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Safeguarding against the degradation of Housing First. 防止“住屋第一”的退化。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-12-10 DOI: 10.17269/s41997-024-00984-5
Nick Kerman
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引用次数: 0
Canada's Census of Environment and public health. 加拿大环境与公共卫生普查。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-09-30 DOI: 10.17269/s41997-024-00954-x
Chris G Buse

The 2021 federal budget committed funding to a co-sponsored Statistics Canada and Environment and Climate Change Canada initiative aimed at conducting a 'census' of Canadian environments. The goal of the Census of Environment (CoE) is "to deliver a full picture of the complex relationship between ecosystems and the economy, society, and human well-being", with obvious implications for the ongoing monitoring and surveillance of environmental influence on human health. This commentary reflects on the evolution of the CoE initiative in describing two opportunities for population and public health researchers, practitioners, and policy-makers in engaging with the CoE and its data. First, it describes stated CoE commitments to enhancing access to complex environmental data and the provision of data processing to support novel analyses and data utilization. Second, it highlights the relative importance of disaggregating environmental data across a variety of bio-geographical scales to engender a holistic understanding of the health of multiple elements that comprise living systems, including consideration of environmental health equity and intersectoral action. It ends with a constructive critique of the CoE's framing of 'ecosystem accounting' to support its maturation, and advocates for public health involvement in centring the importance of health in this initiative into the future.

2021 年联邦预算为加拿大统计局和加拿大环境与气候变化部共同发起的一项旨在对加拿大环境进行 "普查 "的倡议提供了资金。环境普查(CoE)的目标是 "全面反映生态系统与经济、社会和人类福祉之间的复杂关系",这对持续监测和监控环境对人类健康的影响具有明显的意义。本评论通过描述人口与公共卫生研究人员、从业人员和政策制定者在参与 CoE 及其数据时的两个机会,反映了 CoE 计划的演变。首先,它描述了 CoE 在加强复杂环境数据的获取以及提供数据处理以支持新的分析和数据利用方面的承诺。其次,它强调了在各种生物地理尺度上对环境数据进行分类的相对重要性,以便全面了解构成生物系统的多种元素的健康状况,包括考虑环境健康公平性和跨部门行动。报告最后对环境委员会为支持其成熟而制定的 "生态系统核算 "框架提出了建设性的批评意见,并倡导公共卫生参与将健康的重要性集中到未来的这一倡议中。
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引用次数: 0
The rise of anti-trans laws and the role of public health advocacy. 反变性法律的兴起和公共卫生宣传的作用。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-02 DOI: 10.17269/s41997-024-00942-1
Marina Khonina, Travis Salway

The recent surge in anti-trans laws and policies in Canada and the United States has important public health implications, particularly for trans and gender-expansive (TGE) youth. This legislation has the potential to exacerbate minority stress experienced by TGE youth, who already experience higher rates of depression, anxiety, and suicide than their cisgender peers. Social gender affirmation, including respecting affirmed names and pronouns, can reduce the risk of adverse mental health outcomes in TGE youth. However, recent laws requiring parental consent for affirmed names and pronouns in schools can cause additional distress and harm for TGE youth, especially those who lack family support. Public health professionals have a critical role to play in countering the harmful effects of anti-trans legislation by better understanding TGE youth and their needs, advocating for trans rights, supporting trans-led community organizations, and strengthening trans-affirming mental health services.

