Public Health in Practice最新文献

{"title":"The global prevalence of tooth wear in general population: a systematic review and meta-analysis","authors":"Nader Salari ,&nbsp;Amir Hossein Sadeghi ,&nbsp;Amir Abdolmaleki ,&nbsp;Hosna Zarei ,&nbsp;Amir Hossein Ghaderi ,&nbsp;Shamarina Shohaimi ,&nbsp;Masoud Mohammadi","doi":"10.1016/j.puhip.2025.100708","DOIUrl":"10.1016/j.puhip.2025.100708","url":null,"abstract":"<div><h3>Objective</h3><div>Tooth wear (TW), as a common dental challenge, refers to the loss of dental tissue with four types of Attrition, Erosion, Abrasion, and Abfraction. Since there are no scientific reports regarding the global TW prevalence, this study was designed to investigate the prevalence of TW worldwide.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Systematic search was conducted (by November 2024) in valid databases of PubMed, WoS, ScienceDirect, Scopus, Embase, and Google Scholar search engine using the main keywords of “Prevalence”, “Tooth wear”, “Erosion”, “Attrition”, “Abfraction”, and “Abrasion”. The I² index was used to examine heterogeneity, and the Random Effect Model was used for meta-analysis (CMA v.2).</div></div><div><h3>Results</h3><div>Following the review of 133 eligible studies with the sample size of 92,153 individuals with TW, the global prevalence of TW was found to be 40.8 % (95 %CI: 36.7–45, I²: 99.1).</div></div><div><h3>Conclusion</h3><div>According to the high global prevalence of TW, the implementation of a comprehensive strategy by the health care system seems necessary to control TW occurrence and prevent the associated complications.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100708"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of public health education among medical students in Ireland: A qualitative study","authors":"A. Malakhveitchouk ,&nbsp;P. White ,&nbsp;P. Barrett","doi":"10.1016/j.puhip.2026.100730","DOIUrl":"10.1016/j.puhip.2026.100730","url":null,"abstract":"<div><h3>Objectives</h3><div>This study seeks to explore the perceptions, understanding and expectations held by medical students studying in Ireland towards public health (PH) education and the practice of public health medicine (PHM).</div></div><div><h3>Study design</h3><div>Qualitative semi-structured interviews.</div></div><div><h3>Methods</h3><div>Participants were recruited from all medical universities in Ireland using purposive and snowball sampling. Qualitative semi-structured interviews were conducted and transcribed. Thematic analysis was performed using the Braun and Clarke method to identify semantic and latent themes. Transcripts were read repeatedly for familiarization with the data, following which initial codes were created. Related codes were grouped into categories and these were subsequently reviewed to generate themes.</div></div><div><h3>Results</h3><div>13 medical students in their penultimate and final year across five Irish universities were recruited. Three key themes were generated from the analysis. 1) Variations in perceived relevance of PH to medical training. Students articulated mixed views on the importance of PH in the medical curriculum, as well as misconceptions around the role of PH physicians. 2) Deprioritization of PH education during clinical training. Participants perceived that PH was deprioritized by institutions and by students themselves. 3) Limited exposure to PH in practice. The reduced visibility of PH practitioners, and limited exposure to PH workplaces during clinical training deters students from considering PHM as a future career.</div></div><div><h3>Conclusions</h3><div>There is a need to address students’ lack of understanding and misconceptions relating to PH practice within the medical curriculum in Ireland and to provide more practical opportunities for exposure to PHM.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100730"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between county-level poverty and firearm injury health encounters in Maryland, USA","authors":"Khadijah Tiamiyu ,&nbsp;Gayane Yenokyan ,&nbsp;James P. Byrne ,&nbsp;Katherine Hoops","doi":"10.1016/j.puhip.2026.100738","DOIUrl":"10.1016/j.puhip.2026.100738","url":null,"abstract":"<div><h3>Objective</h3><div>Firearm injuries are among the four leading causes of injury deaths in the United States. Prior studies have shown the association between poverty and firearm injuries on the national level, but more focused data at the state level has yet to be studied. The objective of this study was to examine the association between county-level poverty and firearm injury health encounters in Maryland, USA.</div></div><div><h3>Study design</h3><div>This was an ecological study conducted on counties in Maryland from July 2015–July 2020.</div></div><div><h3>Methods</h3><div>This study consisted of residents of all ages with firearm injuries who presented to Maryland healthcare facilities. The outcome variables examined were total firearm injury health encounters and injuries by intent (assault, self-harm, and unintentional). The study exposure was county-level poverty concentration divided into tertiles: 0–7.5 %,7.6–12.0 %, and 12.1–25.8 %. Additional covariates included age, race, sex, and urbanicity.</div></div><div><h3>Results</h3><div>Individuals residing in counties in the highest poverty tertile accounted for 16 % of the total population but 52 % of firearm injury health encounters. Counties in the highest poverty tertile had the highest rates of overall firearm injuries, firearm-related assaults, unintentional, and undetermined injuries, compared to counties in the lowest tertile. However, there was no statistically significant difference in the adjusted firearm self-harm incidence rate comparing counties in the highest poverty tertile to the lowest poverty tertile (IRR: 1.9, 95 % CI: 1.0–3.7).