Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1632029
Odhran Mallon, Freddy Lippert, Eva Pilot
{"title":"Artificial intelligence in prehospital emergency care systems in low- and middle-income countries: cure or curiosity? Insights from a qualitative study.","authors":"Odhran Mallon, Freddy Lippert, Eva Pilot","doi":"10.3389/fpubh.2025.1632029","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1632029","url":null,"abstract":"<p><strong>Introduction: </strong>The adoption of artificial intelligence (AI) in prehospital emergency medicine has predominantly been confined to high-income countries, leaving untapped potential in low- and middle-income countries (LMICs). AI holds promise to address challenges in out-of-hospital care within LMICs, thereby narrowing global health inequities. To achieve this, it is important to understand the success factors and challenges in implementing AI models in these settings.</p><p><strong>Methods: </strong>A scoping review of peer-reviewed studies and semi-structured expert interviews were conducted to identify key insights into AI deployment in LMIC prehospital care. Data collection occurred between June and October 2024. Using thematic analysis, qualitative data was systematically coded to extract common themes within the studies and interview transcripts. Themes were then summarised narratively and supplemented with illustrative quotations in table format.</p><p><strong>Results: </strong>From 16 articles and nine expert interview transcripts, five core themes emerged: (1) the rapid, iterative development of AI technologies; (2) the necessity of high-quality, representative, and unbiased data; (3) resource gaps impacting AI implementation; (4) the imperative of integrating human-centred design principles; and (5) the importance of cultural and contextual relevance for AI acceptance.</p><p><strong>Conclusion: </strong>Additional focus on these areas can help drive the sustainable utilisation and ensuing development of AI in these environments. Strengthening collaboration and education amongst stakeholders and focusing on local needs and user engagement will be critical to promoting future success. Moving forwards, research should emphasise the importance of evidence-based AI development and appropriate data utilisation to ensure equitable, impactful solutions for all users.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1632029"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307453","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1614150
Yuexuan Wu, Zijian Liu, Xuemei He, Xianru Shang
{"title":"Improving the smart care service system for older adults: an emotional experience evaluation framework in the Chinese community.","authors":"Yuexuan Wu, Zijian Liu, Xuemei He, Xianru Shang","doi":"10.3389/fpubh.2025.1614150","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1614150","url":null,"abstract":"<p><strong>Objectives: </strong>Given the rapid growth of the older population, an emotional experience evaluation system is proposed to quantitatively analyze the emotional experiences of older adults within the smart care service system in the current Chinese community settings.</p><p><strong>Methods: </strong>The study is informed by the Pleasure-Arousal-Dominance (PAD) emotion theory and guided by service design thinking. Qualitative research methods were employed to gather information about older adults within the target community. By mapping service scenario interaction touchpoints, the research team deconstructed, clustered, and transformed the system service touchpoints. Evaluation indicators were set from three aspects: smart devices, online software, and offline services, to construct an emotional experience evaluation system. Using quantitative research methods, with user emotional valence as the variable, the study conducted measurement experiments on the emotional experience evaluation of older users, obtaining measurement results from two dimensions: emotional experience tendencies and emotional requirement assessment.</p><p><strong>Results: </strong>We organized the results of emotional experience evaluation data, analyzed the indicator data of each part of the system through visual analysis graphics, and proposed improvement strategies for the three structures of the smart care service system.</p><p><strong>Conclusion: </strong>Care for older adults is facing multifaceted challenges, our research results have obtained the emotional tendencies of older adults toward each indicator of the system. In addition, we have obtained the judgment results of emotional demand for each indicator, analyzed the reasons from both emotional and demand dimensions, proposed service strategies to improve the system, and facilitated the implementation of a circular economy model in community care services for older adults.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1614150"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307594","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1679832
