Journal of prevention (2022)最新文献

Cervical cancer poses a significant public health challenge, especially among tribal women who face barriers in accessing healthcare. This study aimed to evaluate the knowledge, attitudes, and practices of tribal women regarding cervical cancer and HPV screening in Anuppur, a rural district in Madhya Pradesh, India. Conducted between December 2020 and December 2022, the cross-sectional study included one tribal block (Pushprajgarh) and one urban block (Jaithari). The study involved females aged 10-59 years from randomly selected households, excluding those with a history of cancer and those not consenting. Healthcare professionals from local health centres were also included, except those on leave. The sample size was 384, determined using a 95% confidence interval and a 5% margin of error. Data were collected through a structured questionnaire covering sociodemographic characteristics, knowledge, attitudes, and practices related to cervical cancer screening. Knowledge was assessed with questions about risk factors, symptoms, and preventive measures, while attitudes were measured using a 7-point Likert scale. Practice-related questions focused on experiences with Pap smear testing. The study revealed a significant lack of awareness among tribal women about cervical cancer and its link to HPV infection. Many participants had limited understanding of the risk factors, symptoms, and preventive measures, leading to negative attitudes towards screening. Barriers such as financial constraints, cultural beliefs, and limited healthcare access further hindered screening practices. As a result, many women had never undergone cervical cancer screening. These findings highlight the urgent need for targeted interventions and educational programs to improve awareness and promote positive attitudes towards cervical cancer screening among tribal women. Emphasizing the importance of regular screening and addressing misconceptions can help bridge the knowledge gap and enhance preventive measures.

The aim of this study was to evaluate the association between direct health costs related to non-communicable diseases (NCDs) and the level of physical activity in Chinese elderly people. In this longitudinal study, 410 people over 64 years old were selected from health centers. The direct health costs caused by NCDs were recorded on a weekly basis for a period of six months. Also, physical activity was measured using FitBit Flex2™ and as the number of daily steps as well as calories burned during this six month. The multiple linear regression analysis was used to identify the predictors of direct health costs caused by NCDs as the dependent variable. Age, gender, marital status, education level, currently working, Fitbit steps and calories, and BMI were entered into the model as predictor variables to perform a stepwise regression analysis. Four variables of age, BMI, Fitbit steps and Fitbit calories were able to enter the regression model. The model explained 24.8% of the variability of direct health costs due to NCDs. The strongest predictor of health costs was Fitbit calories (B = - 2.113, t =  - 4.807, p < 0.001), followed by BMI (B = 1.267, t = 3.482, p < 0.001), Fitbit steps (B =  - 1.157, t =  - 3.118, p < 0.001), and age (B = 1.115, t = 2.599, p < 0.001). It can be said that having regular physical activity can reduce health costs due to NCDs in Chinese older people.

The digitalization of society increasingly blurs boundaries between analog and digital worlds, offering opportunities such as telemedicine and global connectivity through digital platforms. However, it also presents risks, including cyberbullying, addiction potential, harmful content, misinformation, and privacy concerns from data breaches and surveillance technologies. Social media, with its global reach, amplifies both opportunities for positive engagement and the responsibility to navigate largely unregulated content. Adolescents, due to their developing critical evaluation skills and high prevalence of mental health challenges, are particularly vulnerable in this space and must navigate the risks associated with social media while simultaneously leveraging it for essential developmental tasks, such as identity formation and building social connections. To support them in this challenge, we propose adapting the traditional life skills approach to address the challenges of social media use, empowering adolescents to navigate both digital and analog environments effectively. These life skills include critical thinking, communication, and managing emotions and stress - all of which are essential for navigating social media. Despite its complexities, social media offers a unique platform for health promotion and prevention interventions due to its wide accessibility and reach. It holds significant promise for adolescent health by providing information, motivation, and social support. However, evidence-based, youth-centered prevention strategies on these platforms are still in early development and require further research to ensure effectiveness. Prevention programs integrating proven behavior change techniques, aligning with the preferences and needs of adolescents, and teaching essential life skills can empower them to navigate digital and analog challenges effectively.

