JMIR Public Health and Surveillance最新文献

{"title":"Impact of the National Essential Public Health Service Package on Blood Pressure Control in Chinese People With Hypertension: Retrospective Population-Based Longitudinal Study.","authors":"Feiran Wei, You Ge, Han Li, Yuan Liu","doi":"10.2196/65783","DOIUrl":"10.2196/65783","url":null,"abstract":"<p><strong>Background: </strong>The National Essential Public Health Service Package (NEPHSP) was launched in 2009 to tackle poor blood pressure control in Chinese people with hypertension; however, it's effect is still unclear.</p><p><strong>Objective: </strong>In a retrospective population-based longitudinal study, we aimed to evaluate effect of the NEPHSP on blood pressure control.</p><p><strong>Methods: </strong>A total of 516,777 patients registered in the NEPHSP were included. The blood pressure control data were assessed based on the Residence Health Record System dataset. We longitudinally evaluated the effects of the NEPHSP on blood pressure control by analyzing changes in blood pressure at quarterly follow-ups. Both the degree and trend of the blood pressure changes were analyzed. We conducted stratified analysis to explore effects of the NEPHSP on blood pressure control among subgroups of participants with specific characteristics.</p><p><strong>Results: </strong>The mean baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 147.12 (SD 19.88) mm Hg and 85.11 (SD 11.79) mm Hg, respectively. The control rates of baseline SBP and DBP were 39.79% (205,630/516,777) and 69.21% (357,685/516,777). Compared to baseline, the mean SBP decreased in each quarter by 5.06 mm Hg (95% CI -5.11 to -5.00; P<.001), 6.69 mm Hg (95% CI; -6.74 to -6.63; P<.001), 10.30 mm Hg (95% CI -10.34 to -10.23; P<.001), and 6.63 mm Hg (95% CI -6.68 to -6.57; P<.001). The SBP control rates increased in each quarter to 53.12% (274,493/516,777; β coefficient=0.60, 95% CI 0.59-0.61; P<.001), 56.61% (292,537/516,777; β coefficient=0.76, 95% CI 0.75-0.77; P<.001), 63.4% (327,648/516,777; β coefficient=1.08, 95% CI 1.07-1.09; P<.001), and 55.09% (284,711/516,777; β coefficient=0.69, 95% CI 0.68-0.70; P<.001). Compared to baseline, the mean DBP decreased in each quarter by 1.75 mm Hg (95% CI -1.79 to -1.72; P<.001), 2.64 mm Hg (95% CI -2.68 to -2.61; P<.001), 4.20 mm Hg (95% CI -4.23 to -4.16; P<.001), and 2.64 mm Hg (95% CI -2.68 to -2.61; P<.001). DBP control rates increased in each quarter to 78.11% (403,641/516,777; β coefficient=0.52, 95% CI 0.51-0.53; P<.001), 80.32% (415,062/516,777; β coefficient=0.67, 95% CI 0.66-0.68; P<.001), 83.17% (429,829/516,777; β coefficient=0.89, 95% CI 0.88-0.90; P<.001), and 79.47% (410,662/516,777; β coefficient=0.61, 95% CI 0.60-0.62; P<.001). The older age group had a larger decrease in their mean SBP (β coefficient=0.87, 95% CI 0.85-0.90; P<.001) and a larger increase in SBP control rates (β coefficient=0.054, 95% CI 0.051-0.058; P<.001). The participants with cardiovascular disease (CVD) had a smaller decrease in their mean SBP (β coefficient=-0.38, 95% CI -0.41 to -0.35; P<.001) and smaller increase in SBP control rates (β coefficient=-0.041, 95% CI -0.045 to -0.037; P<.001) compared to the blood pressure of participants without CVD.</p><p><strong>Conclusions: </strong>The NEPHSP was effective in improving bloo","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e65783"},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364900","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":"Ethical Considerations for Wastewater Surveillance Conducted by the US Department of Defense.","authors":"Hunter Jackson Smith, Richard T Agans, William J Kowallis","doi":"10.2196/67145","DOIUrl":"10.2196/67145","url":null,"abstract":"<p><strong>Unlabelled: </strong>The US Department of Defense (DoD) is establishing its wastewater surveillance capacities to support national security objectives and promote the public health and medical readiness of US service members. Wastewater surveillance is an emerging technology that has traditionally been leveraged for detecting infectious diseases. However, its potential future applications could yield a vast and unpredictable amount of information that could be used for a wide variety of both health- and nonhealth-related purposes. The US military also serves an inimitable role for the country and its citizens, and exercises significant levels of control over its service members compared to civilian organizations. Further, its present and potential wastewater surveillance activities may reach far beyond just military installations. These factors raise unique ethical considerations that must be accounted for by leaders and policymakers to ensure the DoD implements a wastewater surveillance network in a manner that is both impactful in supporting public health and appropriate to the scope and population under surveillance. This paper explores important ethical features in conducting wastewater surveillance that are both specific to the DoD experience and applicable to wider public health initiatives.