Journal of Community Health最新文献

{"title":"Over 20 Years of Training in Community-based Participatory Research and Service Learning through the Community Health Fellowship Program.","authors":"Nora Gimpel, Philip Day, Tiffany Kindratt, Victoria Udezi, Juliana Dixon, Hira Hasan","doi":"10.1007/s10900-026-01579-6","DOIUrl":"10.1007/s10900-026-01579-6","url":null,"abstract":"<p><p>A growing number of institutions have integrated Community-Based Participatory Research into their curricula, using diverse models that range from elective to required, short-term to longitudinal, and single profession to interprofessional programs to align with the American Association of Medical Colleges learning objectives. This paper reviews the past two decades of the Community Health Fellowship Program (CHFP) at UT Southwestern Medical Center. It highlights key program accomplishments and presents a mixed-methods analysis of student feedback, including post-program evaluations, program organization, didactic lectures, and community partnerships. Post-program quantitative and qualitative data from student feedback surveys were analyzed to identify patterns and trends across multiple years. From 2002 to 2025, 106 fellows were trained through the CHFP, working with over 50 academic practice and community partnerships. Overall, the program received high ratings, with the strongest scores reflecting knowledgeable staff and instructors, while comparatively lower, though still positive, scores highlighted opportunities to improve program organization and alignment with student expectations at enrollment. Data show that the CHFP successfully built student competence in CBPR aligned with community-identified priorities, with consistent accomplishments, demonstrating the program's sustained impact on community needs and the scientific literature. As a long-standing and evolving initiative, the CHFP offers a model for both emerging and established CBPR-based programs at other academic institutions.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"667-675"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015829","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":"HIV and Tuberculosis Coinfection in Brazil: Cohort Profile Monitored by the Unified Health System (2015-2018).","authors":"Evelyn Lima de Souza, Maria Ines Battistella Nemes, Ana Maroso Alves, Ana Paula Sayuri Sato","doi":"10.1007/s10900-026-01585-8","DOIUrl":"10.1007/s10900-026-01585-8","url":null,"abstract":"<p><p>To describe the sociodemographic and clinical profile of individuals with HIV-tuberculosis coinfection followed in services of the Brazilian Unified Health System (SUS), through the integration of data from the Qualiaids-Brazil Cohort and national health information systems.</p><p><strong>Methods: </strong>Nationwide observational study using data from the Qualiaids-BR Cohort, composed of people living with HIV/AIDS (PLWHA) who initiated antiretroviral therapy (ART) between 2015 and 2018 in SUS services participating in the Qualiaids 2016/2017 survey. Individuals with at least one episode of active tuberculosis after ART initiation were included.</p><p><strong>Results: </strong>A total of 7,747 individuals with HIV-tuberculosis coinfection were identified. The majority were men, young, mixed-race, with low educational levels, and residing in the Southeast region. Social vulnerabilities included alcohol, tobacco, or illicit drug use (> 20%). Half presented an initial viral load > 100,000 copies/mL and 60% had baseline CD4 counts < 200 cells/mm³. Regarding tuberculosis, 80.3% were new cases, 9.5% re-entries, and 5.7% relapses. Treatment duration was concentrated between 6 and 12 months, with a cure rate of 70.9% and abandonment in 10.4% of cases, of which 21.3% also discontinued ART.</p><p><strong>Conclusion: </strong>Data integration enabled a comprehensive profile of HIV-tuberculosis coinfection, consistent with national findings and marked by social vulnerabilities that impact adherence and outcomes. The high proportion of treatment abandonment, also associated with ART discontinuation, highlights systemic weaknesses and the need for integrated care strategies for individuals with HIV-tuberculosis coinfection. The findings reinforce the importance of promoting comprehensive and continuous care to mitigate the impacts of coinfection.