International Journal of Environmental Research and Public Health

10 pages, 249 KiB

Open AccessArticle

The Relationship Between Methadone and Buprenorphine Enrollment and Overdose Prevention and Treatment Behaviors Among a Community Sample of People Who Use Opioids in Baltimore, Maryland

by Carl A. Latkin, Lauren Dayton, Melissa Davey-Rothwell and Abenaa Jones

Int. J. Environ. Res. Public Health 2025, 22(2), 213; https://doi.org/10.3390/ijerph22020213 - 3 Feb 2025

Viewed by 161

Abstract

Background: Methadone and buprenorphine can reduce overdose-related mortality. Behavioral approaches can also reduce fatal overdoses. The current study examined the relationship between methadone and buprenorphine and overdose history and overdose prevention and treatment behaviors. Methods: Between December 2022 and August 2024, 647 individuals [...] Read more.

Background: Methadone and buprenorphine can reduce overdose-related mortality. Behavioral approaches can also reduce fatal overdoses. The current study examined the relationship between methadone and buprenorphine and overdose history and overdose prevention and treatment behaviors. Methods: Between December 2022 and August 2024, 647 individuals who used opioids in the prior month enrolled in a community recruited study on overdose. Participants were administered a face-to-face survey. Key behaviors assessed included overdose recency, testing drugs for potency, ingesting drugs slowly, using fentanyl test strips, using drugs alone, and carrying naloxone. Chi-square and logistic regression models examined the relationships between methadone and buprenorphine and overdose-related outcomes. Results: In total, 32.9% of participants were currently taking methadone and 15.5% buprenorphine. Most (69.2%) reported ever overdosing, and among those, 33.7% had overdosed within the prior 6 months. There were no significant associations between methadone or buprenorphine status and overdose prevention and care behaviors. In the multivariable logistic regression model, methadone use was associated with a lower odds ratio (aOR = 0.49, 95% CI = 0.30–0.79of a recent overdose compared to buprenorphine. Daily or almost daily crack use was associated with greater odds of a recent overdose (aOR = 2.21, 95% CI = 1.44–3.39. Discussion: Findings suggest the importance of promoting overdose prevention and care behaviors to people in drug treatment and training them to promote overdose prevention and care behaviors among their drug-using network members and other community members. Full article

24 pages, 950 KiB

Open AccessSystematic Review

Interventions Addressing Health Literacy in Cancer Care: A Systematic Review of Reviews

by Celine Jeitani, Stephan Van den Broucke and Charlotte Leemans

Int. J. Environ. Res. Public Health 2025, 22(2), 212; https://doi.org/10.3390/ijerph22020212 - 2 Feb 2025

Viewed by 270

Abstract

(1) Background: Interventions addressing the health literacy (HL) of people suffering from an illness such as cancer can improve the understanding of the illness and lead to better-adapted behaviors, regarding the participation in cancer screenings, adhering to the complex multimodal therapy, participating in [...] Read more.

(1) Background: Interventions addressing the health literacy (HL) of people suffering from an illness such as cancer can improve the understanding of the illness and lead to better-adapted behaviors, regarding the participation in cancer screenings, adhering to the complex multimodal therapy, participating in cancer treatment, and self-managing everyday health. This study provides a review of systematic reviews that include intervention articles addressing the HL of patients, healthcare professionals, and/or organizations in cancer, to identify the factors related to their effectiveness, as well as the missing elements, in light of the recent developments in HL research and practice. (2) Methods: A literature search was performed in Embase, Pubmed, PsycINFO, and Science Direct. Existing published reviews of studies targeting the interventions in the oncology domain, and which explicitly mentioned HL as a factor/outcome, were included. (3) Results: One hundred and fifty-five studies were retrieved. Ten fit the criteria and were included in this review. (4) Conclusions: Most of the interventions addressing HL in people with cancer included the target patients’ information and communication skills through education. To keep the full scope of the concept, as investigated in the recent literature, clinical applications of HL in patients with cancer should also consider organizational HL. Full article

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14 pages, 721 KiB

Open AccessArticle

Determinants of Safe Pesticide Handling and Application Among Rural Farmers

by Olamide Stephanie Oshingbade, Haruna Musa Moda, Shade John Akinsete, Mumuni Adejumo and Norr Hassan

Int. J. Environ. Res. Public Health 2025, 22(2), 211; https://doi.org/10.3390/ijerph22020211 - 2 Feb 2025

Viewed by 238

Abstract

The study investigated the determinants of safe pesticide handling and application among farmers in rural communities of Oyo State, ssouthwestern Nigeria. A cross-sectional design utilizing 2-stage cluster sampling techniques was used to select Ido and Ibarapa central Local Government Areas and to interview [...] Read more.

The study investigated the determinants of safe pesticide handling and application among farmers in rural communities of Oyo State, ssouthwestern Nigeria. A cross-sectional design utilizing 2-stage cluster sampling techniques was used to select Ido and Ibarapa central Local Government Areas and to interview 383 farmers via a structured questionnaire. Data were analyzed using descriptive statistics and logistic regression at p = 0.05. Results showed that 41.8% of the farmers had been working with pesticides on farms for at least 5 years, 33.0% attended training on pesticide application, 73.5% had good safety and health knowledge, and 72.3% had safe pesticide handling and application practices. About half (50.2%) stated that they wear coveralls, gloves, and masks to protect their body, face, and hands when applying pesticides, 9.8% use empty pesticide containers for other purposes in the house/farm, while 11.5% blow the nozzle with their mouth to unclog it if it becomes blocked. The three major health symptoms reported by the participants were skin irritation (65.0%), itchy eyes (51.3%), and excessive sweating (32.5%). Having attended training on pesticide application and use enhanced (OR = 2.821; C.I = 1.513–5.261) practicing safe pesticide handling and application. Farmers with good knowledge (OR = 5.494; C.I = 3.385–8.919) were more likely to practice safe pesticide handling and application than those with poor knowledge about pesticide use. It is essential to develop and deliver mandatory comprehensive training programs for farmers on impacts of pesticides on health and environment, along with sustainable safe handling, application, and disposal of pesticides using proper waste management techniques and recognizing early signs and seeking medical assistance. The urgent need to strengthen policy to regulate pesticide use and limit farmers’ access to banned products is also key. Full article

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16 pages, 344 KiB

Open AccessArticle

The Predisposition of Men Who Have Sex with Men to Use Post-Exposure Prophylaxis for HIV in a Capital City in Northeast Brazil

by André Felipe de Castro Pereira Chaves, Yndiara Kássia da Cunha Soares, Eugênio Barbosa de Melo Júnior, Rosilane de Lima Brito Magalhães, Shirley Verônica Melo Almeida Lima, Paulo de Tarso Moura Borges and Telma Maria Evangelista de Araújo

Int. J. Environ. Res. Public Health 2025, 22(2), 210; https://doi.org/10.3390/ijerph22020210 - 2 Feb 2025

Viewed by 274

Abstract

The aim of this study was to analyze the predisposition and factors associated with the use of Post-Exposure Prophylaxis (PEP) for HIV in men who have sex with men (MSM). This was a cross-sectional study conducted in the city of Teresina, Piauí, Brazil, [...] Read more.

