European Journal of Public Health最新文献

{"title":"EPH, where public health meets. See you in Helsinki.","authors":"Tit Albreht, Charlotte Marchandise, Hans Henri P Kluge, Ilmo Keskimäki, Floris Barnhoorn","doi":"10.1093/eurpub/ckaf168","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf168","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 5","pages":"1069-1070"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital-based Living Lab intervention to promote healthy dietary behaviours in adolescents.","authors":"Jisu Lee, Hyeonkyeong Lee, Hyeyeon Lee, Kennedy Diema Konlan, Sun Young Shim","doi":"10.1093/eurpub/ckaf129","DOIUrl":"10.1093/eurpub/ckaf129","url":null,"abstract":"<p><p>Digital health interventions are increasingly used to promote behaviour change in adolescents. The Living Lab approach, fostering collaboration with users and stakeholders to identify real-life problems and co-create sustainable solutions, is gaining traction in health interventions. This study aimed to evaluate the usability of a novel Digital-based Living Lab (D-LLab) designed to promote healthy dietary behaviour in adolescents. The D-LLab was developed in four phases: topic derivation, strategy selection, digital tool selection, and usability assessment. It was implemented over a 4-week period, structured into four participatory phases: identifying problems, exploring solutions, solving problems, and sharing outcomes. Twenty-one adolescents aged 14-16 from one middle school enrolled, with a balanced sample of racial and ethnic adolescents, and native Koreans. Usability was evaluated using a mixed methods approach, incorporating quantitative indicators-appropriateness (system usability scale, SUS), acceptability (satisfaction), and feasibility (completion rate)-alongside qualitative data on participant experiences. The mean SUS score was 70.75, exceeding the benchmark for acceptable usability. Participants rated high satisfaction (mean score: 8.45/10), and 95.2% completed all sessions. High usability appeared to be driven by real-time information sharing and collaborative digital interaction, which supported spontaneous problem solving around dietary issues. The D-LLab demonstrated acceptable usability and strong participant engagement. These findings highlight the feasibility of applying digital-based Living Lab approaches in school settings, warranting further trials to evaluate long-term behavioural impact across diverse populations. This intervention was registered at cris.nih.go.kr as KCT0007004.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"910-915"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic delay in rare diseases in the Campania region: addressing ageing, gender disparities, and the \"postcode lottery effect\" to reduce the patient odyssey.","authors":"Chiara Cirillo, Rossella Duraccio, Mario Fordellone, Emanuele Monda, Bruno De Rosa, Chiara De Stasio, Anna Francesca Smimmo, Anna Fusco, Salvatore Rega, Martina Caiazza, Francesca Marzullo, Raffaele Scarpa, Gioacchino Scarano, Antonio Postiglione, Pietro Buono, Ugo Trama, Massimo Di Gennaro, Giuseppe Borriello, Maria Galdo, Barbara Morgillo, Paolo Chiodini, Giuseppe Limongelli","doi":"10.1093/eurpub/ckaf088","DOIUrl":"10.1093/eurpub/ckaf088","url":null,"abstract":"<p><p>Our study assessed the time to diagnosis of rare diseases (RDs) in Campania and whether there are determinants of diagnostic delay (DD). Demographic characteristics, date of first medical contact and diagnosis, disease macro-groups, and area of residence of patients were recorded. DD was calculated as the time elapsed (in years) from the onset of symptoms to the RD diagnosis date. Based on the Rare Disease Research Consortium consensus document, a time to diagnosis more than one year was considered DD. A multilevel logistic regression was performed. Seven thousand nine hundred and nine patients were included in the analysis; 47.4% were male. The mean DD was 3.4 years and 46% of patients experienced DD. Predictors of DD were female gender (OR 0.90, 95% CI 0.80-0.98, P < .005), age at diagnosis (OR 1.36, 95% CI 1.27-1.45, P < .001), and province of residence (residence in Naples vs. others; OR 0.80, 95% CI 0.73-0.88, P < .001). Immunological, connective tissue, digestive, genitourinary system diseases, and congenital malformations showed more DD than other disorders. Nearly half of the patients with RD experienced DD. The main determinants of DD were female sex, older age at diagnosis.