JMIR Public Health and Surveillance最新文献

{"title":"The Impact on Audience Engagement of Coordinating a Public Health Campaign on Antimicrobial Resistance Through a Network of Health Content Creators: Longitudinal Observational Study.","authors":"Fangyue Chen, Jack Cooper, Amish Acharya, Simon Dryden, Ara Darzi, Kate Grailey","doi":"10.2196/86587","DOIUrl":"10.2196/86587","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a significant global health threat. Several public health campaigns aimed to raise AMR awareness and inspire related behavioral changes have been delivered in a time-specific, coordinated manner, while others have placed less emphasis on campaign timing. Social media platforms can be leveraged as key vehicles for delivering public health campaigns, particularly by collaborating with health content creators who serve as influential messengers. Increasingly, organizations such as the World Health Organization and TikTok have created health content creator networks; however, the impact of such networks in public health campaigns, especially when delivered in a coordinated, time-specific manner, remains uncertain.</p><p><strong>Objective: </strong>This study aimed to investigate whether mobilizing an established health content creator network to create social media content on the topic of AMR, released in a coordinated, time-specific manner, can have an impact on audience engagement.</p><p><strong>Methods: </strong>We conducted a longitudinal observational study evaluating the effect of a coordinated social media campaign (\"Pulse\") on YouTube, delivered by an established health content creator network during an international event on AMR. Members of the network prepared and coordinated the release of AMR-related videos. Engagement analytics were evaluated 6 months after release. The engagement with each campaign video was compared with that for a similar noncoordinated video and with the average engagement of the same creators.</p><p><strong>Results: </strong>Around the day of the Pulse campaign on September 26, 2024, 18 campaign videos were released across 14 YouTube channels. Compared with paired videos, Pulse videos were not associated with higher view counts (incidence rate ratio [IRR] 0.98, 95% CI 0.44-2.13; P=.95) or like counts (IRR 1.10, 95% CI 0.48-2.41; P=.81) but were associated with significantly higher comment counts (IRR 2.99, 95% CI 1.02-8.52; P=.03). When compared with the creators' 12-month channel averages, campaign videos had a significantly higher comment count (IRR 15.5, 95% CI 5.5-24.0; P<.001) but no difference in view counts (IRR -82.0, 95% CI -190.3 to 58.5; P=.26) or like counts (IRR -0.50, 95% CI -6.3 to 10.5; P=.93).</p><p><strong>Conclusions: </strong>Coordinating health content creators to release AMR-related videos on YouTube coinciding with an international AMR event increased audience interactivity but did not enhance reach. This study shows the need to better understand which AMR-specific content factors contribute toward greater traction and to assess audience needs among the wider public to discern how best to harness social media interventions as a tool to improve AMR-related outcomes.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e86587"},"PeriodicalIF":3.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13027679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529111","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":"Trends and Core Competence Shifts in Nurses' Infectious Disease Emergency Response Competence Across COVID-19 Pandemic Phases: Repeated Cross-Sectional Survey and Network Analysis.","authors":"Jiagen Xiang, Qiuxia Liang, Yufei Lu, Meizhen Lin, Juan Liu, Hongman Li, Jingjing Cai, Yan Wu, Bingbing Li, Wenting Liu, Ming Yang, Xiaoning Sun, Yan Luo, Yibing Tan, Hairun Liu, Jiaying Li, Liming Lu, Zengjie Ye","doi":"10.2196/83281","DOIUrl":"10.2196/83281","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic exposed structural vulnerabilities in the global health emergency workforce. Sustained monitoring of response competence dynamics is critical for maintaining health system resilience during protracted outbreaks.</p><p><strong>Objective: </strong>This study aimed to investigate trends and structural transitions in nurses' infectious disease emergency response competence during different phases of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using the Healthcare Workers' Infectious Disease Emergency Response Competence Questionnaire, 3 repeated cross-sectional surveys were conducted in February 2020, August 2021, and February 2023. The participants were matched in a 1:1:1 ratio by their demographic characteristics via propensity scores. Temporal trends were analyzed using ANOVA, and competence structure transitions were examined via network analysis.