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"656-666"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004987","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":"The Role of Community Pharmacies in Seasonal Influenza Vaccination in Syracuse, Italy.","authors":"Claudio Fiorilla, Fabio Contarino, Francesco Leonforte, Vito Nicosia, Giuseppe Leonardo Cucè, Salvatore Caruso, Gioacchino Nicolosi, Antonio Mistretta","doi":"10.1007/s10900-026-01566-x","DOIUrl":"10.1007/s10900-026-01566-x","url":null,"abstract":"<p><p>Influenza remains a major public health challenge, and vaccination is the primary strategy to reduce its burden. Community pharmacies have been introduced as additional vaccination providers in Italy, but their contribution remains insufficiently documented. This study assessed the role of community pharmacies in influenza vaccination in the Siracusa Local Health Authority (LHA) across the 2022/23-2024/25 seasons. A retrospective analysis of the local electronic vaccination registry was conducted. All adults vaccinated during the three influenza seasons were included, with a focus on individuals aged 18-65 years, the group eligible for pharmacy-based vaccination under regional guidelines. Information on vaccine type, administration setting, and patient characteristics was analyzed. Overall, 83,517 individuals received at least one influenza vaccination. Of these, 1,709 (2.0%) were vaccinated in community pharmacies, where standard-dose vaccines predominated (97.1%). Among pharmacy-vaccinated individuals, 272 had at least one underlying condition. In the 18-65-year subgroup, 32,028 individuals were vaccinated, with approximately 2% receiving vaccination in pharmacies. The pharmacy contribution in this subgroup increased over the three seasons from 1.8% to 2.7%. Community pharmacies played a modest but increasing role in influenza vaccination, particularly among adults aged 18-65 years. Within this local setting, the findings reflect an early phase of implementation of pharmacy-based vaccination in Italy. Expanding pharmacy-based vaccination services may improve access to vaccination and support public health strategies to increase adult immunization coverage.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"629-636"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772987","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":"HIV Mortality Surveillance in Nigeria, A Systematic Review of Trends, Determinants, and Implications For Public Health Policy.","authors":"Oluwadamilola M Oladunjoye, David Ishaleku, Olaposi J Olatoregun, Bisayo A Ogundipe","doi":"10.1007/s10900-026-01575-w","DOIUrl":"10.1007/s10900-026-01575-w","url":null,"abstract":"<p><p>Despite substantial progress in expanding antiretroviral therapy (ART) coverage and scaling up prevention interventions, Human Immunodeficiency Virus (HIV) related mortality remains a significant public health challenge in several high-burden settings, including Nigeria. Persistent data system fragmentation, late diagnosis, and socio-structural inequities have slowed progress toward epidemic control. This systematic review synthesizes evidence on the epidemiological trends, determinants, and surveillance performance of HIV mortality in Nigeria, highlighting implications for public health policy and Sustainable Development Goal (SDG) 3.3. A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 framework. Peer-reviewed studies, national surveillance reports, and institutional documents published between 2010 and 2024 were retrieved from PubMed, Scopus, Web of Science, African Journals Online (AJOL), and World Health Organization (WHO) databases. Thematic synthesis was guided by the Public Health Surveillance Theory (PHST), Health Systems Resilience Framework (HSRF), and Socio-Ecological Model of Mortality (SEMM). Data were analyzed across four domains: mortality trends, determinants, surveillance performance, and global comparators. Eighty-two studies met inclusion criteria. HIV-related deaths in Nigeria declined from approximately 220,000 in 2010 to 52,000 in 2023, though progress has plateaued since 2018. Key mortality drivers include late ART initiation, Tuberculosis (TB) and Non-communicable disease (NCD) co-infection, and structural factors such as stigma, poverty, and gender inequity. Institutional challenges including ART stock-outs, poor Electronic Medical Records (EMR-Civil Registration and Vital Statistics (CRVS) linkage, and weak mortality audit systems undermine timely surveillance. Nigeria's CRVS captures < 30% of deaths, with < 10% accurately certified, compared to > 95% capture in countries with integrated digital systems such as South Africa and Brazil. Reducing HIV mortality in Nigeria requires transforming mortality surveillance into an active public health intervention. Integrating electronic medical records with civil registration, expanding verbal autopsy coverage, institutionalizing mortality audits, and addressing structural inequities will strengthen health system resilience and accelerate progress toward HIV epidemic control and SDG targets by 2030.