Archives of Public Health最新文献

{"title":"Validity of RMR equations in underweight, normal weight, overweight, and obese Emirati female young adults.","authors":"Dalia Haroun, Maryam Al Sharif, Rola Al Ghali, Linda Smail","doi":"10.1186/s13690-025-01727-9","DOIUrl":"10.1186/s13690-025-01727-9","url":null,"abstract":"<p><strong>Background: </strong>Predictive equations have been developed to calculate resting metabolic rate (RMR) however they vary in their level of accuracy as they differ in the conditions in which they were developed and the variables that they consider.</p><p><strong>Methods: </strong>This cross-sectional study aims to examine the validity of published RMR equations in Emirati female young adults and develop a new cohort-specific RMR equation. Indirect calorimetry and anthropometric data were obtained from 149 female participants (17-27 years) across all body mass index (BMI) categories.</p><p><strong>Results: </strong>Of the 9 prediction equations examined, Mifflin-St Jeor was the most accurate (mean difference: -15.8-83.8 Kcal/day), while the Harris-Benedict equation was the most inaccurate. In addition to evaluating existing equations, this study developed a new predictive equation-named the MDRL equation-specifically tailored for young Emirati females. The MDRL equation had the lowest mean difference at -0.61 kcal/day, with 95% limits of agreement ranging from - 29.6 to 28.4 kcal/day, and achieved the highest accuracy, with 56.1% of participants having predicted RMR values within 10% of the measured value.</p><p><strong>Conclusions: </strong>The newly developed MDRL equation demonstrated the highest accuracy (56.1%) and the lowest mean difference (-0.61 kcal/day), providing a valid and reliable method to estimate RMR specifically in young Emirati females. This population-specific equation has the potential to improve dietary planning and clinical practice in the UAE. However, further studies are needed to validate this equation in an independent sample and explore its applicability across broader Gulf populations.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"231"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201800","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":"Spatial pattern and influence of mass media exposure on sexual exposure among women with disabilities in sub-Saharan Africa.","authors":"Clifford Odimegwu, Obasanjo Afolabi Bolarinwa, Aliu Mohammed, Ezra Gayawan","doi":"10.1186/s13690-025-01717-x","DOIUrl":"10.1186/s13690-025-01717-x","url":null,"abstract":"<p><strong>Background: </strong>Globally, people with disability have significant limitations in expressing their sexuality, and studies suggest that women with disability have an increased risk of sexually related problems due to impairment in one or more functional domains affecting their sexual desire. Thus, this current study investigated the spatial patterns and the influence of mass media exposure on the sexual exposure of women with disability in sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>We utilised the latest secondary dataset with disability module from a demographic health survey conducted in 10 countries in SSA between 2010 and 2022. A sample size of 16,517 women with disabilities was included. We utilised spatial analysis to show the predicted prevalence of sexual exposure, whilst multilevel binary logistic regression was used to examine the association between mass media exposure, the included covariates and sexual exposure. The five models developed were presented using adjusted odds ratio (aOR) with corresponding 95% confidence intervals (CI), and statistical significance was determined at p < 0.05.</p><p><strong>Results: </strong>The country with the highest prevalence of sexual exposure among women with a disability was Rwanda (77.13%), followed by Mali (72.03%), and the lowest was South Africa with 52.01%. Furthermore, women with disability who were exposed to mass media [aOR = 1.22; 95%(CI = 1.12-1.32)] had higher odds of being sexually exposed compared to those who had no mass media exposure. At the same time, those within the richest wealth index [aOR = 1.33; 95%(1.12-1.59)] were more likely to be sexually exposed compared to those who were within the poorer wealth index. On the other hand, women with disability who reside in communities with higher literacy levels [aOR = 0.80; 95%(CI = 0.71-0.90)] had lower odds of being sexually exposed compared to those who reside in communities with lower literacy levels. CONCLUSIONS AND RECOMMENDATIONS: Findings from this study revealed that the majority of women with disability in SSA were sexually exposed, with those exposed to mass media having a higher risk of being sexually exposed. Thus, there is a need for policymakers to institute educational programs that promote the sexual and reproductive health of women with disability through the mass media.