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Perceptions of COVID-19 and HIV Risk and Related Preventive Health Behaviors in Rural Zambia. 赞比亚农村地区对COVID-19和艾滋病毒风险的认识及相关预防健康行为
IF 1.5 Pub Date : 2025-04-01 Epub Date: 2024-12-11 DOI: 10.1007/s10935-024-00817-8
Mei Tan, Philip E Thuma, Susie Hoffman

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.

风险认知及其与预防性健康行为和其他因素(例如,对疾病的直接体验)的关系对于确定有效的疾病预防目标非常重要。这些关系是否适用于各种疾病还没有得到充分的研究。利用风险认知的整体模型,本研究比较了赞比亚农村社区中COVID-19和艾滋病毒的感知风险水平,检查了感知风险的假设相关因素,并评估了更高的感知风险和/或其相关因素是否与每种疾病的预防行为有关。该样本包括118名成年人,他们参与了一项更大规模的艾滋病毒感染家庭研究。通过调查,收集了风险认知、预防行为、对信息来源的了解、信任、对每种疾病的直接体验和听力、亲社会性等方面的信息。对于每种疾病,感知风险与预防行为无关。COVID-19和艾滋病毒的感知风险水平存在显著差异,它们的相关因素也存在显著差异。拥有可靠的艾滋病毒信息来源与更高的艾滋病毒感知风险有关。直接经历COVID-19与更高的COVID-19感知风险相关,但仅在感兴趣的水平上。尽管针对每种疾病实施预防行为与对每种疾病的更高水平的知识相关,但参与有益于他人的行为(亲社会)的意愿仅与COVID-19预防行为显著相关。不同的疾病引起不同程度的感知风险和参与预防行为,并可能与不同的因素相关。这些差异可能是由于疾病经历的历史,以及文化因素。
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引用次数: 0
Containment Measures and Alcohol Consumption Among Drinking Higher Education Students Before and During the COVID-19 Pandemic: A Multilevel Analysis in 25 Countries. COVID-19 大流行之前和期间的遏制措施与饮酒高校学生的酒精消费:25个国家的多层次分析
Pub Date : 2025-04-01 Epub Date: 2024-09-26 DOI: 10.1007/s10935-024-00807-w
Robert Tholen, Koen Ponnet, Guido Van Hal, Sara de Bruyn, Veerle Buffel, Sarah Van de Velde, Piet Bracke, Philippe Bos, Yildiz Akvardar, Petra Arnold, Heide Busse, Andreas Chatzittofis, Stefanie Helmer, Fatemeh Rabiee-Khan, Vera Skalicka, Theoni Stathopoulou, Marie-Pierre Tavolacci, Claudia van der Heijde, Edwin Wouters

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.

危害性饮酒在高校学生中往往更为突出。COVID-19 大流行严重改变了学生的生活,引发了关于其对学生饮酒模式影响的问题。本研究考察了饮酒行为(每周饮酒和酗酒)的跨国差异,以及这些差异与 COVID-19 大流行第一波期间实施的遏制措施的关联程度。数据来源于 COVID-19 国际学生福祉研究(COVID-19 International Student Well-being Study),涵盖了 25 个中高收入国家的学生。有关政府应对措施的数据来自牛津 COVID-19 政府应对措施追踪系统。对每周饮酒(n = 44,212 人)和酗酒(n = 32,785 人)进行了多层次多叉逻辑回归分析。在每周饮酒和酗酒方面,各国之间存在很大差异。在大多数国家,每周饮酒量的自我报告减少了,暴饮的自我报告大幅减少了。学校停课与每周饮酒量的减少有关,而对社交聚会的限制与每周饮酒量的增加有关。严格指数与暴饮减少有关。研究结果表明,遏制措施与学生饮酒行为的变化之间存在一些微小但重要的关联。未来的研究需要揭示一些学生饮酒量增加的原因,尤其是在对社交聚会有更严格限制的国家。
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引用次数: 0
Nudging Hospital Visitors Towards Stair Use, in Greece. 在希腊,推动医院访客使用楼梯。
Pub Date : 2025-04-01 Epub Date: 2025-02-08 DOI: 10.1007/s10935-025-00827-0
Alexandros Tzikas, George Koulierakis, Konstantinos Athanasakis, Kyriakoula Merakou

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.