</p><p><strong>Results: </strong>Three-wave analyses (n=2525 per wave) demonstrated a sustained decline in competence, from 4.05 (SD 0.63) in February 2020 to 3.81 (SD 0.66) in August 2021 and further to 3.70 (SD 0.66) in February 2023. All pairwise comparisons were statistically significant (all P<.001). Network analysis identified critical structural shifts in competence architecture: in February 2020, the core network node was T24 (emergency management of body fluid exposure; strength=1.764), whereas in August 2021 and February 2023, the core network node was T19 (acquisition of key information on emerging infectious diseases; strength=1.759 and 1.852, respectively). Network structure comparisons revealed significant differences between February 2020 and August 2021 (P=.01) and between February 2020 and February 2023 (P=.01), whereas the difference between August 2021 and February 2023 was not significant (P=.07).</p><p><strong>Conclusions: </strong>Despite accumulated pandemic experience, nurses' infectious disease response competence declined substantially, indicating systemic fragility during prolonged crises. However, this experience reshaped competence architecture, evolving from technical infection prevention toward higher-order competence in information integration and clinical decision-making under uncertainty. To rebuild resilience, phase-specific training programs are essential: early-phase training emphasizes infection prevention, whereas prolonged outbreaks focus on information identification and decision support. Additionally, standardized information platforms and psychological support are essential to manage ongoing pandemic pressures.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e83281"},"PeriodicalIF":3.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13026426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529138","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":"Determining the Association Between Hearing Disability and Injury Risk in Older Adults Using Propensity Score Matching: Quasi-Experimental Study.","authors":"Woo-Ri Lee, Sungyoun Chun, Youyoung An, Hyun Seung Choi","doi":"10.2196/78826","DOIUrl":"10.2196/78826","url":null,"abstract":"<p><strong>Background: </strong>With rapid population aging, both traumatic injuries and hearing disability have become increasingly prevalent among older adults. Hearing disability may increase vulnerability to injury through impaired balance, reduced environmental awareness, and functional limitations; however, longitudinal evidence examining the association between hearing disability and injury risk remains limited.</p><p><strong>Objective: </strong>This study aimed to examine the association between hearing disability and the risk of injury among older adults using a quasi-experimental design with propensity score matching (PSM).</p><p><strong>Methods: </strong>This population-based cohort study included individuals aged 60 years and older with hearing disabilities and a matched control group without disabilities using data from the National Health Insurance Service-Senior cohort from 2008 to 2019. Injury admission, defined using International Classification of Diseases codes S00 to S99, was the primary outcome. A quasi-experimental design was applied using PSM at a 1:3 ratio to balance baseline characteristics between the hearing-disabled and nondisabled groups. Cox proportional hazard regression models adjusted for all covariates were used to estimate hazard ratios. Sensitivity analyses were conducted according to disability severity and injury site.</p><p><strong>Results: </strong>The total number of participants was 43,944, with 10,986 (25%) in the hearing-disabled group and 32,958 (75%) in the nondisabled group, thus confirming a 1:3 matching ratio. The PSM results showed that the standardized mean difference values for all covariates were below the absolute value of 0.1, thus indicating that PSM was successfully performed. The incidence of injury admissions was higher in the hearing-disabled group (1567/10,986, 14.3% of patients) than in the nondisabled group (3966/32,958, 12%), and this difference was statistically significant (P<.001). During the follow-up period, older adults with hearing disability had a significantly higher risk of injury admission compared with those without hearing disability (hazard ratio=1.21, 95% CI 1.14-1.28; P<.001). The association was stronger among individuals with more severe hearing disability and varied by injury site.</p><p><strong>Conclusions: </strong>Hearing disability in older adults is independently associated with increased injury admission risk, with greater severity conferring a higher risk and variation by injury site. Interventions such as hearing aid provision, targeted traffic safety measures, and enhanced community and family support are warranted to mitigate this burden.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e78826"},"PeriodicalIF":3.