Journal of prevention (2022)最新文献

Health anxiety (HA) is a growing concern among medical students due to their continuous exposure to illness-related content, academic stress, and self-monitoring tendencies. While some studies suggest an association between HA and health-related behaviors, findings remain inconclusive, especially particularly among Chinese medical students. This study aimed to examine the relationship between HA and health-related behaviors. This cross-sectional study was conducted among 2,283 Chinese medical students. Participants completed standardized self-report measures assessing demographic characteristics, HA (via the Chinese Short Health Anxiety Inventory, CSHAI), body mass index (BMI), smoking status, dietary patterns, and physical activity levels (via the International Physical Activity Questionnaire-Short Form, IPAQ-SF). Group differences were examined using independent-samples t-tests and chi-square tests. Multiple linear regression was performed to identify factors associated with HA. Approximately one-third of the students reported clinically HA. Among participants, 46.3% were classified as physically inactive and 40.3% were overweight or obese. Additionally, 9.55% were current smokers, and 36.4% reported an unhealthy diet pattern. No significant differences were observed between students with and without HA in terms of BMI, smoking status, or dietary habits (p > 0.05). However, weekly physical activity level was significantly lower among students with HA compared to those without HA (p < 0.001). In regression analysis, physical activity was negatively associated with HA (p < 0.001), indicating that higher levels of physical activity were related to lower HA scores (β= - 0.343). Lower physical activity was associated with higher HA, suggesting that promoting physical activity may be a relevant in efforts to reduce HA among medical students.

Emergency situations range from everyday traffic accidents to incidents of mass gun violence and require individuals to be prepared and willing to act in times of crisis. To encourage people to help one another during such emergencies, the American College of Surgeons developed the Stop the Bleed (STB), a public health program based on the premise that bystanders who are properly trained to treat a victim's bleed injuries have greater chance of preventing hemorrhagic death rather than waiting for first responders to arrive. This study examined the uptake of STB among 117 urban university students located in the Midwestern United States who often feel the pressures of public safety as participants in surrounding city life. Guided by protection motivation theory (PMT), we explored how students' fear of potential mass casualty incidents, threat appraisals, and efficacy appraisals related to their bleed control knowledge acquisition immediately after completing STB training, as well as retention 12 weeks after the training concluded. Results indicated that participation in STB raised students' fears of mass casualty events and self-efficacy. Both factors significantly correlated with bleed control learning outcomes assessed immediately after the STB class; however, they did not predict later retention. We discuss our study's contributions to fear appeals research and PMT theory, before offering recommendations for future hemorrhage control programs, public safety, and prevention research.

Persons with Type 2 diabetes mellitus (T2DM, ~ 38.1 million Americans) are at risk of poor health, cardiovascular disease (CVD) and chronic kidney disease (CKD) if their disease is poorly controlled. T2DM control requires disease self-management through adequate physical activity and optimum diet. We evaluated the physical activity and diet patterns of the US T2DM population against the American Diabetes Association and clinical practice guideline norms, and their associations with health outcomes. Using a cross-sectional, observational study design, we studied the US T2DM population's physical activity and fruit/vegetable intake (independent variables), and their associations with three health outcomes, self-rated health (from the SF-36 question on experienced health status, categorized as excellent/very good/good vs. fair/poor), CVD-free status, and CKD-free status. We used pooled data from the Behavioral Risk Factor Surveillance Surveys (2015, 2017 and 2019) on adults aged 30-75 years with T2DM (defined as diabetes mellitus diagnosed after age 30). Physical activity categories were inactive, insufficiently active, sufficiently active, highly active, and fruit/vegetable intake categories, ≤ 2, 3-4, and ≥ 5 daily servings. We used hierarchical logistic regression, adjusting for demographic variables (age, sex, race), and potentially confounding factors, diabetes severity (disease duration, insulin use), chronic comorbidity, overweight/obese, smoking, alcohol overuse, having a regular healthcare provider, and having health insurance. Missing data were coded as a separate category. We conducted a subgroup analysis of those with ≥ 10 years of disease duration. Among 119,298 respondents with T2DM (52.1% female, mean age 62.1 years, 94% insured), 36.9% were physically inactive and 16.2% insufficiently active, 52.6% consumed ≤ 2 daily servings of fruit/vegetables, 57% reported excellent-good health, 24.7% had CVD, and 9.7% had CKD. Physical activity showed a dose-dependent association with self-rated health (reference group, physically inactive; adjusted OR for insufficiently active 1.77 (95%CI 1.71-1.83), sufficiently active, 2.33 (2.24-2.43), highly active, 2.63 (2.54-2.72)), as did fruit/vegetable intake [reference group ≤ 2 daily servings; OR for 3-4 servings, 1.12 (1.09-1.16), and ≥ 5 servings, 1.13 (1.08-1.17)]. Physical activity was associated with being CKD-free (ORs, 1.29 (1.22-1.37), 1.50 (1.40-1.60), 1.52 (1.44-1.60, respectively), and being CVD-free (1.31 (1.25-1.37), 1.34 (1.28-1.41, and 1.37(1.31-1.42), respectively). Fruit/vegetable intake was not associated with CVD. CKD outcome was not studied due to dietary restrictions of CKD patients. Subgroup analyses (53,925 respondents) showed similar results. Over a third of the US T2DM population and the subgroup with long-term T2DM were physically inactive, a sixth were insufficiently active, and over half had negligible fruit/vegetable intake. On the positive side, even limited physica

