BMC Public Health最新文献

Background: Telephone support services are a viable means of providing population-level support to reduce health risk behaviours. While research exists on the effectiveness of Quitlines to reduce smoking, there is limited other research investigating whether telephone services can provide effective behaviour change support for people with a mental health condition for behaviours including physical activity, healthy eating, and weight management. The aims of this trial were to evaluate the effectiveness of referral of people with a mental health condition to a population-level telephone coaching service to improve health risk behaviours and increase attempts to do so.

Methods: A parallel-group randomised controlled trial was conducted. Participants with a mental health condition (N = 681) were assigned to a control (health information pack) or intervention group (information pack and referral by the research team to a coaching program). Data were collected via telephone surveys at baseline and six months post-recruitment. Primary outcomes were: (1) weekly minutes of moderate-to-vigorous physical activity, (2) daily fruit serves, (3) daily vegetable serves, and (4) attempted behaviour change/weight loss (yes/no; composite measure). Secondary outcomes included weight, Body Mass Index (BMI), and attempts to change each health behaviour individually.

Results: Intention-to-treat analyses found no significant differential change between groups from baseline to six months for primary or secondary outcomes. By follow-up, 242/549 (44%) of intervention participants had enrolled in coaching and completed at least one call, with 16/242 having completed the program, 79 ongoing, and 147 withdrawn. Per-protocol analyses found attempting to improve at least one health behaviour/lose weight was significantly greater in enrolees (OR = 3.7, 95% CI 1.03-13.23) than the control group.

Conclusions: Referral to the program did not improve risk behaviours or weight/BMI but did support behaviour change attempts. Contributing factors may include low program completion by follow-up and impact of COVID-19. Further research is required to better understand participation in and benefits of telephone coaching services for people with a mental health condition.

Trial registration: Registered retrospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12620000351910).

Background: Despite the relatively low prevalence of HIV/AIDS in Korea, the incidence of HIV is steadily increasing, centering on same-sex sexual contact among men in their 20s and 30s. However, in Korean society, where acceptance of homosexuality is low, LGBTQ + research is lacking and there is little empirical data on HIV transmission. This study explored the context in which anal intercourse occurs among male sexual minorities in Korea.

Methods: Data were collected by conducting a web survey targeting paid members of Korea's largest homosexuality portal site (n = 941). The dependent variable was whether anal intercourse was preferred, and the major independent variables were health behavior, health status, and sexual behavioral characteristics.

Results: Those who reported that their gender identity was homosexual tended to prefer anal sex more than those who reported that they were bisexual (Chi-square = 5.165, p <.05). For homosexuals that had more unprotected sex (OR = 1.538, 95% CI = 1.281-1.847), had a primary sex partner (OR = 1.943, 95% CI = 1.345-2.809), and had been diagnosed with an STD (OR = 2.978, 95% CI = 1.592-5.568), there was a high possibility of preferring anal intercourse. Bisexuals were more likely to prefer anal intercourse if they had unprotected sex (OR = 1.715, 95% CI = 1.322-2.225) or had a primary sex partner (OR = 1.927, 95% CI = 1.141-3.257).

Conclusions: This study found that young non-heterosexual men in South Korea are more likely to engage in condomless anal sex while living with HIV/STDs. As a result, primary partners are at higher risk of infection, and bisexual individuals are more likely to transmit HIV/STDs due to similar sexual contexts.

Background: The Trans-theoretical Model (TTM) has been applied in numerous empirical studies concerning physical activity (PA) interventions for children and adolescents. Consequently, the aim of this review is to identify and synthesize the evidence regarding the effectiveness of TTM-based interventions in promoting PA behavior change among this demographic, with the goal of informing future research and policy development.

Methods: A systematic review was performed followed the PRISMA guideline, protocol was registered in PROSPERO (CRD42023416216). Computer-based searches were conducted in the CNKI, Wan-Fang, VIP, Web of Science (WOS), PubMed, and EBSCO databases to identify relevant literature. Two researchers independently conducted the literature screening and quality assessment. The quality of the randomized controlled trials (RCTs) was evaluated using the Risk of Bias Assessment Tool version 5.1.0, as recommended by the Cochrane Collaboration Network. For quality assessment of quasi experiments (QEs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool was employed.