Shuo Peng, Hongzhi He, Xi Luo, Jingping Kang, Xinyi Wang, Yongqiong Tan
{"title":"Real experiences and care needs of frail older patients: a systematic review of qualitative studies.","authors":"Shuo Peng, Hongzhi He, Xi Luo, Jingping Kang, Xinyi Wang, Yongqiong Tan","doi":"10.3389/fpubh.2025.1679832","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1679832","url":null,"abstract":"<p><strong>Objective: </strong>By conducting a meta-synthesis of qualitative research, this study evaluates the real experiences and care needs of frail older patients, providing valuable references and insights for care service providers, policymakers, and medical researchers in developing intervention programs.</p><p><strong>Design: </strong>PubMed, Web of Science, Scopus, Embase, CINAHL, and PsycINFO were searched from the establishment of the databases to August 25, 2024.</p><p><strong>Setting: </strong>The real experiences and care needs of frail older patients are gradually becoming the focus of social attention. Qualitative research is of great significance for improving the quality of care services for such patients in the future.</p><p><strong>Outcome measures: </strong>The quality of the studies included was appraised using the Joanna Briggs Institute Quality Assessment of Qualitative Research criteria. Data extraction was performed using NVivo (v14), and results were synthesized using a meta-synthesis approach.</p><p><strong>Results: </strong>511 frail older patients were included in 15 studies. Three main themes were identified: the negative impact of frailty on the physical, psychological, and behavioral aspects of older patients; positive attitudes toward the current situation among frail older patients; and the multidimensional care needs of frail older patients.</p><p><strong>Conclusion: </strong>Frail older adults face multidimensional challenges in physiology, psychology, and behavior, and have care needs in areas such as professional services and social support.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251038626.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1679832"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307543","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1652535
Bradd Mendoza-Guido, Jose R Montiel-Mora, Cristina Ureña-Salazar, Kenia Barrantes, Luz Chacón
{"title":"Molecular epidemiology of aquatic environments: challenges from sampling to implementation of surveillance programs.","authors":"Bradd Mendoza-Guido, Jose R Montiel-Mora, Cristina Ureña-Salazar, Kenia Barrantes, Luz Chacón","doi":"10.3389/fpubh.2025.1652535","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1652535","url":null,"abstract":"<p><p>Pathogens are introduced into wastewater through human and animal fecal discharge, ultimately contaminating aquatic environments such as rivers and beaches. Molecular tools are commonly used to track outbreak-related pathogens in wastewater due to numerous advantages such as enhanced sensitivity, speed, and specificity. However, many low- and middle-income countries (LMICs) face challenges in developing adequate sanitation infrastructure and accessing or implementing high-cost technologies, which hampers the integration of environmental surveillance into national and regional public health programs. This mini-review summarizes key challenges in applying molecular techniques for water-based epidemiological monitoring of waterborne pathogens in resource-limited settings. We examine obstacles related to sampling aquatic environments, including collecting samples from rivers and concentrating analytes from complex matrices such as wastewater and polluted river or beach waters, emphasizing the importance of preserving environmental representativeness. We provide a brief overview of the most widely used PCR-based technologies for detecting waterborne pathogens and antimicrobial resistance genes (ARGs), discussing their advantages and limitations. We also examine advanced high-throughput technologies, often inaccessible in LMICs, and emerging portable tools that may enhance detection where laboratory infrastructure is limited. Finally, through applied examples, we show how environmental data can make pathogen surveillance more accessible while bridging laboratory research with public health practice.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1652535"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307573","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1670103
Zhaoxia Xu
