Pub Date : 2025-02-19DOI: 10.1057/s41271-025-00560-2
Wesley Shrum, Paige Miller, Nana Osei Asiamah, Fangyue Zou
While scientific understanding of the COVID-19 pandemic increased, conspiracy theories undermined the foundations of public health policy, making it significantly more difficult both to discuss and to implement. Popular alternative narratives include the claim that government was using restrictions to control people's behavior, and that the pandemic was caused by 5G cellular technology. We examine the extent to which alternative beliefs were associated with sociodemographic characteristics and the sources through which people acquired information during the pandemic. Our analysis uses a demographically balanced online survey of 10,022 participants from 50 US states, collected during August of 2021. Results indicate that those holding alternative theories tended to be right leaning, religious, young, male, and unvaccinated individuals. Sources of information were also strong predictors of such beliefs, specifically the extent to which social media were considered reliable.
{"title":"Alternative theories of COVID-19: social dimensions and information sources.","authors":"Wesley Shrum, Paige Miller, Nana Osei Asiamah, Fangyue Zou","doi":"10.1057/s41271-025-00560-2","DOIUrl":"https://doi.org/10.1057/s41271-025-00560-2","url":null,"abstract":"<p><p>While scientific understanding of the COVID-19 pandemic increased, conspiracy theories undermined the foundations of public health policy, making it significantly more difficult both to discuss and to implement. Popular alternative narratives include the claim that government was using restrictions to control people's behavior, and that the pandemic was caused by 5G cellular technology. We examine the extent to which alternative beliefs were associated with sociodemographic characteristics and the sources through which people acquired information during the pandemic. Our analysis uses a demographically balanced online survey of 10,022 participants from 50 US states, collected during August of 2021. Results indicate that those holding alternative theories tended to be right leaning, religious, young, male, and unvaccinated individuals. Sources of information were also strong predictors of such beliefs, specifically the extent to which social media were considered reliable.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460467","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}
Pub Date : 2025-02-11DOI: 10.1057/s41271-025-00557-x
Meena Sehgal, Santosh Jatrana, Louise Johnson
Developing a women's health index is particularly important in the Indian context due to the pronounced disparities in women's health across various social, economic, and geographical segments. This paper focuses on the development and validation of a comprehensive Women's Health Index (WHI) for India. In contrast to previous efforts that predominantly focused on indicators related to pregnancy, childbirth, and the postpartum period, often limited to reproductive or maternal health services, our index adopts a multi-dimensional approach. The WHI comprises 17 variables, representing life stages of women and encompassing a diverse range of factors. Utilizing Principal Component Analysis, we computed the index and conducted statistical tests for internal and external validation. The spatial pattern of WHI reveals substantial inter-district and inter-state disparities. This study thus provides a valuable tool for characterizing women's health and identifying health inequalities at a smaller administrative level in India.
{"title":"Developing and validating a Women's Health Index for India.","authors":"Meena Sehgal, Santosh Jatrana, Louise Johnson","doi":"10.1057/s41271-025-00557-x","DOIUrl":"https://doi.org/10.1057/s41271-025-00557-x","url":null,"abstract":"<p><p>Developing a women's health index is particularly important in the Indian context due to the pronounced disparities in women's health across various social, economic, and geographical segments. This paper focuses on the development and validation of a comprehensive Women's Health Index (WHI) for India. In contrast to previous efforts that predominantly focused on indicators related to pregnancy, childbirth, and the postpartum period, often limited to reproductive or maternal health services, our index adopts a multi-dimensional approach. The WHI comprises 17 variables, representing life stages of women and encompassing a diverse range of factors. Utilizing Principal Component Analysis, we computed the index and conducted statistical tests for internal and external validation. The spatial pattern of WHI reveals substantial inter-district and inter-state disparities. This study thus provides a valuable tool for characterizing women's health and identifying health inequalities at a smaller administrative level in India.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400489","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}
Pub Date : 2025-02-07DOI: 10.1057/s41271-024-00545-7
Leanne Coombe, Priscilla Robinson
{"title":"The education and training of the public health workforce: working at the intersection of the WFPHA Global Charter and the WHO Roadmap.","authors":"Leanne Coombe, Priscilla Robinson","doi":"10.1057/s41271-024-00545-7","DOIUrl":"https://doi.org/10.1057/s41271-024-00545-7","url":null,"abstract":"","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371378","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}
India launched the National Health Mission (NHM) in 2005 to reduce maternal and child mortality by providing equitable, affordable, and quality healthcare services. Studies evaluating the impact of NHM primarily focused on the uptake of maternal and child health (MCH) services, revealing a dearth of evidence on related health outcomes. Using annual time-series data, we estimated the population-level (intention-to-treat effect) impact of the NHM on MCH outcomes such as infant mortality rate (IMR), stillbirth rate, neonatal mortality rate (NMR), and maternal mortality ratio (MMR). Our results exhibit strong consensus on the positive impact on IMR in the post-NHM period, with a significant reduction in its rate and regional inequity. Conversely, our estimates show a moderate impact on stillbirth rate and an insignificant impact on NMR and MMR. Our findings inform policy decisions for strengthening the public health system to amplify the positive gains in MCH outcomes.
