Journal of prevention (2022)最新文献

Globorisk is a country-specific risk prediction model that estimates 10-year cardiovascular disease (CVD) risk. This study aims to evaluate the agreement between different versions of Globorisk and their ability to predict CVD in a nationwide Turkish cohort. Baseline data from 5449 participants aged 40-74 were obtained from Türkiye Chronic Diseases and Risk Factors Survey 2011. Office- and laboratory-based Globorisk risk scores were calculated using age, gender, systolic blood pressure (SBP), current smoking status, body mass index (BMI), diabetes, and total cholesterol levels. Correlation and Bland-Altman analysis were employed to assess the agreement between 10-year risk scores. Multivariable logistic regression models were estimated with Globorisk variables to predict the presence of CVD over a 6-year follow-up period. Model calibration was performed. The study identified 515 incident CVD cases during the 6-year follow-up period. There was a strong positive correlation between 10-year Globorisk versions (r = 0.89). The limit of the agreement was narrower in males (- 6.11 to 6.89%) compared to females (- 7.01 to 7.73%). Age and systolic blood pressure were associated with 6-year CVD in both office- and laboratory-based models. The models showed similar discriminative performance (AUC: 0.68) and predictive accuracy (mean absolute error: 0.009) for 6-year CVD. Both Globorisk models were strongly correlated, had similar discrimination power and predictive accuracy. The office-based Globorisk can be used instead of the laboratory-based model, especially where resources are limited.

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 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.

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.

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.

Risk perception, its relationship to preventive health behaviors and other factors (e.g., direct experience of a disease) are important for determining effective targets for disease prevention. Whether these relationships are the same for various diseases has not been well-researched. Drawing on a holistic model of risk perception, this study compares levels of perceived risk for COVID-19 and HIV in a rural Zambian community, examines hypothesized correlates of perceived risk, and evaluates whether higher perceived risk and/or its correlates are associated with practicing preventive behaviors for each disease. The sample included 118 adults participating in a larger study of families affected by HIV. Via surveys, information about risk perception, preventive behaviors, knowledge about, trust in information sources, direct experience and hearing about each disease, and prosociality, were collected. For each disease, perceived risk was not related to its preventive behaviors. Levels of perceived risk for COVID-19 and HIV differed significantly, as did their correlates. Having trusted sources of information about HIV was related to higher perceived risk of HIV. Direct experience of COVID-19 was related to higher perceived risk of COVID-19, but only at a level of interest. Although practicing preventive behaviors for each condition was related to higher levels of knowledge about each disease at a level of interest, willingness to engage in behavior beneficial to others (prosociality) was significantly related only to COVID-19 preventive behaviors. Different diseases provoke different levels of perceived risk and engagement with preventive behaviors and may be correlated with distinct factors. These differences may be due to history of experience with a disease, as well as cultural factors.

Hazardous alcohol use tends to be more prominent among higher education students. The COVID-19 pandemic severely altered student life, raising questions on its impact on students' alcohol use patterns. The current study examined cross-country variations in drinking behaviors (weekly drinking and binge drinking), and the extent to which these variations were associated with containment measures implemented during the first wave of the COVID-19 pandemic. Data were obtained from the COVID-19 International Student Well-being Study, covering students in 25 middle- and upper-high income countries. Data on government responses were retrieved from the Oxford COVID-19 Government Response Tracker. Multilevel multinomial logistic regression analyses were performed on weekly drinking (n = 44,212) and binge drinking (n = 32,785). Considerable cross-country variation existed for weekly drinking and binge drinking. In the majority of countries, a self-reported decrease in weekly drinking and a substantial self-reported decrease in binge drinking were observed. Closings of schools were associated with decreases in weekly drinking, while limitations on social gatherings were associated with increases in weekly drinking. The stringency index was associated with reporting decreased binge drinking. The study findings demonstrate a number of small yet significant associations between containment measures and changes in student drinking behaviors. Future studies are required to uncover why some students increased their alcohol consumption, particularly in countries with stricter limitations on social gatherings.

Stair use is a physical activity that can be easily incorporated into daily routines, offering numerous health benefits. Nudges are increasingly adopted in public health interventions to promote healthy behaviours, such as physical activity. This study aimed to investigate the effectiveness of nudge-based posters in increasing stair use among hospital visitors in Athens, Greece. The posters were placed at the point-of-choice between stairs and elevators. Hospital visitors using either the stairs or elevators were observed across five phases, namely, baseline, two intervention phases, and two post-intervention phases, each lasting four days. A total of 3,071 choices between the stairs and the elevator were recorded during the study. The differences in proportions of stair users between stages was assessed using the Chi-square test. The results showed that the posters significantly increased stair use from 22.6% at baseline to 37.3% during the first intervention phase. Stair use dropped back to 22.2% during the first post-intervention phase. During the second intervention, stair use rising to 37.8%, followed by a decrease to 22.8% in the second post-intervention phase. These findings suggest that posters placed at the point-of-choice can effectively promote immediate behavioural changes, increasing stair use among hospital visitors. However, their long-term effect has yet to be verified. The simplicity, low cost, and easy applicability of posters make them a promising nudge-based intervention within hospital settings. These characteristics also support the generalization of this approach to other environments as part of public health policies aimed at promoting physical activity and improving overall population health.