JMIR Public Health and Surveillance最新文献

{"title":"Determinants of Health-Promoting Behaviors Among Indonesian Adolescents Living in Child Welfare Institutions: Cross-Sectional Survey Study.","authors":"Aloysia Ispriantari, Hyejung Lee, Sue Kim, Hyeonkyeong Lee, Anna Lee, Chang Park","doi":"10.2196/75024","DOIUrl":"10.2196/75024","url":null,"abstract":"<p><strong>Background: </strong>Adolescents in child welfare institutions often face inadequate facility resources, limited caregiver support, and restricted access to health care services. These obstacles impede their physical, mental, and social development during adolescence, resulting in significant health vulnerabilities. Engaging in health-promoting behaviors (HPBs) can enhance their overall health and quality of life, potentially contributing to improved long-term well-being.</p><p><strong>Objective: </strong>This study aimed to identify the HPBs of adolescents in child welfare institutions in Indonesia and explore the determinants influencing these behaviors using the health promotion model.</p><p><strong>Methods: </strong>This study used a cross-sectional survey design. Adolescents living in welfare institutions were recruited from January 14, 2024, to February 3, 2024. After obtaining institutional review board approval, 6 research assistants visited 17 institutions in Malang and collected data from participants who provided their consent using tablet PCs that linked to the questionnaire. The variables studied included HPBs, health literacy, self-esteem, perceived barriers to action, perceived self-efficacy, and social support. Multivariate structural analysis was conducted using SPSS Statistics (version 26.0; IBM Corp) and SPSS Amos (version 26.0; IBM Corp).</p><p><strong>Results: </strong>A total of 276 adolescents participated in this study. Adolescents' HPBs differed significantly based on age group (P=.03), educational level (P=.04), duration of stay in child welfare institutions (P=.03), and the institutions' accreditation level (P=.02). In the final model, perceived self-efficacy (β=0.538; P<.001) and social support (β=0.256; P<.001) together accounted for 47.9% of the variance in HPBs. Self-esteem was positively correlated with perceived self-efficacy (β=0.184; P<.001) and social support (β=0.303; P<.001) but negatively correlated with perceived barriers to action (β=-0.194; P<.01). Health literacy was also negatively correlated with perceived barriers to action (β=-0.234; P<.001). Self-esteem indirectly affected HPBs through perceived self-efficacy (β=0.099; P<.01) and social support (β=0.078; P<.001).</p><p><strong>Conclusions: </strong>To improve the HPBs of adolescents living in child welfare institutions, their self-esteem needs to be increased to further enhance their self-efficacy and social support. Careful attention and monitoring of HPBs among these adolescents may lead to better health outcomes and support their transition from child welfare institutions to the broader community.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e75024"},"PeriodicalIF":3.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Factors Associated With Spatial Clustering of Incident HIV Infection Cases in High-Prevalence Regions: Quantitative Geospatial Study.","authors":"Qiyu Zhu, Chunnong Jike, Chengdong Xu, Shu Liang, Gang Yu, Dan Yuan, Hong Mai, Yiping Li, Lin Xiao, Ju Wang, Hong Yang, Fengshun Yuan, Jing Hong, Muga Mao, Maogang Shen, Jing Liu, Lin He, Yuehua Wang, Huanyi Cheng, Peng Guan, Yan Jiang, Mengjie Han, Cong Jin, Zhongfu Liu","doi":"10.2196/75291","DOIUrl":"10.2196/75291","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Incident HIV infection is a critical indicator of an ongoing epidemic, particularly in high-burden regions such as Liangshan Yi Autonomous Prefecture in China, where HIV prevalence exceeds 1% in 4 key counties (Butuo, Zhaojue, Meigu, and Yuexi). Identifying spatial clusters and drivers of recent infections is essential for implementing targeted interventions. Despite advancements in geospatial analyses of HIV prevalence, studies identifying drivers of incident HIV clustering remain limited, especially in low-resource settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to identify spatial clusters of recent HIV infections and investigate potential driving factors in 4 key counties of the Liangshan Yi Autonomous Prefecture to inform targeted intervention strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From November 2017 to June 2018, we identified 246 (4.42%) recent HIV infection cases from 5555 newly diagnosed cases through expanded testing of the whole population in 4 key counties of Liangshan Yi Autonomous Prefecture. Recent infection cases were confirmed using limiting antigen avidity enzyme immunoassays or documented seroconversion within 6 months. The spatial distribution of incident HIV infection cases was analyzed using kernel density. Potential drivers, including population density, HIV prevalence, elevation, nighttime light index, urban proximity, and antiretroviral therapy (ART) coverage, were analyzed. The