Journal of Community Health最新文献

{"title":"Continuity of Care at the Edges of America: Rethinking Health for Migrant and Seasonal Agricultural Workers in the U.S. Midwest.","authors":"Jimmy A Reyes","doi":"10.1007/s10900-026-01549-y","DOIUrl":"10.1007/s10900-026-01549-y","url":null,"abstract":"<p><p>Migrant and seasonal agricultural workers are essential to the food systems of the United States (U.S.), yet they experience some of the most persistent health inequities in the nation. In the U.S. Midwest, particularly Iowa and Nebraska, workers arriving from Mexico and Central America confront structural, linguistic, geographic, and policy barriers that disrupt continuity of care and limit access to preventive services. Despite carrying disproportionate burdens of chronic diseases such as diabetes, hypertension, and musculoskeletal conditions, migrant and seasonal workers face fragmented health systems shaped by immigration status, mobility, lack of insurance, transportation barriers, and fear of institutional discrimination. Drawing on emerging models, including community health workers, mobile agricultural clinics, and cross-border health initiatives, this commentary reflects on how more portable and culturally grounded approaches could improve health outcomes for migrant agricultural populations. The Midwest serves as a critical case for reimagining continuity of care within mobile workforces globally, highlighting the need for health systems capable of moving with people rather than confining care to place. Ensuring consistent access to preventive and chronic disease care for migrant workers is essential for advancing equity, strengthening public health resilience, and honoring the labor of those who help feed the nation.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"363-366"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices in the Management of Childhood and Adolescent Obesity: A Survey of Primary Care Providers in the State of Oklahoma, USA.","authors":"Zachary Arnold, Brianna Fleshman, Carson Loncarich, Lamiaa Ali, Jesse Richards, Zhamak Khorgami","doi":"10.1007/s10900-025-01544-9","DOIUrl":"10.1007/s10900-025-01544-9","url":null,"abstract":"<p><p>Pediatric obesity remains a major public health concern in the United States and is associated with early development of cardiometabolic and psychosocial comorbidities. Although early recognition and escalation to evidence-based interventions are recommended, the extent to which primary care providers are prepared to manage pediatric obesity varies. This study assessed the knowledge, attitudes, and practices (KAP) of pediatric and family medicine providers regarding pediatric obesity management, including the use of pharmacologic and surgical treatments. A cross-sectional, anonymous electronic survey was distributed to pediatricians and family medicine providers across Oklahoma through professional networks. The survey included multiple-choice, Likert-scale, and open-ended questions evaluating knowledge of obesity definitions, comfort with treatment options, practice patterns, and access to supportive resources. Quantitative responses were analyzed descriptively, and qualitative responses underwent thematic analysis. Forty providers met inclusion criteria. While most respondents correctly identified obesity thresholds, only 60% accurately defined severe obesity and 65% reported minimal familiarity with pediatric metabolic and bariatric surgery. Limited comfort with obesity management (55%) and poor access to exercise counseling (83%), behavioral health (44%), and bariatric surgical consultation (61%) were common. Pharmacotherapy and surgical referrals remained substantially underutilized. Primary care providers demonstrated knowledge gaps, limited confidence, and restricted access to resources for managing pediatric obesity. Enhanced provider education and improved system-level support are needed to facilitate timely, evidence-based care.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"375-377"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Mortality in Nepal: Identifying High-Risk Groups Through Census Data.","authors":"Monna Kurvinen, Sharad Sharma, Keshab Deuba","doi":"10.1007/s10900-026-01562-1","DOIUrl":"10.1007/s10900-026-01562-1","url":null,"abstract":"<p><p>Nearly all maternal deaths are preventable, yet Nepal's maternal mortality ratio remains high, with social and geographic disparities. Beyond direct obstetric causes, factors such as education, income, and place of residence influence maternal mortality risk, but disaggregated national data remain limited. This study examined the social determinants and timing of maternal deaths in Nepal to identify high-risk groups and inform targeted interventions. A cross-sectional descriptive study was conducted using microdata from the 2021 National Population and Housing Census, applying a stratified, probability-based sampling design to ensure national representativeness. Deaths among women aged 15-49 were identified through household reports. Data were collected on sociodemographic characteristics, household wealth, ethnicity, and place of residence. Deaths were classified by cause, and maternal deaths were further classified by timing, including during pregnancy, childbirth, or within six weeks postpartum. Descriptive statistics were calculated using sampling weights. Of 1,386 deaths among women aged 15 to 49 years, 54 (3.9%) were maternal deaths, with 74.6% occurring within six weeks postpartum. Non-communicable diseases were the leading cause of death overall (49.9%). Maternal deaths were most frequent in Lumbini province, peri-urban and rural areas, and the Tarai region. Socioeconomic disparities were evident, with nearly half of maternal deaths occurring among women from poor households. Most women who died from maternal causes were aged 20-34 years. Maternal mortality in Nepal reflects social and geographic inequalities, with higher risk among poorer women, those in rural and peri-urban areas, and specific provinces, particularly during the postpartum period. Strengthening antenatal care, skilled birth attendance, and equitable, context-specific interventions is essential to reduce preventable maternal deaths.