The aim of this study was to analyze the predisposition and factors associated with the use of Post-Exposure Prophylaxis (PEP) for HIV in men who have sex with men (MSM). This was a cross-sectional study conducted in the city of Teresina, Piauí, Brazil, between January and July 2024. The study sample consisted of 320 MSM. A questionnaire consisting of 37 previously validated questions and a risk perception scale for HIV with eight questions were used. To explain which factors would be associated with predisposition to the use of PEP, a logistic regression analysis was applied with an odds ratio. The criterion for including variables in the logistic model was an association at the 20% level (p ˂ 0.20) in the bivariate analysis. Statistical significance in the final model was set at 5%. Although the vast majority of MSM reported a willingness to use PEP (94.4%), their knowledge about prophylaxis and their HIV risk perceptions were largely unsatisfactory. It was found that living alone reduces the chances of predisposition to PEP use by 75% (AOR = 0.25; p = 0.01), and using a condom during oral sex reduces the chances of predisposition to PEP use by 91% (AOR = 0.09; p < 0.001). In light of this, the importance of greater investments in health education actions that reinforce the mechanisms of HIV transmission, as well as the use of methods for its prevention, is highlighted. In addition, targeted interventions are needed to improve knowledge about PEP and HIV risk perception. Full article

(This article belongs to the Special Issue Infection Prevention and Control in Health Care)

16 pages, 280 KiB

Open AccessArticle

Perceived Barriers and Enablers for Taking Iron–Folic Acid Supplementation Regularly Among Adolescent Girls in Indonesia: A Pilot Study

by Healthy Hidayanty, Nurzakiah Nurzakiah, Irmayanti Irmayanti, Yuliana Yuliana, Helmizar Helmizar and Yahya Yahya

Int. J. Environ. Res. Public Health 2025, 22(2), 209; https://doi.org/10.3390/ijerph22020209 - 1 Feb 2025

Viewed by 313

Abstract

Non-compliance with iron and folic acid (IFA) supplementation is a significant contribution to the high prevalence of anemia among adolescent girls in Indonesia. This pilot study aims to explore the perceived barriers and enablers to regular IFA supplement consumption among adolescent girls. Using [...] Read more.

Non-compliance with iron and folic acid (IFA) supplementation is a significant contribution to the high prevalence of anemia among adolescent girls in Indonesia. This pilot study aims to explore the perceived barriers and enablers to regular IFA supplement consumption among adolescent girls. Using a qualitative approach, data were collected through focus group discussions (FGDs) conducted in Makassar and Padang City. The FGD involved 32 grade eight and nine students from four junior high schools. In-depth interviews were also conducted with health workers, teachers, and parents to triangulate the findings. A thematic analysis was performed using a social cognitive theory framework. The average age of the informants was 13.6 ± 0.6 years. Despite receiving IFA supplements at school, only 47% of informants reported consuming them regularly. Key barriers to regular supplementation included dislike of the taste and smell, parental prohibition, negative experience consuming IFA supplements, the belief that IFA supplements increase menstrual blood flow and volume, and forgetfulness factors. Enablers include self-awareness of the supplement’s benefits, trust in school-provided supplements, and positive support from parents and peers. The findings highlight that both barriers and enablers play a crucial role in influencing IFA supplementation adherence. Addressing these factors is essential for improving compliance and reducing anemia rates among adolescent girls. Given the small sample size and convenience sampling method, this study serves as a pilot, and further research is needed to validate these findings on a larger scale. Full article

21 pages, 768 KiB

Open AccessArticle

Temporal Trends in Stomach and Colorectal Cancer Mortality by Racial Groups in Brazil (2000–2023): A Longitudinal Ecological Study

by Karina Cardoso Meira, Raphael Mendonça Guimarães and Nathalia Sernizon Guimarães

Int. J. Environ. Res. Public Health 2025, 22(2), 208; https://doi.org/10.3390/ijerph22020208 - 31 Jan 2025

Viewed by 431

Abstract

Abstract: This longitudinal ecological study analyzed racial disparities in mortality trends for stomach cancer (SC) and colorectal cancer (CRC) in Brazil (2000 to 2023) stratified by sex. Data from the National Mortality Information System were analyzed for individuals aged 25 to 80. Self-reported [...] Read more.

Abstract: This longitudinal ecological study analyzed racial disparities in mortality trends for stomach cancer (SC) and colorectal cancer (CRC) in Brazil (2000 to 2023) stratified by sex. Data from the National Mortality Information System were analyzed for individuals aged 25 to 80. Self-reported race/skin color followed the Brazilian Institute of Geography and Statistics classification: White (White group) and Black or Brown/multiracial (Black group). Age-standardized mortality rates used the world population as a reference, and Prais–Winsten autoregression calculated trends. SC mortality rates declined for both sexes and racial groups, with a greater reduction in the Annual Percent Change (APC) among Whiteindividuals. Conversely, CRC mortality rates increased, with the Black group showing a higher percentage increase in APC. Despite progress in reducing SC mortality, disparities persist, particularly for CRC, where Black populations experience worse outcomes. Higher SC and CRC mortality rates were observed among White individuals, but the trends highlight the growing burden of CRC in Black populations. These findings emphasize the urgent need to address racial disparities in cancer outcomes, as they remain a critical public health challenge despite advancements in healthcare access and disease control in Brazil. Full article

(This article belongs to the Section Environmental Health)

15 pages, 486 KiB

Open AccessArticle

A Panel of Diverse Inflammatory Biomarkers Is Not Associated with BMI-Calibrated Obesity nor with Dyslipidemia or Dysglycemia in Clinically Healthy Adults Aged 20 to 40 Years

by Mai S. Sater, Zainab H. A. Malalla, Muhalab E. Ali and Hayder A. Giha

Int. J. Environ. Res. Public Health 2025, 22(2), 207; https://doi.org/10.3390/ijerph22020207 - 31 Jan 2025

Viewed by 302

Abstract

Objectives: Low-grade metabolic inflammation is associated with several chronic metabolic disorders, including obesity. However, no concrete evidence that supports obesity as a direct cause of chronic inflammation. This study aims to identify the association of inflammation with obesity in apparently healthy adults. Methods: [...] Read more.

Objectives: Low-grade metabolic inflammation is associated with several chronic metabolic disorders, including obesity. However, no concrete evidence that supports obesity as a direct cause of chronic inflammation. This study aims to identify the association of inflammation with obesity in apparently healthy adults. Methods: In this study, 162 seemingly healthy volunteers, aged between 20 and 40 years, of comparable sex ratio, were recruited and categorized based on their body mass index (BMI) into four obesity scales: normal (N), overweight (OW), obese (OB), and severely obese (SOB). After clinical examination, fasting blood samples were collected from the study subjects for glycemic (fasting blood glucose—FBG, and HbA1c) and lipid (total cholesterol, LDL-C, HDL-C, and triacyl glycerides -TAG) profile analysis. In addition, plasma levels of a panel of diverse inflammatory biomarkers, IL6, IL8, procalcitonin (PCT), TREM1, and uPAR were analyzed by sandwich ELISA. Results: The results showed that LDLC, TAG, FBG, and HbA1c were significantly higher in the obese (OB and SOB) group, compared to the non-obese (N and OW) group, while HDLc was significantly lower. The biomarker levels were not correlated with age or significantly differed between males and females. Importantly, levels of all assessed inflammatory biomarkers were comparable between the obesity classes. Moreover, the assessed biomarkers in subjects with dyslipidemia or dysglycemia were comparable to those with normal profiles. Finally, the biomarker levels were not correlated with the obesity, glycemic, or lipidemic parameters. Conclusions: After correction for age and co-morbidities, our results deny the association of discrete obesity, probably dyslipidemia, and dysglycemia with systemic chronic inflammation. Further studies of local and systemic inflammation in non-elderly, healthy obese subjects are needed. Full article

18 pages, 545 KiB

Open AccessArticle

Qualitative Evaluation of a Garden-Based Healing and Learning Program for Young Adults with Intellectual Disabilities

by Dohun Kim, Eunyeong Park, Hojun Yun, Yumi Baek, Hyeyoung Jin and Hyeryeong Cho

Int. J. Environ. Res. Public Health 2025, 22(2), 206; https://doi.org/10.3390/ijerph22020206 - 31 Jan 2025

Viewed by 266

Abstract

This study investigated the impact of garden-based learning on young adults with intellectual disabilities (YAwID). Since YAwID often experiences difficulties collecting information, experiencing situations, and making decisions independently, we developed and implemented a customized learning program for them and analyzed its impact. This [...] Read more.