</div></div><div><h3>Conclusion</h3><div>Higher levels of poverty are associated with increased rates of firearm injury health encounters in Maryland, underscoring the importance of antipoverty initiatives in addressing firearm injuries.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100738"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structured framework for the development of knowledge, attitudes, and practices surveys addressing brown dog tick-associated Rocky Mountain spotted fever","authors":"K.P. Romo-Dueñas,&nbsp;D.A. Enríquez-Ávila,&nbsp;G. Álvarez-Hernández,&nbsp;S.A. De la Torre-Othón,&nbsp;G.A. Navarro-Armendariz,&nbsp;M.C. Candia-Plata","doi":"10.1016/j.puhip.2025.100703","DOIUrl":"10.1016/j.puhip.2025.100703","url":null,"abstract":"<div><h3>Objectives</h3><div>Rocky Mountain spotted fever (RMSF) is a severe tick-borne disease with high fatality rates in endemic regions, particularly where brown dog ticks proliferate. This study proposes a structured framework for developing surveys addressing knowledge, attitudes, and practices (KAP) related to preventive measures in RMSF.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>We searched major scientific databases using MeSH/DeCS terms and keywords related to “health knowledge, attitudes, practice” and “Rocky Mountain spotted fever”, combined with relevant synonyms and Boolean operators, for studies published between 2003 and 2024 in English, Spanish, and Portuguese. Following PRISMA guidelines, eight eligible studies were identified and assessed with the AXIS tool.</div></div><div><h3>Results</h3><div>While existing studies offered valuable insights, our assessment revealed four significant biases that compromised their methodological quality and the reliability of their findings. To address these limitations, we propose a novel, structured framework for developing future RMSF KAP surveys. This framework integrates: (a) comprehensive risk assessment, (b) a primary prevention stratification pyramid, and (c) a robust logic model.</div></div><div><h3>Conclusions</h3><div>Applying this proposed framework is anticipated to improve the methodological rigor, validity, and reliability of future KAP studies concerning RMSF preventive measures, ultimately enhancing public health interventions.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"Article 100703"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training healthcare providers in adolescent alcohol and substance use screening through project ECHO in rural Pennsylvania: A brief case report.","authors":"Uttara Seshu, Jessica S Beiler, Sarah Cichy, Erik Lehman, Julie Lentes, Jennifer Kraschnewski, Casey N Pinto","doi":"10.1016/j.puhip.2026.100810","DOIUrl":"10.1016/j.puhip.2026.100810","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescent alcohol and substance use remain major public health concerns in Pennsylvania, particularly in medically underserved areas, yet adoption of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for early identification and prevention among healthcare providers remains inconsistent. This study assessed whether participation in a Project ECHO (Extension for Community Healthcare Outcomes) SBIRT series improved providers' knowledge, confidence, and early implementation of SBIRT for alcohol and substance use screening.</p><p><strong>Study design: </strong>We conducted a descriptive evaluation of the Project ECHO SBIRT training using baseline, post-series, and monthly follow-up provider surveys.</p><p><strong>Methods: </strong>Baseline, post-series, and monthly follow-up surveys assessed SBIRT knowledge, screening intent, and real-world implementation. Descriptive statistics summarized provider characteristics, screening practices, and SBIRT utilization across baseline and follow-up surveys. Pre-post knowledge changes were assessed at endline using McNemar's, Bowker's, and Wilcoxon signed-rank tests, with significance set at p < 0.1 due to attrition and high baseline knowledge.</p><p><strong>Results: </strong>A total of 227 providers from 52 Pennsylvania counties participated. At baseline, fewer than half reported routine alcohol or substance use screening during adolescent well-child visits. Post-training, providers demonstrated significant improvements in knowledge of core SBIRT components, including tool feasibility, sensitivity, and applicability to both alcohol and substance use. Monthly follow-up data indicated early real-world implementation, with over half of respondents reporting first-time SBIRT use and increased adolescent screening within 30 days. Persistent barriers to implementing SBIRT included time constraints and patient readiness.</p><p><strong>Conclusions: </strong>Project ECHO is a feasible and scalable public health training model that improves provider knowledge and supports early SBIRT implementation for adolescent substance use, particularly in medically underserved settings.