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"420-427"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an Advance Care Planning Pilot Module for New York City Community Members.","authors":"Sabina Kubayeva, Tyler M Johnson, Nathalie Vieux-Gresham, Alison Snow, Lina Jandorf","doi":"10.1007/s10900-026-01561-2","DOIUrl":"10.1007/s10900-026-01561-2","url":null,"abstract":"<p><p>Advance care planning (ACP) facilitates discussions about future healthcare decisions to ensure alignment with individuals' values, goals, and medical preferences. Despite its benefits, ACP engagement and completion of advance directives (AD) remain limited due to low awareness, misconceptions, and structural barriers. The Tisch Cancer Institute Community Outreach and Engagement Department at Mount Sinai in New York City (NYC) identified this knowledge gap as a key community need. In response, a community-based educational module was created to enhance ACP and AD knowledge. Curriculum development was informed by a literature review and collaboration with health educators, social workers, and palliative care specialists. The intervention included a 30-minute slideshow, a two-page glossary and resource handout, and a healthcare proxy AD form. Workshop impact, acceptability, and feedback were assessed using a validated survey with eight Likert-scale items and two open-ended questions. Descriptive statistics summarized quantitative responses, and thematic analysis was applied to open-ended feedback. Community adult members across NYC participated in eleven workshops held at diverse community sites from June 2024 to June 2025, engaging 141 individuals with a feedback survey response rate of approximately 40% (N = 56). Findings demonstrated acceptability and feasibility. Participants reported increased understanding of ACP concepts and improved confidence in completing ADs. Qualitative comments emphasized clarity, relevance, and practicality of materials. Our community-based educational workshops effectively enhanced ACP knowledge and empowered participants in healthcare decision-making. Future directions include expanding workshop reach, translating materials, and conducting longitudinal follow-up to evaluate sustained engagement and impact on AD completion rates over time.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"413-419"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Locks and Lectures: What Rural Parents Think Would Be Effective Firearm Safety Messaging and Programming.","authors":"Victor A Soupene, Charles Jennissen, Nicholas Stange, Pam Hoogerwerf, Cassidy Branch, Marc Doobay","doi":"10.1007/s10900-025-01533-y","DOIUrl":"10.1007/s10900-025-01533-y","url":null,"abstract":"<p><p>Firearm-related suicides and unintentional injuries occur at higher rates in rural U.S. communities than in urban areas. While safe storage programs may help reduce these injuries, little is known about how to effectively engage rural, farming populations. This study aimed to identify factors influencing firearm safety programming and messaging among parents in rural households. Focus groups were conducted in 2024 with rural Iowa parents recruited via FFA club advisors and through the University of Iowa mass e-mail system. Inclusion criteria included: (1) residence in Iowa with active farming or ranching operations, (2) at least one child aged 10-19 living in the home, and (3) at least one firearm in the household. Discussions followed a moderator guide to identify primary themes, with sub-themes emerging organically. Transcripts were analyzed using Dedoose software. Three researchers independently coded the data and resolved discrepancies through consensus. Thirty-two participants identified trusted messengers as law enforcement, Department of Natural Resources personnel, and community members affected by firearm violence. Teachers, healthcare professionals, and celebrities were viewed as less credible. Participants emphasized age-specific messaging using realistic examples and visuals and suggested integrating firearm safety into existing programs like school curricula, 4-H, FFA and local safety courses. Views on distributing safety devices like locks and safes were mixed. Tailoring firearm safety interventions to reflect the values and preferences of rural communities may improve engagement and effectiveness. Strategies led by trusted local messengers may be particularly impactful.