This study investigated the impact of garden-based learning on young adults with intellectual disabilities (YAwID). Since YAwID often experiences difficulties collecting information, experiencing situations, and making decisions independently, we developed and implemented a customized learning program for them and analyzed its impact. This program was devised specially to help YAwID utilize the garden’s resources properly. The findings showed that garden-based learning generated specific changes in the knowledge, skills, and attitudes of YAwID, such as emotional healing to recover psychological stability, social healing through social relationships, physical healing through new activities, and independent healing through individualized plans. Participants experienced sympathizing with others and maintaining positive relationships and obtained the knowledge, skills, and attitudes necessary for behaving responsibly through gardening. Garden-based learning utilizing flowers and plants enhanced participants’ physical and mental health, improved their functioning, and helped them adapt to the environment and integrate into society. Our program can be considered a form of vocational training by which people with disabilities can enhance their employability by learning gardening skills, promoting their participation in society, and improving their quality of life. Hence, garden-based learning may transform people’s perception of disability and help people with disabilities respond to challenges. Full article

12 pages, 279 KiB

Open AccessReview

Mental and Physical Well-Being of Partners of People Living with Chronic Pain: A Narrative Review

by Toby R. O. Newton-John, Shari Cave and Debbie J. Bean

Int. J. Environ. Res. Public Health 2025, 22(2), 205; https://doi.org/10.3390/ijerph22020205 - 31 Jan 2025

Viewed by 323

Abstract

This narrative review aims to explore the mental and physical well-being of partners of individuals living with chronic pain. Chronic pain not only affects those who suffer from it, but also significantly impacts the lives of their partners; however, the impacts on partners [...] Read more.

This narrative review aims to explore the mental and physical well-being of partners of individuals living with chronic pain. Chronic pain not only affects those who suffer from it, but also significantly impacts the lives of their partners; however, the impacts on partners are not well recognised, despite extensive evidence indicating that their quality of life can be equally affected. This review synthesises current literature to identify the psychological and physical challenges faced by these partners, including increased stress, anxiety, depression, and the potential for developing chronic health conditions themselves. A search of Medline for “chronic pain” and “partner/spouse” from January 1990 to the present was performed, and relevant articles were selected for review. The main findings were that while partners often experience a range of negative physical and psychosocial impacts on their quality of life, dyadic coping strategies can mitigate these effects. This review underscores the importance of future research to develop targeted interventions that address the unique needs of this population, promoting better health outcomes and fostering resilience in the face of chronic pain. Full article

(This article belongs to the Special Issue The Mental Well-Being of Caregivers: Impacts, Benefits and Advancements)

18 pages, 1350 KiB

Open AccessReview

The Health and Well-Being of Women and Girls Who Are Refugees: A Case for Action

by Jinane Chalouhi, David C. Currow, Nuhad Yazbik Dumit, Shailendra Sawleshwarkar, Nancy Glass, Sophie Stanfield, Michelle Digiacomo and Patricia M. Davidson

Int. J. Environ. Res. Public Health 2025, 22(2), 204; https://doi.org/10.3390/ijerph22020204 - 31 Jan 2025

Viewed by 661

Abstract

The plight of displaced people is an escalating global challenge. No longer solely the domain of individuals working in humanitarian settings, the plight of refugees is now a very visible aspect in mainstream health and social services. Refugee women and girls face serious [...] Read more.

The plight of displaced people is an escalating global challenge. No longer solely the domain of individuals working in humanitarian settings, the plight of refugees is now a very visible aspect in mainstream health and social services. Refugee women and girls face serious and interconnected health challenges due to forced displacement, limited access to healthcare, gender-based violence, exploitation, and other factors affecting their health and well-being, particularly social determinants of health. These experiences are often built upon intergenerational forms of abuse such as enduring colonial and patriarchal models where there are fundamental power imbalances and impediments to economic and political stability and as a consequence health and well-being. One in five displaced women and girls experiences sexual violence, which has lasting effects on their physical and mental health. Moreover, financial instability and uncertainty in migration status can further push women and girls into exploitative circumstances, such as modern slavery and survival sex. This paper presents a scoping review using a gender-based lens aimed at analyzing the social determinants impacting the health and well-being of refugee women and girls. The environmental, socio-economic, cultural, and gender-specific drivers of security are described. Advocating for strategies to promote health equity, protection, resilience, and empowerment for refugee women and girls is important for their health and well-being. Achieving this is critical in contributing towards building stronger, healthier, and resilient communities, and creating a buffer to the escalating numbers of people being driven from their homes worldwide. Full article

(This article belongs to the Special Issue Creating the Future We Expect: Enhancing Women’s Health, Well-Being, and Gender Equality)

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20 pages, 556 KiB

Open AccessArticle

Disrupted and Disconnected Post Disaster: Associations Between the Social and Built Environment and Loneliness During COVID-19 in a U.S. Gulf Coast Sample

by Samer Atshan, Lynsay Ayer, Andrew M. Parker, JoNell Strough and Bonnie Ghosh-Dastidar

Int. J. Environ. Res. Public Health 2025, 22(2), 203; https://doi.org/10.3390/ijerph22020203 - 31 Jan 2025

Viewed by 282

Abstract

Loneliness, a significant public health issue, was exacerbated during the COVID-19 pandemic, particularly in disaster-prone regions like the U.S. Gulf Coast. This study examined how social and built environmental factors were associated with pandemic-related disruptions and loneliness among respondents from the third wave [...] Read more.

Loneliness, a significant public health issue, was exacerbated during the COVID-19 pandemic, particularly in disaster-prone regions like the U.S. Gulf Coast. This study examined how social and built environmental factors were associated with pandemic-related disruptions and loneliness among respondents from the third wave of the Survey of Trauma, Resilience, and Opportunity among Neighborhoods in the Gulf (STRONG). Using a retrospective measure of loneliness (pre-pandemic vs. during pandemic), we found that loneliness increased significantly during the pandemic. Using a measure of routine behavior disruptions and measures of both objective (e.g., parks, walkability, etc.) and subjective (e.g., neighborhood safety, social cohesion, etc.) environmental factors, we found that disruptions to daily routines strongly predicted higher loneliness, and subjective measures, such as neighborhood safety, social cohesion, and lacking post-disaster social support, were more salient predictors of loneliness than objective factors such as the number of parks in one’s neighborhood. Difficulty accessing green spaces and housing distress were linked to greater COVID-19 disruptions, indirectly contributing to loneliness. These findings highlight the importance of safe, supportive, and accessible social and physical environments in mitigating loneliness and enhancing community resilience during crises. Full article

(This article belongs to the Special Issue Healthy Spaces, Healthy Lives: Analyzing the Role of Built Environment on Human Health)

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30 pages, 2377 KiB

Open AccessReview

Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?

by Alessandra Rigo, Elena Pisani and Laura Secco

Int. J. Environ. Res. Public Health 2025, 22(2), 202; https://doi.org/10.3390/ijerph22020202 - 30 Jan 2025

Viewed by 548

Abstract

Green Care initiatives (GCIs) encompass various interventions that support physical, mental, and social well-being through interaction with nature. Integrating GCIs into conventional healthcare systems is a complex task that requires multi-actor and multi-level governance efforts. This study examines, through a systematized literature review, [...] Read more.

