International Journal of Environmental Research and Public Health最新文献

{"title":"Balancing Privacy, Trust, and Equity: Patient Perspectives on Substance Use Disorder Data Sharing.","authors":"Mengyi Wei, Michael Todd, Aimee N C Campbell, Darwyn Chern, Eric Lott, Mary J Whitfield, Nick Stavros, Elise Greenberg, Adela Grando","doi":"10.3390/ijerph22040617","DOIUrl":"https://doi.org/10.3390/ijerph22040617","url":null,"abstract":"<p><strong>Background: </strong>Sharing substance use disorder (SUD) data is essential for advancing equitable healthcare and improving outcomes for marginalized populations. However, concerns about privacy, stigma, and adherence to data privacy regulations often hinder effective data sharing. This study explores patient preferences and considerations related to sharing SUD-related medical records, with a focus on the sociocultural and systemic factors that shape their willingness to share.</p><p><strong>Methods: </strong>A total of 357 adult patients from four community-based clinics in Arizona participated in a cross-sectional electronic survey. The survey assessed sociodemographic factors, experiences of stigma (self-directed, anticipated, and provider-based), trust in healthcare providers, satisfaction with care, and willingness to share SUD data across various scenarios. Data were analyzed using descriptive statistics, Pearson correlations, and one-way ANOVA to uncover key associations.</p><p><strong>Results: </strong>Patients identified SUD history, diagnoses, and treatment information as particularly sensitive. Stigma was significantly correlated with increased sensitivity and reduced willingness to share data, especially with providers outside their primary facility (<i>p</i> < 0.001). In contrast, trust in providers and higher satisfaction with care were linked to greater willingness to share data with all providers (<i>p</i> < 0.01). Patients were more inclined to share SUD data during emergencies or for direct treatment purposes than for administrative or research applications (<i>p</i> < 0.001).</p><p><strong>Discussion: </strong>These findings underscore the ethical imperative to address stigma and foster trust to promote equitable SUD data sharing. Policies must empower patients with control over sensitive health information while ensuring cultural competence and fairness in care delivery. Ensuring that patients feel confident in how their data are used may encourage greater participation in health information exchange, ultimately supporting more effective and individualized SUD care.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Hydroxyurea Therapy for Pediatric Sickle Cell Anemia in Tanzania: Evidence from Bugando Medical Centre.","authors":"Maria Inviolata Subira, Emmanuela E Ambrose, Eveline Konje","doi":"10.3390/ijerph22040616","DOIUrl":"https://doi.org/10.3390/ijerph22040616","url":null,"abstract":"<p><p>Hydroxyurea is effective in reducing the severity of Sickle cell anemia (SCA) symptoms, yet adherence remains challenging, particularly in resource-limited settings. Bugando Medical Centre, a major healthcare provider, faces undocumented adherence issues among its pediatric SCA patients. This study aims to evaluate the adherence rate to hydroxyurea therapy among caregivers of children with SCA at Bugando Medical Centre and identify factors contributing to non-adherence. This analytical cross-sectional study involved 172 participants. Data were analyzed using Stata version 15 and modified Poisson regression determined the association between exposures and adherence to hydroxyurea treatment. More than half (68.6%) of the children were aged between 1 and 10 years, with a median age of 8 years (IQR: 5-12). Good adherence to hydroxyurea was observed in 23.8% of participants, while 76.2% showed moderate to poor adherence. Children aged 1-10 years were twice as likely to have good adherence compared to those aged 11-17 years (aPR = 2.98, 95% CI = 1.18, 7.47). Children of caregivers with secondary education had a 41% higher chance of good adherence (aPR = 1.41, 95% CI = 1.19, 2.87) compared to those with primary education. Additionally, children of caregivers with college/university education had a 92% higher chance of good adherence (aPR = 1.92, 95% CI = 1.09, 4.63) compared to those with primary education. Participants with good knowledge of hydroxyurea had a 55% higher chance of good adherence (aPR = 1.55, 95% CI = 1.10, 4.78) compared to those with poor knowledge. Factors such as the child's age and caregiver's educational level are associated with good adherence to hydroxyurea treatment. Despite these associations, overall adherence rates are low, highlighting the need for targeted interventions to enhance knowledge and awareness about the importance of adherence to hydroxyurea treatment.