楼梯的使用是一种身体活动,可以很容易地融入日常生活,提供许多健康益处。在公共卫生干预措施中越来越多地采用轻推,以促进身体活动等健康行为。本研究旨在调查在希腊雅典的医院访客中增加楼梯使用的基于轻推的海报的有效性。海报被放置在楼梯和电梯之间的选择点。通过五个阶段观察使用楼梯或电梯的医院访客,即基线阶段、两个干预阶段和两个干预后阶段,每个阶段持续四天。在研究过程中,总共记录了3071次楼梯和电梯之间的选择。使用卡方检验评估不同阶段间楼梯使用者比例的差异。结果显示,在第一干预阶段,海报显著增加了楼梯使用率,从基线时的22.6%增加到37.3%。在干预后的第一个阶段,楼梯使用率下降到22.2%。在第二次干预期间,楼梯使用率上升到37.8%,随后在干预后的第二个阶段下降到22.8%。这些发现表明,在选择的地点放置海报可以有效地促进立即的行为改变,增加医院访客使用楼梯。然而,它们的长期影响尚未得到证实。海报的简单性、低成本和适用性使其在医院环境中成为一种有前途的基于轻推的干预措施。这些特点也支持将这种做法推广到其他环境,作为旨在促进身体活动和改善总体人口健康的公共卫生政策的一部分。
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引用次数: 0
Using Social Media to Promote Life Skills Among Adolescents: A Debate on Opportunities, Challenges, and Implications for Health and Education. 利用社交媒体促进青少年的生活技能:关于健康和教育的机遇、挑战和影响的辩论。
Pub Date : 2025-04-01 Epub Date: 2025-01-28 DOI: 10.1007/s10935-025-00826-1
Elizabeth Zimmermann, Samuel Tomczyk

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.

社会的数字化日益模糊了模拟世界和数字世界之间的界限,提供了远程医疗和通过数字平台实现全球连接等机会。然而,它也带来了风险,包括网络欺凌、成瘾可能性、有害内容、错误信息以及数据泄露和监控技术带来的隐私问题。拥有全球影响力的社交媒体,既扩大了积极参与的机会,也增加了浏览基本上不受监管内容的责任。青少年由于其批判性评价技能的发展和心理健康挑战的普遍存在,在这方面特别脆弱,必须应对与社交媒体相关的风险,同时利用社交媒体完成基本的发展任务,如形成身份和建立社会联系。为了支持他们应对这一挑战,我们建议调整传统的生活技能方法来应对社交媒体使用的挑战,使青少年能够有效地驾驭数字和模拟环境。这些生活技能包括批判性思维、沟通、管理情绪和压力——所有这些都是驾驭社交媒体所必需的。尽管社交媒体很复杂,但由于其广泛的可及性和覆盖面,它为健康促进和预防干预提供了一个独特的平台。它通过提供信息、动力和社会支持,为青少年健康带来了重大希望。然而,这些平台上以证据为基础、以青年为中心的预防战略仍处于早期发展阶段,需要进一步研究以确保有效性。预防方案整合了经过验证的行为改变技术,与青少年的偏好和需求保持一致,并教授必要的生活技能,可以使他们有效地应对数字和模拟挑战。
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引用次数: 0
Can Expressing Feelings About Violence be a Protective Buffer in the Linkage Between Bullying Victimization and Delinquent Activities? 表达对暴力的感受能否成为欺凌受害者与犯罪活动之间联系的保护性缓冲器?
Pub Date : 2025-04-01 Epub Date: 2024-12-15 DOI: 10.1007/s10935-024-00816-9
Jun Sung Hong, Dong Ha Kim, Timothy I Lawrence, Dexter R Voisin, Björn Sjögren, Robert Thornberg