Green Care initiatives (GCIs) encompass various interventions that support physical, mental, and social well-being through interaction with nature. Integrating GCIs into conventional healthcare systems is a complex task that requires multi-actor and multi-level governance efforts. This study examines, through a systematized literature review, the relevant governance dimensions to facilitate the inclusion of GCIs in traditional care pathways. From the analysis of the 36 selected studies, four key dimensions were identified: organizational structure, knowledge, legitimacy, and decentralization. The analysis highlights the need to strengthen the responsibility of Green Care actors as healthcare service providers, enhance local authorities’ role in creating new integrated service delivery networks, combine different knowledge perspectives, and legitimize non-healthcare actors. Recommendations are made to address these governance aspects to facilitate the integration of GCIs and channel their benefits in prevention and health promotion. Adopting an adequate governance framework is fundamental for mainstreaming GCIs in current healthcare systems. Full article

(This article belongs to the Section Environmental Sciences)

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21 pages, 553 KiB

Open AccessArticle

Impact of Physical Activity on Health Behavior Change and Mental Health During the COVID-19 Epidemic Among Chinese Adults: China Health and Retirement Longitudinal Study (CHARLS)

by Wupeng Yin, Niliarys Sifre-Acosta, Daisy Chamorro, Susmita Chowdhury and Nan Hu

Int. J. Environ. Res. Public Health 2025, 22(2), 201; https://doi.org/10.3390/ijerph22020201 - 30 Jan 2025

Viewed by 536

Abstract

Background: The COVID-19 pandemic caused significant disruptions to daily life, affecting regular physical activity (PA) and health behaviors worldwide. This study investigates the associations between PA domains and changes in health behaviors and mental health outcomes among middle-aged and old Chinese adults. Methods: [...] Read more.

Background: The COVID-19 pandemic caused significant disruptions to daily life, affecting regular physical activity (PA) and health behaviors worldwide. This study investigates the associations between PA domains and changes in health behaviors and mental health outcomes among middle-aged and old Chinese adults. Methods: Using wave 5 cross-sectional data from the 2020 China Health and Retirement Longitudinal Study, we analyzed 17,180 adults aged 45 and above, focusing on health behavior changes such as smoking, alcohol consumption, dietary adjustments, and panic purchasing, as well as mental health outcomes like anxiety and fear. PA was classified by intensity levels—light, moderate, and vigorous—and by activity purposes—total, leisure, and occupational. Results: The findings indicate that leisure PA is associated with healthier behaviors, including lower odds of increased smoking (OR = 0.71, 95% CI: 0.57–0.90) and alcohol consumption (OR = 0.70, 95% CI: 0.54–0.90), whereas occupational PA is linked to adverse behavioral outcomes, such as higher odds of smoking (OR = 1.45, 95% CI: 1.15–1.83) and alcohol use (OR = 1.43, 95% CI: 1.10–1.86). Additionally, participants engaged in all domains of PA were more likely to experience anxiety and fear compared to those who were physically inactive. Conclusions: Our limited understanding of the role PA has on behavioral and mental health during public health crises highlights the importance of having tailored strategies to enhance resilience in similar future scenarios. Full article

(This article belongs to the Section Exercise and Health-Related Quality of Life)

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15 pages, 1341 KiB

Open AccessArticle

Racial and Economic Disparities in High-Temperature Exposure in Brazil

by Hosana Gomes da Silva and Weeberb J. Requia

Int. J. Environ. Res. Public Health 2025, 22(2), 200; https://doi.org/10.3390/ijerph22020200 - 30 Jan 2025

Viewed by 504

Abstract

Primary studies analyzing the distribution of exposure to the consequences of climate change among different vulnerable groups are scarce. This study addresses this gap by investigating racial and economic disparities in high-temperature exposure in Brazil, focusing on the impact on vulnerable subpopulations. We [...] Read more.

Primary studies analyzing the distribution of exposure to the consequences of climate change among different vulnerable groups are scarce. This study addresses this gap by investigating racial and economic disparities in high-temperature exposure in Brazil, focusing on the impact on vulnerable subpopulations. We utilized georeferenced temperature data from the Global High-Resolution Estimates of Extreme Heat (GEHE) and population data from the 2010 Census. The disparity analyses included (i) estimating the exposure rate to temperatures exceeding 28 °C, expressed as population-weighted heat exposure (

\bar{P H E}

); (ii) determining the difference in exposure between the most and least exposed groups; and (iii) calculating weighted Gini coefficients. The findings reveal that low-income and black, brown, and indigenous populations are predominantly the most exposed to

\bar{P H E}

exceeding 28 °C. Nationally, the indigenous population is the most exposed racial group, with a

\bar{P H E}

47% higher than that of the white population. Stratified analyses indicate that, despite varying climatic and environmental conditions across regions, the black-brown-indigenous population consistently faces the highest heat exposure in Brazil. Income disparity analyses show that the lowest per capita income groups are the most exposed to high temperatures across the country. The study highlights the impact of climate change on economic inequality and the deepening of within-country inequalities, particularly affecting socioeconomically disadvantaged groups. These findings underscore the urgent need for evidence-informed public policies to address racial and economic disparities in high-temperature exposure, mitigate health risks associated with climate change, and emphasize the importance of context-sensitive analyses for a comprehensive understanding of heat-related risks and public health. Full article

(This article belongs to the Special Issue Environmental Epidemiology and Spatial Analysis)

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14 pages, 2119 KiB

Open AccessReview

Exploring Human–AI Dynamics in Enhancing Workplace Health and Safety: A Narrative Review

by Jakub Fiegler-Rudol, Karolina Lau, Alina Mroczek and Janusz Kasperczyk

Int. J. Environ. Res. Public Health 2025, 22(2), 199; https://doi.org/10.3390/ijerph22020199 - 30 Jan 2025

Viewed by 543

Abstract

Background: Artificial intelligence (AI) is revolutionizing occupational health and safety (OHS) by addressing workplace hazards and enhancing employee well-being. This review explores the broader context of increasing automation and digitalization, focusing on the role of human–AI interaction in improving workplace health, safety, and [...] Read more.

Background: Artificial intelligence (AI) is revolutionizing occupational health and safety (OHS) by addressing workplace hazards and enhancing employee well-being. This review explores the broader context of increasing automation and digitalization, focusing on the role of human–AI interaction in improving workplace health, safety, and productivity while considering associated challenges. Methods: A narrative review methodology was employed, involving a comprehensive literature search in PubMed, Embase, and Scopus for studies published within the last 25 years. After screening for relevance and eligibility, a total of 52 articles were included in the final analysis. These publications examined various AI applications in OHS, such as wearable technologies, predictive analytics, and ergonomic tools, with a focus on their contributions and limitations. Results: Key findings demonstrate that AI enhances hazard detection, enables real-time monitoring, and improves training through immersive simulations, significantly contributing to safer and more efficient workplaces. However, challenges such as data privacy concerns, algorithmic biases, and reduced worker autonomy were identified as significant barriers to broader AI adoption in OHS. Conclusions: AI holds great promise in transforming OHS practices, but its integration requires ethical frameworks and human-centric collaboration models to ensure transparency, equity, and worker empowerment. Addressing these challenges will allow workplaces to harness the full potential of AI in creating safer, healthier, and more sustainable environments. Full article

(This article belongs to the Special Issue Navigating the AI-Driven Workplace: Emerging Challenges and Innovative Solutions in Occupational Health and Safety)

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16 pages, 3560 KiB

Open AccessArticle

Using Human-Centered Design in Community-Based Public Health Research: Insights from the ECHO Study on COVID-19 Vaccine Hesitancy in Montreal, Canada

by Krystelle Marie Abalovi, Geneviève Fortin, Maryam Parvez, Joyeuse Senga, Joe Abou-Malhab, Cat Tuong-Nguyen, Caroline Quach, Ashley Vandermorris, Kate Zinzser and Britt McKinnon

Int. J. Environ. Res. Public Health 2025, 22(2), 198; https://doi.org/10.3390/ijerph22020198 - 30 Jan 2025

Viewed by 394

Abstract

(1) Background: This study used human-centered design (HCD) within a community-based research project to collaboratively develop local strategies aimed at enhancing COVID-19 vaccine confidence among children and youth. (2) Methods: HCD projects were carried out between December 2021 and August 2022 by four [...] Read more.