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital-Related Determinants of Refusal of Organ Donation in France: A Multilevel Study.","authors":"Régis Bronchard, Gaëlle Santin, Camille Legeai, Anne Bianchi, Séverine Grelier, Caroline Bogue, Olivier Bastien, François Kerbaul","doi":"10.3390/ijerph22040618","DOIUrl":"https://doi.org/10.3390/ijerph22040618","url":null,"abstract":"<p><p>In a worldwide context of organ shortage, refusal of organ donation remains the main reason for the non-procurement of organs from deceased donors. Many studies have characterized the clinical or psychological factors of refusal but not organizational and structural factors in healthcare centers. We used multilevel logistic regression models with hospitals as a random effect to analyze organ procurement among 6734 potential brain-dead donors recorded in the national register in France in 2018 and 2019. According to the opt-out law, 29% of the potential donors refused to donate. Among hospital-related factors, low probability of refusal was related to hospitals audited for the organ donation process by the national program (adjusted odds ratio [aOR] 0.74, 95% confidence interval [CI]: 0.58-0.94), hospitals with high inpatient satisfaction scores for care (aOR 0.95, 95% CI 0.92-0.99) and facilities with a high ratio of nurse donor coordinators to donors (aOR: 0.78; 95% CI: 0.64-0.95). Among clinical factors, the odds of refusal were associated with age younger than 65 years (18-49 years; aOR 1.58, 95% CI 1.37-1.83) and donors with blood group B (aOR 1.32, 95% CI: 1.10-1.59). Hospital-related factors are just as important as individual factors in the procurement of organs from potential brain-dead donors.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Intersectoral Collaboration in Maternal Healthcare for the Realization of Universal Health Coverage in Kenya: The Perspectives of Health Facility Administrators in Kilifi County, Kenya.","authors":"Stephen Okumu Ombere","doi":"10.3390/ijerph22040610","DOIUrl":"https://doi.org/10.3390/ijerph22040610","url":null,"abstract":"<p><p>Intersectoral collaboration is an instrument that enables better productivity by filling in for possible gaps in knowledge, skills, and competencies in a given department by leveraging them from other departments. In Kenya, there is a paucity of information on intersectoral collaboration in healthcare. This article explores the possibilities of intersectoral collaboration, specifically in maternal healthcare, and what can be done to realize such collaborations to drive universal health coverage (UHC) in Kenya. Free maternity services (FMSs) are among the primary healthcare services that push Kenya towards UHC. In light of the centrality of UHC in driving current health policy, there are still several challenges which must be faced before this goal can be achieved. Moreover, competing priorities in health systems necessitate difficult choices regarding which health actions and investments to fund; these are complex, value-based, and highly political decisions. Therefore, the primary objective of this article is to explore health facility administrators' views on whether intersectoral collaboration could help with the realization of UHC in Kenya. The study area was Kilifi County, Kenya. The article is based on follow-up qualitative research conducted between March and July 2016 and from January to July 2017, and follow-up interviews conducted during COVID-19 in 2020 and 2021. The data are analyzed through a thematic analysis approach. The findings indicate that through <i>Linda Mama</i>, the expanded free maternity services program is one of the possible pathways to UHC. However, participants noted fair representation of stakeholders, distributed leadership, and local participation, considering bargaining power as a key issue that could enhance the realization of UHC in intersectoral collaboration through <i>Linda Mama</i>. These techniques require a bottom-up strategy to establish accountability, a sense of ownership, and trust, which are essential for UHC.