Chemsex is a specific practice of sexualized drug use (SDU), linked mainly to the group of men who have sex with men (MSM). This practice has become a public health problem due to the increase in sexually transmitted infections and HIV. However, there are groups and aspects that require greater visibility and research. This study aims to (1) analyze whether the majority of existing studies on chemsex focus on MSM and to what extent studies have addressed other sexual orientations and gender identities; and (2) determine the characteristics and effectiveness of interventions implemented for the prevention and risk reduction associated with chemsex, excluding pre- and post-exposure prophylaxis for HIV. Following PRISMA recommendations, a systematic review was conducted in the Cochrane Library, PubMed/MEDLINE, Scopus and Web of Science databases between April and July 2024. The results were synthesized using a narrative approach and the methodological quality was evaluated of the studies included with the Mixed Methods Appraisal Tool (MMAT) instrument. The first search identified 1314 studies, 14 of them being relevant. The studies analyzed the presence of chemsex and SDU in diverse samples regarding sexual orientation and gender identity. They were plural and addressed multiple aspects that constitute the phenomenon of chemsex. The second search yielded 1985 studies, of which two met the inclusion criteria. No primary or secondary prevention interventions were recorded; however, risk prevention interventions were documented. These interventions demonstrated reductions in chemsex practices, engagement in unsafe sexual behaviors, and substance use. Chemsex reflects complex dynamics within sexually minoritized groups, influenced by gender, sexual orientation, and the collective's inherent insecurities. While risk reduction programs exist, there is a notable lack of primary prevention interventions. Expanding research to include diverse populations and developing inclusive strategies to address this phenomenon is crucial.

The COVID-19 pandemic led to significant shifts in societal norms and individual behaviors, including changes in physical activity levels. This study examines the relationship between socioeconomic and sociodemographic factors and changes in physical activity levels during the pandemic compared to pre-pandemic levels among adult Arkansans. Survey data were collected from 1,205 adult Arkansans in July and August 2020, capturing socioeconomic and sociodemographic characteristics and information on physical activity changes since the onset of the pandemic. Descriptive statistics and multinomial logistic regression analyses were conducted to assess the relative risk of reporting increased or decreased physical activity compared to unchanged levels. Age (RRR _{more physical activity} =0.98, RRR _{less physical activity} =0.98), marital status (RRR _{less physical activity} =0.66), COVID-19-related income loss (RRR _{less physical activity} =0.61), and receipt of a stimulus check (RRR _{less physical activity} =0.64) were significantly associated with changes in physical activity levels during the pandemic. Older individuals, married individuals, those without COVID-19-related income loss, and recipients of stimulus checks were less likely to report decreased physical activity levels. No significant association was found between race/ethnicity and physical activity changes. This study highlights the influence of socioeconomic and sociodemographic factors on physical activity behaviors during the COVID-19 pandemic. These findings underscore the importance of considering socioeconomic and sociodemographic factors in public health interventions to promote physical activity and mitigate health disparities beyond the pandemic.

This study aimed to analyze the causes of school accidents and examine the preliminary findings of a nurse-led, drama-based accident prevention program for children. This was a quasi-experimental study using a pretest-posttest approach with a single group. Data were collected using demographic information, school accident notification form, and Information and Behavior Scales for the Safety Measures of the Students. A total of 407 students formed the sample. A drama-supported education program designed to prevent accidents, developed by nurses working in school health, was implemented based on the most common school accidents. The nurses were actively involved in every program stage, including designing the content, guiding participants, and monitoring progress throughout the intervention. The mean age of the students was 11.2 ± 1.4; 51.8% were girls, and 50.3% were at the primary school. The students' average knowledge scale pretest score was 102.15 ± 21.4736; the behavior scale pretest score was 78.22 ± 11,228; the mean knowledge scale posttest score was 174.75 ± 9.34, behavior scale posttest mean score was 109.62 ± 14.56. This study highlights the crucial role of school nurses in accident prevention and health promotion among students. Based on preliminary findings, drama-based educational programs may improve knowledge and safety behaviors in the school environment.

