Archives of Public Health最新文献

{"title":"A systematic review of the willingness-to-accept and willingness-to-pay disparities in empirical studies in the healthcare field.","authors":"Yue Wang, Xiaoyu Yan, Hongchao Li","doi":"10.1186/s13690-025-01699-w","DOIUrl":"10.1186/s13690-025-01699-w","url":null,"abstract":"<p><strong>Purpose: </strong>Willingness-to-pay (WTP) and willingness-to-accept (WTA) are widely used measures of individual preferences in valuing healthcare services; however, a persistent disparity between them, often with WTA exceeding WTP, raises concerns. This study aims to review empirical research evidence to achieve a comprehensive understanding of the disparity between WTA and WTP for health outcomes or healthcare goods and services.</p><p><strong>Methods: </strong>A search was conducted in PubMed, Embase, Web of Science, and Scopus from inception to November 15, 2023, for empirical research articles reporting both WTA and WTP in the healthcare field. Data extracted from the included studies encompassed WTA and WTP values, participation response rates, and other study characteristics. Descriptive analyses were conducted to compare WTA/WTP ratios across studies, and chi-square tests were applied to examine differences in response rates where applicable.</p><p><strong>Results: </strong>A total of 779 records were identified through database searches. After removing duplicates, 405 records remained for title and abstract screening. Of these, 70 articles were retrieved for full-text review, and 28 articles met the eligibility criteria for inclusion in the final qualitative analysis, encompassing 35 distinct studies or subgroups. The reported WTA/WTP ratios ranged from 0.14 to 29.19, with a median value of 1.61, indicating that individuals often demand higher compensation to give up healthcare benefits than they are willing to pay to obtain them. Among the empirical studies analyzed, 29 studies (82.86%) from 24 articles reported WTA values that exceeded WTP values, while 6 studies (17.14%) from the remaining 4 articles indicated WTA values lower than WTP values. Among the 14 studies reporting both WTA and WTP response rates, six studies indicated a significantly lower WTA response rate compared to the WTP response rate, whereas two studies found the WTA response rate to be significantly higher (P < 0.05). The WTP response rate was observed to range from 0.89 to 20.23 times that of the WTA response rate.</p><p><strong>Conclusions: </strong>The results of this study suggest that losses in health outcomes or healthcare goods and services are valued differently than gains. The disparities between WTA and WTP are influenced by various factors, including the income effect and personal preferences. Individual preferences shape perceptions of WTA and WTP questions, resulting in varied response rates. Considering these disparities in the medical and healthcare fields can assist policymakers in making more informed decisions regarding the allocation of medical and health resources.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"212"},"PeriodicalIF":3.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876103","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 relationship between healthy lifestyle score and incident cardiovascular disease: results from Isfahan Cohort Study (ICS).","authors":"Shahnaz Amani Tirani, Parisa Hajihashemi, Motahare Bateni, Noushin Mohammadifard, Fahimeh Haghighatdoost, Maryam Boshtam, Jamshid Najafian, Masoumeh Sadeghi, Mansoureh Boshtam, Nizal Sarrafzadegan","doi":"10.1186/s13690-025-01696-z","DOIUrl":"10.1186/s13690-025-01696-z","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the combined impact of healthy lifestyle factors on cardiovascular disease (CVD) risk in the Iranian population is limited. This study aimed to examine the association between a healthy lifestyle score (HLS) and the incidence of CVD.</p><p><strong>Methods: </strong>This prospective cohort study, including 5419 adults aged over 35 years, was performed in the framework of the Isfahan Cohort Study (ICS) which is an ongoing study. The HLS (ranging from 0 (unhealthy) to 4 (most healthy)) was derived from four modifiable risk factors: never smoking, diet quality, physical activity, and body mass index (BMI). Investigated cardiovascular outcomes included myocardial infarction (MI), stroke, unstable angina (UA), and CVD mortality. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and assigned 95% confidence intervals (CI).</p><p><strong>Results: </strong>Over a median follow-up of 11.25 years, 785 CVD events occurred, including 159 MI, 164 stroke, 369 UA, and 172 CVD deaths. In the fully-adjusted model, participants with the highest HLS (3-4) had a significantly lower risk of stroke (HR: 0.51; 95% CI: 0.31-0.83; P trend = 0.019) and a tendency towards lower risk of CVD (HR: 0.78; 95% CI: 0.61-0.98; P trend = 0.053) compared to individuals with the lowest HLS (0-1). No significant association was found for MI, UA, or CVD mortality. Age- and sex-specific patterns were also noted for stroke and overall CVD.