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Studies Regarding Assessment of Families Where Children Are at Risk of Harm Due to Parental Substance Misuse.","authors":"Richard D Tustin","doi":"10.3390/ijerph22040612","DOIUrl":"https://doi.org/10.3390/ijerph22040612","url":null,"abstract":"<p><p>Questions arise about links between the use of substances and violence, especially when parents misuse substances and there is potential to expose children to family violence.</p><p><strong>Background: </strong>The review has four aims: identify research into the harmful impacts of parental substance use on children; identify policies in Australia about the risks from parental substance misuse; identify interventions to manage unsafe parental substance use; and review practices involving confidentiality and collaboration when a parent has multiple complex needs.</p><p><strong>Method: </strong>The paper provides a rapid review of the literature, linking parental substance misuse, family violence, and parenting capacity and covering both policies and empirical evidence.</p><p><strong>Results: </strong>The main finding is that parental substance misuse does affect parenting capacity and is associated with family violence. The concept of the cumulative risk of harm to vulnerable children is supported by research but is not yet implemented in policy. Reports indicate that some parents who misuse substances have multiple complex needs including comorbid mental health issues, domestic violence, and difficulty in managing their children's behavior. Early intervention therapies designed to address this cluster of issues are reviewed.</p><p><strong>Conclusion: </strong>There is a need to establish objective assessment instruments that are relevant to the cohort of parents who misuse substances and engage in family violence and to improve policy to ensure vulnerable children and families in which parents misuse substances are referred to appropriate therapies.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Cardiometabolic Risk Factors in Parent-Child Dyads in Guam: Pacific Islands Cohort on Cardiometabolic Health Study.","authors":"Tanisha F Aflague, Grazyna Badowski, Karen Mae A Bacalia, Jaelene Renae Manibusan, Regina-Mae Dominguez, Kathryn Wood, Margaret Hattori-Uchima, Rachael T Leon Guerrero","doi":"10.3390/ijerph22040611","DOIUrl":"https://doi.org/10.3390/ijerph22040611","url":null,"abstract":"<p><p>The Western Pacific region, including Guam, has the highest prevalence of prediabetes and type 2 diabetes mellitus, which are associated with metabolic syndrome (MetS)-a cluster of preventable risk factors. Children with parents with MetS are likely to develop MetS in the future. MetS prevalence in Guam and the impact of MetS on children are unknown. Data from the Pacific Islands Cohort on Cardiometabolic Health (PICCAH) study in Guam were analyzed to determine MetS in adults and MetS risk in children using the International Diabetes Federation criteria and sex- and age-specific waist circumference values for abdominal obesity, respectively. MetS Z-scores were calculated. MetS or MetS risk indicators, including MetS Z-scores, were examined by lifestyle risk factors (parent and child: physical activity and sleep; parent only: sedentary behavior and stress; child only: screen time). The relationship between adult MetS Z-scores and child MetS Z-scores was evaluated using linear-regression analyses. Child-parent risk for MetS was directly correlated in this population. The high prevalence of adult MetS in Guam demonstrates a critical need for interventions involving both parents and children. Expanding the analysis to assess the relationships between other lifestyle factors, like diet, in parent-child dyads is necessary to refine such intervention programs.