{"title":"A population-level impact assessment of the National Health Mission on maternal and child health outcomes in India.","authors":"Abinash Singh, Sukumar Vellakkal, Aswini Kumar Mishra","doi":"10.1057/s41271-025-00558-w","DOIUrl":"https://doi.org/10.1057/s41271-025-00558-w","url":null,"abstract":"<p><p>India launched the National Health Mission (NHM) in 2005 to reduce maternal and child mortality by providing equitable, affordable, and quality healthcare services. Studies evaluating the impact of NHM primarily focused on the uptake of maternal and child health (MCH) services, revealing a dearth of evidence on related health outcomes. Using annual time-series data, we estimated the population-level (intention-to-treat effect) impact of the NHM on MCH outcomes such as infant mortality rate (IMR), stillbirth rate, neonatal mortality rate (NMR), and maternal mortality ratio (MMR). Our results exhibit strong consensus on the positive impact on IMR in the post-NHM period, with a significant reduction in its rate and regional inequity. Conversely, our estimates show a moderate impact on stillbirth rate and an insignificant impact on NMR and MMR. Our findings inform policy decisions for strengthening the public health system to amplify the positive gains in MCH outcomes.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124046","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}
This study explores Taiwanese' perspectives on the potential legalization of surrogacy, an issue with diverse legal stances globally. Conducted between 17 December 2023 and 1 January 2024, this mixed-methods cross-sectional study employed Knowledge and Attitudes of Legalizing Surrogacy (KALS) questionnaire. This instrument assessed opinions and ethical considerations on various aspects including ethics and children's rights, surrogate health, offspring welfare, and social justice. Responses were quantitatively measured on a 5-point scale (with higher scores indicating more accurate knowledge or stronger perceived impact of surrogacy on society) supplemented by qualitative content analysis of open-ended responses. Out of 7780 predominantly female participants (82.8%), all scores were higher for those did not support the legalization of surrogacy (82.1% of respondents). Noteworthy concerns were raised about potential repercussions of legalizing surrogacy, underscoring the need for broader public education before any legal reforms are implemented. There is significant apprehension about surrogacy legalization in Taiwan, especially regarding its impact on women's health and children's welfare.
{"title":"Legalization of surrogacy? Opinions from more than 7700 residents in Taiwan.","authors":"Wei Cheng, Shu-Hsiang Liu, Chih-Yu Chen, Kuo-Yu Chao","doi":"10.1057/s41271-025-00551-3","DOIUrl":"https://doi.org/10.1057/s41271-025-00551-3","url":null,"abstract":"<p><p>This study explores Taiwanese' perspectives on the potential legalization of surrogacy, an issue with diverse legal stances globally. Conducted between 17 December 2023 and 1 January 2024, this mixed-methods cross-sectional study employed Knowledge and Attitudes of Legalizing Surrogacy (KALS) questionnaire. This instrument assessed opinions and ethical considerations on various aspects including ethics and children's rights, surrogate health, offspring welfare, and social justice. Responses were quantitatively measured on a 5-point scale (with higher scores indicating more accurate knowledge or stronger perceived impact of surrogacy on society) supplemented by qualitative content analysis of open-ended responses. Out of 7780 predominantly female participants (82.8%), all scores were higher for those did not support the legalization of surrogacy (82.1% of respondents). Noteworthy concerns were raised about potential repercussions of legalizing surrogacy, underscoring the need for broader public education before any legal reforms are implemented. There is significant apprehension about surrogacy legalization in Taiwan, especially regarding its impact on women's health and children's welfare.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069222","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}
Collaborative initiatives of the drone industry and healthcare sector are becoming a pivotal step in restructuring healthcare service delivery in India. This paper documents knowledge and perceptions of healthcare workers from various districts of Manipur and Nagaland towards the use of drones for medical supply in the region. The study utilized 27 in-depth interviews with healthcare workers to collect qualitative data, which was then analyzed using NVivo 14 for thematic and content analysis. The findings indicated that 57% of respondents are unaware of drones' applications, citing security and privacy concerns and a lack of understanding about their role in the program. This study demonstrates the optimistic perception among healthcare professionals regarding drone delivery of medical supplies to remote areas, highlighting its potential to enhance accessibility and overcome logistical challenges. It emphasizes the need for training, community engagement, and safety measures to ensure effective implementation of drone technology in healthcare delivery.