</p><p><strong>Conclusion: </strong>Our results suggest that a healthier lifestyle was linked to a reduced risk of stroke and showed a trend toward lower CVD risk among Iranian adults. These associations may vary by age and sex.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"211"},"PeriodicalIF":3.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876104","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":"Investigating how homeopaths and chiropractors navigate patient requests for vaccination information in Ontario, Canada: a qualitative study.","authors":"Ibukunoluwa Grace Okusanya, Eve Dubé, Eric Filice, Benjamin Malo, Julie Bettinger, Michelle Driedger, Janice Graham, Devon Greyson, Greg Kawchuk, Noni MacDonald, Shannon MacDonald, Samantha B Meyer","doi":"10.1186/s13690-025-01689-y","DOIUrl":"10.1186/s13690-025-01689-y","url":null,"abstract":"<p><strong>Background: </strong>Chiropractors and homeopaths are trusted sources of health information for many Canadians, including around vaccination. However, within Ontario, Canada, the College of Chiropractors of Ontario and the College of Homeopaths of Ontario regulations state that vaccines are not within their scope of practice and providers should not express views, treat, or advise patients with respect to vaccination. The aims of the present study were to: (1) describe the attitudes and beliefs regarding vaccination held among participating chiropractors and homeopaths; (2) identify the sources of information about vaccination they trust and use to guide their personal vaccination decisions; and (3) describe how they navigate patient requests for guidance on vaccine decision-making within the current regulatory landscape.</p><p><strong>Methods: </strong>Semi-structured interviews (N = 16) were conducted between February 2020-March 2021 and explored participants' opinions on vaccination, sources of information they trust and recommend to their patients, and how they navigate vaccine conversations with patients.</p><p><strong>Results: </strong>Providers' personal beliefs regarding vaccination were described as reinforced by social and professional networks, through their personal experiences, and in consultation with clients. Various strategies were used to support patients while abiding by regulations (e.g. referring patients to providers for whom vaccination is within their scope of practice); however, other strategies described (e.g., stating personal beliefs) could be interpreted as a breach of regulation.</p><p><strong>Conclusions: </strong>This research reinforces existing literature suggesting that patients using chiropractors and homeopaths have questions about vaccination and are looking for trusted information. Public health services should consider engaging with chiropractors and homeopaths to facilitate communication between patients and immunization providers.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"210"},"PeriodicalIF":3.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859810","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 risk factors of low back pain in middle-aged and older adult in China: a cross-sectional study.","authors":"Xue Jiang, Rui Wang, Yi-Wen Bai, Le Tang, Wen-Yuan Xing, Nan Chen, Xue-Qiang Wang","doi":"10.1186/s13690-025-01695-0","DOIUrl":"10.1186/s13690-025-01695-0","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to determine the prevalence of low back pain (LBP) and risk factors among people aged 45 years and above in Mainland China.</p><p><strong>Methods: </strong>This cross-sectional analysis was based on data from 15,743 individuals obtained from the China Health and Retirement Longitudinal Study in 2018. We sampled people aged 45 years and above, representing the national population, with a response rate of 83.8%. Weighted logistic regression analyses were utilized to ascertain factors linked to the prevalence of LBP.</p><p><strong>Results: </strong>The overall prevalence of LBP was 38.5% (37.7-39.2). Female (odds ratio [OR] 2.24 [1.78-2.81], higher education level (OR 1.24 [1.04-1.49]), poorer health status (OR 2.96 [2.44-3.60]), more chronic diseases (OR 1.32 [1.09-1.61]), insufficient sleep (OR 1.45 [1.26-1.67]), alcohol consumption (OR 1.25 [1.04-1.50]), depression (OR 1.39 [1.22-1.59]), and engagement in agricultural work (OR 1.50 [1.32-1.70]) exhibited significant associations with LBP.</p><p><strong>Conclusion: </strong>Among Chinese adults aged 45 years and above, the prevalence of LBP was 38.5%. Significant risk factors for LBP comprised poor health status, a greater number of chronic diseases, poor sleep, alcohol consumption, depression, and employment in the agricultural work.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"207"},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822912","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 the intersectional dynamics of co-morbidities and risk factors among the older population in India.","authors":"Kashfi Nigar, Praveen Kumar Pathak","doi":"10.1186/s13690-025-01546-y","DOIUrl":"10.1186/s13690-025-01546-y","url":null,"abstract":"<p><strong>Background: </strong>As the share of the older population is set to rise from 8% in 2011 to 16% by 2036 in India, the increasing burden of NCDs and the increasing co-morbidities among the older population need greater policy focus to ensure a healthier aging process. Given the structural shifts in the age structure of the population and decreasing family sizes, contextual factors take an even more important role in shaping the health status of the elderly. Therefore, the present study aims to study the intersectional dynamics of demographic, socioeconomic, lifestyle, and contextual factors on the prevalence of co-morbidities among the older population.