(1) Background: This study used human-centered design (HCD) within a community-based research project to collaboratively develop local strategies aimed at enhancing COVID-19 vaccine confidence among children and youth. (2) Methods: HCD projects were carried out between December 2021 and August 2022 by four community-based design (CBD) teams in Montreal, Canada. The CBD teams were composed of parent and youth community members, public health and social science researchers, and HCD specialists. Process evaluation data, collected from the CBD team members through focus group discussions and written questionnaires, were used to reflect on the use of HCD in this project. (3) Results: The CBD teams designed and implemented projects addressing factors they identified as contributing to COVID-19 vaccine hesitancy for children and youth in their communities, including misinformation, lack of trust, social inequities, and resistance to pandemic-related restrictions. The CBD team members appreciated many aspects of the HCD approach, especially the values it stands for, such as empathy, co-creation, and collaboration. HCD and public health specialists described some tension between the different disciplinary approaches. (4) Conclusions: HCD holds promise for addressing complex public health issues, though further exploration of strategies for integrating HCD within established models of community-based public health research is needed. Full article

(This article belongs to the Special Issue Community Interventions in Health Disparities)

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15 pages, 284 KiB

Open AccessArticle

Community Perspectives on Intimate Partner Violence During Pregnancy: A Qualitative Study from Rural Ethiopia

by Zeleke Dutamo Agde, Jeanette H. Magnus, Nega Assefa and Muluemebet Abera Wordofa

Int. J. Environ. Res. Public Health 2025, 22(2), 197; https://doi.org/10.3390/ijerph22020197 - 29 Jan 2025

Viewed by 368

Abstract

Intimate partner violence (IPV) during pregnancy is closely associated with adverse maternal and fetal outcomes. To develop prevention strategies and interventions, the exploration of cultural norms, societal attitudes, and perceptions related to IPV is vital. This study explored community perspectives on IPV during [...] Read more.

Intimate partner violence (IPV) during pregnancy is closely associated with adverse maternal and fetal outcomes. To develop prevention strategies and interventions, the exploration of cultural norms, societal attitudes, and perceptions related to IPV is vital. This study explored community perspectives on IPV during pregnancy in rural Ethiopia. We used an exploratory qualitative study design to collect data. Data were collected through in-depth interviews (IDIs) and focus group discussions (FGDs) guided by a semi-structured topic guide. The data were analyzed using a thematic analysis approach, revealing the following four themes: (1) threats to the health of the mother and the fetus; (2) the contributing factors of IPV during pregnancy; (3) coping strategies for IPV during pregnancy; and (4) the need for intervention. Supportive attitudes toward IPV, early marriage, lack of awareness among offenders about its consequences, alcohol use, poor couple communication, and provocation by wives were found to be the causes of IPV during pregnancy. Participants in this study perceived IPV as a normal and unavoidable aspect of marital relationships. Comprehensive interventions that address challenging the cultural norms that condone IPV, increase community awareness of its detrimental effects, improve couples’ communication skills, and address alcohol abuse among men could play a crucial role in preventing or reducing IPV during pregnancy. Full article

26 pages, 5742 KiB

Open AccessArticle

Structural Violence and the Effects of the Patriarchal Structure on the Diagnosis of Borderline Personality Disorder (BDP): A Critical Study Using Tools on BPD Symptoms and Social Violence

by Elena Valero, Alicia Paillet, Victor Ciudad-Fernández and Marta E. Aparicio-García

Int. J. Environ. Res. Public Health 2025, 22(2), 196; https://doi.org/10.3390/ijerph22020196 - 29 Jan 2025

Viewed by 564

Abstract

This study explores the relationship between borderline personality disorder (BPD) symptoms, measured using the Borderline Symptom List (BSL-23), and experiences of covert social violence, assessed via the Inventory of Covert Social Violence Against Women (IVISEM) and an open-ended survey given to 99 adults [...] Read more.

This study explores the relationship between borderline personality disorder (BPD) symptoms, measured using the Borderline Symptom List (BSL-23), and experiences of covert social violence, assessed via the Inventory of Covert Social Violence Against Women (IVISEM) and an open-ended survey given to 99 adults diagnosed with BPD. Quantitative data revealed significant emotional intensity, with a mean BSL-23 score of 56.81 (SD = 20.31), and a positive correlation (r = 0.29, p < 0.0034) between symptom severity and the number of self-reported disorders. The qualitative analysis highlighted themes of ‘Stigmatization and Structural Violence’ and ‘Gender Expectations’, with 62.9% of participants reporting that their emotions were pathologized as hormonal or exaggerated. The results highlight the significant emotional intensity in participants, particularly related to shame and vulnerability, suggesting these emotions are linked to structural violence perpetuated by patriarchal norms, including covert social violence. Biological explanations for emotionality, such as references to “hormonal” changes and “menstruation”, reinforce the idea that women’s intense emotions are natural, overlooking broader societal and structural factors. The results underscore the impact of the patriarchal structure, emphasizing the need for psychological approaches that address both the symptoms of BPD and the impact of societal and structural violence on women’s emotional health. The study sample underscores the main idea of the study: BPD is predominantly diagnosed in women, which underlines the need to rethink diagnostic tools and professional interventions. These results highlight the need for a feminist critique of the BSL-23 by showing how emotional symptoms are often interpreted through a gendered lens, emphasizing the importance of re-evaluating diagnostic tools to address the impact of societal and structural violence on women’s mental health. Full article

(This article belongs to the Special Issue Innovations in Women’s Health Promotion and Healthcare)

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12 pages, 484 KiB

Open AccessReview

The Role of Virtual Reality in Childhood Obesity Treatment: A Narrative Review

by Qutaibah Oudat, Sarah E. Messiah and Alia Dawlat Ghoneum

Int. J. Environ. Res. Public Health 2025, 22(2), 195; https://doi.org/10.3390/ijerph22020195 - 29 Jan 2025

Viewed by 489

Abstract

Childhood obesity is a critical public health issue linked to long-term complications like type 2 diabetes and cardiovascular disease. This narrative review aimed to examine the effectiveness of virtual reality (VR)-based interventions in supporting key components of obesity treatment—physical activity (PA), nutrition education, [...] Read more.