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"232"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201811","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":"Behavioral factors affecting data quality and information utilization in health facilities in ethiopia, 2023: an exploratory qualitative study.","authors":"Getasew Amare, Meaza Gezu Shentema, Firanbon Teshome, Yordanose Tadesse, Daniel Birhane Enyew, Desalegn Tsegaw, Tajebew Zayede, Berhanu Fikadie Endehabtu, Amare Minyihun, Biniyam Tilahun, Muluemebet Abera Wordofa, Nigusu Getachew, Dawit Wolde Daka, Ketema Lema, Mengistu Yilma, Awugichew Kiflie, Girma Taye, Tilahun Shiferaw, Addisu Birhanu, Mentesenot Seid, Zewdu Alemu, Keneni Gutema Negeri, Alemu Tamiso Debiso, Sisay Yitayih Kassie, Netsanet Abera, Gizachew Robe Ware, Henok Fiseha, Mulugojam Asmare, Mohammed Harir, Manja Yuala, Yakob Wondarad, Tamirat Awel, Mesoud Mohammed, Ariam Hailemariam, Nebiyu Yetsedaw, Akinyi Odera, Melaku Muleta","doi":"10.1186/s13690-025-01715-z","DOIUrl":"10.1186/s13690-025-01715-z","url":null,"abstract":"<p><strong>Background: </strong>A well-functioning Health Information System (HIS) is essential for evidence-based decision-making and improved health outcomes. In Ethiopia, the government's Information Revolution (IR) initiative, supported by programs like the Capacity Building and Mentorship Program (CBMP), aims to strengthen HIS performance by enhancing data quality and use. Despite progress, the behavioural factors influencing data quality and use remain underexplored. This study aimed to investigate behavioural barriers and enablers affecting data quality and information use in health facilities across Ethiopia.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted in CBMP-supported health centers across four regions (Sidama, Amhara, Oromia, and Somali) and one city administration (Addis Ababa). Key informants included health service providers, Health Management Information System (HMIS) focal persons, facility heads, and case team leaders. Using semi-structured guides, data were collected through 43 key informant interviews and 15 focus group discussions (FGDs). Thematic analysis was conducted using Atlas.ti version 7.5 16.</p><p><strong>Results: </strong>The study identified seven key behavioural themes influencing data quality and use: perceived data value, self-efficacy, motivation and commitment, competing priorities, teamwork, protocol adherence, and leadership/governance. While some providers appreciated the value of data in improving service delivery, others deprioritised it due to clinical demands. Self-efficacy was often limited by insufficient training and technical skill gaps. Motivation was negatively impacted by poor recognition and weak support systems. Clinical workloads and cognitive burden further reduced attention to data tasks. Although team collaboration existed, peer learning was limited and sometimes resisted. Adherence to data protocols such as the ESV-ICD-11 and PMT logbooks was inconsistent. Leadership support, role clarity, and accountability mechanisms were found to be weak, affecting overall HIS performance.</p><p><strong>Conclusions: </strong>Behavioural factors, including inconsistent data valuation, low motivation, poor self-efficacy, limited peer collaboration, and weak leadership, are significant barriers to effective HIS practices in Ethiopia. Addressing these challenges will require integrated solutions: digital learning tools like Telegram-based bots to build skills, PMT optimisation strategies, and stronger leadership and accountability frameworks. These combined interventions can improve data quality, support evidence-informed decisions, and strengthen Ethiopia's primary healthcare system.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"230"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201833","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":"Reciprocal association between dietary diversity and subjective well-being in Chinese older adults: a three-wave longitudinal study.","authors":"Ting Wang, Juan Feng, Xiaolong Bu, Yanan Wang, Yanni Su, Qian Dong, Feng Zhong, Cuiping Liu","doi":"10.1186/s13690-025-01721-1","DOIUrl":"10.1186/s13690-025-01721-1","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that diet is closely related to the subjective well-being, but the interaction between dietary diversity and subjective well-being over time has not been reported. This study is designed to provide fresh insights into the relationship between dietary diversity and subjective well-being within a cohort of older Chinese adults.</p><p><strong>Methods: </strong>Data were sourced from the China Longitudinal Survey of Health and Longevity conducted in three waves: 2008-2009 (T1), 2011-2012 (T2), and 2014 (T3). Dietary diversity was determined by the frequency of consumption across various food groups. Subjective well-being was evaluated based on life satisfaction, positive emotions, and negative emotions. The random intercept cross-lagged panel model and linear regression model were employed to analyze the associations between dietary diversity and subjective well-being.</p><p><strong>Results: </strong>The study found that older adults with a higher dietary diversity among 3,680 older participants reported higher subjective well-being. Dietary diversity was positively correlated with subjective well-being across all three waves (rs = 0.143-0.266, ps < 0.01; βs = 0.23-0.40, ps < 0.001). The association remains significant at the between-person level (β = 0.166, p < 0.001) and within-person level (βs = 0.174-0.242, p < 0.001). The random intercept cross-lagged model also indicated an increase in T1 subjective well-being predicted an increase in T2 dietary diversity (β = 0.017, p < 0.05) and an increase in T2 dietary diversity predicted an increase in T3 subjective well-being (β = 0.039, p < 0.05). Sensitivity analyses indicated that the association between dietary diversity and subjective well-being was robust.