</p><p><strong>Methods: </strong>The data from the Indian Human Development Survey, 2012 (IHDS-II), were used to analyze the prevalence of co-morbidity and its confounding factors in India. Univariate analysis for sample distribution, bivariate analysis for the distribution of disease by different predictors with a chi-square test, and logistic regression analyses were used to assess the adjusted association of multimorbidity with different background variables.</p><p><strong>Results: </strong>Overall, around 7% of the older population in India suffers from co-morbidities. We observe that the prevalence of co-morbidities is significantly higher among non-poor (People belonging to a non-poor household category based on the consumption quintiles) older females living alone, non-poor older females living jointly, and among non-poor older males living alone. The odds of having comorbidity among female non-poor and living alone are higher as compared to the female poor living alone. When all the co-variates are included in a single model, we observe that older adults living in nuclear families and residing in the North, Central, and Southern regions of India along with other factors discussed above show higher odds of having co-morbidities.</p><p><strong>Conclusions: </strong>The research findings suggest that directing increased investments towards addressing multiple health issues in the elderly population, with a particular focus on non-poor women and men living alone, could be a more effective strategy in combating multimorbidity among older individuals in India.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"208"},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822909","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":"Genetically proxied gut microbiota and cancer risk: a scoping review of Mendelian randomization studies.","authors":"Yating Cui, Jianguo Xu, Qingyong Zheng, Junfei Wang, Caihua Xu, Mingyue Zhang, Jiang Li, Jinhui Tian","doi":"10.1186/s13690-025-01685-2","DOIUrl":"10.1186/s13690-025-01685-2","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a critical global health issue, and gut microbiota is considered a potential factor in the development of cancers. This review synthesizes evidence from Mendelian Randomization (MR) studies to explore the potential causal links between gut microbiota and cancer risk, thereby addressing the limitations inherent in observational studies.</p><p><strong>Methods: </strong>We adopted a systematic literature review approach to search the PubMed, Embase, and Web of Science databases up to December 2023 for all MR studies examining the relationship between gut microbial diversity, strain-specific abundance, and cancer risk. Data extraction encompassed study design, study population, definition of microbial exposure, details of genetic instrument variables, sample size, effect estimates, and statistical significance. Given the diversity of genetic tools across different studies, the results of each study were presented in the form of a forest plot, and quality was assessed according to STROBE-MR criteria.</p><p><strong>Results: </strong>We reviewed 12 MR studies involving the relationships between 91 gut microbiota species and 14 types of cancer. The studies found that 64 of these gut microbiota species have potential protective effects against cancers, while 52 show tendencies to promote cancer development. Additionally, the relationship between 17 gut microbiota species and cancer remains unclear. Notably, the same gut microbiota species may have distinctly different impacts on different types of cancer.</p><p><strong>Conclusion: </strong>Diverse gut microbiota have varied impacts on different cancer types. This microbial influence on cancer is not static; it changes dynamically. These changes are linked to variations in inflammation, metabolite adjustments, and differences in gut barrier function.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"209"},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822910","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":"Inequalities in the practice of physical activity in the city of São Paulo between 2003 and 2015: Evidence from a population-based study among older adults.","authors":"Bruno Holanda Ferreira, Camila Nascimento Monteiro, Tatiane Kosimenko Ferrari Figueiredo, Margareth Guimarães Lima, Chester Luiz Galvão Cesar, Moisés Goldbaum, Olinda do Carmo Luiz","doi":"10.1186/s13690-025-01630-3","DOIUrl":"10.1186/s13690-025-01630-3","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity is essential for the health and quality of life of older adults, helping to prevent non-communicable diseases and maintain autonomy. However, sociodemographic factors influence physical activity levels, leading to disparities in access and adherence. This study aimed to analyze changes in the frequency of physical activity and sociodemographic inequalities among older adults living in Brazil, using data from two health surveys.