{"title":"Association between nutritional factors and myopia in adolescents: a systematic review and meta-analysis.","authors":"Zhaoxia Xu","doi":"10.3389/fpubh.2025.1670103","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1670103","url":null,"abstract":"<p><strong>Background: </strong>Myopia is a highly prevalent eye disorder among adolescents, and an increasing body of research indicates that nutritional factors may have a significant impact on its development. However, the nature and extent of these relationships remain unclear. This systematic review and meta-analysis aimed to comprehensively evaluate the associations between various nutritional factors, including carbohydrates, proteins, cholesterol, and sodium, and myopia in adolescents.</p><p><strong>Methods: </strong>Multiple databases, such as PubMed, Web of Science, Scopus, and Embase, were systematically searched up to February 15, 2025. The inclusion criteria encompassed observational studies published in English, involving adolescents (aged 6-18 years), and reporting data on the intake of the selected nutritional factors and myopia status. Two reviewers independently screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for continuous outcomes. Random-effects models were applied to account for potential heterogeneity.</p><p><strong>Results: </strong>A total of 7 articles (8 studies) involving 45,993 adolescents were included. Pooled analysis revealed significant associations between nutritional factors and myopia risk. Higher carbohydrate intake was positively linked to myopia (SMD = 0.36, 95% CI: 0.22-0.50, I<sup>2</sup> = 94.8%, <i>p</i> < 0.001), while protein intake showed a protective effect (SMD = -0.25, 95% CI: -0.27 to -0.23, I<sup>2</sup> = 44.0%, <i>p</i> < 0.001). Cholesterol intake was associated with increased myopia risk (SMD = 0.20, 95% CI: 0.10-0.31, I<sup>2</sup> = 91.7%, <i>p</i> < 0.001), and sodium intake demonstrated a strong positive association (SMD = 1.07, 95% CI: 0.93-1.22, I<sup>2</sup> = 96.0%, <i>p</i> < 0.001). Sensitivity analyses confirmed the robustness of results, and no publication bias was detected.</p><p><strong>Conclusion: </strong>This study suggests potential associations between nutritional factors and myopia in adolescents. Carbohydrates, cholesterol, and sodium were positively associated with myopia, whereas proteins showed a possible protective effect. However, given the small number of available studies, the predominance of cross-sectional designs, and substantial heterogeneity, these findings should be considered preliminary. Future well-designed, longitudinal or interventional studies are required to confirm these associations before any firm dietary recommendations can be made for myopia prevention.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1670103"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307497","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":"Chinese version and application of the global health competencies survey for healthcare professionals.","authors":"Xiaoxi Li, Junjie Jia, Jingjing Hu, Xuqi He, Meiqiong Zheng","doi":"10.3389/fpubh.2025.1624826","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1624826","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to introduce and validate the global health competencies survey (GHCS) in the Chinese healthcare context, addressing the need for a comprehensive tool to assess global health competencies among diverse healthcare professionals.</p><p><strong>Methods: </strong>The GHCS underwent meticulous translation and cultural adaptation, engaging 150 healthcare professionals from various disciplines between 1<sup>st</sup> June and 10<sup>th</sup> December, 2023. The study employed a rigorous methodology involving instrument development, translation, data collection, and statistical analysis. Face and content validity, factor analysis, and internal consistency were assessed to validate the survey.</p><p><strong>Results: </strong>The translated GHCS demonstrated robust reliability (Cronbach's alpha = 0.841) and validity. The survey identified competencies, showcased temporal trends, and informed targeted interventions. No floor or ceiling effects were observed, except for one variable (racial/ethnic disparities).</p><p><strong>Conclusion: </strong>The adapted and validated GHCS emerges as a valuable tool for assessing global health competencies among Chinese healthcare professionals. Implications for research use include identifying knowledge gaps, facilitating program improvements, and contributing to reduced health inequities. Despite limitations, such as the absence of criterion validation and Mandarin administration, the GHCS offers a foundation for further research and program enhancements in China.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1624826"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307522","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1661028
Guanbo Wang, Ranran Xiang, Xuemei Yang, Liang Tan