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"862-866"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving early intervention: identifying risk factors for UK military veterans that access military charities-a case-control study and an AI-powered predictive model.","authors":"Giuseppe Serra, Federico Turoldo, Marco Tomietto, Andrew McGill, Matthew D Kiernan","doi":"10.1093/eurpub/ckaf140","DOIUrl":"10.1093/eurpub/ckaf140","url":null,"abstract":"<p><p>Some veterans face unique physical, mental, and social challenges, leading them to seek assistance from military charities. This case-control study uses data from the MONARCH Study and the tri-service food insecurity study, with the aim to identify key risk factors associated with charity usage among UK veterans. Cases (veterans who accessed charities in 2022) were compared to controls (veterans who did not access charities). Logistic regression and a random forest algorithm were used to identify risk factors for charity use. Several risk factors for charity use were identified: younger age, living alone, being a non-officer, and living in rented accommodation. Having dependents was found to be protective but emerged as a risk factor for veterans living alone and protective for veterans living with others. The use of a random forest algorithm confirmed the statistical importance of these variables, offering deeper insights into complex interactions. These results improve our understanding of the risk factors for charity usage by veterans and provide a predictive model that could be implemented in planning service provision in public health. Additionally, it could be used as the basis for the implementation of targeted preventive interventions, allowing for proactive measures to be taken to support veterans before they reach a point of needing charity services in a period of crisis. These predictive models could enable more efficient resource allocation and the development of tailored strategies to address the specific needs of at-risk veteran subgroups.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"867-872"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting under-screened women in cervical cancer: combining self-sampling and human papillomavirus testing with a strategic reminder plan.","authors":"Sara da Graça Pereira, Luís Nobre, Marina Ribeiro, Patrícia Carvalho, Ana Morais, Rita Sousa, Ana Paula Moniz, Francisco Matos, Graça Fernandes, João Pedro Pimentel, José Carlos Marinho, José Luís Sá, Olga Ilhéu, Teresa Rebelo, José Fonseca-Moutinho, Hugo Prazeres, Rui Jorge Nobre, Fernanda Loureiro","doi":"10.1093/eurpub/ckaf122","DOIUrl":"10.1093/eurpub/ckaf122","url":null,"abstract":"<p><p>Cervical cancer (CC) screening is essential for reducing its incidence, yet engaging under-screened women remains challenging. Self-sampling has emerged as a promising solution to enhance attendance; however, its integration into programmes has proven difficult. This study evaluated a multimodal approach combining self-sampling, human papillomavirus (HPV) testing, and personalized contact to reach women not attending conventional CC screening. To achieve this, 801 women aged 30-59 who had not participated in Portugal's Central Region CC screening programme for more than 4 years were selected based on specific criteria. Of these, 114 women were excluded for not meeting eligibility criteria, resulting in 687 eligible participants. Using an 'opt-in' approach, women who consented to participate received cervicovaginal self-sampling kits at home. Multiple contact strategies, including phone calls and reminder letters, were employed to encourage participation. Women testing positive for high-risk HPV (hr-HPV) were referred for gynaecological follow-up. Of the eligible women, 307 (44.7%) consented to participate and 198 (28.8%) provided valid samples for hr-HPV testing. Approximately 60.0% of participants were enrolled after the first reminder phone call, while additional contact strategies accounted for one-third of submitted samples. Among 12 hr-HPV positive cases, 11 completed gynaecological follow-up, resulting in the identification of six cervical lesions. This study confirms the feasibility and effectiveness of combining self-sampling, HPV testing, and personalized contact strategies to improve CC screening uptake among under-screened women. The findings highlight the potential of such interventions to address participation gaps and enhance early detection of cervical lesions, ultimately reducing CC incidence.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"984-991"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences as a risk factor for depression-overweight comorbidity in adolescence and young adulthood.","authors":"Fanny Kilpi, Ana Goncalves Soares, Laura D Howe","doi":"10.1093/eurpub/ckaf102","DOIUrl":"10.1093/eurpub/ckaf102","url":null,"abstract":"<p><p>The comorbidity of depression and overweight is a manifestation of mental-physical multimorbidity, a marker of complex healthcare needs. We sought to examine how adverse childhood experiences (ACEs) are associated with depression-overweight comorbidity in the period of adolescence and early adulthood, and the extent to which associations are sensitive to age, sex, and socioeconomic background. Using data from 4734 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, we estimated relative risk ratios (RRR) for the associations of multiple ACEs (physical, emotional, and sexual abuse, emotional neglect, being bullied, parental substance abuse, violence between parents, parental criminal conviction, parental separation, parental mental