BMC Public Health最新文献

Background: Globally, increasing numbers of adolescents use digital devices for learning, and this educational screen exposure may alter behavioral patterns and be associated with the rising prevalence of adolescent overweight. Limited research has examined the interrelationships among educational screen exposure, adolescent overweight, physical activity, and sleep quality. This study aims to assess the impact of educational screen exposure on adolescent overweight prevalence and to identify related mediating risk behaviors.

Methods: Data on 41,157 adolescents from 16 cities in China were from the Database of Youth Health. Body mass and height were measured to estimate body mass index. Physical activity and sleep quality data were collected using a self-administered questionnaire. We drew data from two waves (2015 and 2017) of adolescent health surveys, which coincided with China's online education policy since 2015. The implementation of this policy resulted in a substantial increase in adolescents' educational screen exposure, with the intensity of the policy implementation influenced by local Internet infrastructure. We allocated adolescents into exposure and control groups based on the local Internet penetration rate. Leveraging this policy-driven natural experiment, a difference-in-differences approach was then applied to compare changes in overweight prevalence, physical activity, and sleep quality before and after the policy implementation between these two groups.

Results: The increase in overweight prevalence of adolescents in the exposure group from 2015 to 2017 was 3.1% greater than those in the control group (Coef. 0.03, 95% CI: 0.01 to 0.05, p < 0.01). The exposure group showed significant reductions in physical activity frequency (Coef. -0.49, 95% CI: -0.52 to -0.45) and sleep quality (Coef. -0.06, 95% CI: -0.09 to -0.02). Mediation analyses suggested that reduced physical activity and sleep quality were plausible mediating variables linking educational screen exposure and overweight prevalence. Male adolescents experienced a greater increase in overweight associated with educational screen exposure compared to their peers (Coef. 0.026, 95% CI: 0.01 to 0.04).

Conclusions: Educational screen exposure may contribute to increased overweight in adolescents by reducing physical exercise and impairing sleep quality. Educators, guardians, and policymakers should consider effective measures to minimize the adverse impacts of educational screen exposure by promoting physical activities among adolescents.

Background: Providing sexual and reproductive (SRH) health education to youth can improve outcomes including knowledge of sexually transmitted infections and use of condoms. Programs integrating soccer and sexual health education have shown promise in improving HIV-related outcomes in African countries; however, little is known about programs in other regions of the world, using other sports, or focusing on other SRH outcomes. Therefore, the purpose of this scoping review is to identify and compare a broader spectrum of integrated programs and their outcomes.

Methods: Four databases were searched for articles mentioning SRH education, sports, adolescents, and synonyms of these concepts. References from articles selected for data extraction were also hand-searched. Articles were included in the review if they (1) reported on an intervention in which youth both play a sport and are explicitly taught a curriculum to improve any SRH outcome; (2) were published between 2000 and 2022; (3) reported quantitative outcome data; and (4) included participants between 10 and 24 years old. Two co-authors extracted data from the selected studies. Narrative synthesis and descriptive tables were used to summarize extracted data.

Results: Of 4,161 records identified by the search, 21 met the inclusion criteria. The majority of the programs were implemented in Africa (n = 13). Sports included football/soccer (n = 15), netball/basketball (n = 2), cricket (n = 2), and unspecified sports (n = 4). Most (n = 12) interventions were multi-session programs lasting up to 12 weeks. HIV/AIDS prevention (n = 16) and prevention of gender-based violence (n = 13) were the most common SRH topics. Seven studies included random assignment to treatment and control. Significant improvements were reported by most of the studies measuring HIV-related outcomes as well as all three studies reporting outcomes related to contraception or pregnancy. Less than half of the studies measuring gender roles, gender norms, or gender-based violence reported positive outcomes.

Conclusions: Integrated sport and SRH interventions show promise as a way to attract and engage youth in SRH programming. Additional research is needed to better understand the specific content, context, and implementation strategies that are associated with positive outcomes.

Online family drug prevention programs have been shown to affect the behavior of children and adolescents. This study presents the formative evaluation results of the online implementation of Familias Fortes, a Brazilian-adapted version of the Strengthening Families Program (SFP 10-14). A total of 31 families participated in the evaluation, and data were collected from 74 observations, 64 fidelity forms, 20 focus groups, and 16 semi-structured interviews in groups located in five cities with a total of 113 participants. The evaluation focused on three outcomes: fidelity, appropriateness, and feasibility. Low fidelity was observed, with videos and audio content not consistently sent as planned, although most core elements were maintained. The program's appropriateness showed good accessibility and utilization of video content by participants, but confidentiality was lacking in adolescent meetings. Feasibility analysis revealed challenges related to poor internet access, malfunctioning of facilitator cameras, issues with time management and internal organization of institutions, and insufficient facilitator training. Specific problematic activities were identified, and recommendations for improvement were made. This included enhancing internet connectivity, developing a new manual specific to the online format, improving time management for facilitators, providing more interactive facilitator training, and considering a hybrid format. Adaptations for the aforementioned difficulties are needed before an online version of Familias Fortes could be disseminated in Brazil as a pilot model.

Background: Accessibility is a key indicator for assessing the spatial configuration of elderly care institutions (ECIs). Identification of its spatial disparities is crucial for improving resource allocation efficiency and promoting healthy aging. However, existing accessibility evaluations have insufficient modeling precision in terms of adapting to dynamic traffic conditions and the actual needs of elderly people.

Methods: This study introduces a novel approach by integrating real-time navigation data, the elderly's preferences, and traditional accessibility evaluations to analyse the accessibility of ECIs at district and street-scale spatial units in Fuzhou, China. Using interpolation, trend, and cluster analyses in ArcGIS and SPSS software, we further identified the spatial disparity characteristics of elderly care institution accessibility.

Results: The results show that the current spatial distribution of ECIs does not adequately align with the demand distribution of elderly populations. This is manifested in several ways: (1) inefficient allocation of elderly care resources, as evidenced by the fact that while the central areas and their surroundings offer a greater number of accessible ECIs, these areas also have a higher elderly population densities and generally longer service access times; (2) significant spatial disparities in elderly care institution accessibility with polarized characteristics: central areas characterized by intensive development exhibit markedly higher accessibility compared to peripheral areas; (3) mismatches between supply and demand (i.e., accessibility of ECIs and elderly population) in certain urban local areas, specifically within and around central areas, as well as certain coastal areas.

Conclusion: These findings highlight the urgent need for implementing differentiated planning strategies and policy interventions to ensure a more equitable distribution of ECIs. The proposed method in this study provides urban planners and policymakers with a more refined scientific tool for effectively assessing the accessibility of ECIs, identifying shortcomings in resource allocation, and creating more age-friendly living environments. This approach can be adapted to support healthy aging initiatives in diverse urban contexts.