{"title":"Digital technology empowers exercise health management in older adults: a systematic review and meta-analysis of the effects of mHealth-based interventions on physical activity and body composition in older adults.","authors":"Guanbo Wang, Ranran Xiang, Xuemei Yang, Liang Tan","doi":"10.3389/fpubh.2025.1661028","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1661028","url":null,"abstract":"<p><strong>Background: </strong>Prolonged Sedentary behavior (SB) and lack of Physical Activity (PA) in the older population significantly increase the risk of chronic disease development. The use of mobile health (mHealth) apps may have a positive impact on older adults, helping to increase their physical activity levels and optimize body composition. However, the effectiveness of mHealth-based interventions and potential moderators in this population is not fully understood.</p><p><strong>Objective: </strong>To assess the effectiveness of a mHealth-based intervention in promoting PA/moderate to vigorous physical activity (MVPA), reducing SB, and lowering body mass index (BMI) in older adults. The moderating effects of the mHealth intervention effects were also explored through subgroup analysis.</p><p><strong>Method: </strong>This study searched Embase, PubMed, Web of Science, and Cochrane databases (as of June 2025) to include randomized controlled trials (RCT) evaluating the effects of mHealth on PA, MVPA, SB, and BMI in older adults. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using random effects models.</p><p><strong>Results: </strong>A total of 14 RCTs were included (sample size = 2,511). mHealth intervention significantly elevated PA (SMD = 0.18, 95%CI: 0.01 to 0.35) and MVPA (SMD = 0.48, 95%CI: 0.20 to 0.75) and reduced SB (SMD = -0.55, 95% CI: -0.79 to -0.32), but no significant improvement in BMI (SMD = -0.27, 95% CI: -0.79 to 0.25). Subgroup analyses showed that: Commercial applications were better than research-based applications (PA: SMD = 0.18 vs. 0.07; MVPA: SMD = 0.70 vs. 0.31); more than 3 behavior change techniques (BCTs) interventions were effective for MVPA enhancement (SMD = 0.49) and SB reduction (SMD = -0.77); and the use of a theory paradigm intervention was more effective on SB reduction (SMD = -0.77 vs. 0.38).</p><p><strong>Conclusion: </strong>mHealth apps were effective in increasing PA/MVPA levels and reducing SB levels in older adults, but did not reach statistical significance in terms of BMI improvement. Through subgroup analyses, this study further found that commercial apps demonstrated greater strengths in promoting PA/MVPA; meanwhile, integrating more than 3 BCTs synergistically promoted MVPA levels and reduced SB.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1661028"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307626","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1661141
Yiran Li, Lulu Meng, Siyu Liang, Yan Zhang, Wenjia Li, Jiali Duan, Ruoxiang Cao, Jie Li, Liyu Huang
{"title":"Association between peer behaviors and family environment and pre-packaged sugar-sweetened beverage consumption among primary and secondary school students in Beijing.","authors":"Yiran Li, Lulu Meng, Siyu Liang, Yan Zhang, Wenjia Li, Jiali Duan, Ruoxiang Cao, Jie Li, Liyu Huang","doi":"10.3389/fpubh.2025.1661141","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1661141","url":null,"abstract":"<p><strong>Background: </strong>Sugar-sweetened beverage (SSB) consumption among children and adolescents remains high worldwide. In China, most studies have examined either peer or family influences, but few have assessed their combined effects, particularly for pre-packaged SSBs.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 2,317 primary and secondary school students in Beijing between October and November 2024. Students and their caregivers completed paired questionnaires on pre-packaged SSB consumption and potential influencing factors. Multivariable logistic regression was used to examine associations between peer and family factors and SSB consumption, adjusting for demographic and behavioral covariates.</p><p><strong>Results: </strong>In the past week, 81.9% of students consumed at least one type of pre-packaged SSB. With the increase of age, the intake of SSBs increased in children. Fruit/vegetable beverages were the most commonly consumed beverages for primary school students, and tea beverages were the most commonly consumed beverages for secondary school students. Peer-influenced purchasing behavior (OR: 1.600,95% CI:1.318-1.941), peer-sharing behavior (OR: 1.373,95% CI:1.106-1.704), household accessibility (OR: 1.305,95% CI:1.085-1.570) and parental supportive attitudes toward SSBs (OR: 2.246,95% CI:1.691-2.981) were associated with high consumption of SSBs. Similar associations were observed for carbonated beverages, tea beverages, milk beverages, and other categories, though effect sizes varied.</p><p><strong>Conclusion: </strong>Peer behaviors and family environments substantially influence pre-packaged SSB consumption among children and adolescents in Beijing. Targeted interventions should include banning SSB sales in school canteens, introducing warning labels on high-sugar beverages, and promoting parental education to reduce home availability.