International Journal of Environmental Research and Public Health最新文献

{"title":"MMR Vaccination Coverage and Epidemiological Patterns in Al-Baha, Saudi Arabia, 2020-2024: Analysis of Suspected and Laboratory-Confirmed Cases.","authors":"Anwar Alomari, Mona Al-Qahtani","doi":"10.3390/ijerph22091404","DOIUrl":"10.3390/ijerph22091404","url":null,"abstract":"<p><strong>Background: </strong>High national MMR coverage in Saudi Arabia coexists with sporadic measles, mumps, and rubella cases. Local data are needed to describe vaccination coverage among the reported cases and patterns of laboratory-confirmed infections.</p><p><strong>Objectives: </strong>This study was conducted to describe MMR vaccination coverage among the reported suspected cases and patterns of laboratory-confirmed measles, mumps, and rubella in Al-Baha, Saudi Arabia, from January 2020 to August 2024, and to examine associations between demographics, residence, vaccination status, and case classification.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of surveillance records from the Al-Baha Communicable Disease Reporting System. We summarized the demographics, vaccination history, and final classification for 295 reported suspected cases. Inferential analyses (chi-square and logistic regression) used laboratory-confirmed cases only. Statistical significance was <i>p</i> < 0.05.</p><p><strong>Results: </strong>Of 295 reported suspected cases, 239 (81.0%) were discarded after investigation, and 52 (17.6%) were confirmed (including 50 laboratory-confirmed and two epidemiologically confirmed), with 3 (1.0%) remaining under review at analysis. Among all reported cases, the vaccination status was ≥2 doses, 57.6% (<i>n</i> = 170), one dose, 19.0% (<i>n</i> = 56), and unvaccinated/unknown, 23.4% (<i>n</i> = 69). Among the laboratory-confirmed infections, measles was clustered in unvaccinated/unknown, mumps was clustered in single-dose recipients, and rubella was in ≥2-dose recipients. In multivariable models, males had higher odds of a laboratory-confirmed infection, and rural residence was associated with increased odds. The confidence intervals were wide due to small numbers.</p><p><strong>Conclusions: </strong>Reported surveillance data show persistent laboratory-confirmed MMR infections in Al-Baha with demographic and geographic disparities. The findings support targeted efforts to complete two-dose schedules, strengthen rural access, and improve immunization record systems. The results are associations and not causal measures of vaccine effectiveness, and should be interpreted in light of small confirmed case counts.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179838","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":"Recreational Performance Evaluation of Urban Forests: Spatial, Socio-Cultural, and Public Health-Related Perspectives.","authors":"Zeynep Pirselimoğlu Batman, Elvan Ender Altay","doi":"10.3390/ijerph22091401","DOIUrl":"10.3390/ijerph22091401","url":null,"abstract":"<p><p>Urban forests are natural habitat areas within urban ecosystems that enhance physical, mental, and social well-being. By integrating natural and cultural values into the urban landscape, these areas offer individuals opportunities to interact with nature and engage in various recreational activities. Recreational activities increase physical activity levels, help reduce stress, strengthen mental health, and foster social interaction, thereby significantly protecting and improving public health. This study aims to evaluate the recreational performance of urban forests-an essential component of the urban ecosystem-through a multidimensional approach. In this context, ecological (topography, vegetation, water resources, soil structure, climate), physical (accessibility, infrastructure, area size), social (activity diversity, usage intensity, community events), and cultural (landscape values, urban identity, conservation status of cultural landscapes) factors were considered as key indicators. Bursa Atatürk Urban Forest was selected as the study area, and the methodology integrated SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis with weighted multi-criteria decision-making techniques. In addition, the qualitative data obtained were supported by statistical analysis methods to reveal the relationships among the criteria quantitatively. Through this holistic approach, the recreational performance of the urban forest was evaluated scientifically, leading to the conclusion that the area's strengths should be preserved, its weaknesses improved, and its cultural landscape values managed sustainably. The study provides a valuable decision-support framework capable of guiding strategic planning for the future.