The European Prevention Curriculum (EUPC) is a European initiative to promote professional and quality-assured substance use prevention. In Austria, the EUPC is trialled via a three-year pilot project to explore its appropriateness and long-term feasibility. We report on the first two years of EUPC project implementation as part of a Special Issue on EUPC implementation practice and lessons learnt. As of January 2025, four national trainers had delivered a total of four trainings (three in-person, one online), reaching over 70 professionals in Austria and six from neighbouring countries. EUPC training was offered free of charge, and a three-day format appeared to work best for the basic module. Participants recommended EUPC for continuation beyond the pilot phase, citing not only its potential to promote professionalisation, quality assurance and evidence-based work but also to facilitate exchanges of perspectives, networking and a common prevention language among different professionals. Existing prevention infrastructures were used to create a suitable system for project coordination and dissemination of EUPC. The pilot is jointly undertaken by two major stakeholders representing different contexts: the national public health institute and the national association of provincial addiction prevention units. Creating a shared vision for the project and securing necessary funding was initially challenging but was achieved through relationship-building, a shared commitment to 'quality in prevention' and a focus on the potential benefits of offering EUPC. These aspects also helped to successfully navigate the balance between a flexible approach to EUPC at the European level and the practical need for a structured approach in Austria. Our insights from a formative evaluation, routine data collection and team discussions can support further development of EUPC at the European level and in other countries.

In Bosnia and Herzegovina, prevention efforts have traditionally relied on methods not informed by scientific evidence, limiting their effectiveness. This practitioner narrative explores the implementation of the European Prevention Curriculum (EUPC) in Bosnia and Herzegovina as part of a Special Issue on EUPC implementation practice and lessons learnt, examining the first outcomes of the training on decision, opinion, and policy makers (DOPs) and its role in fostering the adoption of evidence-based prevention strategies. Since 2022, ten EUPC training courses have been conducted in nine cities, engaging 178 key stakeholders from various sectors. The training aims to enhance participants' knowledge of science-based prevention principles and equip them with tools for informed decision-making in policy development and program implementation. To assess the outcome of EUPC training, we analyzed changes in policy discussions, strategic planning, and funding allocation for prevention programs. Key indicators include the proposal for the first national Prevention Strategy and the revision of public funding criteria to prioritize evidence-based initiatives. These findings demonstrate the training's role in shaping a more structured and effective prevention landscape. By systematically strengthening the capacity of key stakeholders, EUPC training serves as a catalyst for embedding science-based prevention within national frameworks. This paper highlights its potential to drive a paradigm shift toward sustainable, evidence-informed public health policies.

This paper outlines the adaptation and implementation of the European Prevention Curriculum (EUPC) in Brazil, launched in 2022 to enhance the skills of professionals in substance use prevention. The EUPC-Brazil project follows a decentralized model with significant collaboration from regional and local stakeholders, as well as international partners, such as the European Union Drugs Agency (EUDA). The curriculum was adapted through feedback from local professionals and policymakers, ensuring its relevance to national needs while maintaining European best practices. Initial pilot trainings have shown positive results, with participants reporting increased competence in applying evidence-based practices. Challenges such as resource limitations and regional disparities in access to training are being addressed through ongoing adaptation and the creation of virtual communities for continued peer learning. The findings provide key insights for other countries looking to implement the EUPC, emphasizing the importance of local adaptation, stakeholder engagement, and long-term sustainability.

