Journal of public health (Oxford, England)最新文献

Background: Perceived usability is a key determinant of eHealth intervention uptake. This study evaluated the usability of Alerta Alcohol 2.0, an animation-based, computer-tailored game designed to prevent alcohol use and binge drinking among adolescents.

Methods: A cross-sectional mixed-methods approach was employed, combining a self-report questionnaire and cognitive debriefing using the think-aloud protocol.

Results: Thirty-five participants (mean age = 16.57 years; 71.4% female) completed the five-session program. Results showed that older adolescents were more likely to recommend the intervention and perceived its length as more appropriate. Adolescents engaging in binge drinking responded more positively to the design and videos, found the difficulty level more suitable, and required less assistance. Participants with a positive general evaluation of the program scored higher on most of the 21 usability items than those with a negative evaluation. Key areas for improvement, such as repetitive questions, technical glitches, and text readability, were identified and addressed.

Conclusions: This study highlights the value of a systematic feasibility process, rooted in evidence and informed by adolescents' perspectives, to enhance program usability. Findings provide initial support for the usability of Alerta Alcohol 2.0 and inform future development of computer-tailored interventions targeting adolescent health behaviors.

Background: Publicly funded health insurance schemes aim to reduce financial barriers and improve access to care among underserved populations. This study explored the gaps and challenges in the implementation of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) among residents of an urban slum in Puducherry, South India.

Methods: A community-based cross-sectional study was conducted in 2023 among adults randomly selected from 273 households in an urban coastal slum in Puducherry, a Union Territory of India. Data were collected through face-to-face interview using a semi-structured questionnaire with domains on socio-demographic characteristics, awareness, and utilization of PMJAY scheme. Date were entered in real time using the Epicollect5 mobile application and analysed using IBM SPSS version 21.

Results: Out of 273 interviewed participants, 161 (59%) were aware of the scheme and 177 (65%) were eligible to avail the scheme. Among the 177 eligible households, 49% had registered and 14% had utilized the benefits under the scheme. Difficult registration procedure and limited coverage of services under the scheme with respect to empanelled hospitals and treatment package were reported as challenges.

Conclusions: Despite moderate awareness, registration, and utilization of PMJAY among urban slum dwellers remain low. Addressing system-level barriers and expanding coverage are essential for improving uptake among vulnerable populations.

Background: Since the end of New Labour's health inequality strategy, health inequalities in the UK have been widening. A recent critique suggested that New Labour policy actors were misdirected towards less effective solutions by the 'international consensus' understanding of health inequalities, which counterproductively medicalizes social inequality. This research explored whether social, economic and health policy actors at devolved levels shared this 'international consensus' policy frame of health inequality.

Methods: The Scottish Government and Greater Manchester Combined Authority were chosen as case study polities. Thirty-four policymakers were interviewed, and a frame analysis was conducted of thirty social, economic and health policy strategy texts, published between 2017 and 2022.

Results: The 'international consensus' policy frame was supported in these contexts by strong moral language, highlighting the social injustice of systematically distributed illness and death. However, political support was building behind health inequality framed in relation to 'illness-related economic inactivity' and 'healthcare for disadvantaged groups'. These two alternative frames using the same term directed policy solutions towards individual-level reactive healthcare, rather than population-level preventive public policy.

Conclusions: 'Health inequality' is understood in three competing ways in these policy settings. Alternative terms, such as 'social inequalities in health' and 'healthcare inequality', are preferable to minimize ambiguities.

Background: Community nursery nurses (CNNs) play a vital role in UK health visiting teams, promoting child development and school readiness. The Infant to School (I2S) programme, delivered by CNNs under health visitor supervision, provides structured early intervention for families facing adversity.

Aim: To formatively evaluate the I2S programme from the perspective of CNNs, focusing on short-term outcomes, reported effects on children and families, and impacts on CNNs.

Methods: Seventeen of twenty CNNs (85%) completed an anonymised questionnaire. Quantitative data were analysed descriptively, and qualitative responses were analysed thematically.

Findings: Between September 2023 and February 2025, 212 families participated in the I2S programme, with language development as the main concern. CNNs reported that I2S enhanced their confidence, skills, and job satisfaction, enabling more structured, culturally sensitive, and relationship-based support. All respondents reported helping families to set and achieve short-term goals and connect with community services; 88% reported building strong relationships. Key themes included improved professional competence, greater ability to support families, and identified areas for further training and resource development.

Conclusion: This evaluation contributes new insight into the role of CNNs in supporting school readiness through a structured, health visiting-embedded programme. Continued evaluation, incorporating parental and child outcome data, is required to assess long-term impact and scalability.

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. This study aimed to investigate the dose-response relationship between leisure-time physical activity (LTPA) and cardiovascular health, assessed by heart age and predicted 10-year CVD risk, and explore the mediating role of inflammatory regulation.

Methods: This cross-sectional study included 6658 individuals aged 30-74 years from National Health and Nutrition Examination Survey 2015-2018. Heatmap visualization assessed variable distributions, while generalized linear regression models (GLMs) and restricted cubic splines quantitatively examined the LTPA-cardiovascular health associations.

Results: Heatmap visualization revealed that, among the 26 variables evaluated, LTPA was inversely associated with heart age, predicted 10-year CVD risk, and odds ratio for high CVD risk. GLM analyses indicated that each additional hour per week of LTPA was associated with a 0.17-year reduction in heart age, a 0.07% decrease in predicted 10-year CVD risk, and a 5% lower odds for having high CVD risk. Vigorous-intensity LTPA showed stronger benefits than moderate activity. Systemic inflammation biomarkers significantly mediated the associations between LTPA and cardiovascular health.