spatial lag regression model was used to identify factors associated with clustering of recent infection cases. The Geodetector q-statistic was used to quantify nonlinear interactive effects among these factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant spatial autocorrelation was observed in the distribution of recent HIV cases (Moran I=0.11; P&lt;.01). Six spatial clusters were identified, and all were located near urban centers or major roads. Furthermore, 5 factors were identified by the spatial lag regression model as being significantly correlated with the clustering of recent HIV infection cases, including population density (β=0.59; P&lt;.001), HIV prevalence (β=0.02; P&lt;.001), distance to local urban area (β=-3.10; P=.01), SD of elevation (β=-0.15; P=.02), and ART coverage rate (β=183.80; P&lt;.01). Geodetector analysis revealed strong interactive effects among these 5 factors, with population density and HIV prevalence exhibiting the largest interactive effect (q=0.69).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study reveals that besides HIV prevalence, urbanization-related factors (population density and proximity to urban area) and transportation accessibility drive incident HIV clustering in Liangshan Yi Autonomous Prefecture. Paradoxically, higher ART coverage was associated with increased transmission, suggesting the need for integrated prevention strategies beyond ART expansion. Furthermore, the township-level geospatial approach provides a valuable model for pinpointing transmission hot spot","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e75291"},"PeriodicalIF":3.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal Trends in Deaths From External Causes in Brazil: 23-Year Ecological and Population-Based Study.","authors":"Lucas Almeida Andrade, Wandklebson Silva da Paz, Luís Ricardo Santos de Melo, Débora Dos Santos Tavares, Alvaro Francisco Lopes de Sousa, Emerson Lucas Silva Camargo, Carla Aparecida Arena Ventura, Regina Claudia Silva Souza, Karina Conceição Gomes Machado de Araújo, Carlos Dornels Freire de Souza, Allan Dantas Dos Santos, Fagner Alfredo Ardisson Cirino Campos, Márcio Bezerra Santos","doi":"10.2196/68002","DOIUrl":"10.2196/68002","url":null,"abstract":"<p><strong>Background: </strong>Mortality from external causes is a major public health issue globally, with significant impacts on both lives and economies. In Brazil, external cause mortality has shown spatiotemporal variations across regions, influenced by social, economic, and demographic factors.</p><p><strong>Objective: </strong>This study aimed to examine the spatiotemporal dynamics of mortality from external causes in Brazil for 23 years (2000-2022), identifying patterns across regions and demographic groups and assessing the major contributing causes of death.</p><p><strong>Methods: </strong>This ecological study used data from the Brazilian Mortality Information System (SIM) and used joinpoint regression to analyze temporal trends, Moran I for spatial analysis, and Poisson scanning statistics for spatiotemporal patterns. A total of 3,240,023 deaths were analyzed, with specific attention given to regional and demographic disparities.</p><p><strong>Results: </strong>The study found that mortality from external causes remained significant, with men and young adults (20-39 years) having the highest rates of death. The main causes of death were assaults (36.61%), transport accidents (26.55%), falls (7.83%), and self-harm (7.43%). Despite an overall decrease in mortality, increases were observed in the North and Northeast regions and among the older adults. High-risk areas were predominantly located in the North, Northeast, and Central-West regions. The mortality trends varied by region, with significant differences in risk across the country.</p><p><strong>Conclusions: </strong>Although there was a general reduction in mortality from external causes in Brazil, this trend was not uniform across all regions. The North, Northeast, and Central-West regions showed the highest mortality risks, with men and young adults being the most affected demographic groups. These findings emphasize the need for targeted public health interventions that address the regional and demographic disparities in mortality from external causes.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e68002"},"PeriodicalIF":3.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/Ethnic Inequities in Polysubstance Use Among Online Help-Seeking Sexual and Gender Minoritized People in San Francisco From 2022 to 2025: Cross-Sectional Study.","authors":"Jarett Maycott, Sean Arayasirikul","doi":"10.2196/82313","DOIUrl":"10.2196/82313","url":null,"abstract":"<p><p>This research letter characterizes racial/ethnic disparities in polysubstance use among 409 online help-seeking sexual and gender minoritized people in San Francisco. Findings demonstrate the central role of tobacco as a co-occurring substance for participants who are Black, Indigenous, and people of color compared to their White counterparts.