Results: A total of 22 articles were included in the systematic review. Stage-matched interventions and interventions designed based on a more complete structure of the TTM are more likely to promote an increase in the actual levels of PA among children and adolescents, as well as to facilitate an increase in their PA stages. Interventions that combine health information and health behavior feedback are more likely to promote an increase in actual PA levels and the advancement of PA stages; while interventions that include PA programs are more likely to facilitate improvements in health indicators.

Conclusion: The effectiveness of TTM-based PA behavior change interventions for children and adolescents depends on the specific measures employed. Interventions that are stage-matched and integrate multiple behavior change techniques using the complete TTM structure are more likely to enhance PA and its associated health benefits. However, there are several normative issues that remain. These include the misuse of incremental stages as a substitute for PA, neglect of stage specificity when applying the model, a lack of framework for behavior change techniques in targeted interventions, and an absence of a dynamic feedback process.

Background: Cholera persists as a global public health threat, endangering the lives of vulnerable societies including the MENA region where many countries are facing recent cholera outbreaks. The present study aimed to characterize the knowledge, attitude, and practices status related to cholera in six MENA countries in the MENA region.

Methods: A cross-sectional study was conducted using a structured, validated questionnaire and distributed across different social media platforms in Egypt, Sudan, Jordan, Syria, Lebanon, and Yemen between December 2022 and January 2023. Univariate and multivariate analyses were used to determine factors associated with knowledge, attitudes, and practices related to cholera.

Results: A total of 2971 participants were included in the study, of which 62.5% were females; with a mean age of 34.8 ± 12.3 years; 85.4% heard about cholera; and 1.9% experienced cholera infection during cholera outbreaks in their countries. Among those who heard about cholera, 50.7% had adequate knowledge, 67.3% had desirable attitudes, and 50.3% reported good practices. Multivariate analysis revealed that being older, highly educated, employed, working in the medical field, and living in an outbreak country were the significant predictors affecting good knowledge. Additionally, good attitudes were significantly increased by older ages, females, those working in the medical sector, and those living in an outbreak country. Whereas working in the medical sector and having a larger number of people living in the same house significantly decreased the practice scores.

Conclusions: Raising community awareness about fecal-oral diseases transmitted via contaminated food or water, such as cholera, is crucial. This can be achieved by organizing targeted awareness campaigns for the whole community. Furthermore, mandatory educational workshops and programs for medical professionals are essential, as they serve as role models for the community.

Objective: To understand the prevalence of food neophobia in preschool children and the factors that influence it.

Methods: This is a cross-sectional study based on attribution theory with 575 parents of preschool children aged 3 to 6 years in two public kindergarten in Yangzhou City, Jiangsu Province from December 2021 to January 2022. Parents completed the General Information Questionnaire, the Child Food Neophobia Scale, the Parent Temperament Questionnaire, and the Caregiver Feeding Style Questionnaire.

Results: The results of our study showed that the prevalence of severe food neophobia in preschool children was 20.69%. Childhood food allergy was a positive predictor of food neophobia; parents' own willingness to consume new foods was a negative predictor of childhood food neophobia. Authoritarian feeding style (compared to uninvolved parenting style), and easy temperament are protective factors for severe food neophobia in children. Difficult, slow to warm up temperament are risk factors for severe food neophobia in children.

Conclusions: Parental feeding style, child temperament, parents' own willingness to try new foods and food preparation, and children's history of food allergies are important factors influencing food neophobia. The results of the study can be used in the future to explore more variables related to food neophobia in children and to seek effective targets for intervention.

Background: The effect of pre-pregnancy intrauterine device (IUD) use on subsequent preterm birth (PTB) remains unclear. We aim to investigate the association between IUD use before pregnancy and subsequent PTB.

Methods: A total of 240,437 women who participated in the National Free Preconception Health Examination Project (NFPHEP) in Yunnan from 2013 to 2019 were included in the study. All study participants were classified into three groups according to their use of pre-pregnancy contraceptive methods: non-method users, IUD users, and other method users. We used a multivariable Poisson regression model to investigate the association between the use of an IUD before pregnancy and subsequent PTB. Further models analyzed the multiplicative and additive interactions between pre-pregnancy IUD use and county deprivation.