{"title":"Perspectives of healthcare workers on drone-enabled healthcare delivery in challenging terrains of Manipur and Nagaland, India: a qualitative research.","authors":"Sumit Aggarwal, Nupur Mahajan, Prakamya Gupta, Sivaraman Balaji, Simmy, Naorem Shyamjai Singh, Ayangla Saku, Balram Bhargava, Samiran Panda","doi":"10.1057/s41271-025-00553-1","DOIUrl":"https://doi.org/10.1057/s41271-025-00553-1","url":null,"abstract":"<p><p>Collaborative initiatives of the drone industry and healthcare sector are becoming a pivotal step in restructuring healthcare service delivery in India. This paper documents knowledge and perceptions of healthcare workers from various districts of Manipur and Nagaland towards the use of drones for medical supply in the region. The study utilized 27 in-depth interviews with healthcare workers to collect qualitative data, which was then analyzed using NVivo 14 for thematic and content analysis. The findings indicated that 57% of respondents are unaware of drones' applications, citing security and privacy concerns and a lack of understanding about their role in the program. This study demonstrates the optimistic perception among healthcare professionals regarding drone delivery of medical supplies to remote areas, highlighting its potential to enhance accessibility and overcome logistical challenges. It emphasizes the need for training, community engagement, and safety measures to ensure effective implementation of drone technology in healthcare delivery.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054029","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}
Pub Date : 2025-01-22DOI: 10.1057/s41271-025-00548-y
Mohammad S Razai, Sally Hargreaves, Pippa Oakeshott
Vaccination during pregnancy is crucial due to increased maternal vulnerability to infectious diseases. However, uptake of recommended vaccines (influenza, pertussis, COVID-19) remains suboptimal, particularly among disadvantaged groups. This qualitative study explored healthcare professionals' (HCPs) perspectives, selected purposively, on factors influencing maternal vaccination in London. Data from a workshop transcript and an online quality improvement survey involving 15 GPs, two midwives, two obstetricians and one pharmacist were thematically analysed. HCPs highlighted that pregnant women perceive the benefits of pertussis vaccination more positively than other vaccines. Clear, consistent communication and integrating vaccinations into routine antenatal care were identified as essential for improving accessibility and convenience. The critical role of midwives influencing vaccination decisions was emphasised. While recognising the potential of AI-based technologies to disseminate vaccine information, concerns were raised about trust, digital literacy and information quality, highlighting the need for tailored, reliable strategies to boost maternal vaccination rates and improve health outcomes.