最近,加拿大和美国的反变性法律和政策激增,这对公共健康产生了重要影响,尤其是对变性和性别开放(TGE)青年而言。这些法律有可能会加剧变性和性别开放青年所经历的少数群体压力,他们的抑郁、焦虑和自杀率已经高于他们的同龄人。社会性别肯定,包括尊重被肯定的姓名和代词,可以降低 TGE 青少年出现不良心理健康后果的风险。然而,最近要求家长同意在学校使用肯定的姓名和代词的法律可能会给 TGE 青少年,尤其是那些缺乏家庭支持的青少年带来额外的困扰和伤害。公共卫生专业人员在抵制反变性立法的有害影响方面可以发挥关键作用,他们可以更好地了解 TGE 青少年及其需求,倡导变性权利,支持由变性人领导的社区组织,并加强支持变性人的心理健康服务。
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引用次数: 0
Championing public health: Why CPHA needs you now.
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 DOI: 10.17269/s41997-025-01000-0
Laura C Rosella
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引用次数: 0
Experiences with discrimination during pregnancy in Canada and associations with depression and anxiety symptoms. 加拿大孕妇在怀孕期间遭受歧视的经历及其与抑郁和焦虑症状的关系。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI: 10.17269/s41997-024-00933-2
Kelsey P Davis, Makayla Freeman, Pariza Fazal, Kristin A Reynolds, Charlie Rioux, Danielle L Beatty Moody, Beatrice Pui-Yee Lai, Gerald F Giesbrecht, Catherine Lebel, Lianne Tomfohr-Madsen

Objectives: Experiences of discrimination reported during pregnancy are common and are associated with poor mental health and adverse birth outcomes. No Canadian studies have investigated interpersonal discrimination during pregnancy. This study aimed to quantify and identify lived-experiences of discrimination in a Canadian cohort of pregnant individuals, and examine associations with concurrent prenatal anxiety and depression symptoms.

Methods: Pregnant individuals from the pan-Canadian Pregnancy During the Pandemic (PdP) study (n = 1943) completed the Everyday Discrimination Scale (EDS), demographic measures and self-report measures of depression and anxiety symptoms. Descriptive statistics and ANCOVA were used to assess prevalence of discrimination and associated mental health outcomes. Open-text responses (n = 189) to a question investigating reasons for discrimination were analyzed using conventional content analysis.

Results: Approximately three quarters (72%) of pregnant individuals experienced at least one instance of discrimination during their pregnancy or within the year prior. Pregnant individuals experiencing more frequent and/or more types of discrimination were more likely to identify as non-white, not be partnered, have lower socioeconomic status, and have a pre-pregnancy history of anxiety and depression. The most common attributions for interpersonal discrimination were gender, age, and education/income level. Pregnant individuals who experienced more frequent discrimination and/or more types of discrimination were more likely to report clinically significant symptoms of depression and anxiety (n = 623; 35.2% and 49.1%, respectively) compared to those who reported no discrimination (n = 539; 11.5% and 19.1%, respectively). Conventional content analysis of open-text responses generated the following main themes: (1) personal attributes and sociodemographic characteristics, (2) occupation, (3) the COVID-19 pandemic, (4) pregnancy and parenting, and (5) causes outside the self.

Conclusion: Frequent discrimination was associated with more adverse concurrent mental health symptoms. Understanding experiences of discrimination can inform interventions that better address the needs of pregnant individuals and their infants.