The current study explores whether expressing feelings about violence through journal or notebook and/or school assignment might be associated with a decrease in delinquent activities, such as substance use, theft of property, and assaultive behaviors. A cross-sectional study with purposive sampling was conducted. The participants were comprised of African American adolescents in four Chicago's Southside neighborhoods. Measures included bullying victimization, substance use, theft of property, assaultive behavior, expressing feelings about violence, and the covariates (age, biological sex, and government assistance). Analyses were univariate analyses and a two-step hierarchical multiple regression. Regarding the study sample, the average age was 15.84 years, 45.6% were males, and 75.7% received government assistance. Bullying victimization was positively associated with substance use, and expressing feelings about violence moderated the association between the two. Bullying victimization was also positively associated with theft of property, and expression feelings about violence moderated the association between the two. Although bullying victimization was positively associated with assaultive behavior, expressing feelings about violence did not moderate the association between the two. Findings suggest a significant role of expressing feelings about violence in buffering the adverse outcomes of bullying victimization among adolescents in low-resourced neighborhoods. Expressing feelings about violence may serve as an effective coping mechanism for adolescents who are consistently exposed to violence.

本研究探讨了通过日记或笔记本和/或学校作业来表达对暴力的感受是否会与减少药物使用、财产盗窃和攻击行为等犯罪活动有关。研究采用有目的抽样的横断面研究方法。研究对象是芝加哥南部四个社区的非裔美国青少年。测量指标包括欺凌受害情况、药物使用、财产盗窃、攻击行为、表达对暴力的感受以及协变量(年龄、生理性别和政府援助)。分析方法包括单变量分析和两步分层多元回归。研究样本的平均年龄为 15.84 岁,45.6% 为男性,75.7% 接受过政府援助。受欺凌与药物使用呈正相关,而表达对暴力的感受则缓和了两者之间的关系。受欺凌与偷窃财产也呈正相关,而表达对暴力的感受则缓和了两者之间的关系。虽然受欺凌与攻击行为呈正相关,但表达对暴力的感受并不能调节两者之间的关系。研究结果表明,表达对暴力的感受在缓冲低资源社区青少年遭受欺凌的不良后果方面起着重要作用。对于经常遭受暴力的青少年来说,表达对暴力的感受可能是一种有效的应对机制。
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引用次数: 0
Constellations of Depressive Symptoms, Substance Use, and Risky Sexual Behavior Among Higher Education Students: A Moderated Mediation Analysis of Mask-Wearing Practice During COVID-19. 高等教育学生抑郁症状、物质使用和危险性行为的星座:COVID-19期间戴口罩行为的有调节中介分析
Pub Date : 2025-04-01 Epub Date: 2024-12-04 DOI: 10.1007/s10935-024-00815-w
Arati Maleku, Youn Kyoung Kim, JongSerl Chun, Mee Young Um, James P Canfield, Ifolu J David, Sung Seek Moon, Mansoo Yu

Mental health and substance use emerged as critical factors associated with health risk behaviors during the COVID-19 pandemic, and its importance has only grown in the post-pandemic period, particularly among priority groups like higher education students. To enhance our understanding of how mental health and substance use factors interact with preventive measures like mask-wearing to affect risky sexual behaviors (RSBs), our study examined the associations between depressive symptoms, substance use, and RSBs among college and university students in the United States. We specifically aimed to assess the impact of mask-wearing on the association between depressive symptoms, binge drinking and marijuana use, and RSBs during the pandemic. Data were collected through nonprobability sampling from 835 students at five universities via an online survey conducted between July and August 2020. Using the PROCESS macro, we analyzed the mediating effects of binge drinking and marijuana use on the association between depressive symptoms and RSBs (Model 4), as well as the moderating effect of mask-wearing on the association between depressive symptoms, binge drinking and marijuana use, and RSBs. Our findings revealed that mask-wearing significantly moderated the combined association between depressive symptoms, marijuana use, binge drinking, and RSBs. As we navigate the post-pandemic period, it is crucial for existing programs addressing health risk behaviors to consider the direct and indirect associations between mental health and substance use. Understanding these protective and health risk behaviors is essential for informing targeted prevention and intervention efforts in the post-pandemic landscape.