Results: Of all the participants, 45,374 (18.9%) used IUDs before pregnancy, 39,414 (16.4%) used other contraceptive methods, and 155,649 (64.7%) were non-method users. The overall PTB rate was 5.30% (95% confidence interval [95% CI], 5.20-5.38%), and women in the IUD group had a significantly lower PTB rate (4.86%, 95% CI 4.66-5.06%) than women in the non-method (5.42%, 95% CI 5.31-5.53%) and other method groups (5.33%, 95% CI 5.11-5.56%). IUD use before pregnancy was associated with a reduced risk of subsequent PTB (model 1: adjusted relative risk [aRR] 0.84, 95% CI 0.80 to 0.89; model 2: aRR 0.84, 95% CI 0.79 to 0.90). In counties with a normal level of development, IUD users had a 30% lower risk of subsequent PTB than non-users (aRR 0.70, 95% CI 0.63 to 0.78). Compared with non-IUD users (incuding non-method and other method users) from the least developed counties, those from counties with a normal level of socioeconomic development had the lowest risk of subsequent PTB (aRR 0.71, 0.62 to 0.82). The additive interaction between pre-pregnancy IUD use and low level of county development was statistically significant (relative excess risk due to interaction [RERI] -0.27, -0.41 to -0.14).

Conclusion: Pre-pregnancy IUD use is associated with a reduced risk of subsequent PTB. Pre-pregnancy IUD users in counties with a normal level of development were associated with a lower risk of subsequent PTB than their counterparts in the least developed countries.

Objective: This study examines the longitudinal influence of quarantine and the COVID-19 surge after quarantine was released on behavioral and mental problems among the Chinese university students.

Methods: A longitudinal observation design was utilized. There were 10 waves of surveys including the pre-quarantine period, the quarantine period, and the quarantine releasing period. The non-parametric linear mixed-effects model and generalized estimating equations were used to examine the association between the dependent and independent variables.

Results: Two-hundred and two (88.21%) participants completed 10 waves of the survey. The COVID-19 surge was positively associated with perceived severity for COVID-19 infection (β: 0.2162, p < 0.01), the quarantine period was negatively associated with perceived risk (β: -0.3632, p < 0.01). The quarantine was negatively associated with both behavior belief (β: -0.6164, p < 0.01) and outcome belief for lockdown (β: -0.0976, p < 0.01). The COVID-19 surge was only positively associated with behavior belief for the lockdown (β: 0.1073, p < 0.01). Both the COVID-19 surge and the quarantine periods were positively associated with mental disorders, and the standard β values were 0.2611 and 0.3846. The quarantine also had an influence on short sleep duration (β: 0.2681, p < 0.05).

Conclusion: This study yielded new information about the influence of the COVID-19 surge, the quarantine period and the period after quarantine was released on the behavioral and mental problems among Chinese university students. Policy changes and health education are essential for minimizing the adverse health effects of these responses. This may have important implications for policies and disease prevention strategies targeted at controlling COVID-19.

Background: Migraine is an extremely prevalent and disabling primary neurological disease worldwide. Although multiple forms of patient education for migraine management have been employed in the past decades, the quality and reliability of headache-related online videos targeting migraine patients remained unclear, particularly those in China. Therefore, in this study, our research team aimed to explore the overall quality and credibility of online videos concerning patient education on migraine treatment in China Mainland.

Methods: A total of 182 online videos concerning migraine treatment were retrieved from four most popular Chinese language online video platforms, including Douyin, BiliBili, Haokan Video, and Xigua Video. Our research team collected the producer identity and basic information of these videos, and then used two major score instruments, i.e., the Global Quality Score (GQS) scale and the DISCERN questionnaire, to evaluate the quality and reliability of its content. Subsequently, overall descriptive analysis and detailed comparison among specific video platforms and producers were performed. Finally, using the Spearman correlation coefficient, we also explored the potential correlation between video general information and video quality and reliability.