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13026427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529160","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":"Prevalence and Associated Factors of Renal Disease in Saudi Residents Attending Primary Health Care Centers in Riyadh, Saudi Arabia: Cross-Sectional Study.","authors":"Saad Alshahrani, Ashraf A El-Metwally, Awad Alshahrani, Badr F Al-Khateeb, Aljohrah Ibrahim Aldubikhi, Khadijah Angawi, Amani Alharthy, Lubna Alnaim, Amal Mousa Zaidan, Raed Aldahash","doi":"10.2196/81849","DOIUrl":"10.2196/81849","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Renal disease represents a significant and growing public health concern globally and within Saudi Arabia. Despite the increasing burden of noncommunicable diseases, population-based data on the prevalence and determinants of renal disease in Saudi Arabia remain limited. Understanding epidemiology, including prevalence and associated risk factors of renal disease in the context of Saudi Arabia, is essential for designing preventive and early detection strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to estimate the prevalence of renal disease and to identify sociodemographic, behavioral, and clinically associated factors among adults attending primary health care centers (PHCs) in Riyadh, Saudi Arabia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional, community-based study was conducted between March 2023 and July 2023 across 48 PHCs within Riyadh, using a consecutive sampling strategy. Adults aged 18 years and older were recruited and completed a validated, interviewer-administered electronic questionnaire assessing sociodemographic characteristics, lifestyle behaviors, and medical history, including comorbid conditions and health care access. Multivariable logistic regression was used to determine factors associated with self-reported renal disease, with results expressed as adjusted odds ratios (AORs) and 95% CIs, ensuring model adequacy and precision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14,239 participants were surveyed (n=7519, 52.8% female; mean age 41.6, SD 13.2 y). The prevalence of self-reported renal disease (including chronic kidney disease and kidney stones) was 3.5% (n=504). Individuals aged younger than 50 years had higher odds of renal disease (AOR 1.22, 95% CI 1.02-1.47). Female individuals were more likely to report renal disease than males (AOR 1.51, 95% CI 1.24-1.84). Participants with health insurance had increased odds (AOR1.74; 95% CI 1.44-2.11). Smoking was strongly associated with renal disease (AOR 3.07, 95% CI 2.38-3.96). Other important associated factors included comorbidities such as diabetes (AOR 1.51, 95% CI 1.12-2.04), hypertension (AOR 2.27, 95% CI 1.67-3.08), obesity (AOR 12.75, 95% CI 9.97-16.30), hypercholesterolemia (AOR 1.93, 95% CI 1.43-2.60), and heart disease (AOR 6.84, 95% CI 5.14-9.10).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This large, community-based cross-sectional study identifies a significant burden of renal disease among adults in Riyadh and highlights several modifiable risk factors that could be targeted in preventive health programs. The findings emphasize the importance of integrating renal health screening within PHCs and strengthening public health strategies addressing obesity, hypertension, and smoking. While the study relied on self-reported data without biomarker or clinical confirmation, potentially underestimating true prevalence and introducing misclassification bias, it provides a crucial population-level baseline that can guide resou","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e81849"},"PeriodicalIF":3.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521072","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":"Social Networks and Their Influence on the Choice of Unassisted Smoking Cessation: Cross-Sectional Study in Six Cities in China.","authors":"Sihui Peng, Tingzhong Yang, Lijing Li, Weifang Zhang, Randall R Cottrell","doi":"10.2196/74147","DOIUrl":"10.2196/74147","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Many countries, including China, have implemented nationwide smoking cessation programs in accordance with Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). However, the use of assisted smoking cessation services remains low, while unassisted smoking cessation (USC) methods are widely preferred. Studies have shown that many individual and environmental factors are associated with USC adoption. However, no studies have examined the association between social networks and USC adoption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examined the effects of social networks on USC choice among male smokers in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional multivariable sampling design was used to interview subjects from six selected cities in China. The study sample included only male participants. A standardized questionnaire was used to obtain information about sociodemographic characteristics, social networks, and USC choice. Multivariable logistic regression models were used to examine the association between social networks and USC choice. Furthermore, quantitative analysis was conducted to demonstrate the dose-response relationship between the city-level social networks and the prevalence of USC. Structural equation modeling (SEM) was used to establish the mechanisms by which reference group norms affect USC through social networks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 2852 smokers, of whom 1647 (57.7%) had attempted to or had quit smoking. Among them, 91.6% (n=1509; 95% CI 90.9%-97.5%) reported quitting without assistance, and 42.1% (n=58; 95% CI 32.4%-61.3%) of the remaining 138 (8.4%) participants who used USC methods achieved abstinence. Multiple logistic regression analysis found that although the higher social network (HSN) is not significantly associated with USC adoption, both the ordinary