在COVID-19大流行期间,心理健康和药物使用成为与健康风险行为相关的关键因素,其重要性在大流行后时期只会增加,特别是在高等教育学生等优先群体中。为了加强我们对心理健康和物质使用因素如何与戴口罩等预防措施相互作用以影响危险性行为(RSBs)的理解,我们的研究调查了美国大学生的抑郁症状、物质使用和RSBs之间的关系。我们特别旨在评估戴口罩对大流行期间抑郁症状、酗酒和大麻使用与RSBs之间关系的影响。2020年7月至8月期间,对5所大学的835名学生进行了在线调查,通过非概率抽样收集了数据。我们利用PROCESS宏分析了酗酒和大麻使用对抑郁症状与RSBs关联的中介作用(模型4),以及戴口罩对抑郁症状、酗酒和大麻使用与RSBs关联的调节作用。我们的研究结果显示,戴口罩显著减缓了抑郁症状、大麻使用、酗酒和RSBs之间的联合关联。在我们应对大流行后时期时,考虑精神健康与药物使用之间的直接和间接联系,对于解决健康风险行为的现有规划至关重要。了解这些保护性和健康风险行为对于在大流行后开展有针对性的预防和干预工作至关重要。
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引用次数: 0
Participants' Experience with Gamification Elements of a School-Based Health Promotion Intervention in Italy: A Mixed Methods Study. 意大利参与者对校本健康促进干预游戏化元素的体验:混合方法研究
Pub Date : 2025-04-01 Epub Date: 2024-12-18 DOI: 10.1007/s10935-024-00820-z
Giovanni Aresi, Benedetta Chiavegatti, Elena Marta

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.

游戏化干预包括旨在激励和吸引用户的游戏元素组合,从而解决参与者在干预中参与度低和热情低的问题。游戏化并不适用于所有情境,它的成功取决于情境和目标用户。然而,缺乏对模拟健康干预措施的研究。定性和定量数据同时收集,以检查参与者对食物游戏的体验,这是一种模拟游戏化干预,旨在促进高中生更健康、更可持续的食物选择。学生团队竞争完成由同学领导的主题挑战。来自2022/23版的64名学生参加了焦点小组访谈(N = 11), 119名学生完成了一项调查(回复率为56.1%),该调查的指标是该计划的五个游戏元素的响应性和感知动机影响。结果表明,该计划的参与程度相对较高。学生们看重食物游戏,因为它让他们有机会展示自己的能动性和自主性,并与同伴一起在团队中工作,从而满足自我决定理论所描述的能力、关系和自主性的基本需求,并提供一种授权体验。《食物游戏》中最缺乏激励的游戏元素便是排行榜和团队间竞争。焦点小组的数据证实了学生们对项目中嵌入的竞争的矛盾心理,并指出了潜在的意想不到的后果,包括团队间的冲突、压力和游戏内在动机的降低。讨论了食物游戏化方法的优势和劣势,以及对预防研究和实践的影响。
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引用次数: 0
Correction: Containment Measures and Alcohol Consumption Among Drinking Higher Education Students Before and During the COVID-19 Pandemic: A Multilevel Analysis in 25 Countries. 更正:在COVID-19大流行之前和期间,饮酒高等教育学生的控制措施和酒精消费量:25个国家的多层次分析。
Pub Date : 2025-04-01 DOI: 10.1007/s10935-024-00823-w
Robert Tholen, Koen Ponnet, Guido Van Hal, Sara de Bruyn, Veerle Buffel, Sarah Van de Velde, Piet Bracke, Philippe Bos, Yildiz Akvardar, Petra Arnold, Heide Busse, Andreas Chatzittofis, Stefanie Helmer, Fatemeh Rabiee-Khan, Vera Skalicka, Theoni Stathopoulou, Marie-Pierre Tavolacci, Claudia van der Heijde, Edwin Wouters
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引用次数: 0
Risk Factors of At-Risk/Problem Gambling Among Young Adult Spanish Students. 西班牙青年学生中的 "濒危/问题赌博 "风险因素。
Pub Date : 2025-04-01 Epub Date: 2024-11-21 DOI: 10.1007/s10935-024-00814-x
A Krotter, R Secades-Villa, C Iza-Fernández, A González-Roz