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e67145"},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364898","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":"Consistency of Daily Number of Reported COVID-19 Cases in 191 Countries From 2020 to 2022: Comparative Analysis of 2 Major Data Sources.","authors":"Han Liu, Huiying Zong, Yang Yang, David C Schwebel, Bin Xie, Peishan Ning, Zhenzhen Rao, Li Li, Guoqing Hu","doi":"10.2196/65439","DOIUrl":"10.2196/65439","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic represents one of the most challenging public health emergencies in recent world history, causing about 7.07 million deaths globally by September 24, 2024. Accurate, timely, and consistent data are critical for early response to situations like the COVID-19 pandemic.</p><p><strong>Objective: </strong>This study aimed to evaluate consistency of daily reported COVID-19 cases in 191 countries from the Johns Hopkins University Center for Systems Science and Engineering (JHU CSSE) and the World Health Organization (WHO) dashboards during 2020-2022.</p><p><strong>Methods: </strong>We retrieved data concerning new daily COVID-19 cases in 191 countries covered by both data sources from January 22, 2020, to December 31, 2022. The ratios of numbers of daily reported cases from the 2 sources were calculated to measure data consistency. We performed simple linear regression to examine significant changes in the ratio of numbers of daily reported cases during the study period.</p><p><strong>Results: </strong>Of 191 WHO member countries, only 60 displayed excellent data consistency in the number of daily reported COVID-19 cases between the WHO and JHU CSSE dashboards (mean ratio 0.9-1.1). Data consistency changed greatly across the 191 countries from 2020 to 2022 and differed across 4 types of countries, categorized by income. Data inconsistency between the 2 data sources generally decreased slightly over time, both for the 191 countries combined and within the 4 types of income-defined countries. The absolute relative difference between the 2 data sources increased in 84 countries, particularly for Malta (R2=0.25), Montenegro (R2=0.30), and the United States (R2=0.29), but it decreased significantly in 40 countries.</p><p><strong>Conclusions: </strong>The inconsistency between the 2 data sources warrants further research. Construction of public health surveillance and data collection systems for public health emergencies like the COVID-19 pandemic should be strengthened in the future.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e65439"},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382227","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":"The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial.","authors":"Katie B Biello, Kenneth H Mayer, Hyman Scott, Pablo K Valente, Jonathan Hill-Rorie, Susan Buchbinder, Lucinda Ackah-Toffey, Patrick S Sullivan, Lisa Hightow-Weidman, Albert Y Liu","doi":"10.2196/63428","DOIUrl":"10.2196/63428","url":null,"abstract":"<p><strong>Background: </strong>Young sexual minority men have among the highest rates of HIV in the United States; yet, the use of evidence-based prevention strategies, including routine HIV testing and pre-exposure prophylaxis (PrEP), remains low. Mobile apps have enormous potential to increase HIV testing and PrEP use among young sexual minority men.</p><p><strong>Objective: </strong>This study aims to assess the efficacy of 2 theory- and community-informed mobile apps-LYNX (APT Mobility) and MyChoices (Keymind)-to improve HIV testing and PrEP initiation among young sexual minority men.