Childhood obesity is a critical public health issue linked to long-term complications like type 2 diabetes and cardiovascular disease. This narrative review aimed to examine the effectiveness of virtual reality (VR)-based interventions in supporting key components of obesity treatment—physical activity (PA), nutrition education, and behavior change—particularly in children under 12. Using the intensive health behavior and lifestyle treatment (IHBLT) approach, we synthesized findings from studies published between 2014 and 2024. Of the studies reviewed, only one study met inclusion criteria, showing that VR-based interventions effectively increased light-intensity PA and reduced sedentary behavior in children, though these effects were not sustained long-term. The scarcity of studies limits the generalizability of these findings, emphasizing the need for caution in interpretation. Our review highlights a significant gap in the literature regarding VR’s role in childhood obesity treatment. Future research should explore the efficacy of VR in promoting PA, enhancing nutrition education, and supporting sustained behavior changes. Expanding this evidence base is vital for developing accessible and engaging interventions tailored to young children. Addressing this gap could enhance obesity treatment options, offering innovative and effective strategies to improve health outcomes in this vulnerable population. Full article

(This article belongs to the Special Issue The Management of Nutrition and Obesity)

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16 pages, 1469 KiB

Open AccessArticle

Assessment of Perceived Physical Literacy and Its Relationship with 24-Hour Movement Guidelines in Adolescents: The ENERGYCO Study

by Víctor Manuel Valle-Muñoz, Estela Águila-Lara, Manuel Ávila-García, José Manuel Segura-Díaz, Pablo Campos-Garzón, Yaira Barranco-Ruiz, Romina Gisele Saucedo-Araujo and Emilio Villa-González

Int. J. Environ. Res. Public Health 2025, 22(2), 194; https://doi.org/10.3390/ijerph22020194 - 29 Jan 2025

Viewed by 447

Abstract

Scientific evidence suggests that meeting the 24-hour movement guidelines is associated with numerous health benefits. One concept that emphasizes an individual’s active lifestyle is physical literacy (PL). However, the relationship between PL and 24 h movement guidelines in adolescents has not been analyzed [...] Read more.

Scientific evidence suggests that meeting the 24-hour movement guidelines is associated with numerous health benefits. One concept that emphasizes an individual’s active lifestyle is physical literacy (PL). However, the relationship between PL and 24 h movement guidelines in adolescents has not been analyzed to date. The aim of this study was to examine the relationship between perceived physical literacy (PPL) and adherence to the 24-hour movement guidelines in Spanish adolescents. This cross-sectional study included a total of 56 adolescents (mean age 13.2 ± 1.3 years). PL was assessed using the Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI), categorizing participants into low, medium, and high PPL levels. To determine compliance with movement guidelines (24-hour movement), physical activity was assessed through accelerometry, while screen time and sleep duration were evaluated using questionnaires. One-way ANOVA and chi-square analysis were used to examine PPL levels and adherence to the 24-hour movement guidelines. The results indicated that higher levels of PPL were associated with greater adherence to the 24-hour movement guidelines. Specifically, most participants met one or two recommendations as PPL increased (p = 0.002). In the medium PPL group, 50% met one recommendation, 37.5% met two, and 12.5% did not meet any, while in the high PPL group, 52.8% met one recommendation, 41.7% met two, and 5.6% did not meet any. These findings suggest that higher levels of PPL are associated with greater adherence to the 24-hour movement guidelines. Future studies should explore this association in larger samples of Spanish adolescents and should promote the practical implications regarding the importance of designing educational programs. This should be achieved through curricula that are based on PL and that integrate strategies to reduce screen time, promote healthy sleep habits, and foster a comprehensive and sustainable understanding of these among adolescents. Full article

(This article belongs to the Special Issue Sweat It Out: The Health Benefits of Physical Activity and Exercise)

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19 pages, 2199 KiB

Open AccessArticle

Exploring Client Perceptions on Gaining Infant Feeding Information Through the Texas Women, Infants, and Children (WIC) Chatbot

by Kelci Baez, Lesli Biediger-Friedman, Cassandra M. Johnson, Emily Stubblefield, Lizzeth Escalera and Brittany Reese Markides

Int. J. Environ. Res. Public Health 2025, 22(2), 193; https://doi.org/10.3390/ijerph22020193 - 29 Jan 2025

Viewed by 435

Abstract

The modernization of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program is a priority. The Texas WIC chatbot, Maya, streamlines client interactions through dialog-based responses. This qualitative study explored client capabilities, motivations, and opportunities for seeking nutrition information about [...] Read more.

The modernization of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program is a priority. The Texas WIC chatbot, Maya, streamlines client interactions through dialog-based responses. This qualitative study explored client capabilities, motivations, and opportunities for seeking nutrition information about breastfeeding, formula feeding, infant feeding safety, adequacy of infant feeding, and complementary feeding via a chatbot. A team conducted in-depth semi-structured interviews with Texas WIC clients (n = 19 women). All interviews were transcribed and subjected to a two-coder, four-phase process utilizing a theory-based codebook. Codes were compiled and thematically categorized. Identified themes included (1) motivations through necessity or resource availability, (2) client capabilities and Maya usability, and (3) opportunities for connection, support, and encouragement. Texas WIC clients that participated in this study expressed motivations, capabilities, and opportunities to engage with nutrition information through Maya. They described Maya as a favorable resource for behavior changes, and a trusted source of nutrition information, citing the credibility of WIC and reliability of the chatbot. The findings may inform future research and development of public health chatbots. Additional research is required to explore how different factors such as language and technology usage may impact client capabilities, motivations, and opportunities to seek nutrition information with regard to infant feeding. Full article

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18 pages, 271 KiB

Open AccessArticle

Living in a Constant State of Fear: Phenomenological Study on Experiences of Women with High-Risk Pregnancy Waiting for Childbirth in Mpumalanga Province, South Africa

by Zodwa Joyce Mphego, Mathildah Mpata Mokgatle and Sphiwe Madiba

Int. J. Environ. Res. Public Health 2025, 22(2), 192; https://doi.org/10.3390/ijerph22020192 - 29 Jan 2025

Viewed by 360

Abstract

Research and obstetric medicine often ignore the emotional aspect of high-risk pregnant women in clinical management and care. Even more so, research does not adequately address psychosocial well-being in high-risk pregnancies, particularly in low and middle-income countries, including South Africa. Thus, this study [...] Read more.

Research and obstetric medicine often ignore the emotional aspect of high-risk pregnant women in clinical management and care. Even more so, research does not adequately address psychosocial well-being in high-risk pregnancies, particularly in low and middle-income countries, including South Africa. Thus, this study aimed to explore and describe the experiences and psychosocial support needs of women waiting for childbirth in high-risk pregnancies. We conducted a descriptive phenomenological inquiry in special clinics in two hospitals in the Nkangala District Municipality of Mpumalanga Province, South Africa. A purposive sampling strategy was used to select 15 women aged 22 to 43 years, and in-depth interviews were conducted. An inductive thematic analysis approach was used. The women experience high levels of negative emotions such as shock and disbelief, fear, pain and sorrow, lack of control and hopelessness, and anxiety following a diagnosis of high-risk pregnancy. Fear was the most expressed feeling by the women; their thoughts were dominated by fear, and they lived in constant fear throughout the pregnancy journey due to the unpredictable pregnancy outcomes and the potential risks in high-risk pregnancies. Overall, the negative emotions are interlinked and bonded in the experiences of women with high-risk pregnancies, are experienced throughout the journey of waiting for childbirth, and contribute to high levels of stress and anxiety. Further exploration is needed to identify effective ways to support these women. Full article

(This article belongs to the Special Issue Reproductive Health Care for Women)

14 pages, 621 KiB

Open AccessArticle

“One Size Doesn’t Fit All”: Design Considerations for an Exercise Program to Improve Physical Function in Older Veterans with Serious Mental Illness

by Julia Browne, Whitney L. Mills, Courtney T. Lopez, Noah S. Philip, Katherine S. Hall, Alexander S. Young, Kate M. Guthrie and Wen-Chih Wu

Int. J. Environ. Res. Public Health 2025, 22(2), 191; https://doi.org/10.3390/ijerph22020191 - 29 Jan 2025

Viewed by 409

Abstract

Older adults with serious mental illness (SMI) (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) have compromised physical function that adversely affects their quality of life. Exercise is an effective intervention to improve function in older persons; however, older people with SMI experience barriers to [...] Read more.