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Maternal Consumption of Ultra-Processed Foods with Feeding Practices and Malnutrition in Breastfed Infants: A Cross-Sectional Study.","authors":"Juliana Morais de Sousa, Danielle Soares Bezerra, Lara Virginia Pessoa de Lima, Priscila Gomes de Oliveira, Nicolie Mattenhauer de Oliveira, Elias Kelvin Severiano de Araújo, Lígia Rejane Siqueira Garcia, Juliana Fernandes Dos Santos Dametto, Karla Danielly da Silva Ribeiro","doi":"10.3390/ijerph22040608","DOIUrl":"https://doi.org/10.3390/ijerph22040608","url":null,"abstract":"<p><p>Although the adverse health effects of consuming ultra-processed foods (UPFs) are well-documented, limited evidence exists on their impact during lactation. This study examined the association between maternal UPF consumption, feeding practices, and malnutrition in breastfed infants. A cross-sectional analysis was conducted with 111 mother-child pairs up to 150 days postpartum. Infant feeding practices were assessed using WHO indicators, and malnutrition was evaluated by length-for-age and BMI-for-age. Maternal dietary intake was estimated using two 24 h recalls, and UPF consumption was classified by the Nova classification. Dyads were grouped based on the highest UPF consumption quartile, and adjusted binary logistic regression was applied. UPFs accounted for 26% of the maternal diet on average. While 71.2% of infants were exclusively breastfed, one-third were overweight, and 11.7% were stunted. High maternal UPF consumption (>32% of energy) was associated with increased odds of malnutrition by BMI-for-age (wasting or overweight) (OR 3.38; 95% CI: 1.29-8.83) and stunting (OR 3.89; 95% CI: 1.04-14.58). Feeding practices showed no association. These findings highlight that maternal UPF consumption is associated with malnutrition odds in breastfed infants in the population assessed, emphasizing the need for dietary guidance during lactation to improve infant health outcomes.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of Light Mode and Dark Mode Features on Visual Fatigue in Tablet Users.","authors":"Praphatson Sengsoon, Roongnapa Intaruk","doi":"10.3390/ijerph22040609","DOIUrl":"https://doi.org/10.3390/ijerph22040609","url":null,"abstract":"<p><p><b>Background:</b> Prolonged tablet use can cause visual fatigue, dry eye, and changes in critical flicker frequency, affecting visual comfort and performance. While the light and dark mode features aim to reduce eye strain, their immediate effects on these issues remain unclear. <b>Objective:</b> To compare the immediate effects of light and dark mode features on visual fatigue in tablet users. <b>Methods:</b> This experimental study involved 30 female tablet users. The participants were randomly assigned using a block randomization method to use both light and dark mode features. Visual fatigue, critical flicker frequency, and dry eye symptoms were measured before and after exposure to each mode. <b>Results:</b> No statistically significant difference in visual fatigue was observed between the two modes (<i>p</i> > 0.05). However, a statistically significant difference was found in critical flicker frequency (<i>p</i> < 0.05) and dry eye symptoms (<i>p</i> < 0.05) between the two modes. Furthermore, visual fatigue, critical flicker frequency, and dry eye symptoms significantly increased after tablet use in both modes (<i>p</i> < 0.05). <b>Conclusions:</b> Both light and dark mode features impact visual fatigue, critical flicker frequency, and dry eye symptoms. However, the dark mode may help reduce the risk of eye fatigue compared to the light mode. Further studies are recommended to explore the long-term effects and optimize screen settings for visual comfort.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistency of Condom Use with Lubricants and Associated Factors Among Men Who Have Sex with Men in Ghana: Evidence from Integrated Bio-Behavioral Surveillance Survey.","authors":"Ratif Abdulai, Edith Phalane, Kyeremeh Atuahene, Isaiah Doe Kwao, Rita Afriyie, Yegnanew A Shiferaw, Refilwe Nancy Phaswana-Mafuya","doi":"10.3390/ijerph22040599","DOIUrl":"https://doi.org/10.3390/ijerph22040599","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Several studies conducted worldwide have reported on the effectiveness of consistent condom use with lubricants in preventing HIV transmission and acquisition; however, men who have sex with men (MSM) in Ghana continue to be disproportionately affected by the HIV burden. They are stigmatized, discriminated against, and criminalized, leading to social isolation, reduced access to health care, and inadequate targeted interventions. The dissemination of HIV prevention tools such as condoms and lubricants is also mainly focused on the general population, and this approach overlooks the specific needs and