</p><p><strong>Methods: </strong>Between October 2019 and May 2022, we implemented a 3-arm, parallel randomized controlled trial in 9 US cities to test the efficacy of the LYNX and MyChoices apps against standard of care (SOC) among young sexual minority men (aged 15-29 years) reporting anal sex with cisgender male or transgender female in the last 12 months. Randomization was 1:1:1 and was stratified by site and participant age; there was no masking. The co-primary outcomes were self-reported HIV testing and PrEP initiation over 6 months of follow-up.</p><p><strong>Results: </strong>A total of 381 young sexual minority men were randomized. The mean age was 22 (SD 3.2) years. Nearly one-fifth were Black, non-Hispanic (n=67, 18%), Hispanic or Latino men (n=67, 18%), and 60% identified as gay (n=228). In total, 200 (53%) participants resided in the Southern United States. At baseline, participants self-reported the following: 29% (n=110) had never had an HIV test and 85% (n=324) had never used PrEP. Sociodemographic and behavioral characteristics did not differ by study arm. Compared to SOC (n=72, 59%), participants randomized to MyChoices (n=87, 74%; P=.01) were more likely to have received at least 1 HIV test over 6 months of follow-up; those randomized to LYNX also had a higher proportion of testing (n=80, 70%) but it did not reach the a priori threshold for statistical significance (P=.08). Participants in both MyChoices (n=23, 21%) and LYNX (n=21, 20%) arms had higher rates of starting PrEP compared to SOC (n=19, 16%), yet these differences were not statistically significant (P=.52).</p><p><strong>Conclusions: </strong>In addition to facilitating earlier treatment among those who become aware of their HIV status, given the ubiquity of mobile apps and modest resources required to scale this intervention, a 25% relative increase in HIV testing among young sexual minority men, as seen in this study, could meaningfully reduce HIV incidence in the United States.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03965221; https://clinicaltrials.gov/study/NCT03965221.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e63428"},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189522","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":"When Infodemic Meets Epidemic: Systematic Literature Review.","authors":"Chaimae Asaad, Imane Khaouja, Mounir Ghogho, Karim Baïna","doi":"10.2196/55642","DOIUrl":"10.2196/55642","url":null,"abstract":"<p><strong>Background: </strong>Epidemics and outbreaks present arduous challenges, requiring both individual and communal efforts. The significant medical, emotional, and financial burden associated with epidemics creates feelings of distrust, fear, and loss of control, making vulnerable populations prone to exploitation and manipulation through misinformation, rumors, and conspiracies. The use of social media sites has increased in the last decade. As a result, significant amounts of public data can be leveraged for biosurveillance. Social media sites can also provide a platform to quickly and efficiently reach a sizable percentage of the population; therefore, they have a potential role in various aspects of epidemic mitigation.</p><p><strong>Objective: </strong>This systematic literature review aimed to provide a methodical overview of the integration of social media in 3 epidemic-related contexts: epidemic monitoring, misinformation detection, and the relationship with mental health. The aim is to understand how social media has been used efficiently in these contexts, and which gaps need further research efforts.</p><p><strong>Methods: </strong>Three research questions, related to epidemic monitoring, misinformation, and mental health, were conceptualized for this review. In the first PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) stage, 13,522 publications were collected from several digital libraries (PubMed, IEEE Xplore, ScienceDirect, SpringerLink, MDPI, ACM, and ACL) and gray literature sources (arXiv and ProQuest), spanning from 2010 to 2022. A total of 242 (1.79%) papers were selected for inclusion and were synthesized to identify themes, methods, epidemics studied, and social media sites used.</p><p><strong>Results: </strong>Five main themes were identified in the literature, as follows: epidemic forecasting and surveillance, public opinion understanding, fake news identification and characterization, mental health assessment, and association of social media use with psychological outcomes. Social media data were found to be an efficient tool to gauge public response, monitor discourse, identify misleading and fake news, and estimate the mental health toll of epidemics. Findings uncovered a need for more robust applications of lessons learned from epidemic \"postmortem documentation.