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"611-620"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772938","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":"Enhancing Community Health Worker Communication: Evaluating Simulation-Based Training in Motivational Interviewing.","authors":"Rebekah Chance-Revels, Quyen Phan, Kevin Crawford, Laika Steiger, Beth Ann Swan","doi":"10.1007/s10900-025-01543-w","DOIUrl":"10.1007/s10900-025-01543-w","url":null,"abstract":"<p><p>Community health workers act as essential links between underserved communities and healthcare systems, promoting equity, building trust, and addressing social determinants of health. To be effective, they need strong communication skills, such as motivational interviewing, which supports behavior change by encouraging self-motivation and resolving ambivalence. This evaluation examined the impact of simulation-based training on the motivational interviewing skills of community health workers enrolled in a structured workforce program. Community Health Worker trainees (n = 277) attended a one-day session that included didactic lessons and simulations focusing on vaccine confidence, smoking cessation, and childhood obesity. Trainees' confidence was assessed through pre- and post-training surveys in three areas: engaging in conversations with people holding different opinions, applying motivational interviewing techniques, and using culturally appropriate resources to combat misinformation. Results showed significant improvements in confidence across all areas, with the greatest gain in engaging individuals with differing viewpoints, followed by applying motivational interviewing skills, and a smaller but meaningful increase in addressing misinformation. Qualitative feedback reinforced these findings, highlighting the value of realistic role-play, immediate feedback, structured preparation, and reflection. While further practice and long-term evaluation are necessary, simulation-based motivational interviewing training appears promising for enhancing community health workers' ability to promote behavior change and community engagement.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"542-548"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623186","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":"Outcomes of a Medical Interpreter Training Program for Community Health Workers in a Rural Area of the State of Kansas, USA.","authors":"Ton Miras Neira, Kara Hollins, Christina M Pacheco, Clarissa Carrillo Martinez, Edward Ellerbeck, Elizabeth Ablah, Jordyn Coonrod, Sarah Finocchario-Kessler","doi":"10.1007/s10900-026-01569-8","DOIUrl":"10.1007/s10900-026-01569-8","url":null,"abstract":"<p><p>Effective patient-provider communication plays an essential role in healthcare outcomes, thus patients with limited English proficiency (LEP) in the United States experience barriers to optimal healthcare. The Hispanic LEP population is growing in many states, while the number of trained medical interpreters has not kept pace with demand. This gap is especially pronounced in rural Kansas, where lack of interpretation services is frequently cited as a barrier to healthcare access. Spanish-speaking community health workers often navigate this process for patients despite lack of formal training or organizational infrastructure support to carry out these duties. To address this need, an intensive Medical Interpreter Training was designed specifically for CHWs in rural Kansas. Spanish- English bilingual CHWs from rural Kansas were recruited for the program, which aimed to build essential knowledge, skills, and professionalism for effective medical and community interpreting. The 5-day, 40-hour training achieved a 91% pass rate, with 20 of 22 participants earning qualification to pursue national medical interpreter certification provided by both the Certification Commission for Healthcare Interpreters and the National Board of Certification for Medical Interpreters. Significant pre-post improvements were observed in confidence, knowledge, understanding, complexity, and comfort across medical interpretation domains; professional behavior remained high at baseline and post-training. Qualitative feedback highlighted the value of interactive role-playing, hands-on activities, and expert instruction, and comprehensive coverage of ethical standards and cultural competence. The CHW-MITP demonstrates that training CHWs in medical interpretation is a feasible strategy that potentially reduces language barriers for Spanish-speaking populations in rural Kansas.