Results: The overall quality and reliability of the migraine-related information provided by online videos were poor, yet those uploaded to Douyin were relatively more satisfactory. Among all study videos, 10 encouraged patients to keep a headache diary, 12 warned about the risk of medication overuse, and 32 emphasized the preventive treatment of chronic migraine. However, the treatment recommendations proposed by video creators were highly heterogenous, with the most frequently mentioned pharmacological, non-pharmacological, and traditional Chinese medicine measures being Triptans (n = 57, 31.3%), massage (n = 40, 22.0%), and acupuncture (n = 31, 17.0%), respectively. We also observed slight positive correlations between video quality and the numbers of likes and comments received.

Conclusions: The results of our research revealed that the quality and reliability of Chinese language online videos focused on patient education for migraine treatment were inadequate, suggesting that viewers should treat these contents with caution. However, the prospects for video-based patient education remain promising. Implementing appropriate strategies, such as strengthening regulations on health-related videos and instituting a review process conducted by medical professionals, may elevate the overall quality and trustworthiness of medical information shared through online video platforms.

Background: Adverse childhood experiences (ACEs) increase individuals' risks of poor health across the life course. For children that suffer household-based ACEs, experiences in other settings such as schools have the potential to exacerbate or mitigate risks of poor health. However, few studies have examined such effects. This study aimed to examine relationships between household-based ACEs, school experiences and adult health outcomes.

Methods: A national cross-sectional household survey (N = 1,868 aged 18+) was undertaken in Wales using random quota sampling (November 2022 to March 2023). Measures included nine household-based ACEs; two measures of childhood school experience (having been bullied, sense of school belonging); and adult health outcomes (smoking, binge drinking, low mental wellbeing, mental illness, violence). Associations between ACEs, school experience and health outcomes were examined using chi squared tests and binary logistic regression.

Results: The proportion reporting both having been bullied and lower school belonging increased with ACE count (0 ACEs 6%, 4 + ACEs 51%). Higher ACE count was independently associated with increased risk of all adult health outcomes except binge drinking, while poorer school experience (having been bullied, lower school belonging) was associated with increased risk of low mental wellbeing, mental illness and violence victimisation. For example, adjusted odds of current mental illness rose to 3.98 in those reporting 4 + ACEs (vs. 0 ACEs) and 3.37 in those reporting both having been bullied and lower school belonging (vs. not bullied, higher school belonging). In individuals with 4 + ACEs, adjusted prevalence of current mental illness reduced from 44% in those reporting both having been bullied and lower school belonging to 19% in those reporting not having been bullied and higher school belonging.

Conclusions: For children who grow up in adverse home environments, exposure to further adversity at school may amplify risks of poorer health and life outcomes. However, schools are opportune settings for children who lack safety and support at home to recover from stress, develop resilience and access support. Trauma-informed approaches in schools that recognise the impacts of adversity and support children to overcome it have the potential to improve educational and health outcomes. Further research is needed to identify effective approaches.

Background: Private providers (PPs), rather than public facilities, are often the first point of contact in the health system for people with tuberculosis (TB). However, PP's potential for enhancing TB detection remains underutilized.

Methods: TB REACH is an initiative of Stop TB Partnership focused on improving TB detection and notification. We analyzed the results of interventions using private provider engagement (PPE) to impact TB detection and notification across four TB REACH funding waves from May 2018 through March 2022.

Results: Overall, 35 projects documented screening of 13,038,586 people for TB, referral of 384,364 (3% of those screened) for diagnostic testing, and testing of 332,266 (86%) people. In total, 64,456 all forms of TB were diagnosed, and 62,830 (97% of those diagnosed) were linked to treatment. To diagnose one person with TB, the overall number needed to screen and test was, respectively, 281 (range across projects: 2-8,705) and 7 (range across projects: 1-24). Twenty-five projects mapped 69,187 PPs, both formal and informal, and engaged 21,206 (31%) providers during the intervention period, 12,211 (58%) of whom actively referred at least one person with TB symptoms during the intervention period. During the implementation period, TB notifications in the intervention areas increased by 25% (n = 61,123; from 246,845 to 307,968), with 20% of the total TB notifications attributed to the PPE projects. The mean and median cost per person started on treatment through the PPE projects was USD 221 and USD 481 (range across projects: 23 - 8,689).

Conclusions: Our findings suggest that structured and targeted PPE enhances TB case finding and contribute in closing the gap of missing cases. These results emphasize the need for wider implementation and scale-up of PPE in the TB response.