目的:据报道,怀孕期间遭受歧视的经历很常见,而且与心理健康状况不佳和不良分娩结果有关。加拿大还没有研究调查过孕期人际歧视问题。本研究旨在量化和识别加拿大孕妇队列中的歧视经历,并研究其与同时出现的产前焦虑和抑郁症状之间的关联:泛加拿大大流行期间妊娠(PdP)研究中的孕妇(n = 1943)完成了日常歧视量表(EDS)、人口统计学测量以及抑郁和焦虑症状的自我报告测量。描述性统计和方差分析用于评估歧视的普遍程度和相关的心理健康结果。对调查歧视原因的问题的开放文本回答(n = 189)采用传统的内容分析法进行了分析:大约四分之三(72%)的孕妇在怀孕期间或之前一年内至少遭受过一次歧视。受到更频繁和/或更多类型歧视的孕妇更有可能被认定为非白人、没有伴侣、社会经济地位较低、孕前有焦虑和抑郁史。人际歧视最常见的原因是性别、年龄和教育/收入水平。与没有受到歧视的孕妇(539 人,分别占 11.5%和 19.1%)相比,受到更频繁歧视和/或更多类型歧视的孕妇更有可能报告有临床意义的抑郁和焦虑症状(623 人,分别占 35.2%和 49.1%)。对开放文本回复的常规内容分析得出以下主要主题:(1) 个人属性和社会人口特征,(2) 职业,(3) COVID-19 大流行,(4) 怀孕和养育子女,(5) 自我以外的原因:结论:经常受到歧视与并发的更多不良心理健康症状有关。了解歧视经历可以为干预措施提供依据,从而更好地满足孕妇及其婴儿的需求。
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引用次数: 0
Equity-oriented food supports: Learnings from the Nova Scotia COVID-19 pandemic response. 以公平为导向的食品支持:从新斯科舍省 COVID-19 大流行应对措施中汲取经验。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-09-09 DOI: 10.17269/s41997-024-00929-y
Valerie Blair, Eleanor Eville, Christine Johnson, Heather Monahan

Setting: Public health measures enacted during the COVID-19 pandemic significantly impacted Nova Scotians experiencing food insecurity. Public Health (PH), Nova Scotia Health, created a provincial Housing Isolation Program (HIP) which addressed barriers to isolation, including food access, for COVID-19 cases and contacts being followed by PH.

Intervention: HIP worked with partners to coordinate and respond to urgent food needs of isolating clients by providing grocery and meal delivery options. HIP also made referrals to government and community partners for income and food supports. This program was intended to minimize the spread of COVID-19 by facilitating isolation while meeting basic needs for people with no other means of support.

Outcomes: From December 2020 to March 2022, HIP completed grocery and meal deliveries for 579 clients, 1351 referrals to a provincial Income Support Program, and 231 referrals to external food supports. HIP staff worked with clients to manage potential perceptions of stigma. Challenges reported included the urgency of food needs, lack of social supports, and availability and accessibility constraints in rural communities, as well as difficulty accessing culturally appropriate foods and special diets.

Implications: This intervention demonstrates the importance of addressing food insecurity during emergency preparedness, planning, and response. During emergencies, planning and mobilizing food access requires an equity-oriented approach to overcome stigma. Broadly, continued reliance on charitable responses creates significant vulnerability during emergencies and addressing root causes of food insecurity through social policy will provide longer-term protection.

背景:COVID-19 大流行期间颁布的公共卫生措施严重影响了新斯科舍省的食物无保障人群。新斯科舍省卫生部公共卫生局(PH)制定了一项省级住房隔离计划(HIP),解决COVID-19病例和PH跟踪的接触者的隔离障碍,包括食物获取问题:干预措施:HIP 与合作伙伴合作,通过提供食品杂货和送餐服务,协调并满足与世隔绝客户的紧急食品需求。HIP 还向政府和社区合作伙伴推荐收入和食品支持。该计划旨在通过为孤立无援的人提供便利,同时满足他们的基本需求,从而最大限度地减少 COVID-19 的传播:从 2020 年 12 月到 2022 年 3 月,HIP 共为 579 名客户提供了杂货和膳食,将 1351 人转介到省级收入支持计划,并将 231 人转介到外部食品支持计划。HIP 工作人员与客户合作,以管理潜在的耻辱感。据报告,面临的挑战包括食品需求的紧迫性、缺乏社会支持、农村社区的可用性和可及性限制,以及难以获得文化适宜的食品和特殊饮食:这项干预措施表明了在应急准备、规划和响应过程中解决粮食不安全问题的重要性。在紧急情况下,规划和动员食物获取需要以公平为导向的方法,以克服耻辱感。从广义上讲,继续依赖慈善应对措施会在紧急情况下造成严重的脆弱性,而通过社会政策解决粮食不安全的根本原因将提供更长期的保护。
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引用次数: 0
The challenging concept of eradication: A core concept guiding and frustrating public health. 具有挑战性的根除概念:指导和阻碍公共卫生的核心理念。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-02 DOI: 10.17269/s41997-024-00947-w
Arthur Caplan, Nathaniel Mamo