illness, or suicide) with depression only, overweight only or their comorbidity at ages 17 and 24. We tested whether associations differed by sex and socioeconomic background, indicated by parental education. Most ACEs were associated with depression-overweight comorbidity, and there was a dose-response relationship whereby a greater number of ACEs was associated with greater risk, and this continued from adolescence to young adulthood. Some ACEs associations with comorbidity appeared to be influenced by sex: at age 17, females had stronger associations for parental separation and mental health problems, and at age 24, sexual abuse had a stronger association in males. We did not find evidence that the sensitivity to ACEs varied by parental education. ACEs across childhood are associated with depression and depression-overweight comorbidity in late adolescence, which indicates their potential impact on the early manifestation of complex healthcare needs.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"896-902"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspective of pregnant women on feasibility of integrating cervical cancer screening into antenatal care in the Netherlands: a questionnaire study.","authors":"Nick M A van der Hoeven, Adriaan J C van den Brule, Heleen J van Beekhuizen, Inge M C M de Kok, Maaike J M van de Sande, Marieke Biemans, Folkert J van Kemenade","doi":"10.1093/eurpub/ckaf121","DOIUrl":"10.1093/eurpub/ckaf121","url":null,"abstract":"<p><strong>Background: </strong>Dutch programmed cervical cancer screening starts at the age of 30, but efficacy is hampered due to low uptake, especially among youngest invitees aged 30-40 (< 50%). Currently, pregnant women are excluded from screening, but we hypothesize that participation could be increased if screening would be discussed routinely during obstetric care, motivating unscreened women to attend. Via this questionnaire study, we aimed to assess whether pregnant women in the Netherlands considered such \"antenatal screening\" acceptable.</p><p><strong>Methods: </strong>In 2021 and 2022, a single written questionnaire was provided to pregnant women aged 30 years or older, undergoing obstetric care in the Rotterdam region, the Netherlands. Women were asked about previous screening attendance and perceived feasibility of antenatal screening, including benefits and harms. Primary outcome was the percentage of women considering antenatal screening feasible. Secondary outcomes included considered benefits and harms of antenatal screening and differences between adequately screened and un-/under screened women.</p><p><strong>Results: </strong>In total, 372 out of 1511 (24.6%) returned the questionnaire. Among respondents 106 of 372 (28.5%) were un-/under screened. Of all responders, 78% considered introduction of antenatal screening a good idea, without difference among adequately screened (78.9%) vs un-/under screened women (75%; P = .25). Benefits of antenatal screening considered most by respondents were a feeling of reassurance (58.5%) and easier scheduling (37.0%).</p><p><strong>Conclusions: </strong>Introduction of cervical cancer screening via obstetric care is considered acceptable by a majority of pregnant women in the Netherlands. Benefits considered most were a feeling of reassurance and easier scheduling of attendance.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"970-976"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery attributions and future expectations for antibiotics after precautionary prescribing.","authors":"Elisabeth D C Sievert, Lars Korn, Rian Gross, Robert Böhm, Cornelia Betsch","doi":"10.1093/eurpub/ckaf146","DOIUrl":"10.1093/eurpub/ckaf146","url":null,"abstract":"<p><p>Antibiotic overuse is a significant public health challenge, and antibiotics are often prescribed as a precaution. While precautionary prescribing often aims to meet perceived patient expectations, it can unintentionally reinforce the belief that antibiotics are necessary and effective. This study examines how the communication of precautionary antibiotic prescribing shapes patients' beliefs in what actually made them better and how these causal beliefs, in turn, affect their expectations for antibiotics in future illness situations. In the two preregistered online experiments with UK adults (N = 252 and N = 2448), participants imagined having an ear infection, receiving a precautionary prescription, taking antibiotics, and recovering shortly thereafter. We manipulated whether participants received statistical information about the likelihood of a self-limiting recovery (base-rate information) before the prescription. Participants then evaluated what caused their recovery and whether they expected to receive antibiotics for a future, unrelated illness. Across both studies, participants generally attributed their recovery to the antibiotics, even when told that the infection was likely to resolve on its own. This attribution was associated with stronger expectations of receiving antibiotics for future illnesses. However, participants who received base-rate information more accurately attributed their recovery, suggesting that statistical context can partially correct causal beliefs. Precautionary prescribing can unintentionally shape patients' beliefs about antibiotic efficacy, which, in turn, reinforces future demand. Providing patients with brief information on self-limiting infections may help reduce inappropriate antibiotic expectations and support prudent and more sustainable prescribing practices.