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e82313"},"PeriodicalIF":3.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Long-Acting Injectable Pre-Exposure Prophylaxis Among Men Who Have Sex With Men and Transgender Individuals in Europe Using Structural Text Modeling Technique: Cross-Sectional Study.","authors":"Haoyi Wang, Johann Kolstee, Julio Croce Martinez, David van de Vijver, Jonathan Tosh, Melanie Schroeder, Ama Appiah, Hanne Ml Zimmermann, Kai J Jonas","doi":"10.2196/72491","DOIUrl":"10.2196/72491","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Oral pre-exposure prophylaxis (PrEP) effectively prevents HIV but remains unevenly accessible across Europe. Long-acting PrEP (LA-PrEP), recently approved in Europe, offers new HIV protection options. However, no qualitative evidence is available to inform people's perceptions of this novel modality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study provides the first large-scale, qualitative evidence in English from 20 European countries on how men who have sex with men (MSM) and trans* individuals perceive LA-PrEP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed open-ended responses from 3123 HIV-negative MSM and trans* individuals from 20 European countries who completed the PROTECT survey in English. Participants were asked to describe what LA-PrEP means to them using words or short phrases. We used word clouds for initial insights and structural topic modeling to identify topics and explore their relevance across socioeconomic status, migration background, oral PrEP use, and affordability and the association of these perceptions with LA-PrEP intention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The responses reflected generally positive associations toward LA-PrEP, with the most frequently mentioned word being \"safe,\" \"freedom,\" and \"convenient.\" However, some ambivalent and negative perceptions, such as \"nothing,\" \"unknown,\" \"dunno,\" and \"unnecessary,\" were also noted. Structural topic modeling identified 5 main response topics: safety, empowerment, convenience/reliability, peace of mind, and concerns/uncertainties. The empowerment offered by LA-PrEP was the most prominent topic, representing one third (28.1%) of the responses, followed by safety (21%), convenience and reliability (16%), and peace of mind (15%), while concerns/uncertainties made up 20%. Variation in the relevance of these topics was found, showing LA-PrEP being seen as more empowering (=.070, 95% CI 0.042-0.097) and convenient (=.057, 95% CI 0.034-0.081) by current oral PrEP users, but less empowering (=-.052, 95% CI -0.087 to 0.017) and convenient (=-.034, 95% CI -0.064 to 0.005) for individuals in countries with limited oral PrEP access and affordability. The topic of safety was more relevant among those with lower levels of education (=.052, 95% CI 0.022-0.083) and those living in a country where PrEP was not reimbursed (=.035, 95% CI 0.002-0.069), but less relevant among current oral PrEP users (=-.094, 95% CI -0.12 to 0.066). We also found that ambivalent and negative perceptions were less relevant among current oral PrEP users (=-.032, 95% CI -0.056 to 0.007) and were negatively associated with a lower intention to use LA-PrEP (=-.075, 95% CI -0.101 to 0.005).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our research showed that MSM and trans* individuals in Europe generally have a positive outlook on LA-PrEP, suggesting it is likely to be well accepted upon its introduction in Europe. However, a subset of the target population may be hesitant to adopt LA-PrEP, und","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e72491"},"PeriodicalIF":3.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Success Factors for Optimizing COVID-19 Vaccine Uptake Among Indigenous Populations in Taiwan: Cross-Sectional Questionnaire Survey.","authors":"Jia-Chi Tu Abùs Isbabanal, Ray-E Chang, Liam O'Neill, Ting-Hung Chen, Po-Han Lee, Tsan-Teng Ou","doi":"10.2196/75278","DOIUrl":"10.2196/75278","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has devastated economies and strained health care systems worldwide. Vaccination is crucial for outbreak control, but disparities persist between and within countries. In Taiwan, certain indigenous regions show lower vaccination rates, prompting comprehensive inquiries.</p><p><strong>Objective: </strong>This study aims to identify predictors for COVID-19 vaccination and develop strategies for indigenous communities.</p><p><strong>Methods: </strong>This cross-sectional study, conducted from May 13 to July 18, 2022, surveyed indigenous community members older than 55 years residing in a mountain area in southern Taiwan. Based on the health belief model, the questionnaire covered sociodemographic factors, health-related issues, and trust in physicians. The analysis included bivariate analysis, logistic regression, and mediation analysis.