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100810"},"PeriodicalIF":2.2,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inadvertent post-expiry COVID-19 vaccination in 282 seniors: Safety, efficacy, and implications for extended off-label stability data.","authors":"Henrik Klasson","doi":"10.1016/j.puhip.2026.100802","DOIUrl":"10.1016/j.puhip.2026.100802","url":null,"abstract":"<p><strong>Objectives: </strong>To describe safety and clinical outcomes after inadvertent post-expiry administration of Pfizer-BioNTech SARS-CoV-2 vaccine to adults aged ≥80 years in Swedish primary care; indicate what can (and cannot) be inferred about efficacy from real-world follow-up; and identify system needs for clearer expiry labelling and producer-led, longer-horizon post-expiry evidence. The study was not designed to estimate vaccine effectiveness.</p><p><strong>Study design: </strong>Service evaluation; observational single-arm cohort (ambispective).</p><p><strong>Methods: </strong>After discovery that 282 recipients had received doses 3-5 months past the labelled expiry, 280 survivors were informed and offered in-date revaccination within ∼4 weeks. Clinicians recorded revaccination uptake, adverse events exceeding expected post-mRNA symptoms after expired and (if applicable) in-date doses, and any confirmed/strongly suspected COVID-19 prior to revaccination; deaths were attributed via records. A change in manufacturer presentation of shortened/altered expiry encountered locally at point of care was documented.</p><p><strong>Results: </strong>208/280 accepted revaccination; 72/280 declined. Two deaths occurred from age-related/pre-existing illness (not vaccination-related). No serious or unexpected adverse events were recorded after expired or in-date doses. A small number reported mild, self-limited illness compatible with COVID-19; there were no hospitalisations and no laboratory-confirmed cases.</p><p><strong>Conclusions: </strong>In this cohort of older seniors, inadvertent post-expiry vaccination was followed by no safety signal and no COVID-19 hospitalisations; effectiveness cannot be quantified from this design. Given recurring human error and cold-chain stress, clearer expiry labelling and transparent, real-life post-expiry stability/efficacy data (weeks-months; including temperature-excursion profiles) are needed to support patient safety, reduce wastage, and strengthen preparedness.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100802"},"PeriodicalIF":2.2,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections and lessons learned from implementing the Ontario Health Equity Impact Assessment Tool in community practice.","authors":"Francis Routledge, Sabrina Campanella, Yona Lunsky, Johanna Lake, Kenneth Po-Lun Fung","doi":"10.1016/j.puhip.2026.100796","DOIUrl":"10.1016/j.puhip.2026.100796","url":null,"abstract":"<p><strong>Objectives: </strong>In this commentary, we describe our experience using the Ontario Ministry of Health's Health Equity Impact Assessment (HEIA) Tool as part of a project evaluating the implementation of an Acceptance and Commitment Training (ACT) workshop for family caregivers of neurodivergent people and people with disabilities from multiple communities across Canada.</p><p><strong>Study design/methods: </strong>Caregiver and clinician ACT facilitators completed the HEIA Tool to promote awareness of potential health (in)equities related to the workshop.</p><p><strong>Results: </strong>Facilitators reported challenges understanding and implementing the Tool, which prompted our team to customize it for this context.</p><p><strong>Conclusions: </strong>We outline recommendations based on the implementation strategies we used, which may have relevance to other community-based programs or initiatives seeking to conduct a health equity assessment.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100796"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing inequalities in the primary and secondary outpatient interface: A policy-focused evidence brief.","authors":"Amy Dehn Lunn, Heidi Lynch, Bilaal Adam, Jenny Blythe, Emily Clark, Serge Amba'a Engamba, Payam Torabi, Adnaan Ghanchi, John Ford","doi":"10.1016/j.puhip.2026.100783","DOIUrl":"10.1016/j.puhip.2026.100783","url":null,"abstract":"<p><strong>The policy challenge: </strong>In the UK, an estimated 15 million primary care appointments are used every year dealing with issues between primary and secondary care. A dysfunctional primary-secondary care interface impacts on patient experience, safety and staff workload, and is likely to widen health inequalities by disproportionately impacting underserved populations. Health care systems globally have implemented numerous initiatives to improve this interface. While the aim is often to increase efficiency, short-term efficiency gains may be outweighed by populations missing out on care and subsequently presenting late and acutely. Here we explore what works to address inequalities in the primary-secondary care interface.</p><p><strong>Key evidence to inform policy: </strong>Most evidence describes the problem of inequalities at the primary-secondary care interface, rather than identifying solutions. We identified five points at which inequalities can arise, and action should be considered: 1) referral from primary care, 2) navigating the health and care system, 3) integration of care, 4) follow-up after initial appointment and 5) policies when patients miss appointments. Evidence exists for the use of care coordinators, co-location of services, culturally tailored services, and appointment reminder systems. Patient-initiated follow-up should be used with caution.