The European Prevention Curriculum (EUPC) was introduced in Greece through the European Commission co-funded project, ASAP training. In this project, a comprehensive training on EUPC for decision-, opinion- and policy-makers was developed with basic and advanced modules. The first EUPC trainings in Greece began in 2019. Since then, both the basic and the advanced modules of the EUPC have been offered by four accredited trainers. Between 2019 and mid-2024, EUPC training engaged 89 professionals. Trainings are conducted based on the Trainer's Guide developed under ASAP, with updates incorporated when available by the EUDA, ensuring alignment with the latest evidence in the science of prevention. While maintaining fidelity to Trainer's Guide, minor adaptations, such as extending the duration, have been introduced to better suit stakeholders involved so far, encouraging reflection on current practices and enhancing engagement. EUPC has contributed to the establishment of a common language in prevention, updating professionals with current evidence-based practices, and fostering critical reflection on existing practices. Despite challenges such as resistance to change and the need for structured evaluations of EUPC trainings, the curriculum has empowered professionals by reinforcing the importance of rigorous, systematic approaches in designing and implementing prevention strategies and interventions. Future plans aim to expand EUPC's reach into the education sector and address broader risk behaviours, while expanding its reach to regional and local levels as well as ensuring its sustainability. These initiatives underscore EUPC's pivotal role in shaping a cohesive prevention framework that benefits both local communities and national policy objectives.

The Flemish community in Belgium has been actively involved in the European Prevention Curriculum (EUPC) since its adaptation of the UPC (Universal Prevention Curriculum) to the European context, followed by participation in the ASAP-training project (Building effective drug prevention results across Europe, based on prevention systems analysis and widespread professional training). This practitioner narrative explores the implementation of the EUPC in the Flemish community in Belgium as part of a Special Issue on EUPC implementation practice and lessons learnt. The implementation of the EUPC in the Flemish community has demonstrated positive effects on the broader substance use prevention landscape, highlighting the importance of high-quality prevention initiatives. Despite these successes, challenges persist, particularly within a prevention support system constrained by limited resources. Key obstacle is getting and maintaining the engagement of decision-makers, opinion leaders, and policymakers, which were central to the EUPC's original focus. In response to this challenge, the Flemish community is gradually developing supplementary materials. These efforts continue to be guided by EUPC-related content, aiming to enhance the region's capacity for effective substance use prevention.

The European Prevention Curriculum (EUPC) was introduced in Georgia to ensure the quality of the National Drug Prevention Strategy implementation. This paper provides a practitioner's narrative of the experiences and lessons learned during the implementation of EUPC in Georgia, as part of a Special Issue on EUPC implementation experiences. The narrative is grounded in the authors' direct involvement in the implementation of the EUPC, including the translation and cultural adaptation of the curriculum, the capacity building of national trainers, and the delivery and evaluation of EUPC training to 146 local stakeholders. Drawing on implementation experiences, training participant feedback, and implementers' observations, the account highlights key lessons learned. The translation and cultural adaptations of the EUPC manual along with the development of national training capacity laid a strong foundation for piloting the first EUPC training for decision-makers, opinion leaders and policymakers (DOPs) in Georgia. As a result of the training, participants demonstrated an increased understanding of evidence-based prevention principles. However, challenges emerged, including the culture-specific pace of content comprehension and the participants' limited prior exposure to evidence-based prevention. Key lessons include the necessity to tailor training complexity to the needs of different target groups while putting in place the mechanisms assuring fidelity, quality and the necessity of creating a sustainable infrastructure for EUPC implementation.

This practitioner narrative provides a comprehensive overview of the implementation of the European Prevention Curriculum (EUPC) in Cyprus, contributing to the Special Issue on EUPC implementation practices and lessons learned. The Cyprus National Addictions Authority (NAAC) is the main coordinating body responsible for licit and illicit substances, as well as gambling disorders, as defined by national legislation. As the national reference point and coordination centre for the EUPC, NAAC has played a key role in introducing and establishing EUPC training in Cyprus. By the end of 2024, five training sessions had taken place with the participation of 68 Decision-Opinion-and Policy-Makers (DOPs) from various sectors, including governmental and non-governmental organizations, law enforcement, and education. These training sessions have been facilitated by four national trainers, with the goal of conducting two training cycles per year to ensure broad participation. The integration of the EUPC into the licensing and funding processes of prevention programs has streamlined associated procedures, providing a structured rationale and evidence-based knowledge to relevant stakeholders. Since the introduction of the EUPC, trainers have noticed a gradual shift in the perception of evidence-based prevention among NAAC and stakeholders in the field of addictions. However, embedding EUPC principles into national practices is an ongoing process that requires sustained efforts. Change does not occur overnight, and the full impact of the EUPC at the national level will only become evident over time. Looking ahead, NAAC is committed to advocating for the continued delivery of EUPC training for prevention DOPs. Data on process evaluation is being collected, with plans to analyze evaluation data in the future and assess the effectiveness of these training sessions.