</p><p><strong>Results: </strong>Most participants (N=203) were aged 55-64 years (102/203, 50.2%), female (129/203, 63.5%), married (104/203, 51.2%), with low education (165/203, 81.3%), and engaged in agriculture (79/203, 38.9%) or were unemployed (104/203, 51.2%). Logistic regression revealed that unvaccinated individuals were significantly more likely to perceive lower COVID-19 threats (P=.03), fewer vaccination benefits (P=.04), higher barriers to vaccination (P=.02), and weaker responses to external cues to action (P<.001), while no significant differences were observed in trust in physicians. Mediation analyses further indicated that trust in physicians influenced vaccine uptake indirectly through perceived barriers. The indirect effect was statistically significant (95% bootstrap CI 0.013 to 0.437), suggesting a full mediation effect.</p><p><strong>Conclusions: </strong>Effective pandemic prevention strategies for indigenous communities should be grounded in a nuanced understanding of local needs and incorporate bottom-up approaches to avoid cultural saturation and the exacerbation of existing health disparities. Ensuring the accuracy and clarity of vaccine-related information received by indigenous older adults is essential. Local health authorities should consider deploying health care professionals to engage directly with indigenous older adults and their caregivers, delivering culturally appropriate and evidence-based information to address concerns regarding vaccine safety and perceived risks. Such efforts are critical to strengthening vaccine confidence and increasing vaccination uptake in these communities.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e75278"},"PeriodicalIF":3.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Social Media Strategies in Community-Partnered HIV Research: Practical Considerations From 3 Ongoing Studies.","authors":"Elena P Rosenberg-Carlson, Tamra B Loeb, Raquel G Hernandez, Jane J Lee, Aima A Ahonkhai, Jessica M Perkins, Chunqing Lin, Sung-Jae Lee, Sharon Hurt, Luke Johnsen, Alison B Hamilton","doi":"10.2196/73318","DOIUrl":"10.2196/73318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In recent years, social media has emerged as a pivotal tool in implementation science efforts to address the HIV epidemic. Engaging community partners is essential to ensure the successful and equitable implementation of social media strategies. There is a notable lack of scholarship addressing the operational considerations for studies using social media strategies in community-partnered HIV research. This article seeks to bridge this gap by consolidating field notes and practical considerations derived from 3 ongoing NIH-supported studies focused on Ending the HIV Epidemic in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This article aims to inform the design, planning, and implementation of operationally effective community-partnered social media strategies in HIV research, ultimately contributing to enhancements in HIV practice and improved outcomes across the HIV prevention and care continua.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Supported by the University of California, Los Angeles Rapid, Rigorous, Relevant (3R) Implementation Science Hub, the 3 Ending the HIV Epidemic projects convened to form the community-partnered social media campaigns working group. The working group used the Consolidated Framework for Implementation Research to help identify and organize key barriers and facilitators of relevance to implementation of the projects' social media strategies. Given the high degree of interrelatedness across reported factors, the working group thematically synthesized the content into 5 practical considerations to inform use of community-partnered social media strategies in HIV research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The practical considerations identified by the community-partnered social media campaigns working group include the following: (1) the power and pitfalls of social media platforms (ie, opportunities and challenges inherent to social media platforms that may affect use of social media strategies in HIV research), (2) messengers and messages matter (ie, ensuring the appropriateness, acceptability, and quality of social media messengers and content), (3) the significance of the sociopolitical environment (ie, characterizing the sociopolitical environment surrounding HIV and its potential impact on implementing social media strategies to reach priority populations), (4) investing in academic-community partnerships (ie, cultivating positive and productive academic-community partnerships to support implementation of social media strategies in HIV research), and (5) the alignment of the institutional environment and research approach (ie, assessing and working to address features of institutional environments that may impact implementation of social media strategies in community-partnered HIV research).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;As use of social media in HIV research and practice continues to grow, the practical considerations presented in this paper can help research teams anticipate fa","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e73318"},"PeriodicalIF":3.