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"621-628"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772941","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":"Non-Adherence to Anti-Tuberculosis Treatment and Its Determinants Among Tuberculosis Patients in Tanzania.","authors":"Meshack Morice, Bernadetha Hugho Kimario, Indo Ndaigeze, Damas Dismas Nyabenda","doi":"10.1007/s10900-026-01581-y","DOIUrl":"10.1007/s10900-026-01581-y","url":null,"abstract":"<p><p>Non-adherence to anti-tuberculosis (TB) treatment remains a major barrier to effective TB control, contributing to poor treatment outcomes, relapse, and the emergence of drug-resistant TB. Evidence on the magnitude and determinants of non-adherence in Tanzania is limited. This study assessed the prevalence of non-adherence to anti-TB treatment and its associated factors. A hospital-based cross-sectional study was conducted among adult TB patients receiving treatment at Mwananyamala Regional Referral Hospital. 245 participants were recruited using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire. Descriptive statistics were used to summarize participant characteristics. Log-binomial regression analysis was performed to estimate crude and adjusted prevalence ratios (PRs) with 95% confidence intervals (CIs) for factors associated with non-adherence, with significance set at p < 0.05. The prevalence of anti-TB non-adherence was 33.5%. Experiencing side effects (aPR = 1.664; 95% CI: 1.129-2.449) and poor knowledge about TB (aPR = 1.704; 95% CI: 1.062-2.732) were associated with increased likelihood of non-adherence. Family support was associated with a lower likelihood of non-adherence (aPR = 0.696; 95% CI: 0.487-0.994). Other socio-demographic, clinical, and health system factors were not significantly associated with non-adherence. Non-adherence to anti-TB treatment remains high in Tanzania, affecting approximately one-third of patients. Medication side effects and poor TB knowledge are key drivers of non-adherence, while family support plays a protective role. Interventions focusing on patient education, effective management of treatment side effects, and strengthening family and community support systems are essential to improve adherence and enhance TB control efforts.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"648-655"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963792","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":"Nicotine Pouch Awareness, Susceptibility, and Use Among California College Students.","authors":"Nora Satybaldiyeva, Nina C Schleicher, Page D Dobbs, Trent O Johnson, Arzoo Alam, Judith J Prochaska, Lisa Henriksen","doi":"10.1007/s10900-026-01577-8","DOIUrl":"10.1007/s10900-026-01577-8","url":null,"abstract":"<p><p>Research about perceptions and use of nicotine pouches among young adults is limited. This study assessed changes in awareness, susceptibility, and use of nicotine pouches among college-enrolled young adults. The analysis pooled data from two independent, cross-sectional surveys of California college students (n = 9,606, ages 18-24) in 2022 and 2024. Outcomes were nicotine pouch awareness, susceptibility to use, ever and current use, all dichotomized and modeled as a function of survey year, student demographics, and college type (four-year vs. community college). In 2024, college students' awareness of nicotine pouches was 66.9%, susceptibility was 31.7%, ever use was 15.1%, and current use was 11.5%. All outcomes increased between years. In adjusted models including interactions with survey year, increase in nicotine pouch awareness (aOR = 2.20; 95% CI: 1.81, 2.67) was significantly higher among sexual/gender minority (SGM) students (aOR = 1.28; 95% CI: 1.07, 1.71) compared to heterosexual men and was attenuated among students at community colleges (aOR = 0.80; 95% CI: 0.67, 0.95) compared to four-year colleges. Ever use of nicotine pouches nearly doubled (aOR = 1.97; 95% CI: 1.71, 2.28). Increase in current use (aOR = 3.28; 95% CI: 2.32, 4.65) was attenuated among Hispanic/Latinx students (aOR = 0.66; 95% CI: 0.44, 0.99) compared to non-Hispanic/Latinx White students. Increasing awareness, susceptibility, and use of nicotine pouches among California college students raise important considerations for tobacco control. Prevention and cessation efforts should be informed by an escalated increase in awareness among students identifying as SGM and students attending a four-year university (vs. community college).