</p><p><strong>Conclusions: </strong>A longitudinal, reciprocal relationship exists between dietary diversity and subjective well-being in Chinese older adults. The findings underscore the significance of a diversified diet in enhancing the subjective well-being of older adults.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"228"},"PeriodicalIF":3.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187376","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":"Sustained frailty remission and future cardiovascular disease risk: a longitudinal study from the UK Biobank.","authors":"Mengting Liu, Qiang Zhang, Lianke Wang, Panpan Wang, Ying Qin, Qianyu Zhou, Mingyang Zhao, Tong Wanyan, Changqing Sun","doi":"10.1186/s13690-025-01711-3","DOIUrl":"10.1186/s13690-025-01711-3","url":null,"abstract":"<p><strong>Background: </strong>Physical frailty has been recognized as reversible and an important risk factor for cardiovascular disease (CVD). However, little is known about sustained frailty remission and its impact on CVD. The study aimed to assess the association between sustained frailty remission and incident CVD.</p><p><strong>Methods: </strong>Data were derived from the UK Biobank. Physical frailty was evaluated by the Fried frailty phenotype, and frailty transition patterns across three waves that is instance 0, instance 1, and instance 2 were defined. Incident CVD was defined by the International Classification of Diseases, 10th Revision (codes I00-I99). Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI), and stratified by age and sex.</p><p><strong>Results: </strong>A total of 2,391 participants from the UK Biobank (mean age: 54.97 years) were included. 1,513 participants remained robust and 351 participants experienced sustained frailty remission. Over a median follow-up duration of 4.6 years, 508 participants developed CVD. Compared with stable pre-frail or frail individuals, those with sustained frailty remission had a lower future CVD risk (HR = 0.72, 95% CI: 0.53-0.99). The association remained significant in middle-aged adults (< 65 years; HR = 0.69, 95% CI: 0.50-0.98), and a stronger, though non-significant, association was observed in females (HR = 0.64, 95% CI: 0.38-1.08) than in males (HR = 0.80, 95% CI: 0.53-1.21).</p><p><strong>Conclusions: </strong>Sustained frailty remission was associated with a reduced risk of developing CVD. Physical frailty may serve as an early indicator of CVD risk and a potential target for intervention strategies.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"227"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139192","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":"Physical activity and sports behavior of children and adolescents with and without disabilities from Germany: results from the cross-sectional KiGGS wave 2 study.","authors":"Selina Seemüller, Anne Kerstin Reimers","doi":"10.1186/s13690-025-01728-8","DOIUrl":"10.1186/s13690-025-01728-8","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) offers significant health benefits for children and adolescents with (CAWD) and without (CAWoD) disabilities. As there's no data about the PA in different settings of CAWD in Germany, the present study aims to identify and compare PA participation in CAWD and CAWoD, focusing on meeting the World Health Organizational (WHO) PA recommendations and participation in sports activities (non-organised and organised sport in higher intensities) and sports clubs.</p><p><strong>Method: </strong>This study used data from the cross-sectional nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). To analyse and compare PA behaviour, Pearson Chi²-tests and binary logistic regression models were performed.</p><p><strong>Results: </strong>All PA values were analysed in 250 CAWD and 12,557 CAWoD aged 0-17 years. In CAWD PA values were lower than in CAWoD. Only 21.6% (54) of CAWD met the PA recommendations. Regarding participation in sport clubs, 44.6% (108) of CAWD compared to 60.3% (7,511) of CAWoD participated. Across sporting activities, 60.4% (151) of CAWD participate compared to 75.2% (9,488) of CAWoD. Statistically significant differences were identified across sport club participation (OR: 0.54, 95% CI [0.45, 0.78]) as well as sporting activities (OR: 0.59, 95% CI [0.42, 0.71]).</p><p><strong>Discussion: </strong>CAWD are less active compared to their peers without disabilities, showing significantly lower participation in sporting activities and sport clubs.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"226"},"PeriodicalIF":3.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070777","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":"Physical activity, physical mobility, and mental health among persons 70 years or older: results from a large population-based study in Sweden.","authors":"Malin Asp, Bo Simonsson, Anu Molarius","doi":"10.1186/s13690-025-01718-w","DOIUrl":"10.1186/s13690-025-01718-w","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity, impaired physical mobility and poor mental health are common in the older population and increasing as the population ages. We examined the relationships between physical activity, physical mobility, and mental health in the general population of older adults.