social network (OSN) and the lower social network (LSN) are significantly negatively associated with USC adoption. Compared to the low-size group of the OSN, the odds ratios (ORs) for the medium-, high-, and very high-size groups were 0.23 (95% CI 0.10-0.80), 0.22 (95% CI 0.07-0.60), and 0.25 (95% CI 0.08-0.72), respectively. Similarly, compared to the low- and medium-size groups of the LSN, the OR for the high-size group was 0.32 (95% CI 0.23-0.45). The analysis revealed a significant positive dose-response relationship of city-level OSN and LSN sizes with the probability of USC adoption, as indicated by regression coefficients β=0.2784 (P&lt;.01) and β=2.2269 (P&lt;.01), respectively. SEM analysis indicated that the size of OSNs and LSNs exerts an indirect effect on the relationship between reference group norms and USC (β=0.2315, P&lt;.01; β=0.4613, P&lt;.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both OSNs and LSNs are significantly negatively associated with USC adoption. The findings underscore the significance of USC and its potential role in reducing smoking prev","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e74147"},"PeriodicalIF":3.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512096","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":"Physical Activity Indicators Among Children and Adolescents in Lebanon, Qatar, and the United Arab Emirates: Comparative Synthesis of Active Healthy Kids Report Card Data From 1998 to 2022.","authors":"Ameneh Baghestani, Lina Majed, Merilyn Lock, Ali Alrahma, Patrick Abi Nader, Suzan Sayegh, Abdulla Saeed Al-Mohannadi, Javaid Nauman, Salomé Aubert, Mark S Tremblay, Tom Loney","doi":"10.2196/85998","DOIUrl":"10.2196/85998","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physical inactivity and sedentary behavior are important modifiable risk factors for noncommunicable diseases. High prevalences of physical inactivity among children and adolescents continue to represent a significant public health challenge globally, with approximately two-thirds of children worldwide not achieving the recommended daily amount of physical activity (PA). Countries in the Middle East exhibit some of the highest levels of physical inactivity and sedentary behavior, which contribute to the increasing rates of obesity among children and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to provide a comparative synthesis of PA indicators among children and adolescents in Lebanon, Qatar, and the United Arab Emirates (UAE) based on the Active Healthy Kids Global Alliance (AHKGA) PA Report Cards and further compare the findings with regional and global trends.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were synthesized from previous AHKGA PA Report Cards published by researchers from Lebanon, Qatar, the UAE in the years 2016 (Global Matrix 2.0; 1998-2014 data), 2018 (Global Matrix 3.0; 2016-2017 data) and 2022 (Global Matrix 4.0; 2017-2022 data). We evaluated 10 key PA indicators across these countries to identify trends and gaps in PA levels among children and adolescents. These findings were further compared with regional and global data gathered and published in previous iterations of the AHKGA Global Matrix.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Based on data collected between 1998 and 2022, less than one-third (15%-33%) of children and adolescents in Lebanon, Qatar, and the UAE achieved the recommended daily average of 60 minutes of moderate- to vigorous-intensity PA. Additionally, more than one-half (45%-74%) of children and adolescents exceeded the recommended limit of 2 hours of recreational screen time per day. Overall, boys were more physically active than girls; however, PA levels declined with increasing age. Other behavioral indicators such as participation in organized sports and active transportation revealed insufficient PA levels. The results were slightly better for sources of influence indicators especially with the opportunities provided by schools and governments. Compared with global estimates, PA levels in the Middle Eastern countries were similar to the averages observed across Asian countries participating in the AHKGA; however, they were generally lower than PA levels in other regions of the world.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Data from a 25-year period show consistently low levels of PA and high levels of sedentary behavior among children and adolescents from these 3 Arab Middle Eastern countries. Despite governmental investments in implementation of PA initiatives, there seems to be a lag in eliciting increases in PA at the population level. Evidence points to a critical need for behavioral and lifestyle modifications among children and adolescents. These concerns are ex","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e85998"},"PeriodicalIF":3.