Older adults with serious mental illness (SMI) (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) have compromised physical function that adversely affects their quality of life. Exercise is an effective intervention to improve function in older persons; however, older people with SMI experience barriers to exercise engagement. This study sought to obtain feedback on an exercise program in development for older people with SMI that comprised home-based exercise delivery, individualized exercise prescription, and motivational health coaching calls. Individual interviews and focus groups were conducted with older Veterans with SMI (n = 3) and clinical staff serving this population (directors: n = 3; clinicians: n = 15, k = 3) to elicit feedback on the perceived feasibility and acceptability of the preliminary program and recommendations for modifications to the program. Rapid analysis was used to summarize transcripts of audio-recorded interviews and focus groups. Results indicated a strong perceived feasibility and acceptability of the preliminary intervention because of how the individualized exercise prescription component (i.e., exercise plan) would be personalized to the Veteran’s preferences and abilities. Clinical staff participants expressed concerns about how the lack of real-time supervision would negatively affect exercise completion. Participants recommended tailoring the home-based exercise delivery and motivational health coaching calls components to each Veteran’s unique context. Full article

(This article belongs to the Special Issue Aging Strong: Promoting Exercise and Nutrition to Combat Frailty in Older Adults)

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15 pages, 291 KiB

Open AccessArticle

Characterizing Engagement with Web-Based Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Traumatic Stress and Substance Misuse After Interpersonal Violence

by Alexandra N. Brockdorf, Emily L. Tilstra-Ferrell, Carla K. Danielson, Angela D. Moreland, Alyssa A. Rheingold, Selime R. Salim, Amanda K. Gilmore, Rachel E. Siciliano, Daniel W. Smith and Christine K. Hahn

Int. J. Environ. Res. Public Health 2025, 22(2), 190; https://doi.org/10.3390/ijerph22020190 - 29 Jan 2025

Viewed by 456

Abstract

Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal [...] Read more.

Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors. Full article

(This article belongs to the Special Issue Domestic Violence and Associated Mental Health Harms)

14 pages, 738 KiB

Open AccessArticle

Examining Health Insurance and Non-Medical Challenges Among Vietnamese Americans in Texas During the COVID-19 Pandemic

by Alexander Le, Saba Siddiqi, Celine Nguyen, Ben King, Paul Gerardo Yeh, Jannette Diep, Lauren Gilbert and Bich-May Nguyen

Int. J. Environ. Res. Public Health 2025, 22(2), 189; https://doi.org/10.3390/ijerph22020189 - 29 Jan 2025

Viewed by 512

Abstract

When COVID-19 data on Asian Americans are available, they are frequently aggregated, concealing community-specific concerns. Consequently, there is limited COVID-19 literature on Vietnamese Americans. In this study, we investigated the association between health insurance coverage and non-medical challenges during the COVID-19 pandemic, in [...] Read more.

When COVID-19 data on Asian Americans are available, they are frequently aggregated, concealing community-specific concerns. Consequently, there is limited COVID-19 literature on Vietnamese Americans. In this study, we investigated the association between health insurance coverage and non-medical challenges during the COVID-19 pandemic, in Vietnamese Americans in Texas. The NIH Community Engagement Alliance (CEAL) Common Survey 2 was administered electronically in English and Vietnamese and contained 23 questions about non-medical drivers of health, COVID-19 vaccination, and research participation. Vietnamese American adults in Texas were recruited between September 2021 and March 2022 via partnerships with community organizations. Responses were compared and analyzed using logistic regression. Of 217 respondents, 23 (11%) were uninsured. Of the uninsured participants, 43% lost health insurance coverage during the COVID-19 pandemic. Uninsured individuals had significantly higher odds of experiencing non-medical challenges, including obtaining housing (OR = 6.10, p < 0.001), food (OR = 6.41, p < 0.001), and medications (OR = 3.45, p < 0.05) than insured individuals. Uninsured individuals had a significantly longer time-lapse since seeing a healthcare provider (ordinal OR = 0.20, p < 0.05) than insured individuals. Thus, lack of insurance is strongly associated with non-medical challenges during the COVID-19 pandemic among Vietnamese Americans in Texas. Disaggregating data can address non-medical drivers of health, advancing equity for marginalized communities. Full article

(This article belongs to the Special Issue 3rd Edition: Social Determinants of Health)

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8 pages, 236 KiB

Open AccessPerspective

A Hope for Hope: Refocusing Health Promotion on Hopefulness to Reduce Alcohol Consumption and Breast Cancer

by Paul R. Ward, Kristen Foley, Megan Warin, Catherine Palmer, Sarah MacLean and Belinda Lunnay

Int. J. Environ. Res. Public Health 2025, 22(2), 188; https://doi.org/10.3390/ijerph22020188 - 29 Jan 2025

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Abstract

Our perspective paper focuses on the sociology of hope and is a call to action for health promotion policy makers to create the conditions for hopefulness in alcohol reduction policy, advocacy and programs for/with midlife women. Alcohol is a major risk factor for [...] Read more.

Our perspective paper focuses on the sociology of hope and is a call to action for health promotion policy makers to create the conditions for hopefulness in alcohol reduction policy, advocacy and programs for/with midlife women. Alcohol is a major risk factor for breast cancer, and high proportions of midlife women in most high-income countries drink at “risky” levels, increasing the chances of breast cancer (due to both age and alcohol consumption). At present, alcohol reduction approaches convey mostly individualised risk messages and imply personal responsibility for behaviour change, stripped from contexts, and heavy drinking persists among groups. New approaches that address the social norms, identities and practices that operate to sustain heavy drinking are necessary considering alcohol harms. We argue that focusing on changing these factors to support hopeful futures may create hope for midlife women to reduce alcohol consumption. We synthesise contemporary theories on the sociology of hope and analyse how these might help to refocus health promotion policy on hopefulness in the context of alcohol reduction and breast cancer prevention. We will draw on Freire’s notions of a Pedagogy of Oppression and a Pedagogy of Hope to show how enabling people to recognise and respond to the “oppressive forces” shaping their alcohol consumption might lead to more hopeful futures with reduced alcohol consumption for priority populations. Our focus on building hope into health-promoting alcohol reduction approaches intends to shift policy focus from the individual as the “problem” towards hope being a “solution”. Full article

(This article belongs to the Special Issue Perspectives in Global Health)

17 pages, 1012 KiB

Open AccessArticle

Water Insecurity in the Jordan Valley: Community Perspectives on Its Impacts on Maternal and Child Health

by Antonia Walther, Amira Shaheen, Hamza Zubeidat, Ghassan Shakhshir and Shakoor Hajat

Int. J. Environ. Res. Public Health 2025, 22(2), 187; https://doi.org/10.3390/ijerph22020187 - 28 Jan 2025

Viewed by 455

Abstract

The Jordan Valley in the West Bank in Palestine provides a unique social, environmental, and geopolitical context in regard to the global challenge of water insecurity, where its impacts on child and maternal health are only partly understood. Existing research has been largely [...] Read more.