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179879","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 Structure of Demand, Control, and Stability-Support Underlying the Job Content Questionnaire (JCQ) 2.0-An Innovative Tool for Assessing Multilevel Work Characteristics.","authors":"Maren Formazin, BongKyoo Choi, Maureen F Dollard, Jian Li, Sarven S McLinton, Wilfred Agbenyikey, Sung-Il Cho, Irene Houtman, Robert Karasek","doi":"10.3390/ijerph22091403","DOIUrl":"10.3390/ijerph22091403","url":null,"abstract":"<p><p>Dominant theories in the field of occupational stress have so far mainly focused only on job task level psychosocial factors. Our novelty was to move the field forward by testing a new multilevel conceptualization of workplace health-related psychosocial factors, captured in the new JCQ 2.0 tool. The JCQ 2.0 tool assesses the theoretical constructs Demand (D), Control (C) and Stability-Support (S-S) at the task and the organizational level in accordance with the Associationalist Demand/Control (ADC) Model. We aimed for a first step to assess the generalizability of the framework by collecting data in four different countries (Korea, China, Australia, and Germany). Using structural equation modeling, the task level three-factor DCS structure was largely confirmed across all four countries (with one exception: skill discretion was an indicator of both control and demand). The organizational level, three-factor DCS-S structure was tested and confirmed in the German data only (only data with sufficient scales). Similarly, the multilevel DCS-S model could only be tested with the German data only and was largely confirmed with the three organizational level factors (D, C, and S-S) as antecedents to their task level analogues (with one exception: supervisor support was an indicator of organizational rather than task level support). The findings provide a first step to advancing existing knowledge by providing preliminary support for a multilevel DCS model. Further multilevel longitudinal research is required to verify the main findings and explain some of the nuances uncovered here.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179896","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":"Conceptualising a Community-Based Response to Loneliness: The Representational Anchoring of Nature-Based Social Prescription by Professionals in Marseille, Insights from the RECETAS Project.","authors":"Lucie Cattaneo, Alexandre Daguzan, Gabriela García Vélez, Stéphanie Gentile","doi":"10.3390/ijerph22091400","DOIUrl":"10.3390/ijerph22091400","url":null,"abstract":"<p><strong>Background: </strong>Urban loneliness is rising worldwide and is a recognised public-health threat. Nature-Based Social Prescriptions (NBSPs), guided group activities in natural settings, are being piloted in six cities through the EU project RECETAS. However, in new contexts such as Marseille, its implementation is constrained by professionals' limited knowledge of the concept.</p><p><strong>Objectives: </strong>(i) Exploring how professionals in Marseille (France) conceptualise NBSPs; (ii) Identifying perceived facilitators and barriers to implementing NBSPs among residents facing social isolation and loneliness.</p><p><strong>Methods: </strong>Twelve semi-structured interviews were conducted with health, social-care, and urban-environment professionals selected via network mapping and snowball sampling. Verbatim transcripts underwent inductive thematic analysis informed by Social Representation Theory, with double coding to enhance reliability.</p><p><strong>Results: </strong>Five analytic themes emerged: (1) a holistic health paradigm linking nature, community, and well-being; (2) stark ecological inequities with limited green-space access in deprived districts; (3) work challenges due to the urgent needs of individuals facing significant socio-economic challenges in demanding contexts; (4) a key tension between a perceived top-down process and a preference for participatory approaches; (5) drivers and obstacles: strong professional endorsement of NBSPs meets significant systemic and institutional constraints.</p><p><strong>Conclusions: </strong>Professionals endorse NBSPs as a promising approach against loneliness, provided programmes tackle structural inequities and adopt participatory governance. Results inform the Marseille RECETAS pilot and contribute to global discussions on environmentally anchored health promotion.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179706","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":"Prolonged Exposure to Antiretroviral Therapy and Risk of Developing Hypertension Among HIV-Infected Clinic Attendees: A Pilot Study in Rural Eastern Cape Province, South Africa.","authors":"Teke Apalata, Urgent Tsuro, Olufunmilayo Olukemi Akapo","doi":"10.3390/ijerph22091397","DOIUrl":"10.3390/ijerph22091397","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) has significantly improved outcomes in individuals with human immunodeficiency virus (HIV), yet its long-term cardiovascular effects, especially on hypertension risk, remain debated. This pilot study investigated hypertension risk factors in HIV-positive patients undergoing ART and aimed at hypothesis generation rather than drawing definitive causal conclusions. Seventy HIV-infected adults without baseline hypertension were enrolled and followed. Hypertension was defined using the 2017 ACC/AHA guidelines by the South African Hypertension Society. Data on demographic, anthropometric, metabolic, inflammatory, coagulation, and HIV-related variables were collected. Cox regression analysis identified independent predictors of hypertension. Participants had a median age of 37 years (IOR = 10.96), with 84.3% being female. After a median ART exposure of 61.01 months (range: 2-164), 27 individuals (38.6%) developed high blood pressure. In multivariable Cox models adjusting for metabolic syndrome and BMI, age ≥ 35 years was associated with a 2.2-fold higher hypertension risk (Hazard Ratio [HR]: 2.2; 95% Confidence Interval [CI]: 1.04-4.55; <i>p</i> = 0.04). Elevated triglycerides significantly increased risk, with a 7.9-fold higher likelihood of hypertension (HR: 7.9; 95% CI: 1.04-59.5; <i>p</i> = 0.046). ART regimen type, whether initial or current, did not independently predict hypertension. In conclusion, hypertension is prevalent during ART. We hypothesized that traditional cardiovascular risk factors, notably age ≥35 years and hypertriglyceridemia, were key independent predictors, emphasizing the need for routine cardiovascular risk assessment in HIV management.