The celebrated 1980 announcement that smallpox had been eradicated was made using the following definition of eradication: "Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts: intervention measures are no longer needed." Public health around the world works with this definition of "eradication," setting it as a goal for other infectious disease control programs. The definition is simple. Its application, however, has produced long-running and complex public health campaigns that threaten the commitment of funders, health care providers, and governments. In this paper, the authors demonstrate the disease-specific challenges of eradication through the example of the Global Polio Eradication Initiative (GPEI). While many deem eradication worth its high costs because it is the end of morbidity and mortality from a disease, it does not mean the end of disease control efforts. Public health must be prepared for the possibility of disease reoccurrence in the form of undetected natural reservoirs of disease, lab leaks from stored samples, bioterror attacks using stolen samples, and the synthetic recreation of microbes. This paper clarifies the role of reoccurrence prevention in eradication, calling for its addition in the definition of eradication.

1980 年宣布根除天花这一著名消息时使用了以下根除的定义:"通过有意识的努力,将由特定病原体引起的全球感染率永久降低到零:不再需要干预措施"。全世界的公共卫生工作都遵循这一 "根除 "定义,并将其作为其他传染病控制计划的目标。定义很简单。然而,它的应用却产生了长期而复杂的公共卫生运动,威胁着资助者、医疗服务提供者和政府的承诺。在本文中,作者以全球根除脊髓灰质炎行动(GPEI)为例,说明了根除工作面临的特定疾病挑战。尽管许多人认为根除工作值得付出高昂的代价,因为它终结了一种疾病的发病率和死亡率,但这并不意味着疾病控制工作的终结。公共卫生必须做好准备,应对疾病再次发生的可能性,其形式包括未被发现的天然疾病库、实验室储存样本的泄漏、利用偷来的样本进行的生物恐怖袭击以及微生物的合成再造。本文阐明了预防再发生在根除工作中的作用,呼吁在根除的定义中加入预防再发生的内容。
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引用次数: 0
Initiatives to increase breast and cervical cancer-related knowledge, screening, and health behaviours among Black women. 在黑人妇女中开展提高乳腺癌和宫颈癌相关知识、筛查和健康行为的活动。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.17269/s41997-024-00953-y
Camille Williams, Elaine Goulbourne, Elijah Gyansa, Ayan Hashi, Ielaf Khalil, Rumaisa Khan, Patricia Rabel-Jeudy, Ruth Heisey, Aisha Lofters

Setting: In Canada, racialized and immigrant women are typically under-screened for breast and cervical cancer. Under-screening is linked to numerous barriers to access, including lack of awareness, fear of pain, the stigma of cancer, socio-cultural factors like language, and various socio-economic factors. To address these barriers, our team developed a series of initiatives to promote awareness of breast and cervical health among Black women.

Intervention: Building on the development of a breast cancer resource hub for Black women, and in partnership with relevant community organizations, we implemented a series of virtual educational and cancer screening events (two of each thus far). Both event series were targeted towards Black women and tailored to their needs.

Outcomes: Each educational event attracted more than 450 attendees and had average attendance times > 1 h. Most (> 87%) survey respondents agreed that an event specifically for Black women helped them feel supported. The 2022 and 2023 screening events provided breast and/or cervical cancer screening for 46 and 48 women, respectively. In both years, most women (> 90% of question respondents) noted that they were (extremely) likely to go for a mammogram or Pap test when next due.

Implications: Both event series provided targeted opportunities for Black women to learn about prevention, risk factors, resources, and screening related to women's cancers. It is possible that, over time, such culturally tailored events can reduce or remove the stigmas associated with cancer and decrease differences in cancer-related knowledge and behaviours between racialized and non-racialized groups.