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1661141"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307514","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":"Healthcare quality evaluation of tertiary public hospitals in ethnic border regions under China's performance assessment system-based on the entropy weight TOPSIS method and RSR fuzzy set.","authors":"Junjie Huang, Yanlong Wu, HuiPing Pan, Haitao Yuan, Xinwen Liu, Huiyu Wang, Pingping Zeng, Zhong Tang, Pinghua Zhu","doi":"10.3389/fpubh.2025.1668065","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1668065","url":null,"abstract":"<p><strong>Objective: </strong>Performance evaluation is critical for improving healthcare quality and service delivery. This study analyzes the healthcare quality of tertiary hospitals across various cities in Guangxi under China's public hospital performance assessment policy to identify influencing factors and propose targeted improvement strategies for the national evaluation system.</p><p><strong>Methods: </strong>The healthcare quality of general hospitals in Guangxi from 2019 to 2022 was evaluated using a fuzzy set entropy-weighted TOPSIS and RSR method, followed by a comprehensive city-level ranking.</p><p><strong>Results: </strong>Entropy-weighted TOPSIS revealed the top three weighted indicators: (1) number of referred-out patients, (2) low-risk group mortality rate, and (3) proportion of reviewed prescriptions. The quality of H7 and H11 improved significantly, while H9 consistently ranked in the top 4. The RSR stratification classified H1, H2, H8, and H9 as high-performing, H6 and H12 as low-performing, and H4, H5, H6, H12, and H13 as persistently below average for four consecutive years. Using the fuzzy set method, H1, H9, H11, and H1 were ranked as the highest-performing cities from 2019 to 2022, respectively.</p><p><strong>Conclusion: </strong>There are minor discrepancies among the three methodologies, but the trends remain largely consistent. The fuzzy-combined approach provides more robust evaluations, which offers actionable insights for healthcare quality enhancement and management standardization. Consequently, hospitals should improve the quality of services and sustain the core competitiveness of public hospitals by implementing tiered healthcare systems and standardized prescription review protocols.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1668065"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307580","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}
Frontiers in Public HealthPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1644600
Matilde Zornoza-Moreno, Susana Sánchez-Manresa, María Cruz Gómez-Moreno, María Pilar Ros Abellán, Jaime J Pérez-Martín
{"title":"Vaccinating and non-vaccinating parents' attitudes toward influenza vaccination in children under 5 years old in Spain.","authors":"Matilde Zornoza-Moreno, Susana Sánchez-Manresa, María Cruz Gómez-Moreno, María Pilar Ros Abellán, Jaime J Pérez-Martín","doi":"10.3389/fpubh.2025.1644600","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1644600","url":null,"abstract":"<p><strong>Background: </strong>Vaccines against seasonal influenza represent the best option to reduce the cases and severity of the disease in children under 5 years. In Spain, the Region of Murcia was a pioneer in implementing universal vaccination at schools. The study aimed to evaluate the acceptance and attitudes of parents of children of 6-59 months old toward influenza vaccination and factors associated with parents' decision to vaccinate their children during the 2023-2024 campaign.</p><p><strong>Methods: </strong>This prospective, descriptive study used a questionnaire to collect data from parents of vaccinated (VC) and non-vaccinated children (nVC). VC received either the live-attenuated intranasal vaccine (LAIV) or the intramuscular vaccine (IIV) depending on their age.</p><p><strong>Results: </strong>Parent's self-vaccination/intention in this campaign (OR: 8.51) and in the previous one (OR: 4.49), and children's compliance with vaccination schedule (OR: 7.83) were the main factors associated with the probability of children being vaccinated against influenza. The main reason for vaccinating was to protect the child (IIV: 92.5% vs. LAIV: 91.0%), while waiting for further experience with the vaccine (21.0%) and lack of recommendation from the healthcare professional (20.4%) were the major reasons for not vaccinating. Most vaccinating parents (IIV: 90.4% vs. LAIV: 93.9%, <i>p</i> < 0.001) were satisfied with the vaccine. Among VC at school, 95.8% of parents were satisfied and 97.4% would recommend for family and friends.</p><p><strong>Conclusions: </strong>Parents of VC, especially those vaccinated with LAIV at schools, were highly satisfied with the vaccine. Parent's influenza vaccination status and children's compliance with vaccination schedule were determinant for parent's decision to vaccinate children under 5 years old. More information about influenza vaccination could help increase vaccination rates in these children.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1644600"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307684","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}