Conclusions: The findings support a dose-dependent cardioprotective effect of LTPA, partially mediated through anti-inflammatory pathways. These results highlight the importance of promoting LTPA, particularly vigorous-intensity activity, for cardiovascular health promotion.

Objectives: This systematic review and meta-analysis aimed to compile and analyze available evidence to estimate the pooled prevalence of undernutrition (underweight, stunting, and wasting) among tribal children in India.

Methods: A comprehensive literature search was done using PubMed and Google Scholar and other web-based searches to find studies reporting the prevalence of undernutrition (underweight, stunting, and wasting) among tribal children of India. Out of 1606 identified studies, 58 met the eligibility criteria. Meta-analysis was performed using the inverse variance method, and the random effect model was used to estimate the pooled prevalence. The heterogeneity across studies was assessed using the I2 statistic.

Results: The meta-analysis revealed that the overall pooled prevalence of underweight among tribal children was 43.78% (95% CI: 38.80%-48.83%). The pooled prevalence of stunting and wasting was 43.16% (95% CI: 39.10%-47.26%) and 29.58% (95% CI: 25.59%-33.73%). The significant heterogeneity observed across studies was likely due to variations in study design, geographic location, and measurement methods.

Conclusion: This systematic review and meta-analysis highlight the alarmingly high burden of undernutrition among tribal children of India, with nearly half of the population being underweight and stunted and a substantial proportion suffering from wasting. These findings highlight the pressing need for tailored public health interventions that tackle the specific challenges encountered by tribal communities, including improving healthcare access, addressing poverty, and overcoming geographical barriers. Targeted interventions focusing on nutrition supplementation, health service accessibility, and socio-economic support are urgently recommended to reduce undernutrition in tribal children.

Background: A substantial disparity exists in cancer screening rates between individuals with and without physical disabilities, and there is a lack of information on the perceptions and experiences of cancer screening among individuals with disabilities and the factors influencing their participation.

Methods: In this cross-sectional descriptive study, data were collected from 167 individuals with physical disabilities in Korea, using a questionnaire survey. Data were analyzed using descriptive statistics, t-tests, ANOVA, chi-squared tests, Pearson's correlation, and multiple logistic regression analysis.

Results: The participation rate of individuals with physical disabilities in the national cancer screening program over the past 2 years was 55.1%. Perceived benefits of cancer screening were positive, whereas perceived barriers were lower than moderate. Self-efficacy regarding cancer screening was slightly above moderate. Individuals with prior health screening experience showed a significantly higher tendency to participate. Previous experience with health screening also led to differences in perceptions of cancer screening. Health screening experience and perceived benefits of cancer screening significantly influenced participation in national cancer screening.

Conclusions: To increase cancer screening participation among individuals with physical disabilities, it is crucial to not only reduce barriers to cancer screening but also enhance perceptions of its importance and benefits.

Background: While productivity loss has been studied in various populations, the impact of multimorbidity on workplace productivity at a population level remains understudied. This study estimates the productivity losses attributable to multimorbidity.

Method: Using data from four waves of the Household, Income and Labour Dynamics in Australia (HILDA) survey, we investigated the relationship between multimorbidity and productivity loss. Negative binomial and logistic regression models were employed to analyze absenteeism, presenteeism, and working hour tension as measures of productivity loss.

Results: We found a significant association between multimorbidity and increased absenteeism, presenteeism and working hour tension. After controlling for socio-economic, demographic, health, and workplace-related factors, individuals with multimorbidity had a 1.07-fold higher rate of absenteeism (incidence rate ratios: 1.07; 95% CI: 1.02-1.13) compared to those without serious illness. Their odds of experiencing presenteeism were three times higher, and the incidence of working hour tension was 32% higher. On average, the annual cost of absenteeism was AU$265.20 higher for individuals with multimorbidity than for those without serious illness.

Conclusion: Our results underscore the need for evidence-based workplace policies to support the productivity and well-being of employees living with multimorbidity.

Background: Community Network-Driven COVID-19 Testing and Vaccination of Vulnerable Populations in the Central United States (C3) evaluates the use of Social Network Strategy (SNS) with educational messaging to improve COVID-19 testing and vaccination among people most impacted by the pandemic.

Methods: We enrolled individuals with low-income who identify as Hispanic/Latino or a history of criminal legal involvement (CLI) through social network referral and randomized participants 1:1 to SNS vs. SNS plus messaging (SNS+), which included a self-affirmation activity and educational video. We assessed for COVID-19 testing and, among baseline unvaccinated participants, vaccination at 21 days, and used mixed effects logistic regression to examine outcomes.

Results: Of 1328 participants (SNS+: 667, SNS: 661), 46.6% identified as Black/African American, 33.4% as Hispanic/Latino, and 43.8% reported history of CLI. Majority (66.3%) reported testing and, of unvaccinated participants, 11.9% reported vaccination at follow-up. There were no differences in testing (aOR 0.89, 95% CI 0.71, 1.11, P = .49) or vaccination (aOR 1.46, 95% CI 0.78, 2.76, P = .30) among participants who received SNS+ compared to SNS after adjusting for recruitment wave and clustering within sites and referral chains.

Conclusions: Social network referral successfully engaged communities disproportionately impacted by COVID-19 in testing and vaccination. Compared to SNS alone, adding educational messaging did not increase testing or vaccination. Additional work is needed to implement SNS to increase vaccination rates among vulnerable populations.