</p><p><strong>Further considerations and implications: </strong>Policymakers should consider programmes that include support mechanisms to help attendance at specialist appointments, care coordinators, inclusive and culturally competent communication, flexibility, co-location where possible and using patient-initiated follow up on a case-by-case basis. Improved evaluation and monitoring are also needed to understand the current and evolving impact of health care interface policy across different communities.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100783"},"PeriodicalIF":2.2,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving behavioural interventions in healthcare to address the needs of disadvantaged groups: A policy-focused evidence brief.","authors":"Anna Gkiouleka, Sashika Harasgama, Helen Pearce, Lucy Johnson, Isla Kuhn, Amy Dehn Lunn, Danielle Lamb, Payam Torabi, Alice Vodden, Serge Engamba, Jack Birch, Adnaan Ghanchi, John Ford","doi":"10.1016/j.puhip.2026.100780","DOIUrl":"10.1016/j.puhip.2026.100780","url":null,"abstract":"<p><strong>The policy challenge: </strong>Chronic conditions like cardiovascular disease and Type 2 Diabetes share common modifiable risk factors. Although behavioural interventions can help in reducing these risks in the overall population, they are often less effective for disadvantaged groups and may risk worsening inequalities. A systemic approach is needed, with healthcare systems playing a key role in adapting such interventions to be more inclusive and accessible to those who need them the most. This policy-focused evidence brief explores international evidence on improving behavioural interventions for disadvantaged groups.</p><p><strong>Key evidence to inform policy: </strong>There is no single set of specific interventions that can guarantee improved access, uptake and effectiveness of behavioural interventions among disadvantaged groups. However, effective interventions share four key features: they 1) adopt a targeted approach, 2) address stigma 3) are tailored to the users' linguistic and cultural backgrounds, and 4) involve long-term, multi-component programmes co-created with disadvantaged communities.</p><p><strong>Further considerations and implications: </strong>To improve effectiveness, policies should target disadvantaged groups, address linguistic and cultural barriers, co-create interventions with communities, and combat stigma through tailored approaches and professional training. Sustainable, long-term support mechanisms are needed to maintain health benefits and reduce inequalities in behavioural intervention outcomes. Current evidence offers limited insights into specific intervention components and their differential impacts across diverse groups. Future research should address these gaps to provide more specific guidance for policy and practice.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100780"},"PeriodicalIF":2.2,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering health care staff to address health inequalities: A policy-focused evidence brief.","authors":"Danielle Lamb, Sashika Harasgama, Amy Dehn Lunn, Camille Gajria, Helena Painter, Helen Pearce, Alice Vodden, Adnaan Ghanchi, John Ford","doi":"10.1016/j.puhip.2026.100774","DOIUrl":"10.1016/j.puhip.2026.100774","url":null,"abstract":"<p><strong>The policy challenge: </strong>Leveraging the health care workforce to take action on health and care inequalities has significant potential, with the NHS in England employing 1.5 million people. Minority ethnic groups are over-represented in the NHS workforce, but underrepresented in senior roles, with high discrimination rates and limited career progression. Chronic workforce shortages exacerbate these issues, increasing workloads and reducing morale. Additionally, inequitable staff distribution, favouring affluent areas over deprived ones, hinders progress in disadvantaged communities. Systemic changes are needed to promote equity in the workforce and close health inequalities gaps. Here, we review the policy-focused evidence that explores how to empower healthcare staff to address inequalities.</p><p><strong>Key evidence to inform policy: </strong>We identified four key themes of how staff can be empowered to address health and care inequalities: 1) empowering through skills, 2) empowering through resources, 3) empowering through workforce structure, and 4) empowering through staff champions. There is evidence that training in cultural competency, anti-racism, anti-stigma, advocacy, health literacy, and game-based training can empower staff. However, these interventions require adequate time and should be complimented by innovative care models, such as trauma-informed care. Furthermore, the workforce should be diverse at all levels with enhanced professional development for employees from underrepresented backgrounds. Staff champion programmes can promote workforce equality, fostering collaboration and innovation.</p><p><strong>Further considerations and implications: </strong>Research on staff empowerment to tackle inequalities is limited and often focuses on staff rather than patient outcomes. There are also challenges in measuring cultural competence and comparing studies. Key training areas include cultural competency (ethnicity, LGBTQ+, and mental health), anti-stigma, anti-racism, advocacy, and low health literacy perspectives. Organisations should provide culturally competent resources, promote trauma-informed care, and ensure staff have sufficient time to support patients with complex needs and equity-focused improvements.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100774"},"PeriodicalIF":2.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}