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"304-311"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Factors Associated with E-cigarettes and Heated Tobacco Products Use among Vietnamese Adolescents.","authors":"Ngoc Minh Luu, Pham Bich Diep, Thi Hai Phan, Tu Anh Duong, Van Minh Hoang, Hai Thanh Phan, Thi Thanh Toan Do, Bao Giang Kim","doi":"10.1007/s10900-025-01535-w","DOIUrl":"10.1007/s10900-025-01535-w","url":null,"abstract":"<p><p>This study aims to examine the situation and factors associated with e-cigarette and heated tobacco products (HTPs) use among Vietnamese adolescents. We used data on e-cigarette use among youth in Vietnam from the 2022 Global Youth Tobacco Survey (GYTS), which is a school-based cross-sectional survey of secondary and high school students aged 13-15. Weighted prevalences of e-cigarette and HTP use were calculated. Factors associated with e-cigarette and HTP use were examined using multivariable logistic regressions. A total of 3,873 students aged 13 to 15 were included in the final analysis. The prevalence of ever use of e-cigarettes and HTPs was 7.8% and 1.5%, while the prevalence of current use was 3.5% for e-cigarettes and 0.6% for HTPs. Peer influence was associated with ever (aOR 2.43, 95% CI 1.78-3.31) and current e-cigarette use (aOR 1.86, 95% CI 1.16-2.97). Advertisement exposure was linked to ever (aOR 1.90, 95% CI 1.36-2.63) and current e-cigarette use (aOR 2.50, 95% CI 1.59-3.93), and ever HTP use (aOR 2.00, 95% CI 1.18-3.38). Current conventional cigarette use showed the strongest associations, with higher odds of ever e-cigarette (AOR 9.56, 95% CI 4.75-19.27), ever HTP (aOR 14.02, 95% CI 5.63-34.93), current e-cigarette (aOR 12.55, 95% CI 6.88-22.87), and current HTP use (aOR 12.35, 95% CI 2.33-65.38). This study highlights the rising prevalence of e-cigarette and HTP use among Vietnamese adolescents. Dual use of conventional cigarettes and these alternative tobacco products is strongly associated, emphasizing the need for targeted interventions.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"240-248"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Impact of Patient Demographics on Outreach Efforts for a Student-Run LGBTQIA + Free Clinic.","authors":"Geoffrey Xue, Anthony Barnes, Gabriel Alexander Lee, Lucas Raphael Lee, Courtney DuBois Shihabuddin","doi":"10.1007/s10900-025-01517-y","DOIUrl":"10.1007/s10900-025-01517-y","url":null,"abstract":"<p><p>The LGBTQIA + community faces unique health disparities that can lead to severe barriers to care. The Rainbow Clinic is a specialty clinic at the Columbus Free Clinic, a student-run free clinic affiliated with a large academic institution in the Midwest, that provides free primary and specialty care for uninsured and underinsured patients in Columbus, Ohio. Unfortunately, there is a paucity of literature depicting how to best reach these patient populations. This study sought to examine the outreach strategies for patient recruitment to the Rainbow Clinic with a retrospective chart review of past patients (N = 77). 44.2% of respondents discovered the clinic through social media. Age strongly and negatively correlated with appointment frequency (r = -0.665, p < 0.001), while income showed a moderate positive correlation (r = 0.464, p < 0.001). Preliminary data is a promising foundation for future research to improve recruitment of vulnerable populations. Correlations between age and social-media related appointments and income and social-media associated appointments can be helpful to address specific modes of outreach for target populations in the LGBTQIA + community.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"249-255"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Education in the United States and Reflections on Accelerated Pathways.","authors":"Pascal James Imperato","doi":"10.1007/s10900-026-01558-x","DOIUrl":"10.1007/s10900-026-01558-x","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The education of allopathic (MD) and osteopathic (DO) physicians in the United States (US) in general required four years of undergraduate study leading to a baccalaureate degree and four years of medical education afterwards. This pattern has been in existence for over a century. However, with scientific medical advances, specialties developed, requiring additional training following graduation in residencies which are from one to seven years in duration. Sub-specialization eventually developed and requires additional years of training in fellowships. The length of medical school education, residencies, and fellowships, evolved over time and gave rise to the need for accreditation agencies which could verify adherence to what became national standards. In tandem, US states and territories, which have the authority to license physicians, developed medical licensure boards which oversaw in-state examinations. This in turn gave rise to a complex system of reciprocity between states. The development of a standard national examination was a slow process first begun by the National Board of Medical Examiners (NBME) whose exam scores were eventually recognized by some states but not by others. In 1973, the Federation of State Medical Boards (FSMB) created a licensure examination known as the Federation Licensing Examination (FLEX). In the early 1990s, agreement was reached to create a uniform national examination sponsored by the FSMB and the NBME which came to be known as the three-step United States Medical Licensing Examination (USMLE). From projections of physician shortages in the 1970's, the US moved into a projection of physician surplus in the 1980s. The US Department of Health, Education and Welfare established a Graduate Medical Education National Advisory Committee (GMENAC) which was in session from 1976 to 1980. Prominent participants on this committee were the American Medical Association (AMA) and the Association of American Medical Colleges (AAMC). This committee unfortunately and inaccurately concluded that there would be a surplus of 70,000 physicians in the US by 1990. As a result, existing medical schools were requested to reduce entering class sizes, and a