</p><p><strong>Methods: </strong>The information on older adults (60 years or older) was obtained from two Health Surveys (ISA-Capital) conducted in the city of São Paulo, Brazil, in 2003 and 2015. The variables analyzed included sociodemographic characteristics and physical activity levels, considering the combined domains of leisure-time and transportation. Prevalence and 95% Confidence Intervals (95% CI) were calculated, and comparisons were made via crude and adjusted Prevalence Ratios (PR) by Poisson regression.</p><p><strong>Results: </strong>Between 2003 and 2015, the prevalence of sufficient physical activity increased from 20.5% to 30.1%, representing a percentage change of 46.8%. When stratified by sociodemographic characteristics, the 2015 survey showed a significant increase in older adults with a sufficient level of physical activity concentrated among individuals aged 60-69 years (PR = 1.43; 95%CI 1.10-1.86), male (PR = 1.45; 95%CI 1.10-1.91), with partner (PR = 1.42; 95%CI 1.08-1.88), with up to 3 years of education (PR = 1.53; 95%CI 1.11-2.09), and who self-identified as race/skin color black or brown (PR = 1.70; 95%CI 1.12-2.59), when compared to their respective counterparts in the 2003 survey.</p><p><strong>Conclusions: </strong>Overall, over 12 years, the prevalence of older adults achieving sufficient physical activity levels increased, although unevenly, highlighting the need for policies and interventions to promote more significant equity in access to physical activity opportunities.</p><p><strong>Significance/implications: </strong>These findings highlight the persistent inequalities in physical activity, emphasizing the need for targeted policies and interventions to ensure equitable access to physical activity opportunities among older adults.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"206"},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822911","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":"Disparities in the incidence and prevalence of psychotic disorders among people with and without disabilities in south Korea: A national database study.","authors":"Kyoung Eun Yeob, So Young Kim, Yeon Yong Kim, Jong Hyock Park","doi":"10.1186/s13690-025-01691-4","DOIUrl":"10.1186/s13690-025-01691-4","url":null,"abstract":"<p><strong>Background: </strong>Numerous epidemiological studies on psychotic disorders have been conducted, however, most were from an etiological perspective, used small sample sizes, or focused on a limited number of disabilities. Few studies have investigated all types of disabilities over a long observation period, and none have included the entire adult population of a country. To explore potential differences in the incidence and prevalence of psychotic disorders between patients with and without disabilities, we conducted a serial cross-sectional study.</p><p><strong>Methods: </strong>This study was conducted using a data set linking the Korean National Health Insurance Service database, and disability registration data. Age-standardized incidence or prevalence rates were calculated for each year during 2008-2017 according to the presence, severity, and type of the disability. Factors associated with psychotic disorders were examined by multivariate logistic regression using the most recent data.</p><p><strong>Results: </strong>The age-standardized incidence and prevalence of psychotic disorders were higher among people with disabilities than among those without disabilities across all age groups, with particularly high rates observed among people with severe disabilities and those with intellectual disabilities. The gap in the prevalence of psychotic disorders between people with and without disabilities has widened over time. In regression analyses, adjusting for sociodemographic characteristics and mental health substantially reduced the odds ratios.</p><p><strong>Conclusions: </strong>The incidence and prevalence of psychotic disorders were higher in people with disabilities, especially those with severe disabilities, and intellectual disabilities. Policy efforts are needed to narrow the gap people with and without disabilities.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"205"},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785689","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":"Long-term impact of the COVID-19 pandemic on physical activity and estimated cardiorespiratory fitness in south American adults: a multi-country cross-sectional online survey.","authors":"Victor Zuniga Dourado, Maria do Socorro Morais Pereira Simões, Vinícius Tonon Lauria, Pablo Gulayin, Laura Gutierrez, Ricardo Peña-Silva, Isabel Pereyra-González, Alfonsina Ortiz, Sandra Lopez-Arana, Indah Suci Widyahening, Laila Al-Shaar, Goodarz Danaei, Rosana Poggio","doi":"10.1186/s13690-025-01664-7","DOIUrl":"10.1186/s13690-025-01664-7","url":null,"abstract":"<p><strong>Background: </strong>Restriction measures during the COVID-19 pandemic may have reduced opportunities to engage in physical activity. This study explored the changes in self-reported physical activity level (PAL), risk factors, and estimated cardiorespiratory fitness (eCRF) among south American adults by comparing data reflecting the pre-pandemic period to data collected during the survey.