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and Risk Factors of Scrub Typhus in South Korea, From 2013 to 2019: Bayesian Spatiotemporal Analysis.","authors":"Jeehyun Kim, Penelope Vounatsou, Byung Chul Chun","doi":"10.2196/68437","DOIUrl":"10.2196/68437","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Scrub typhus (ST), also known as tsutsugamushi disease, is a common febrile vector-borne illness in South Korea, transmitted by trombiculid mites infected with Orientia tsutsugamushi, with rodents serving as the main hosts. Although vector-borne diseases like ST require both a One Health approach and a spatiotemporal perspective to fully understand their complex dynamics, previous studies have often lacked integrated analyses that simultaneously address disease dynamics, vectors, and environmental shifts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to explore spatiotemporal trends, high-risk areas, and risk factors of ST by simultaneously incorporating host and environmental information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;ST cases were extracted from the 2013-2019 Korea National Health Insurance Service data at 250 municipal levels and by epidemiological weeks (International Classification of Diseases, Tenth Revision, Clinical Modification code: A75.3). Data on potential risk factors, including the maximum probability of rodent presence, area of dry field farming, forest coverage, woman farmer population, and financial independence, were obtained from publicly available sources. In particular, the maximum rodent presence probability was estimated using a maximum entropy model incorporating ecological and climate variables. Spatial autocorrelation was assessed using Global Moran I statistics with 999 Monte Carlo permutations. Spatial and temporal clusters were identified using Getis-Ord Gi* and hot and cold spot trend analyses. Bayesian hurdle models with a spatiotemporal interaction term, accounting for zero-inflated Poisson distribution, were used to identify associations between ST incidence and regional factors. Stratification analyses by gender and age group (0-39, 40-59, 60-79, and ≥80 years) were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between 2013 and 2019, 95,601 ST patients were reported. ST incidence had positive spatial autocorrelation (I=0.600; P=.01), with spatial expansion from southwestern to northeastern regions. Spatiotemporal models demonstrated better fit compared with spatial and temporal models, as indicated by lower Watanabe-Akaike information criterion (WAIC) values. Municipalities with higher rodent suitability (β coefficient=0.618; 95% credible interval [CrI] 0.425-0.812) and lower financial independence from central government (β coefficient=-0.304; 95% CrI -0.445 to -0.163) had higher likelihoods of increased ST incidence, even after adjusting for spatiotemporal autocorrelation. However, risk factors varied by age group: among individuals aged 40 years or older, ST incidence was positively associated with rodent suitability, while patients in the 0-39 years age group showed no association with rodent suitability (β coefficient=0.028; 95% CrI -0.072 to 0.126), and ST incidence was negatively associated with the women farmer population (β coefficient=-0.115; 95% Crl=-0.223 to -0.006).&lt;/p&gt;&lt;p&gt;","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e68437"},"PeriodicalIF":3.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Injury Registry Data on Policymaking, Hospitalizations, and Mortality: Systematic Review.","authors":"Ana Cláudia Medeiros-de-Souza, Luana Emanuelly Sinhori Lopes, Tayna Felicissimo Gomes de Souza Bandeira, Lucas Reis Correia, Naiza Nayla Bandeira de Sá, Bruno Zocca de Oliveira","doi":"10.2196/67115","DOIUrl":"10.2196/67115","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Brazilian project, launched in 2021, aims to establish a nationwide injury registry that systematically collects detailed information on incidents and individuals across the country, regardless of injury severity. The registry integrates information from prehospital and hospital care, various health systems lacking interoperability, and data from sectors such as firefighters and police. Its primary aim is to enhance health surveillance by providing timely, high-quality information that guides prevention strategies and informs policymaking. In addition, the project seeks to reduce morbidity and mortality associated with injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the effects of injury registry data on policymaking, hospitalization rates or duration, and mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD42023481528). A total of 5 databases were searched in November 2023, with an update conducted in March 2024, incorporating reference lists from the studies included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, resolving disagreements with a third reviewer. Studies were eligible if they reported results related to the implementation and use of injury or trauma registry data for at least one outcome of interest, while those based