\" A vast gap exists between retrospective analysis of epidemic management and result integration in prospective studies.</p><p><strong>Conclusions: </strong>Harnessing the full potential of social media in epidemic-related tasks requires streamlining the results of epidemic forecasting, public opinion understanding, and misinformation detection, all while keeping abreast of potential mental health implications. Proactive prevention has thus become vital for epidemic curtailment and containment.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e55642"},"PeriodicalIF":3.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122807","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":"Mapping Key Populations to Develop Improved HIV and AIDS Interventions: Multiphase Cross-Sectional Observational Mapping Study Using a District and City Approach.","authors":"Pande Putu Januraga, Endang Lukitosari, Lanny Luhukay, Rizky Hasby, Aang Sutrisna","doi":"10.2196/56820","DOIUrl":"10.2196/56820","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Indonesia's vast archipelago and substantial population size present unique challenges in addressing its multifaceted HIV epidemic, with 90% of its 514 districts and cities reporting cases. Identifying key populations (KPs) is essential for effectively targeting interventions and allocating resources to address the changing dynamics of the epidemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We examine the 2022 mapping of Indonesia's KPs to develop improved HIV and AIDS interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In 2022, a district-based mapping of KPs was conducted across 201 districts and cities chosen for their HIV program intensity. This multiphase process included participatory workshops for hotspot identification, followed by direct hotspot observation, then followed by a second direct observation in selected hotspots for quality control. Data from 49,346 informants (KPs) were collected and analyzed. The results from individual hotspots were aggregated at the district or city level, and a formula was used to estimate the population size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mapping initiative identified 18,339 hotspots across 201 districts and cities, revealing substantial disparities in hotspot distribution. Of the 18,339 hotspots, 16,964 (92.5%) were observed, of which 1822 (10.74%) underwent a second review to enhance data accuracy. The findings mostly aligned with local stakeholders' estimates, but showed a lower median. Interviews indicated a shift in KP dynamics, with a median decline in hotspot attendance since the pandemic, and there was notable variation in mapping results across district categories. In \"comprehensive\" areas, the average results for men who have sex with men (MSM), people who inject drugs, transgender women, and female sex workers (FSWs) were 1008 (median 694, IQR 317-1367), 224 (median 114, IQR 59-202), 196 (median 167, IQR 81-265), and 775 (median 573, IQR 352-1131), respectively. \"Medium\" areas had lower averages: MSM at 381 (median 199, IQR 91-454), people who inject drugs at 51 (median 54, IQR 15-63), transgender women at 101 (median 55, IQR 29-127), and FSWs at 304 (median 231, IQR 118-425). \"Basic\" areas showed the lowest averages: MSM at 161 (median 73, IQR 49-285), people who inject drugs at 7 (median 7, IQR 7-7), transgender women at 59 (median 26, IQR 12-60), and FSWs at 161 (median 131, IQR 59-188). Comparisons with ongoing outreach programs revealed substantial differences: the mapped MSM population was &gt;50% lower than program coverage; the estimates for people who inject drugs were twice as high as the program coverage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The mapping results highlight significant variations in hotspots and KPs across districts and cities and underscore the necessity of adaptive HIV prevention strategies. The findings informed programmatic decisions, such as reallocating resources to underserved districts and recalibrating outreach strategies to better match K","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e56820"},"PeriodicalIF":3.