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey between July 2021 through March 2022 using validated questionnaires (e.g., GPAQ and WHO-STEPS) on a convenience sample of 1,934 adults (68.7% women) from Argentina (n = 484), Brazil (n = 405), Chile (n = 279), Colombia (n = 343) and Uruguay (n = 423). We compared self-reported PAL, risk factors, and eCRF before the pandemic period and at the time of the survey (mean 842 days from the first reported case in each country). Data were presented as medians (interquartile range [IQR]) or means (95% confidence interval [CI]) for continuous variables and percentages for categorical ones. Paired data analyses were conducted using paired t-tests, Wilcoxon Signed Rank test, and McNamar's tests, as applicable.</p><p><strong>Results: </strong>We observed a decrease in PAL at work (median, 0 METs/min/week and interquartile range, [0-240] vs. 0 METs/min/week [0-30]; p = 0.032) and active transportation domains (0 METs/min/week [0-693] vs. 0 METs/min/week [0-594]; p = 0.008). In addition, the median sedentary time on weekdays increased by 60 min/day (360 [240-540] vs 420 [240-600]; p < 0.001). We also observed an increase in the proportion of participants with hypertension (12.9 vs. 16.5%), diabetes (6.8 vs. 9.8%), dyslipidemia (18.9 to 24%), depression symptoms (14.4 to 15.4%) and obesity (15.4 to 18.2%) compared with pre-pandemic levels (all p-values < 0.05). The eCRF was significantly lower at the survey time compared with pre-pandemic levels (mean difference, -1.17 mL/min/kg (or 3.34%): 95% CI, -1.03 to -1.30) even after adjusting for age (-0.50 mL/min/kg (or 1.45%): 95% CI -0.37 to -0.64).</p><p><strong>Conclusions: </strong>Across five countries in South America, social restriction policies to control the COVID-19 pandemic may have reduced physical activity and estimated cardiorespiratory fitness with no recovery until the survey time.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"203"},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785691","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":"Identifying clinically useful COVID-19 population and emergency department phenotypes across the pre-Omicron and Omicron periods.","authors":"Lander Rodriguez-Idiazabal, Daniel Fernández, Jose M Quintana, Julia Garcia-Asensio, Maria Jose Legarreta, Nere Larrea, Irantzu Barrio","doi":"10.1186/s13690-025-01681-6","DOIUrl":"10.1186/s13690-025-01681-6","url":null,"abstract":"<p><strong>Background: </strong>Rapidly phenotyping patients can enhance healthcare management during new pandemic outbreaks. This can be accomplished through data-driven unsupervised methods that do not require clinical outcomes to be available. This study aimed to identify and compare phenotypes of COVID-19 patients and the subset of those patients who visited emergency departments using clustering techniques based on a limited set of easily accessible variables across different stages of the pandemic.</p><p><strong>Methods: </strong>We conducted a population-based retrospective study that included all reported adult COVID-19 patients in the Basque Country from March 1, 2020, to January 9, 2022. Phenotypes were identified separately for the pre-Omicron and Omicron periods in an unsupervised manner using clustering techniques based on easily obtainable clinical and sociodemographic variables. The clinical characteristics of the phenotypes were compared, and subsequently their association with the clinical outcomes was assessed.</p><p><strong>Results: </strong>Four phenotypes were identified in both the general population and the emergency department sub-group in the pre-Omicron period, whereas three phenotypes were extracted in Omicron. Within each scenario, these phenotypes varied significantly in age and comorbidity rates, leading to varying associations with COVID-19 outcomes. Despite their similarities, the emergency department phenotypes consistently experienced worse outcomes than their general population counterparts. Moreover, the population and emergency department phenotypes identified during the Omicron period resembled those from the pre-Omicron stage, suggesting stable phenotypic structures throughout the pandemic.</p><p><strong>Conclusions: </strong>This study highlights the potential of phenotype identification based on a few accessible variables for a meaningful segregation of patients. This approach could be extended to future pandemics as a preventive public health strategy, especially considering the growing likelihood of facing new ones.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"204"},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785690","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}