moratorium was placed on the development of new medical schools. This policy remained in place for almost 25 years. It was then realized by the organizations that oversaw the accreditation of allopathic and osteopathic medical schools that the US had and would continue to have a shortage of physicians. The AAMC and its accreditor of medical schools, the Liaison Committee on Medical Education (LCME) approved the creation of new medical schools and the expansion of classes in existing ones. This however only resulted in some 7,000 more MDs graduating annually compared to 1980 for a total of 22,000 per year. Accelerating medical school from four to three years has been viewed by some, but not by all medical educators, as a means to increase the supply of physicians and to reduc","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"204-210"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Knowledge, Attitude, and Anxiety among Healthcare Providers and Medical Students in Iraq about Monkeypox Virus during the 2024 Global Outbreak.","authors":"Nabeel Al-Fatlawi, Abdulrahman Khaldoon Hamid, Ghadeer Ali Hassan, Sajjad Ghanim Al-Badri, Sajjad K Naseem, Yousif Ali Madlul, Noran Muhsin Al-Gizey, Fatimah Al-Shujairi, Osama Al-Fatlawi, Ahmed Dheyaa Al-Obaidi","doi":"10.1007/s10900-025-01545-8","DOIUrl":"10.1007/s10900-025-01545-8","url":null,"abstract":"<p><p>The resurgence of monkeypox (MPX) as a global public health emergency in 2024 highlighted the challenges faced by healthcare systems worldwide, particularly in resource-limited settings like Iraq. Understanding the knowledge, attitudes, and anxiety levels among healthcare providers and medical students is crucial to enhance preparedness and response strategies during outbreaks. This study aimed to evaluate the knowledge, attitudes, and anxiety levels of Iraqi healthcare providers and medical students regarding MPX, identifying gaps that may hinder effective outbreak response and public health education. A cross-sectional study was conducted among healthcare providers and medical students across Iraq. Data were collected through an online, self-administered survey distributed via digital platforms between September 1, 2024, and January 15, 2025. The questionnaire assessed participants' knowledge, attitudes, and anxiety regarding MPX. A total of 200 participants were included, with a mean age of 21.84 ± 2.49 years, predominantly female (74%) and single (96%). While 73.8% of participants recognized isolation as a prevention method, 63.8% identified multiple transmission routes, and only 40% were aware of MPX prior to the study. The average anxiety score was 17.92 ± 5.76, reflecting moderate anxiety, with higher scores observed among females. Knowledge gaps persisted in recognizing symptoms like lymphadenopathy (51.3%) and treatment options, with 38.8% believing there was no treatment. Vaccination willingness was moderate, with only 65% willing to be vaccinated. Social media was the primary source of information (63.7%), often contributing to misinformation. Significant gaps in knowledge and varying attitudes highlight the need for targeted educational campaigns and improved communication strategies to prepare healthcare professionals for managing emerging infectious diseases like MPX. Addressing these gaps can mitigate anxiety and enhance healthcare preparedness in Iraq and similar settings.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"338-343"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociocultural Antecedents of HPV Vaccination Completion Among Mothers of Mexican Descent: the Mediating Role of Mother-Daughter Connectedness.","authors":"Julia Lechuga, Junqi Chen, Alia Komsany, Alyssa Martinez, Uchenna Gbugu, Sierra Galvan","doi":"10.1007/s10900-025-01539-6","DOIUrl":"10.1007/s10900-025-01539-6","url":null,"abstract":"<p><p>The Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and a leading cause of cervical cancer. Latinas have higher rates of cervical cancer incidence and mortality compared to non-Latina White women. The HPV vaccine is a primary form of prevention recommended for pre-adolescents but, vaccine completion of the two dose vaccine series is low among Latina adolescents. The purpose of the study was to investigate the association between sociocultural variables, mother-daughter connectedness, and communication about sexual health on HPV vaccine completion thereby moving beyond prior research that has focused on individual attitudes or provider recommendations. A cross-sectional survey was administered to 192 Latina mothers of Mexican descent. Linear regression and an exploratory model depicting associations between the variables and vaccination completion was tested through path analysis. Mother-daughter conversations about birth control emerged as the strongest predictor of vaccination completion. Indices of fit for a modified exploratory model were χ2(18) = 1.28 χ2/df = 5.76, p = .001; CFI = 0.96; TLI = 0.94; RMSEA = 0.03. Estimates of indirect effects indicated that mother-daughter connectedness had an indirect effect on comfort having sexuality-related conversations which in turn, had an indirect effect on conversations about birth control. Findings contribute by elucidating the nuanced mechanisms through which parental relationship quality and communication practices shape parental uptake of sexual and reproductive health behaviors for children. Findings respond to calls for culturally relevant family-level approaches to HPV vaccination.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"329-337"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}