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065729","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":"An Explainable Artificial Intelligence Text Classifier for Suicidality Prediction in Youth Crisis Text Line Users: Development and Validation Study.","authors":"Julia Thomas, Antonia Lucht, Jacob Segler, Richard Wundrack, Marcel Miché, Roselind Lieb, Lars Kuchinke, Gunther Meinlschmidt","doi":"10.2196/63809","DOIUrl":"10.2196/63809","url":null,"abstract":"<p><strong>Background: </strong>Suicide represents a critical public health concern, and machine learning (ML) models offer the potential for identifying at-risk individuals. Recent studies using benchmark datasets and real-world social media data have demonstrated the capability of pretrained large language models in predicting suicidal ideation and behaviors (SIB) in speech and text.</p><p><strong>Objective: </strong>This study aimed to (1) develop and implement ML methods for predicting SIBs in a real-world crisis helpline dataset, using transformer-based pretrained models as a foundation; (2) evaluate, cross-validate, and benchmark the model against traditional text classification approaches; and (3) train an explainable model to highlight relevant risk-associated features.</p><p><strong>Methods: </strong>We analyzed chat protocols from adolescents and young adults (aged 14-25 years) seeking assistance from a German crisis helpline. An ML model was developed using a transformer-based language model architecture with pretrained weights and long short-term memory layers. The model predicted suicidal ideation (SI) and advanced suicidal engagement (ASE), as indicated by composite Columbia-Suicide Severity Rating Scale scores. We compared model performance against a classical word-vector-based ML model. We subsequently computed discrimination, calibration, clinical utility, and explainability information using a Shapley Additive Explanations value-based post hoc estimation model.</p><p><strong>Results: </strong>The dataset comprised 1348 help-seeking encounters (1011 for training and 337 for testing). The transformer-based classifier achieved a macroaveraged area under the curve (AUC) receiver operating characteristic (ROC) of 0.89 (95% CI 0.81-0.91) and an overall accuracy of 0.79 (95% CI 0.73-0.99). This performance surpassed the word-vector-based baseline model (AUC-ROC=0.77, 95% CI 0.64-0.90; accuracy=0.61, 95% CI 0.61-0.80). The transformer model demonstrated excellent prediction for nonsuicidal sessions (AUC-ROC=0.96, 95% CI 0.96-0.99) and good prediction for SI and ASE, with AUC-ROCs of 0.85 (95% CI 0.97-0.86) and 0.87 (95% CI 0.81-0.88), respectively. The Brier Skill Score indicated a 44% improvement in classification performance over the baseline model. The Shapley Additive Explanations model identified language features predictive of SIBs, including self-reference, negation, expressions of low self-esteem, and absolutist language.</p><p><strong>Conclusions: </strong>Neural networks using large language model-based transfer learning can accurately identify SI and ASE. The post hoc explainer model revealed language features associated with SI and ASE. Such models may potentially support clinical decision-making in suicide prevention services. Future research should explore multimodal input features and temporal aspects of suicide risk.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e63809"},"PeriodicalIF":3.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065725","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":"Mindfulness Intervention for Health Information Avoidance in Older Adults: Mixed Methods Study.","authors":"Chenyu Gu, Liquan Qian, Xiaojie Zhuo","doi":"10.2196/69554","DOIUrl":"10.2196/69554","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The global aging population and rapid development of digital technology have made health management among older adults an urgent public health issue. The complexity of online health information often leads to psychological challenges, such as cyberchondria, exacerbating health information avoidance behaviors. These behaviors hinder effective health management; yet, little research examines their mechanisms or intervention strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigates the mechanisms influencing health information avoidance among older adults, emphasizing the mediating role of cyberchondria. In addition, it evaluates the effectiveness of mindfulness meditation as an intervention strategy to mitigate these behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods approach was used, combining