on other sources were excluded. Synthesis of findings was presented in tables, and the observed results were reported as number or percentage differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 9100 studies retrieved, 3951 were excluded due to duplication, leaving 5149 for selection, with 15 full texts reviewed. Only 5 studies met the inclusion criteria, highlighting a notable scarcity of research on the effects or results of registry data on injury outcomes. It is important to note that the studies included reflect correlations rather than causalities, and there are currently no publications on impact. The findings suggest that injury and trauma registries have the potential to inform policymaking, which can lead to enhanced health outcomes. One study noted a 3-day reduction in intensive care unit stay (from 16 to 13 days; P&lt;.05) and a 4% reduction in expected hospital mortality (from 17.5% to 21.5%) for patients with an Injury Severity Score ≥16, while another showed a 42% annual decrease in traffic injury hospital admissions (from 45 to 16). Significant methodological heterogeneity and the small number of studies limited the feasibility of a meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Establishing an injury registry in Brazil presents a significant opportunity to enhance health outcomes through informed policymaking. While it is crucial to set appropriat","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e67115"},"PeriodicalIF":3.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Commercial Food Environments on Local Type 2 Diabetes Burden: Cross-Sectional and Ecological Multimodeling Study.","authors":"Kurubaran Ganasegeran, Mohd Rizal Abdul Manaf, Lance A Waller, Nazarudin Safian, Muhammad Faid Mohd Rizal, Wye Lee Chiew, Feisul Mustapha, Khairul Nizam Abdul Maulud","doi":"10.2196/70045","DOIUrl":"10.2196/70045","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neighborhoods resulting from rapid urbanization processes are often saturated with eateries for local communities, potentially increasing exposure to unhealthy foods and creating diabetogenic residential habitats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We examined the association between proximity of commercial food outlets to local neighborhood residences and type 2 diabetes (T2D) cases to explore how local T2D rates vary by location and provide policy-driven metrics to monitor food outlet density as a potential control for high local T2D rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional ecological study included 11,354 patients with active T2D aged ≥20 years geocoded using approximate neighborhood residence aggregated to area-level rates and counts by subdistricts (mukims) in Penang, northern Malaysia. We used the National Diabetes Registry complemented with data from medical records across 29 primary care clinics throughout the state. Food establishment data were retrieved from the Open Data Portal sourced through the Penang GeoHub, and urbanization indicators were retrieved from MyCensus 2020. We executed point-level proximity- and density-based area-level analysis through multimodel aspatial and spatial regression methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our final hierarchical linear regression revealed that the distance to food complexes, hawker markets, kopitiams (a type of coffee shop), 24-7 convenience stores, fast food outlets, and public markets showed statistically significant associations (P&lt;.05) with the age and BMI of patients with T2D. In the multiscale geographically weighted regression model, the adjusted R&lt;sup&gt;2&lt;/sup&gt; values ranged from 0.15 to 0.62, with lower values observed across the mainland. The multiscale geographically weighted regression model yielded average β coefficients for densities of kopitiams (β=0.256), fast food outlets (β=-0.061), 24-7 convenience stores (β=0.028), supermarkets (β=0.122), public markets (β=0.067), and nasi kandar (a type of rice dish) restaurants (β=-0.064), urban growth rate (β=0.189), and population density (β=-0.080; t&lt;sub&gt;65.835&lt;/sub&gt;≥1.96 in all cases). We established population-attributable fractions suggesting that, if local neighborhoods underwent township restructuring to remove food complexes, hawker markets, or kopitiams, an estimated reduction of 0.21%, 0.27%, and 0.09%, respectively, in the risk of T2D cases in Penang would be anticipated. However, if local neighborhoods underwent township restructuring to add hawker complexes, nasi kandar restaurants, fast food outlets, 24-7 convenience stores, public markets, or supermarkets, an estimated reduction of between 0.07% and 0.64% in the number of residents with risk of T2D was estimated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The reported variations provide insights into the associations between high neighborhood T2D rates and the density of a range of food outlets. We observed that these associatio","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e70045"},"PeriodicalIF":3.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}