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"1020-1025"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost-effectiveness of education and support group interventions aimed at promoting breastfeeding.","authors":"Ifigeneia Mavranezouli, Sharangini Rajesh, Shalmali Deshpande, Vivien Swanson, Charlotte Wright, Samantha Ross, Victoria L Sibson, Karen McLean, Anita Kambo, Shereen Fisher, Patrick Muller, Maija Kallioinen","doi":"10.1093/eurpub/ckaf172","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf172","url":null,"abstract":"<p><p>Breastfeeding, especially exclusive, is associated with long-lasting health benefits to mothers and babies and healthcare cost-savings; however, breastfeeding rates are low in many high-income countries. Education and support interventions are effective in promoting breastfeeding but evidence on their cost-effectiveness is limited, uncertain, or negative. Our study objective was to assess the cost-effectiveness of group-based breastfeeding interventions from the National Health Service (NHS) and Personal Social Services (PSS) perspective in England. We used decision-analytic modelling to estimate incremental costs, clinical benefits (prevention of infections and death in babies, prevention of breast cancer in mothers) and quality-adjusted life-years (QALYs) of group breastfeeding interventions from the NHS/PSS perspective in England. A systematic review and meta-regression of randomized controlled trials was performed to estimate intervention effectiveness, while data on the benefits of breastfeeding were obtained from large published meta-analyses. Other model inputs were derived from published literature and national statistics. Compared with standard care alone, group breastfeeding interventions resulted in fewer infections and deaths in babies, fewer cases of breast cancer in mothers and higher QALYs (0.004 per mother-baby dyad), through increased rates of breastfeeding, and yielded cost-savings (£89 per mother-baby dyad) that outweighed intervention costs (£28 per mother-baby dyad). Group interventions that promote breastfeeding by providing education, advice and support to mothers are likely cost-effective in England. Further research should enhance the evidence base on the clinical and cost-effectiveness of breastfeeding interventions, considering their differential effects on different socioeconomic groups and a wider range of clinical benefits of breastfeeding.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective associations between diabetes and depressive symptoms across European regions: a secondary analysis of ELSA, TILDA, and SHARE datasets.","authors":"Jaroslav Gottfried, Katarzyna Gajewska, Belinda Hernández, Rose Anne Kenny, Cathy Lloyd, Arie Nouwen, Shane O'Donnell, Ricardo Rodrigues, Norbert Schmitz, Sonya Deschênes","doi":"10.1093/eurpub/ckaf132","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf132","url":null,"abstract":"<p><p>This article investigates predictive associations between diabetes and depressive symptoms across Ireland, the United Kingdom, and four European regions. The data were obtained by merging datasets from three large prospective cohort studies-the English Longitudinal Study on Ageing, The Irish Longitudinal study on Ageing, and the Survey on Health, Ageing and Retirement in Europe. We first applied a survival analysis design to two samples of 43 061 and 35 993 participants, investigating elevated depressive symptoms as a risk factor for diabetes, and diabetes as a risk factor for elevated depressive symptoms, respectively. We next applied a multilevel modeling approach to examine depressive symptoms before, during, and after diabetes onset across 101 799 participants. We found a bidirectional association between diabetes and depressive symptoms; however, the strength of these associations did not significantly differ between the regions (P > .01). The results also showed that individuals with newly diagnosed diabetes consistently reported higher depressive symptoms than those without diabetes, even before diagnosis. However, we observed no country-specific differences in the gradual changes in depressive symptoms regardless of participants' diabetes status. Diabetes at baseline was associated with higher risk of developing depression; and vice versa. These associations were not moderated by geographical location. Therefore, the risks of diabetes and depressive symptoms comorbidity seem to be equal across all observed geographic regions.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}