The gambling industry in Spain has experienced sustained growth in recent years. This has raised concerns about its potential impact, particularly during emerging adulthood, which is a high-risk period for the development of problematic gambling behaviors. The aim of this study was to estimate the prevalence of problem gambling in young Spanish adults and to examine individual factors associated with at-risk or problem gambling. The participants were 2762 young adults studying at university and vocational schools (64.16% women, Mage = 19.47; SD = 1.64) recruited in three Spanish autonomous communities. Individuals completed an e-assessment including sociodemographic variables, gambling-related characteristics, and the Problematic Gambling Severity Index. A total of 3.51%, 2.14%, and 0.51% were low risk, moderate risk, and problem gamblers, respectively. Predictors of at-risk/problem gambling were early gambling onset (OR 0.790; 95% CI 0.672, .929), mixed versus offline modality gambling access (OR 2.216; 95% CI 1.396, 3.516), and having gambled in the previous year in a casino (OR 1.910; 95% CI 1.194, 3.056), sports betting (OR 1.597; 95% CI 1.003, 2.542), or electronic gaming machines (OR 2.111; 95% CI 1.064, 4.189). Gambling is ubiquitous in the general population and a high proportion of young adults present low and moderate risk of problem gambling. Addressing gambling is a public health challenge and policies to regulate it should be targeted at delaying the age of onset and restricting access to online gambling.

西班牙的博彩业近年来持续增长。这引起了人们对其潜在影响的关注,尤其是在新兴的成年期,这是发展问题赌博行为的高危期。本研究旨在估算问题赌博在西班牙年轻成年人中的流行率,并研究与高危赌博或问题赌博相关的个体因素。参与者是在西班牙三个自治区招募的 2762 名在大学和职业学校学习的年轻人(64.16% 为女性,Mage = 19.47; SD = 1.64)。他们完成了一项电子评估,内容包括社会人口变量、赌博相关特征和问题赌博严重程度指数。其中分别有 3.51%、2.14% 和 0.51% 的人属于低风险、中度风险和问题赌徒。高危/问题赌博的预测因素包括:赌博开始较早(OR 0.790; 95% CI 0.672, .929)、混合赌博方式与离线赌博方式(OR 2.216; 95% CI 1.396, 3.在过去一年中,曾在赌场(OR 1.910;95% CI 1.194,3.056)、体育博彩(OR 1.597;95% CI 1.003,2.542)或电子游戏机(OR 2.111;95% CI 1.064,4.189)中赌博。)赌博在普通人群中无处不在,有很大一部分年轻人存在低度和中度赌博问题风险。解决赌博问题是一项公共卫生挑战,规范赌博的政策应着眼于推迟开始赌博的年龄和限制网上赌博。
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引用次数: 0
Advancing Prevention Science: Three Years of the Journal of Prevention. 推进预防科学:预防杂志三年。
Pub Date : 2025-04-01 DOI: 10.1007/s10935-025-00838-x
Zila M Sanchez
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引用次数: 0
期刊
Journal of prevention (2022)
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