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179829","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":"Health Communication in Times of Pandemics: A Framework for Increased Community Participation in Infection Prevention.","authors":"Ahmed Alobaydullah, Andrew Scott LaJoie","doi":"10.3390/ijerph22091398","DOIUrl":"10.3390/ijerph22091398","url":null,"abstract":"<p><strong>Introduction: </strong>Pandemic communication faces significant challenges due to the dynamic nature of disease outbreaks, societal influences, and evolving communication platforms. Effective non-pharmaceutical interventions (NPIs) depend on robust health communication strategies. This study aims to develop a conceptual model to guide NPIs communication during pandemics, grounded in widely applied risk communication theories.</p><p><strong>Methods: </strong>Using Jabareen's conceptual framework analysis method, this study synthesized interdisciplinary literature from public health, psychology, and risk communication. The method involves mapping data sources and concept categorization and integration. We examined Crisis and Emergency Risk Communication (CERC), the Social Amplification of Risk Framework (SARF), and Social Cognitive Theory (SCT) to develop a comprehensive NPIs communication framework.</p><p><strong>Results: </strong>The Pandemic Behavioral Prevention Framework delineates pandemic communication into five phases: pre-crisis, initial event, maintenance, resolution, and evaluation. It emphasizes targeting vulnerable populations, addressing trust deficits, and leveraging effective communication channels. Key concepts such as self-efficacy, vicarious learning, and social risk amplification are integrated to enhance public adherence to NPIs.</p><p><strong>Conclusion: </strong>The framework bridges gaps in pandemic communication by integrating risk and health communication principles, fostering trust, and addressing social determinants of health. It highlights the importance of pre-crisis education and the utilization of social media for targeted messaging.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179959","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":"Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study.","authors":"Peter S Reed, Yonsu Kim, Jay J Shen, Sai Kosaraju, Mingon Kang, Jennifer Carson, Iulia Ioanitoaia Chaudhry, Sarah Kim, Connor Jeong, Yena Hwang, Ji Won Yoo","doi":"10.3390/ijerph22091399","DOIUrl":"10.3390/ijerph22091399","url":null,"abstract":"<p><p>Identifying strategies to enhance patient engagement and to control healthcare costs promotes a responsive and efficient healthcare system. The aim of this study is to predict healthcare cost savings associated with delivering telehealth advance care planning (ACP) to patients living with dementia. Two Geriatrics Workforce Enhancement Programs delivered training to primary care providers on using telehealth to provide ACP. Using electronic health records data from 6344 dual-eligible Medicare/Medicaid patients receiving telehealth primary care from trained providers in an urban safety net system, persons living with dementia (<i>n</i> = 401) were identified by extracting ICD-10 codes. The primary outcome was the estimated hospitalization-associated cost, with a key independent variable of ACP billing status. Multiple linear regressions and machine learning techniques estimated the impact of telehealth ACP on hospitalization-associated costs with a differential analysis by race. Compared to non-Hispanic Whites, hospitalization costs among Hispanic elders were higher by USD 14,232.40. Costs for non-English speakers or those having increased comorbidities were higher by USD 27,346.60 and USD 26,072.70, respectively. Overall, receiving ACP was associated with lower costs of USD 23,928.84. Dementia patients seen by primary care providers in a system receiving training to offer ACP via telehealth realized significant cost savings, with marked differences among those of non-White racial backgrounds.