The Jordan Valley in the West Bank in Palestine provides a unique social, environmental, and geopolitical context in regard to the global challenge of water insecurity, where its impacts on child and maternal health are only partly understood. Existing research has been largely limited to investigations of water quantity/quality and direct health outcomes, such as infectious disease. This qualitative study aimed to provide a holistic perspective of the challenge of water insecurity and child health, by investigating household water insecurity in Palestine. Focus group discussions explored the lived experiences of women from marginalized communities. These were then thematically analyzed, in reference to social theory. The study identified context-specific aspects of water insecurity, shaped by the background in Palestine involving the occupation and ongoing violent conflict in the area. These challenges disproportionately affect women, who are primarily responsible for water management within their communities, leading to embodied experiences, heightened negative emotions, and increased conflict, both within households and the broader community. Consequently, these stressors heavily impact children: limited caretaking time, due to economic pressures, children’s involvement in water-related tasks, and the disruption of social cohesion at both the community and household level, ultimately affect their physical and mental health and their ability to learn and play. Our findings could guide research and policy efforts in developing context-sensitive tools, such as a child water stress index for Palestine. Full article

(This article belongs to the Section Global Health)

21 pages, 311 KiB

Open AccessArticle

Factor Structure and Psychometric Properties of the Italian Version of the Childbearing Motivations Scale

by Antonio Gattamelata, Maria Elisabetta Coccia, Giulia Fioravanti, Vanessa Prisca Zurkirch and Nieves Moyano

Int. J. Environ. Res. Public Health 2025, 22(2), 186; https://doi.org/10.3390/ijerph22020186 - 28 Jan 2025

Viewed by 439

Abstract

The Childbearing Motivations Scale (CMS) is a multidimensional self-report measure of positive and negative motivations influencing the decision to become a parent. This study aimed to validate the Italian version of the CMS. A sample of 522 participants (27% men and 73% women) [...] Read more.

The Childbearing Motivations Scale (CMS) is a multidimensional self-report measure of positive and negative motivations influencing the decision to become a parent. This study aimed to validate the Italian version of the CMS. A sample of 522 participants (27% men and 73% women) aged from 18 to 55 years was recruited. The four-factor model for the positive subscale and the five-factor model for the negative subscale of the CMS demonstrated a good fit. Reliability values ranged from 0.70 to 0.91. Both factors had evidence for convergent validity with sex, age, and relationship duration: women reported lower in some of the negative motivations to become a mother in contrast to men. Moreover, the greater the age, the lower the negative motivations for becoming a parent. Those in a longer relationship indicated lower negative motivations. No significant correlations were found for the positive motivations subscale. Significant differences were found for income levels (low vs. medium/high) regarding personal fulfillment, financial problems, and body-image concerns, as well as in cultural levels (medium vs. high) concerning economic constraints, intergenerational continuity, immaturity, and physical suffering. These findings suggest that individuals with lower economic resources scored higher across all these areas on the Negative Childbearing Motivations subscale. Our findings indicate that the CMS can be used to reliably assess the motivations for parenthood among Italian men and women. Full article

(This article belongs to the Special Issue Risk and Protective Factors for Maternal and Paternal Mental Health during the Perinatal Period)

14 pages, 324 KiB

Open AccessArticle

Worry and Depressive Symptoms in Adolescents with Neurodevelopmental Disorders

by Suzanne Stewart, Stephen John Houghton, Ken Glasgow and Leslie Macqueen

Int. J. Environ. Res. Public Health 2025, 22(2), 185; https://doi.org/10.3390/ijerph22020185 - 28 Jan 2025

Viewed by 403

Abstract

Although worry is a normal cognitive process experienced by adolescents, for a significant number, it can reach intense and uncontrollable levels. If left untreated, these worries can lead to significant mental health problems that are maintained into adulthood. Adolescents with neurodevelopmental disorders (NDDs) [...] Read more.

Although worry is a normal cognitive process experienced by adolescents, for a significant number, it can reach intense and uncontrollable levels. If left untreated, these worries can lead to significant mental health problems that are maintained into adulthood. Adolescents with neurodevelopmental disorders (NDDs) may be more prone to cognitive biases (that precede worry) and therefore highly vulnerable to worry. Limited research has examined worry in adolescents with NDDs; however, most studies have focused on measuring anxiety. The present research administered an instrument specifically developed to measure worry to 404 10 to 16-year-old mainstream school-aged adolescents, 204 (123 males, 81 females) of whom had a formally diagnosed NDD. A measure of depressive symptoms was also administered. Confirmatory factor analysis revealed a satisfactory fitting model for worry. Multivariate analysis of variance revealed no interaction effects or main effect for worry according to NDD/non-NDD status. There were, however, main effects for sex, with females scoring significantly higher than males on worry about academic success and the future; worry about peer relationships; combined worry score; and depressive symptoms. The findings of this study offer psychologists and educators a brief validated measure of worry that is suited to mainstream school adolescents with or without NDDs. The wider implications of the findings in the context of education and intervention for students with NDDs are discussed. Full article

(This article belongs to the Special Issue Students’ Education and Mental Health)

13 pages, 625 KiB

Open AccessArticle

Can 12-Week Resistance Training Improve Muscle Strength, Dynamic Balance and the Metabolic Profile in Older Adults with Type 2 Diabetes Mellitus?

by André Luiz de Seixas Soares, Guilherme Carlos Brech, Adriana Machado-Lima, Joselma Rodrigues dos Santos, Júlia Maria D’ Andréa Greve, Marcus Vinicius Grecco, Mara Afonso, Juliana Cristina Sousa, Ariana Tito Rodrigues, Matheus Henrique dos Santos Lino, Vanderlei Carneiro da Silva, Patricia Nemara Freitas de Souza Carneiro, Alexandre Lopes Evangelista, Catherine L. Davis and Angelica Castilho Alonso

Int. J. Environ. Res. Public Health 2025, 22(2), 184; https://doi.org/10.3390/ijerph22020184 - 28 Jan 2025

Viewed by 403

Abstract

The present study aimed to evaluate the effects of 12-week resistance training (RT) on muscle strength, dynamic balance, glycemic control and the lipid profile. Methods: The Laboratory of Movement Studies in the University of São Paulo, Brazil, developed this longitudinal study between 2021 [...] Read more.

The present study aimed to evaluate the effects of 12-week resistance training (RT) on muscle strength, dynamic balance, glycemic control and the lipid profile. Methods: The Laboratory of Movement Studies in the University of São Paulo, Brazil, developed this longitudinal study between 2021 and 2023. It assessed 62 males with type 2 diabetes mellitus pre and post an RT protocol. The participants, who were 69.8 (±3.9) years old, took part in a 12-week twice-weekly RT program. Three sets of eight to twelve repetitions each were executed for eight exercises targeting the large muscle groups. The intensity was set between 7 and 8 out of 10 for perceived effort, according to the Omni Resistance Exercise Scale. All participants were evaluated pre and post in knee extensor and flexor strength by isokinetic dynamometry, handgrip strength by manual dynamometry and dynamic postural balance by a force platform, as well as blood tests to determine the lipid and glycemic profiles. For comparison, paired t or Wilcoxon tests were used at an alpha of 5%. Results: There was an improvement in muscular strength by handgrip restricted to the non-dominant side (p = 0.033) and for the bilateral knee flexors (p < 0.001) and extensors (p < 0.001), as determined by isokinetic dynamometry. There was no improvement in dynamic postural balance, glycemic control or lipid control. Conclusions: The 12-week RT promoted improved muscle strength in knee extension and flexion and non-dominant grip pressure but did not affect dynamic balance, glycemic control or the lipid profile. Full article

(This article belongs to the Special Issue The Healthcare of Metabolic Diseases and Chronic Diseases)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 2 (February 2025) – 82 articles

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