9, 95%CI: 19.2, 30.7）。新生儿黄疸管理知识改善最大（DID: 60），其次是危险信号检测（DID: 40.0）。干预还增强了参与者对新生儿高胆红素血症的积极态度（DID: 13.1, 95%CI: 8.1, 18.0）。提高了对新生儿高胆红素血症的认识的母亲对新生儿高胆红素血症的好感度几乎是其他母亲的五倍。结论：chw主导的以家庭为基础的产前敏感化干预措施显著提高了母亲对新生儿高胆红素血症检测和管理的认识和态度。将这种增敏纳入现有卫生系统的产前护理可能是改善孟加拉国新生儿健康结果的一种切实可行的方法。

{"title":"Effectiveness of prenatal intervention on neonatal hyperbilirubinemia management in rural Bangladesh: Results from a cluster-randomized trial","authors":"Supta Sarker , Farjana Jahan , Sarker Masud Parvez , A.K.M. Shoab , Rezaul Hasan , Shams El Arifeen , Sk Masum Billah , Md Mahbubul Hoque , Mahbubur Rahman","doi":"10.1016/j.puhe.2024.12.018","DOIUrl":"10.1016/j.puhe.2024.12.018","url":null,"abstract":"<div><h3>Objectives</h3><div>Nearly 80 % of severe neonatal hyperbilirubinemia cases are identified too late for medical treatment in lower-middle-income countries. Parents’ understanding of neonatal jaundice is crucial for early detection and effective treatment. This study evaluated the effectiveness of prenatal sensitization in improving maternal knowledge and attitude toward neonatal hyperbilirubinemia management in Bangladesh.</div></div><div><h3>Study design</h3><div>Cluster-randomized trial.</div></div><div><h3>Methods</h3><div>Between September 2019 and March 2021, a prospective home-based intervention trial on neonatal hyperbilirubinemia was conducted in 20 interventions and comparison clusters through community health workers (CHW). Participants were pregnant women in their second or third trimester of pregnancy. Proportion-based difference-in-difference (DID) was calculated to determine changes in the mother's knowledge and attitude towards newborn jaundice.</div></div><div><h3>Results</h3><div>A total of 539 pregnant women were enrolled, 273 in the intervention, and 266 in the comparison arm. Following the intervention, participant's overall knowledge level about neonatal hyperbilirubinemia increased significantly (DID: 24.9, 95%CI: 19.2, 30.7) from baseline (33.2 %) to endline (70.5 %). Knowledge of newborn jaundice management showed the most improvement (DID: 60), followed by danger signs detection (DID: 40.0). The intervention also enhanced participants' positive attitudes regarding neonatal hyperbilirubinemia (DID: 13.1, 95%CI: 8.1, 18.0). Mothers with improved knowledge of neonatal hyperbilirubinemia were nearly five times more likely to have a favorable attitude toward it than those with counterparts.</div></div><div><h3>Conclusions</h3><div>CHW-led home-based prenatal sensitization interventions substantially improved mothers' awareness and attitudes toward neonatal hyperbilirubinemia detection and management. Integrating such sensitization into prenatal care of the existing health system could be a practical approach to improve neonatal health outcomes in Bangladesh.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"238 ","pages":"Pages 221-228"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0