The deterioration in health and functionality in older ages, in addition to biological changes, is affected by physical changes. Therefore, early retirement may become an inevitable choice. This study aimed to evaluate the relationship between limitations in daily living activities, mobility, and other health factors with early retirement in workers aged 50-67 in the 4th wave of the SHARE study in Europe. In this prospective cohort study, the working status was examined in 4 waves. The frequency of early retirement was 16.1%; it was higher in male and low-educated people. Those with poor self-perceived health and those with more chronic diseases retired earlier. The frequency of early retirement was 16.0% for those who had no difficulty in basic daily living activities, 22.4% for those who had difficulties (p 0.019), and those who had limitations retired earlier (RR 1.50). Early retirement was higher in those with two or more chronic diseases compared to those without (RR 1.26) and was higher in those who consumed alcohol 5 days a week than those who didn't (RR 1.34). A 1-unit increase in BMI increased the risk by 1.02 times. It has been clearly revealed how important basic activities are for early retirement. This new finding is a gain for the literature and will provide new insights intervention studies. Those who had difficulty in instrumental activities and mobility retired early more often, but this wasn't statistically significant. Our findings will contribute to increasing workplace protective approaches, and maintaining a healthy working force for years.

Gamified interventions consist of a combination of game elements designed to motivate and engage users, thus addressing issues of participant low participation and enthusiasm in interventions. Gamification does not work well in all situations and its success depends on the context and target users. However, there is a lack of research on analog health interventions. Qualitative and quantitative data were collected in parallel to examine participants' experiences with Food Game, an analog gamified intervention designed to promote healthier and more sustainable food choices among high school students. Teams of students compete to complete peer-led thematic challenges. Sixty-four students from the 2022/23 edition participated in focus group interviews (N = 11), and 119 completed a survey (56.1% response rate) with indicators of responsiveness and perceived motivational impact of the program's five game elements. Results indicate a relatively high level of engagement with the program. Students valued Food Game because it gave them the opportunity to demonstrate their sense of agency and autonomy and to work in a group with their peers, thus addressing basic needs for competence, relatedness, and autonomy as described by Self-Determination Theory and providing an empowering experience. The least motivating game element in the Food Game was the leaderboard and inter-team competition. Focus group data confirmed students' ambivalence about the competition embedded in the program and pointed to potential unintended consequences, including inter-team conflict, stress, and reduced intrinsic motivation to play. The strengths and weaknesses of Food Game approach to gamification are discussed, along with implications for prevention research and practice.

Background: Wearable technologies have the potential to support health promotion and disease prevention. However, it remains unclear how the role of social determinants of health (SDoH) and digital determinants of health (DDoH) plays in this context.

Objective: This study investigates differences in sociodemographic factors and digital health literacy between wearable users and non-users, whether the association with wearable use varies across age groups and its potential mediator.

Methods: A cross-sectional nationwide telephone survey was conducted in November 2022 in a panel of adult internet users in Germany. Assessments included self-reported wearable use, sociodemographic factors (sex, age, education, household size and income, and residence region), and digital health literacy (measured with the eHealth Literacy Scale, eHEALS). Associations between wearable use, sociodemographic factors and digital health literacy were analyzed using binomial logistic regression models in the total sample and with age group stratification, with a supplementary mediation analysis examining digital health literacy as a mediator in the relationship between age and wearable use.

Results: Overall, 24% (223/932) of participants (52% male, mean age 55.6 years) reported using wearables for health. Wearable use was lower among participants aged 65 and above, with lower educational attainment, living in 1-2 person households, with below-average household income, and residing in smaller cities or former East Germany. Wearable use prevalence is substantially lower in older age groups (18-40: 36%; 41-64: 26%; 65+:14%). Wearable users reported higher levels of digital health literacy (mean: 30.7, SD = 5) than non-users (mean: 28.3, SD = 6). Stratified analyses indicate that the association between digital health literacy and wearable use varies by age group, with significant positive association observed in older age groups (OR = 1.00, 95% CI: 0.94 to 1.07 in age group 18-40; OR = 1.07, 95% CI: 1.03 to 1.12 in age group 41-64; OR = 1.11, 95% CI: 1.04 to 1.19 in age group 65+). Mediation analysis indicated that digital health literacy partially mediates the relationship between age and wearable use (indirect effect: coefficient = -0.0156, 95% CI: -0.0244 to -0.00791, p <.001).

Conclusions: This study indicates sociodemographic disparities in wearable use among the German population and differences in digital health literacy between wearable users and non-users. A generational divide in wearable use was identified, with older adults being less likely to embrace this technology. This was especially true for older adults with lower digital health literacy. Future public health initiatives employing health technologies should take SDoH and DDoH into consideration to ensure effective and equitable impacts.