背景:在加拿大,种族妇女和移民妇女的乳腺癌和宫颈癌筛查通常不足。乳腺癌和宫颈癌筛查不足与许多障碍有关,包括缺乏认识、害怕疼痛、癌症的耻辱感、语言等社会文化因素以及各种社会经济因素。为了消除这些障碍,我们的团队制定了一系列措施,以提高黑人妇女对乳腺和宫颈健康的认识:干预措施:在为黑人妇女开发乳腺癌资源中心的基础上,我们与相关社区组织合作,开展了一系列虚拟教育和癌症筛查活动(迄今为止各开展了两次)。这两个系列活动都以黑人妇女为对象,并根据她们的需求量身定制:每次教育活动都吸引了 450 多人参加,平均参加时间大于 1 小时。大多数(大于 87%)调查对象都认为,专门针对黑人女性的活动让她们感受到了支持。2022 年和 2023 年的筛查活动分别为 46 名和 48 名妇女提供了乳腺癌和/或宫颈癌筛查。在这两年中,大多数妇女(> 90% 的问题受访者)都表示,她们(极有可能)在下一次到期时去做乳房 X 光检查或子宫颈抹片检查:这两个系列活动都为黑人妇女提供了有针对性的机会,让她们了解与妇女癌症有关的预防、风险因素、资源和筛查。随着时间的推移,这种根据文化定制的活动有可能减少或消除与癌症相关的污名,并减少种族化群体和非种族化群体之间在癌症相关知识和行为方面的差异。
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引用次数: 0
To use or not to use behavioural science evidence in designing health promotion interventions: Identification of targets for capacity building. 在设计健康促进干预措施时使用或不使用行为科学证据:确定能力建设的目标。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-26 DOI: 10.17269/s41997-024-00948-9
Ariane Bélanger-Gravel, Kim L Lavoie, Sophie Desroches, Tracie A Barnett, Marie-Claude Paquette, Frédéric Therrien, Lise Gauvin

Objectives: The behavioural sciences provide useful evidence to design effective health promotion interventions, but evidence is infrequently integrated in practice. This study examined associations between theoretical domains framework (TDF) constructs and public health practitioners' use of behavioural science evidence to plan public health actions.

Methods: Using a cross-sectional design, a convenience sample of 160 practitioners were recruited from public health agencies across Canada. Respondents completed an online questionnaire assessing TDF constructs and the use of behavioural science theory and approaches (i.e., evidence) in their practice. Logistic regression analyses allowed for identification of factors associated with evidence use and intentions. All analyses were adjusted for sex, years of experience, and type of public health agency.

Results: Greater skills (ORadj = 4.1, 95%CI 1.3, 13.5) and stronger intentions/aligned goals (ORadj = 9.2, 95%CI 2.3, 36.1) were associated with greater use of behavioural science evidence to plan public health actions. Greater perceived capacity to overcome widespread absence of use of behavioural science evidence in their organization (ORadj = 7.2, 95%CI 1.7, 30.3) was also associated with greater use. More knowledge (ORadj = 8.6, 95%CI 1.9, 39.1) and stronger beliefs about consequences (ORadj = 4.0, 95%CI 1.1, 14.7) were significantly associated with stronger intentions/aligned goals.

Conclusion: Findings show that more knowledge, positive attitudes, and stronger perceived competence are associated with greater likelihood of using behavioural science evidence to plan interventions. The use of behavioural science evidence will also require strengthening the norm pertaining to this professional practice in public health organizations.