</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"603-610"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772871","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":"Exploring Health Priorities in the Barbershop: A Modified Delphi Study of Barbers' and Clients' Views on What is Important and What is Feasible.","authors":"Kaylyn A Garcia, Kalyn Prothro, Trishna Patel, Micheal Priester, Terry Woods, Guillermo Wippold","doi":"10.1007/s10900-026-01584-9","DOIUrl":"10.1007/s10900-026-01584-9","url":null,"abstract":"<p><p>Barbershops are a place of cultural significance for many Black men and have been the site of successful health promotion programming; yet, efforts conducted in barbershops should recognize the contextual and organizational constraints of the site. The present study used a modified Delphi poll to identify health topics that were important among Black men and feasible to address in the barbershop according to barbers (Round 1) and clients (Round 2). A total of 63 individuals participated in this study (n = 29 barbers and n = 34 clients). Barbers were presented with 54 health topics and were asked to rate the importance and feasibility of addressing each health topic among Black men in the barbershop. Results were then plotted in a Go-Zone plot with four quadrants-(Go-Zone 1) high importance and feasibility;(Go-Zone2)low importance and high feasibility;(Go-Zone3) low importance and feasibility ;and(Go-Zone4)high importance and low feasibility. Results in Go-Zones 1, 2, and 4 were then presented to clients. Results were then plotted again and t-tests were performed to examine differences between barbers and clients. Final results visually display the importance/feasibility of each health concern according to barbers and clients. Additionally, t-test analyses indicate that barbers view health concerns as more important/feasible than their clients. The results of this study have important implications for the contextually-aligned design and implementation of health promotion programming in barbershops.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":"695-706"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054955","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":"Leprosy-Related Stigma and Social Representations Among Persons Affected by Leprosy and Primary Healthcare Professionals: A Structural Analysis in the Brazilian Amazon.","authors":"Francisco Albino de Araújo, Vinicius Silva Dos Santos, Woska Pires da Costa, Eloiza Toledo Bauduina, Italla Maria Pinheiro Bezerra, Luiz Carlos de Abreu","doi":"10.1007/s10900-026-01618-2","DOIUrl":"https://doi.org/10.1007/s10900-026-01618-2","url":null,"abstract":"<p><p>Leprosy remains a persistent public health challenge not only because transmission continues in endemic settings, but also because stigma remains embedded in social relations, institutional practices, and historical forms of exclusion. This study analyzes the social representations of leprosy among persons affected by leprosy and primary healthcare professionals in a historically endemic area of the Brazilian Amazon, with particular attention to how these representations shape disease recognition, stigma, and care. An exploratory mixed-methods design combined structured questionnaires with a Free Word Association Test to investigate shared meanings of leprosy among 34 persons affected by leprosy (age available for 23 participants; range, 20-85 years) and 19 primary healthcare professionals. Findings show that leprosy is socially understood less through biomedical curability than through stigma, visible bodily damage, and exclusionary meanings, reflected in candidate central elements such as \"prejudice\", \"deformity\", and \"pain\". Although most affected participants recognized that leprosy is curable, substantial knowledge gaps were identified, particularly regarding transmission pathways. Similar limitations were observed among healthcare professionals, indicating weaknesses in diagnostic preparedness within primary healthcare. These results suggest that stigma in leprosy cannot be reduced to insufficient knowledge alone, but should instead be understood as a biosocial phenomenon produced through the interaction of social meanings, embodied experience, and institutional conditions. These dynamics may contribute to delayed diagnosis and reinforce the continued neglect of the disease, requiring integrated strategies that go beyond biomedical control, strengthen primary healthcare, and transform the social and institutional conditions that sustain stigma, diagnostic delay, and exclusion.</p>","PeriodicalId":15550,"journal":{"name":"Journal of Community Health","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591988","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}