{"title":"Challenges and opportunities of vaccination during pregnancy: perspectives of 20 healthcare professionals.","authors":"Mohammad S Razai, Sally Hargreaves, Pippa Oakeshott","doi":"10.1057/s41271-025-00548-y","DOIUrl":"https://doi.org/10.1057/s41271-025-00548-y","url":null,"abstract":"<p><p>Vaccination during pregnancy is crucial due to increased maternal vulnerability to infectious diseases. However, uptake of recommended vaccines (influenza, pertussis, COVID-19) remains suboptimal, particularly among disadvantaged groups. This qualitative study explored healthcare professionals' (HCPs) perspectives, selected purposively, on factors influencing maternal vaccination in London. Data from a workshop transcript and an online quality improvement survey involving 15 GPs, two midwives, two obstetricians and one pharmacist were thematically analysed. HCPs highlighted that pregnant women perceive the benefits of pertussis vaccination more positively than other vaccines. Clear, consistent communication and integrating vaccinations into routine antenatal care were identified as essential for improving accessibility and convenience. The critical role of midwives influencing vaccination decisions was emphasised. While recognising the potential of AI-based technologies to disseminate vaccine information, concerns were raised about trust, digital literacy and information quality, highlighting the need for tailored, reliable strategies to boost maternal vaccination rates and improve health outcomes.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025595","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}
Pub Date : 2025-01-20DOI: 10.1057/s41271-025-00556-y
Elena N Naumova
{"title":"Challenges of online surveys and synthetic data in achieving reproducibility in public health research: echoes of the \"rise of the machines\".","authors":"Elena N Naumova","doi":"10.1057/s41271-025-00556-y","DOIUrl":"https://doi.org/10.1057/s41271-025-00556-y","url":null,"abstract":"","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015135","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}
Pub Date : 2025-01-19DOI: 10.1057/s41271-025-00554-0
Pei-Hsun Hsieh
This study examines the relationship between vaccine mandates and public sentiment toward vaccines and health officials on Twitter. I analyzed 6.6 million vaccine-related tweets from July 2021 to February 2022 in the United States. Leveraging a large language model, BERT, I identified tweets discussing vaccine mandates even when lacking explicit keywords. Compared to non-mandate tweets, those mentioning mandates exhibit greater negativity, anger, and freedom-related language. Furthermore, increased state-level discussion of mandates correlates with rising levels of negativity and anger toward both vaccines and public health officials. Finally, greater disparity in vaccination progress across counties within a state is associated with increased anger in tweets directed toward both.
{"title":"Psychological reactance to vaccine mandates on Twitter: a study of sentiments in the United States.","authors":"Pei-Hsun Hsieh","doi":"10.1057/s41271-025-00554-0","DOIUrl":"https://doi.org/10.1057/s41271-025-00554-0","url":null,"abstract":"<p><p>This study examines the relationship between vaccine mandates and public sentiment toward vaccines and health officials on Twitter. I analyzed 6.6 million vaccine-related tweets from July 2021 to February 2022 in the United States. Leveraging a large language model, BERT, I identified tweets discussing vaccine mandates even when lacking explicit keywords. Compared to non-mandate tweets, those mentioning mandates exhibit greater negativity, anger, and freedom-related language. Furthermore, increased state-level discussion of mandates correlates with rising levels of negativity and anger toward both vaccines and public health officials. Finally, greater disparity in vaccination progress across counties within a state is associated with increased anger in tweets directed toward both.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015198","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}
Pub Date : 2025-01-19DOI: 10.1057/s41271-025-00549-x
Bruno González-Cacheda, Celso Cancela Outeda
The objective of this study was to understand factors that influence the attitude, knowledge, use, and access to e-health services in Spain. We examined the relationship between socio-demographic characteristics of participants and their attitudes toward, knowledge of and use of video-consultation, digital medical records, and experiences with digital devices. We conducted secondary data analysis using information collected by the Health Barometer # 8822 carried out by the Centro de Investigaciones Sociológicas. People with a lower level of education and social class, less digital experience, older, and foreign nationality have a low use of digital medical records. Similarly, the attitude and willingness to receive medical care via video-consultation were related to these socio-demographic factors. Thus, the use of e-health services might exacerbate inequity of the health system in Spain. To improve equity related to the e-health services, we recommend implementing a tailored approach supported by educational programs.
{"title":"Understanding attitudes, knowledge, and use of e-health services in the health system in Spain.","authors":"Bruno González-Cacheda, Celso Cancela Outeda","doi":"10.1057/s41271-025-00549-x","DOIUrl":"https://doi.org/10.1057/s41271-025-00549-x","url":null,"abstract":"<p><p>The objective of this study was to understand factors that influence the attitude, knowledge, use, and access to e-health services in Spain. We examined the relationship between socio-demographic characteristics of participants and their attitudes toward, knowledge of and use of video-consultation, digital medical records, and experiences with digital devices. We conducted secondary data analysis using information collected by the Health Barometer # 8822 carried out by the Centro de Investigaciones Sociológicas. People with a lower level of education and social class, less digital experience, older, and foreign nationality have a low use of digital medical records. Similarly, the attitude and willingness to receive medical care via video-consultation were related to these socio-demographic factors. Thus, the use of e-health services might exacerbate inequity of the health system in Spain. To improve equity related to the e-health services, we recommend implementing a tailored approach supported by educational programs.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015200","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}