目标:行为科学为设计有效的健康促进干预措施提供了有用的证据,但在实践中却很少整合这些证据。本研究探讨了理论领域框架(TDF)构建与公共卫生从业人员利用行为科学证据规划公共卫生行动之间的关联:方法:采用横断面设计,从加拿大各地的公共卫生机构招募了 160 名从业人员。受访者填写了一份在线调查问卷,对 TDF 构建以及行为科学理论和方法(即证据)在其实践中的使用情况进行评估。通过逻辑回归分析,确定了与证据使用和意向相关的因素。所有分析均根据性别、工作年限和公共卫生机构类型进行了调整:更高的技能(ORadj = 4.1,95%CI 1.3,13.5)和更强的意愿/更一致的目标(ORadj = 9.2,95%CI 2.3,36.1)与更多地使用行为科学证据来规划公共卫生行动有关。认为自己更有能力克服组织中普遍缺乏使用行为科学证据的问题(ORadj = 7.2,95%CI 1.7,30.3)也与更多使用行为科学证据有关。更多的知识(ORadj = 8.6,95%CI 1.9,39.1)和更强的后果信念(ORadj = 4.0,95%CI 1.1,14.7)与更强的意愿/一致的目标显著相关:研究结果表明,更多的知识、积极的态度和更强的认知能力与更有可能使用行为科学证据来规划干预措施有关。使用行为科学证据还需要加强公共卫生组织中与这一专业实践相关的规范。
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引用次数: 0
A prospective study analyzing the use of free public sunscreen dispensers. 一项分析免费公共防晒霜发放机使用情况的前瞻性研究。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI: 10.17269/s41997-024-00946-x
Samuel Farag, Karen Farag, Mélissa Généreux

Setting: This study evaluates the impact of sunscreen dispensers in increasing sunscreen usage and awareness in Summerside, Prince Edward Island, Canada.

Intervention: In June 2022, three touchless sunscreen dispensers offering free Health Canada-approved SPF 30 sunscreen were installed in areas of high pedestrian traffic. A team of four city workers gathered observational data over a 17-day span between July and August 2022.

Outcomes: Seven days of monitoring took place at the city ballpark, seven at a children's park, and three at the city beachfront boardwalk. In total, 1202 individuals were observed near the dispensers, of whom 209 utilized the dispensers, yielding a usage rate of 17.4 per 100 persons. The usage rate varied by location, with the children's park recording a higher average (40.0 users per 100 persons), and was also weather-dependent, with increased usage on sunny days (average of 52.2 users per 100 persons). The majority of users were classified with a Fitzpatrick skin type of I or II. The sunscreen bags, designed for 2000 applications, did not require refilling during the observation period. The QR code associated with the dispensers was scanned 14 times.

Implications: The findings of this study indicate that installing sunscreen dispensers in public spaces may increase the frequency of sunscreen application. Both the location of the dispensers and the perception of weather conditions seem to impact usage rates.

环境:本研究评估了防晒霜分发机对提高加拿大爱德华王子岛萨默赛德市的防晒霜使用率和防晒意识的影响:2022 年 6 月,在人流密集区安装了三台非接触式防晒霜分发机,免费提供加拿大卫生部批准的 SPF 30 防晒霜。由四名城市工作人员组成的小组在 2022 年 7 月至 8 月的 17 天内收集了观察数据:在市立棒球场进行了七天的监测,在儿童公园进行了七天的监测,在市海滨木板路进行了三天的监测。在饮水机附近共观察到 1202 人,其中 209 人使用了饮水机,使用率为每 100 人 17.4 次。使用率因地点而异,儿童公园的平均使用率较高(每 100 人中有 40.0 人使用),使用率还与天气有关,晴天的使用率更高(每 100 人中平均有 52.2 人使用)。大多数使用者的菲茨帕特里克皮肤类型为 I 型或 II 型。防晒袋的设计使用次数为 2000 次,在观察期间无需重新装满。与分发器相关的二维码被扫描了 14 次:本研究的结果表明,在公共场所安装防晒霜发放机可能会增加涂抹防晒霜的频率。饮水机的位置和对天气条件的感知似乎都会影响使用率。
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引用次数: 0
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