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179886","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":"Ambient and Bedroom Heat in Relation to Sleep Health in a Marginalized Community That Is One of the Hottest in Los Angeles.","authors":"Hasibe Caballero-Gomez, Jill Johnston, Chandra L Jackson, Lizette Romano, Lara J Cushing","doi":"10.3390/ijerph22091391","DOIUrl":"10.3390/ijerph22091391","url":null,"abstract":"<p><p>The majority of Americans do not regularly get the recommended amount of sleep and sleep deficiencies disproportionately burden marginalized communities. We conducted a longitudinal cohort study measuring bedroom air temperature and humidity over three non-consecutive weeks (<i>N</i> = 19 participants; 409 observation nights) using HOBO loggers and sleep health using wrist-actigraphy and sleep diaries. Outdoor temperature and humidity were obtained from a nearby weather station. Linear mixed-effects regression models assessed relationships between temperature and sleep health metrics. Nighttime indoor apparent temperature ranged from 26 to 35 °C and averaged 5 °C higher than outdoors. On average, participants slept 6.7 h per night with 83% sleep efficiency. After adjustment, a 5 °C increase in indoor nighttime dry bulb temperature was associated with a 23 min reduction in mean total sleep time (β = -23.30 [-43.30, -3.45]) and mean onset latency increase of approximately 2 min (β = 1.85 [0.50, 6.65]). Nighttime heat waves were associated with a 4% reduction in mean sleep efficiency (β = -3.71 [-6.83, -0.66]) and an 11 min increase in onset latency (β = 11.32 [2.60, 20.75]). We found evidence that rising summertime temperatures reduced sleep health in a disproportionately impacted community, suggesting that climate change will worsen existing sleep health disparities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179859","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":"Chronic Pain Prevalence and Psychosocial Burden in the Italian Population from the 2019 European Health Interview Survey.","authors":"Alice Maraschini, Michael Tenti, William Raffaeli, Laura Iannucci, Lidia Gargiulo, Alessandra Burgio, Giada Minelli, Corrado Fagnani, Emanuela Medda, Maurizio Ferri, Miriam Salemi, Virgilia Toccaceli","doi":"10.3390/ijerph22091395","DOIUrl":"10.3390/ijerph22091395","url":null,"abstract":"<p><p>Chronic pain (CP) is a global healthcare concern requiring careful monitoring. In Italy, the most recent CP prevalence estimates date back to 2003. In this work, we analyzed data from the 2019 European Health Interview Survey, based on a representative sample of the Italian population (n = 44,492), to update national CP prevalence estimates and evaluate its psychosocial burden. CP was detected using a validated questionnaire. Our results show that approximately 10.5 million adults (24.1%) suffer from CP; prevalence and intensity are higher among females and increase with age. In 54.3% of cases, CP was triggered by a diagnosed disease, while 13.6% remain undiagnosed and 14.8% do not seek treatment for CP. Severe CP accounts for 29.4% of cases. Individuals with severe CP are significantly more likely to experience difficulties in social participation (OR 4.82; CI 4.41-5.27), increased work absences (OR 4.18; CI 3.53-4.94), depression (OR 7.10; CI 6.22-8.11), and greater use of primary (OR 2.90; CI 2.64-3.18) and specialist healthcare (OR 2.63; CI 2.40-2.89) as well as diagnostic procedures (OR 2.27; CI 2.07-2.49). Among subjects diagnosed with depression or severe chronic anxiety, CP seems to reduce access to mental health care (OR 0.75; CI 0.61-0.92) and increase abandonment due to financial barriers (OR 1.57; CI 1.07-2.31). Unlike a few countries (e.g., Spain and Denmark) that have recorded a generally increasing trend in CP prevalence, our figures confirm a quite stable national epidemiological pattern. Our estimates underscore the need for careful management of CP and its psychosocial burden. Since data were collected just before the COVID-19 pandemic, they may represent a crucial baseline for monitoring post-pandemic trends.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179534","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":"Loneliness by Design: The Structural Logic of Isolation in Engagement-Driven Systems.","authors":"Lauren Dwyer","doi":"10.3390/ijerph22091394","DOIUrl":"10.3390/ijerph22091394","url":null,"abstract":"<p><p>As the prevalence of public discourse pertaining to loneliness increases, digital interventions, such as artificial intelligence companions, are being introduced as methods for fostering connection and mitigating individual negative experiences of loneliness. These tools, while increasing in volume and popularity, operate within and are shaped by the same engagement-driven systems that have been found to contribute to loneliness. This meta-narrative review examines how algorithmic infrastructures, which are optimized for retention, emotional predictability, and behavioural nudging, not only mediate responses to loneliness but participate in its ongoing production. Flattening complex social dynamics into curated, low-friction interactions, these systems gradually displace relational agency and erode users' capacity for autonomous social decision making. Drawing on frameworks from communication studies and behavioural information design, this review finds that loneliness is understood both as an emotional or interpersonal state and as a logical consequence of hegemonic digital and technological design paradigms. Without addressing the structural logics of platform capitalism and algorithmic control, digital public health interventions risk treating loneliness as an individual deficit rather than a systemic outcome. Finally, a model is proposed for evaluating and designing digital public health interventions that resist behavioural enclosure and support autonomy, relational depth, systemic accountability, and structural transparency.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179693","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}