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512110","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":"Digital Tools' Effectiveness on Physical Activity Outcomes in Children and Adolescents: Umbrella Review.","authors":"Garden Tabacchi, Antonino Scardina, Antonella Amato, Marta Giardina, Giulia Accardi, Valentina Di Liberto, Giuseppe Giglia, Sonya Vasto, Monica Frinchi, Paolo Boffetta, Walter Mazzucco, Marianna Bellafiore","doi":"10.2196/75769","DOIUrl":"10.2196/75769","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A substantial proportion of children and adolescents worldwide do not meet current physical activity (PA) guidelines. So digital tools interventions have been implemented worldwide. However, evidence regarding the effectiveness of these remains inconsistent, underscoring the need for a comprehensive synthesis of the available literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This umbrella review aimed to summarize and critically evaluate the characteristics and effectiveness of digital interventions designed to increase PA in children and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An overview of systematic reviews (SRs) and meta-analyses of randomized controlled trials (RCTs) was conducted in accordance with the PRIOR (Preferred Reporting Items for Overviews of Reviews) and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Literature Search Extension) checklists. Reviews published between 2018 and 2025 were searched in SCOPUS, PubMed or MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and SPORTDiscus or EBSCO, using a combination of terms addressing the type of digital tool (eg, apps, wearables, etc) and device-based PA outcomes. Eligible SRs and meta-analyses focused on populations aged 6-17 years and evaluated digital interventions aimed at increasing PA. Methodological quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) for SRs and meta-analyses, and Risk of Bias 2 for RCTs. Intervention characteristics and effectiveness outcomes were summarized as frequencies, and chi-square tests were applied to explore differences in effectiveness across study features.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-eight SRs or meta-analyses comprising 62 RCTs were included. The reviews' quality was moderate to poor, and 7/62 (11.3%) of RCTs were judged to have a high risk of bias. The mainly addressed PA outcomes were moderate-to-vigorous PA and step counts, commonly measured using accelerometers and pedometers. Overall, 45.2% of interventions demonstrated effectiveness for at least 1 PA outcome. Higher effectiveness rates were observed in RCTs that targeted PA as the sole primary outcome (19/32, 59.4%), used wearables as both the digital intervention component (7/11, 63.6%) and delivery device (8/12, 66.7%), and used pedometers for PA outcome measurement (13/16, 81.3%). Significant differences in effectiveness were found for the type of PA assessment device (P=.003) and for interventions targeting low-income populations, which showed lower effectiveness (P=.01). Additional trends were identified for geographic region (P=.06), intervention setting (P=.09), baseline activity level (P=.06), intervention focus (P=.09), and device brand (P=.09).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This novel umbrella review provides a comprehensive synthesis of digital PA interventions in youth, foreseeing potential factors that may influence their effectiveness, and highlig","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e75769"},"PeriodicalIF":3.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13013097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512161","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":"Longitudinal Analysis of Variations in Daily Step Counts and Long-Term Implications of COVID-19 Waves and Restriction Phases in Qatar's Step Into Health Program: Mixed Methods Study.","authors":"Lina Majed, Suzan Sayegh, Feriel Dalansi, Abdulla Saeed Al-Mohannadi, Marco Cardinale, Abdulaziz Farooq","doi":"10.2196/76860","DOIUrl":"10.2196/76860","url":null,"abstract":"<p><strong>Background: </strong>Public health restrictive measures adopted during the COVID-19 pandemic led to significant changes in lifestyles. Global declines in physical activity (PA) and increases in sedentary behavior were noted. These trends were observed within different regions of the world, pointing toward potential long-term implications for PA behaviors.</p><p><strong>Objective: </strong>This mixed methods study aims to assess variations in daily step counts in Qatar using device-driven data throughout all 3 COVID-19 waves (February 2020 to February 2023) compared with a full pre-COVID-19 year. In-depth interviews were further conducted with randomly selected participants to gain insights into determinants, perceptions, and barriers of PA during the pandemic.</p><p><strong>Methods: </strong>A total of 362 participants (60/362, 16.6% female) from the Step Into Health community-based program reported daily step counts using pedometers (170/362, 47%) or a mobile phone app (192/362, 53%). Linear mixed models examined changes in daily step counts across 19 phases of implementation and lifting of restrictions. Overall, 9 participants also completed semistructured interviews that were analyzed thematically and phenomenologically. Triangulation of quantitative and qualitative data was applied to interpret convergences and divergences between device-measured activity patterns and lived experiences.