quantitative and qualitative methodologies. Substudy 1 developed a theoretical model based on self-determination theory to explore internal (positive metacognition and health self-efficacy) and external (subjective norms and health information similarity) factors influencing health information avoidance, with cyberchondria as a mediator. A cross-sectional survey (N=236) was conducted to test the proposed model. Substudy 2 involved a 4-week mindfulness meditation intervention (N=94) to assess its impact on reducing health information avoidance behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Study 1 showed that positive metacognition (β=.26, P=.002), health self-efficacy (β=.25, P&lt;.001), and health information similarity (β=.29, P&lt;.001) significantly predicted health information avoidance among older adults. Cyberchondria mediated these effects: positive metacognition (effect=0.106, 95% CI 0.035-0.189), health self-efficacy (effect=0.103, 95% CI 0.043-0.185), and health information similarity (effect=0.120, 95% CI 0.063-0.191). Subjective norms did not significantly predict health information avoidance (β=‒.11, P=.13), and cyberchondria did not mediate this relationship (effect=‒0.045, 95% CI ‒0.102 to 0.016). Study 2 found that after the 4-week mindfulness intervention, the intervention group (group 1: n=46) exhibited significantly higher mindfulness levels than the control group (group 2: n=48; M&lt;sub&gt;group1&lt;/sub&gt;=4.122, M&lt;sub&gt;group2&lt;/sub&gt;=3.606, P&lt;.001) and higher levels compared with preintervention (M&lt;sub&gt;t2&lt;/sub&gt;=4.122, M&lt;sub&gt;t1&lt;/sub&gt;=3.502, P&lt;.001, where t1=preintervention and t2=postintervention). However, cyberchondria levels did not change significantly (M&lt;sub&gt;t1&lt;/sub&gt;=2.848, M&lt;sub&gt;t2&lt;/sub&gt;=2.685, P=.18). Nevertheless, the results revealed a significant interaction effect between mindfulness and cyberchondria on health information avoidance (effect=‒0.357, P=.002, 95% CI ‒0.580 to ‒0.131), suggesting that mindfulness intervention effectively inhibited the transformation of cyberchondria into health information avoidance behavior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study reveals the role of cybercho","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e69554"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058911","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":"Epidemiological Features, Clinical Symptoms, and Environmental Risk Factors for Notifiable Japanese Encephalitis in Taiwan From 2008 to 2020: Retrospective Study.","authors":"Fu-Huang Lin, Yu-Ching Chou, Chi-Jeng Hsieh, Chia-Peng Yu","doi":"10.2196/63053","DOIUrl":"10.2196/63053","url":null,"abstract":"<p><strong>Background: </strong>Japanese encephalitis (JE) is a zoonotic parasitic disease caused by the Japanese encephalitis virus (JEV), and may cause fever, nausea, headache, or meningitis. It is currently unclear whether the epidemiological characteristics of the JEV have been affected by the extreme climatic conditions that have been observed in recent years.</p><p><strong>Objective: </strong>This study aimed to examine the epidemiological characteristics, trends, and potential risk factors of JE in Taiwan from 2008 to 2020. Specifically, the study focused on gender, age, season, residential area, clinical manifestations, high-risk areas, and the impact of environmental and climate factors.</p><p><strong>Methods: </strong>This study reviewed publicly available annual summary data on reported JE cases in the Taiwan Centers for Diseases Control between 2008 and 2020.</p><p><strong>Results: </strong>This study collected 309 confirmed domestic patients and 4 patients with imported JE. There was an increasing trend in the incidence of JE, 0.69-1.57 cases per 1,000,000 people, peaking in 2018. Case fatality rate was 7.7% (24/313). Comparing sex, age, season, and place of residence, the incidence rate was highest in males, 40- to 59-year-old patients, summer, and the Eastern region, with 1.89, 3.27, 1.25, and 12.2 cases per million people, respectively. The average coverage rate of the JE vaccine for children in Taiwan is 94.9%. Additionally, the major clinical manifestations of the cases included fever, unconsciousness, headache, stiff necks, psychological symptoms, vomiting, and meningitis. The major occurrence places of JE included paddy fields, pig farms, pigeon farms, poultry farms, and ponds. For air pollution factors, linear regression analysis showed that SO2 (ppb) concentration was positively associated with JE cases (β=2.184, P=.02), but O3 (ppb) concentration was negatively associated with them (β=-0.157, P=.01). For climate factors, relative humidity (%) was positively associated with JE cases (β=.380, P=.02).