vulnerabilities of MSM. This study aimed to determine the prevalence and associated factors of consistent condom use with lubricants among MSM in Ghana. We analyzed cross-sectional data from the Ghana Men's Study II dataset involving 4095 MSM aged 18 years and above. De-identified data were imported into STATA (College Station, TX, USA, software version 17) for data analysis. Descriptive analysis was performed to describe relevant characteristics of the study population. Multivariable logistic regression analysis was performed for significant variables in bivariate analysis to determine the associated factors of consistent condom use with lubricants. All the statistical analyses were performed at a 95% confidence interval, with significant differences at &lt;i&gt;p&lt;/i&gt; &lt; 0.05. The prevalence of consistent condom use with lubricants during penetrative anal sex was highest with male partners (44.9%), followed by female partners (40.0%), and all sexual partners (38.9%), respectively. In multivariable logistic regression analysis, having a senior high school education (AOR: 1.76; 95% CI: 0.88-3.12, &lt;i&gt;p&lt;/i&gt; = 0.039), tertiary education or higher (AOR: 2.24; 95% CI: 0.86-3.23, &lt;i&gt;p&lt;/i&gt; = 0.041), being an insertive sex partner (AOR: 1.26; 95% CI: 1.02-1.56, &lt;i&gt;p&lt;/i&gt; = 0.029), being a sex worker (AOR: 1.41; 95% CI: 1.00-1.98, &lt;i&gt;p&lt;/i&gt; = 0.048), buying sex from other males (AOR: 1.32; 95% CI: 1.03-1.70, &lt;i&gt;p&lt;/i&gt; = 0.027), being a light drinker (AOR: 0.54; 95% CI: 0.42-0.68, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), being a moderate drinker (AOR: 0.48; 95% CI: 0.30-0.78, &lt;i&gt;p&lt;/i&gt; = 0.003), and possessing good HIV knowledge (AOR: 1.79; 95% CI: 1.46-2.20, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) had higher odds of consistent condom use with lubricants. Being Islamic (AOR: 0.65; 95% CI: 0.49-0.87, &lt;i&gt;p&lt;/i&gt; = 0.004), having a low income (AOR: 0.57; 95% CI: 0.42-0.77, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and easy access (AOR: 0.52; 95% CI: 0.37-0.72, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) to condoms were positively associated with consistent condom use. This study found a low prevalence of consistent condom use with lubricants among the MSM population in Ghana. The study also found a range of socio-demographic, behavioral, and structural factors associated with consistent condom use with lubricants. This calls for very specific and unique public health interventions, such as developing a predictive model to identify and mitigate barriers to consis","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Challenges and Opportunities for Accessing Early Hearing Detection and Intervention: A Narrative Inquiry from South Africa.","authors":"Katijah Khoza-Shangase, Ntsako Precious Maluleke","doi":"10.3390/ijerph22040605","DOIUrl":"https://doi.org/10.3390/ijerph22040605","url":null,"abstract":"<p><strong>Background: </strong>Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading to delayed diagnosis and intervention.</p><p><strong>Aim: </strong>This study explores caregivers' experiences with EHDI services, identifying key challenges and facilitators affecting access and timely intervention.</p><p><strong>Methods: </strong>A narrative inquiry approach was used as part of a broader research initiative on family-centred EHDI. Nine caregivers of children who are deaf or hard of hearing (DHH) were purposively sampled, and data were collected through semi-structured interviews.</p><p><strong>Results: </strong>Thematic analysis revealed systemic and structural challenges, logistical and financial constraints, and caregiver-related factors that hindered access to EHDI services. Key facilitators included caregiver knowledge and advocacy, family support services such as counselling and South African Sign Language training, and high-quality audiological and educational services.</p><p><strong>Conclusions: </strong>Findings emphasise the need for policy-driven reforms, including expanding newborn hearing screening programmes, improving financial assistance mechanisms, and increasing public awareness. Addressing these challenges and leveraging facilitators can help South Africa align with global EHDI benchmarks and improve outcomes for DHH children.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}