</p><p><strong>Results: </strong>Significant declines in daily step counts (ie, from 689 to 1013 steps) were observed at the onset of each wave (P<.001), were especially marked at wave 2, and were followed by a recovery of step count following the lifting of restrictions at each wave (ie, increase of 609 to 1147 steps). Different patterns of change in step count emerged within sex (P=.03), age (P=.03), and BMI (P=.01) groups, where larger variations were seen among male individuals, pedometer users, and normal-weight participants. Qualitative themes (ie, disrupted routines, reliance on home-based exercise, and media influence) contextualized these patterns and explained subgroup differences.</p><p><strong>Conclusions: </strong>The largest drops in daily step count coincided with increased case severity and Ramadan. Integration of quantitative and qualitative findings showed that declines in activity were shaped not only by restrictions but also by fear, motivation, and contextual factors. These results underscore the importance of designing interventions that encourage outdoor activity and provide reliable social media-based guidance during public health crises.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e76860"},"PeriodicalIF":3.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503865","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":"Association Between Health Literacy and Prehypertension in South Korean Adults: Cross-Sectional Study Using the 2023 Korea National Health and Nutrition Examination Survey.","authors":"Jiyeon Chun, Dan Bi Kim, Suk-Yong Jang, Eun-Cheol Park","doi":"10.2196/82684","DOIUrl":"10.2196/82684","url":null,"abstract":"<p><strong>Background: </strong>Hypertension represents an important global health challenge, closely linked to cardiovascular diseases and elevated premature mortality rates. Prehypertension, defined as elevated blood pressure not meeting the diagnostic criteria for hypertension, necessitates early intervention to prevent disease progression. Health literacy, defined as the capacity to comprehend and use health-related information, is a key determinant of health outcomes but has rarely been studied in the context of prehypertension prevention.</p><p><strong>Objective: </strong>This study investigated the association between health literacy and prehypertension in South Korean adults. Unlike prior research focusing on treatment adherence in diagnosed patients, this study used the most recent nationally representative data to explore how domain-specific health literacy is associated with prehypertension across various subgroups, identifying potential mechanisms for intervention.</p><p><strong>Methods: </strong>Data were obtained from the 2023 Korea National Health and Nutrition Examination Survey, a nationally representative cross-sectional study. A stratified, multistage clustered sampling design was used to invite participants. Adults aged 19 years and older (N=1873) who completed the Korean Health Literacy Index were included. Prehypertension was defined as a systolic blood pressure of 130 to 139 mm Hg or a diastolic blood pressure of 80 to 89 mm Hg. A multivariable survey-weighted logistic regression model was used to assess the associations between health literacy and prehypertension, adjusting for sociodemographic and health-related covariates.</p><p><strong>Results: </strong>Of the 1873 participants, 319 (17.0%) had prehypertension, and 1098 (58.6%) showed low health literacy. After adjustment, those with low health literacy had a 43% higher likelihood of prehypertension (odds ratio 1.43, 95% CI 1.07-1.91) than those with high health literacy. Subgroup analyses revealed that the protective impact of health literacy is not uniform but is modulated by demographic contexts.</p><p><strong>Conclusions: </strong>The observed patterns may reflect three potential mechanisms: (1) motivation for and dependency on health information (eg, in women, middle-aged, lower education, and unemployed groups), (2) synergy between health literacy and resources (eg, in high-income, urban, married, and employer-insured groups), and (3) preventive efficacy in low-risk populations. Low health literacy was significantly associated with prehypertension, with variations across subgroups suggesting context-dependent mechanisms. Health literacy may serve as a modifiable determinant and compensatory resource for cardiovascular risk prevention, particularly in populations with limited access to health care. Targeted interventions that address domain-specific health literacy deficits are needed to reduce the prehypertension burden.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e82684"},"PeriodicalIF":3.9,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491154","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":"Correction: Diagnostic Testing Preferences in Rural and Vulnerable Populations During a Pandemic: Discrete Choice Experiment.","authors":"Eline van den Broek-Altenburg, Jamie Benson, Yvonne Jonk, Abimbola Leslie, Jan Carney, Gary Stein","doi":"10.2196/87714","DOIUrl":"10.2196/87714","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/68734.].</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"12 ","pages":"e87714"},"PeriodicalIF":3.9,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147457697","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}