</p><p><strong>Methods: </strong>The study is based on 12 959 men and women aged 70 years or older answering a survey questionnaire sent to a random population sample in Mid-Sweden in 2022 (response rate 66%). The associations between physical activity (at least 150 min/week), physical mobility (no difficulties e.g. in walking short distances or climbing stairs) and mental health were investigated with multiple logistic regression analyses, adjusting for gender, age group and educational level. Mental health was measured with symptoms of anxiety or worry, and self-reported diagnosed depression.</p><p><strong>Results: </strong>In total, 51% were physically inactive and 31% had impaired physical mobility. Symptoms of anxiety or worry (33%) were more common among older people who were physically inactive than among those who were physically active (24%). The prevalence of symptoms of anxiety or worry was also higher among those with impaired physical mobility (40%) than among those with physical mobility (23%). Physical inactivity and impaired physical mobility were also associated with self-reported depression. When stratified by physical mobility, physical inactivity was significantly associated with symptoms of anxiety or worry (OR: 1.20, 95% CI: 1.08-1.34) and self-reported depression (OR: 1.66, 95% CI: 1.27-2.17) among those with physical mobility, whereas no association was found among those with impaired physical mobility.</p><p><strong>Conclusion: </strong>The results suggest that physical activity is positively associated with mental health among older people with physical mobility. However, about one in three in the older population has impaired physical mobility with poorer mental health irrespective of physical activity. These results are important for promoting mental health in an aging population.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"225"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031097","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 changing role of family income in mental health from childhood to adolescence: findings from a UK longitudinal study.","authors":"Murong Yang, Mara Violato, Claire Carson","doi":"10.1186/s13690-025-01702-4","DOIUrl":"10.1186/s13690-025-01702-4","url":null,"abstract":"<p><strong>Background: </strong>Childhood and adolescence are critical periods of emotional and psychological development, during which socioeconomic factors such as family income may have varying effects on mental health. While previous research suggests that children from lower-income families tend to have poorer mental health outcomes, it is unclear how this association changes with age. Understanding these patterns is essential for designing interventions that target the most vulnerable periods in development. This study investigates the relationship between family income and mental health across childhood and adolescence in the UK, identifying potential age-related changes in the strength of this association.</p><p><strong>Methods: </strong>A sample of 5667 children from the UK Millennium Cohort Study was followed from ages 3 to 17 years. Overall mental health problems, internalising and externalising problems were measured using the Strengths and Difficulties Questionnaire. Family income was assessed using inflation-adjusted annual family income, adjusted for family size and composition, and a binary indicator of poverty status. Panel data linear fixed-effects models were used to control for unobserved heterogeneity.</p><p><strong>Results: </strong>Higher family income was associated with better child mental health, but the magnitude of the effect varied with age. After adjustment for confounders, lower income predicted poorer overall mental health at ages 11 and 14 years, with the strongest association observed at 14. Weak association was found at ages 3, 5, 7, and 17. A similar trend was observed for externalising problems, while the income protective effect on internalising problems showed a significant increase with age. No substantial sex differences were observed in these associations.</p><p><strong>Conclusions: </strong>Child mental health-income gradient exists in the UK and varies with age, being stronger in adolescence than childhood, and for internalising symptoms. Family income interventions/redistributions in early adolescence are more likely to reduce mental health problems in young people.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"224"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974697","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":"Key stakeholders' perspectives on implementation of risk-based population breast cancer screening in Australia - \"We can either get on the bus or get under it\".","authors":"Jocelyn Lippey, Louise Keogh, Stephanie Best, Rebecca Purvis, Gregory Bruce Mann, Laura Forrest","doi":"10.1186/s13690-025-01690-5","DOIUrl":"10.1186/s13690-025-01690-5","url":null,"abstract":"<p><strong>Background: </strong>Risk-based breast cancer screening would be a dramatic shift from the current one-size-fits-all model to a tailored approach where screening modality and frequency is directed by individual risk. This project assesses what key stakeholders, defined as those holding managerial and decision-making roles within BreastScreen, consider the issues are with implementing a risk-based approach to screening.