</p><p><strong>Conclusions: </strong>This study is the first to report confirmed cases of JE from the surveillance data of the Taiwan Centers for Diseases Control between 2008 and 2020. It identified residence, season, and age as risk factors for JE in Taiwan. Air pollution and climatic factors also influenced the rise in JE cases. This study confirmed that JE remains a prevalent infectious disease in Taiwan, with its epidemic gradually increasing in severity. These findings empower clinicians and health care providers to make informed decisions, guiding their care and resource allocation for patients with JE, a disease that significantly impacts the health and well-being of the Taiwanese population.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e63053"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065727","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":"Effectiveness of Frequent Point-of-Care Molecular COVID-19 Surveillance in a Rural Workplace: Nonrandomized Controlled Clinical Trial Among Miners.","authors":"Akshay Sood, William Cotton Jarrell, Xin W Shore, Nestor Sosa, Alisha Parada, Nicholas Edwardson, Alexandra V Yingling, Teah Amirkabirian, Qiuying Cheng, Ivy Hurwitz, Linda S Cook, Shuguang Leng, Orrin B Myers, Douglas J Perkins","doi":"10.2196/59845","DOIUrl":"10.2196/59845","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have assessed the risk of SARS-CoV-2 exposure and infection among health care workers during the pandemic. However, far fewer studies have investigated the impact of SARS-CoV-2 on essential workers in other sectors. Moreover, guidance for maintaining a safely operating workplace in sectors outside of health care remains limited. Workplace surveillance has been recommended by the Centers for Disease Control and Prevention, but few studies have examined the feasibility or effectiveness of this approach.</p><p><strong>Objective: </strong>The objective of this study was to investigate the feasibility and effectiveness of using frequent point-of-care molecular workplace surveillance as an intervention strategy to prevent the spread of SARS-CoV-2 at essential rural workplaces (mining sites) where physical distancing, remote work, and flexible schedules are not possible.</p><p><strong>Methods: </strong>In this nonrandomized controlled clinical trial conducted from February 2021, to March 2022, 169 miners in New Mexico (intervention cohort) and 61 miners in Wyoming (control cohort) were enrolled. Investigators performed point-of-care rapid antigen testing on midnasal swabs (NSs) self-collected by intervention miners. Our first outcome was the intervention acceptance rate in the intervention cohort. Our second outcome was the rate of cumulative postbaseline seropositivity to SARS-CoV-2 nucleocapsid protein, which was analyzed in the intervention cohort and compared to the control cohort between baseline and 12 months. The diagnostic accuracy of detecting SARS-CoV-2 using rapid antigen testing on NSs was compared to laboratory-based reverse transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs (NPSs) in a subset of 68 samples.</p><p><strong>Results: </strong>Our intervention had a mean acceptance rate of 96.4% (11,413/11,842). The intervention miners exhibited a lower cumulative postbaseline incident seropositivity at 12 months compared to control miners (14/97, 14% vs 17/45, 38%; P=.002). Analysis of SARS-CoV-2 antigen detection in self-administered NSs revealed 100% sensitivity and specificity compared to laboratory-based RT-PCR testing on NPSs.</p><p><strong>Conclusions: </strong>Our findings establish frequent point-of-care molecular workplace COVID-19 surveillance as a feasible option for keeping essential rural workplaces open and preventing SARS-CoV-2 spread. These findings extend beyond this study, providing valuable insights for designing interventions to maintain employees' safety at other essential workplaces during an infectious disease outbreak.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e59845"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052657","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}