</p><p><strong>Methods: </strong>A qualitative approach was undertaken, recruiting participants through professional networks with interviews guided by the Consolidated Framework of Implementation Research (CFIR). Participants were key stakeholders defined as those managing, overseeing and influencing Breast Screen throughout Australia. Data were deductively coded against a CFIR-informed codebook, followed by content analysis per CFIR domain.</p><p><strong>Results: </strong>Twenty interviews were conducted with 21 participants. 144 initial codes consolidated into 17 final themes. Key stakeholders are supportive and optimistic about risk-based screening in principle; however several issues exist, including knowledge gaps precluding support of evidence-based implementation. Concerns about worsening inequities within screening, cost and communication with clients are major issues key stakeholders consider important to address in the planning and implementing a change to the program.</p><p><strong>Conclusions: </strong>Key stakeholders in Australia were overwhelmingly enthusiastic about the benefits of a risk-based approach however there are concerns about risk assessment utility, cost and the potential risk to equity in the program. Systematic assessment of these concerns will be required to facilitate successful change to the well-established breast screening program in Australia should risk-stratification be undertaken.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"223"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974650","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":"Educational determinants of immunization coverage among internally displaced persons (IDPs) in Mogadishu: a cross-sectional study.","authors":"Yusuf Hared Abdi, Yakub Burhan Abdullahi, Mohamed Sharif Abdi, Sharmake Gaiye Bashir, Naima Ibrahim Ahmed","doi":"10.1186/s13690-025-01707-z","DOIUrl":"10.1186/s13690-025-01707-z","url":null,"abstract":"<p><strong>Background: </strong>Immunization remains a cornerstone of global public health; however, Somalia faces critical challenges in achieving equitable vaccination coverage, particularly among internally displaced individuals (IDPs). The National immunization rates for diseases such as diphtheria-tetanus-pertussis (DTP3), measles, and polio remain below 50%, exacerbated by decades of conflict, fragile healthcare infrastructure, and socioeconomic disparities. IDPs in Somalia encounter unique barriers, including overcrowded living conditions and limited access to healthcare and mobility, which disrupt care continuity. This study examined the immunization coverage disparities between IDPs and urban residents in Somalia, focusing on the sociodemographic and attitudinal determinants of vaccine uptake. By analyzing factors such as education, income, marital status, and vaccine perceptions, this study aimed to inform targeted strategies to improve vaccination access in conflict-affected settings.</p><p><strong>Method: </strong>A cross-sectional study was conducted in March 2025 across two IDP camps (ANFAC and Sahal) in Somalia's Banadir Region. Using stratified systematic sampling, 384 participants were enrolled, and data were collected via structured questionnaires administered in Somali. Vaccination status was verified through immunization cards or self-reports, and the predictor variables included age, education, occupation, income, marital status, and attitudes toward vaccine safety and efficacy. Statistical analysis employed Chi-square tests and multivariate logistic regression were used to identify the determinants of vaccine uptake with adjustments for confounders.</p><p><strong>Result: </strong>This study revealed significant immunization disparities primarily associated with educational attainment. Participants with secondary education achieved vaccination rates of 72.6% versus 41.2% among those without formal education. Multivariate analysis identified secondary education (AOR = 3.82, 95% CI: 1.74-8.40, p = 0.001) and tertiary education (AOR = 7.95, 95% CI: 3.33-19.01, p < 0.001) as the strongest predictors of full vaccination, followed by marital status (divorced/widowed: AOR = 0.33, 95% CI: 0.14-0.81, p = 0.015). Household income and positive vaccine attitudes showed no significant association in the adjusted model.</p><p><strong>Conclusion: </strong>Educational disparities emerge as the most critical barrier to immunization among Somali IDPs. The findings highlight the need for integrated interventions prioritizing community-led education programs and mobile vaccination clinics with cold chain capacity. These strategies, combined with health system strengthening for mobile populations, could reduce zero-dose children by 50% and advance Immunization Agenda 2030 targets. The study underscores that improving access to education may have greater impact on vaccine uptake than economic interventions alone.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"222"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974494","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}