International Journal of Environmental Research and Public Health最新文献

{"title":"'You've Just Got to Keep Pestering': Barriers and Enablers of Attaining Continuity of Hepatitis C Care for People Transitioning Between Prison and Community Health Services in South-East Queensland, Australia.","authors":"Idin Panahi, Linda A Selvey, Cheneal Puljević, Amanda Kvassay, Dorrit Grimstrup, Andrew Smirnov","doi":"10.3390/ijerph22020238","DOIUrl":"10.3390/ijerph22020238","url":null,"abstract":"<p><p>Highly effective direct-acting antiviral (DAA) therapies for hepatitis C (HCV) have been available in Australian prisons since 2016. To address treatment interruption following release from prisons, the Queensland Injector's Health Network (QuIHN) launched a Prison Transition Service (PTS) in south-east Queensland, Australia. Presently, the factors associated with continuity of post-release HCV care are poorly understood. The objective of this qualitative study was to explore the barriers and facilitators to HCV treatment among people recently released from prisons among PTS clients and stakeholders. Qualitative interviews were conducted with 27 participants, namely, 13 clients and 14 stakeholders (health and community support workers) of the PTS. We conducted thematic analysis using the framework of person-, provider-, and system-level barriers and facilitators. Person-level barriers included competing priorities post-release, while facilitators included self-improvement after treatment completion, preventing transmission to family, and social support. Provider-level treatment barriers included enacted stigma, limited prison health service capacity, and post-release health system challenges. Systemic barriers included stigma relating to HCV, injecting drug use, incarceration, and limited availability of harm reduction services. Policy changes and investment are required to expand HCV treatment in south-east Queensland prisons to facilitate patient navigation into community care. In terms of reducing stigma among health staff and the general community towards people with HCV, a history of incarceration and/or who inject drugs is crucial for improving treatment rates. Strategies such as peer-led or nurse-practitioner-led models of care may help improve treatment completion. Continuity of HCV treatment post-release from prisons is essential for Australia to meet the WHO's 2030 HCV elimination target.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505359","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":"Physical and Mental Health of Caregivers and Educators of Preschool-Aged Children: Identifying Benefits and Barriers to Outdoor Time, How Outdoor Time Can Make a Difference for Health Equity, and Why Income Matters.","authors":"Amber L Fyfe-Johnson, Carolyn J Noonan, Maria B Butcher, Magdalena K Haakenstad","doi":"10.3390/ijerph22020236","DOIUrl":"10.3390/ijerph22020236","url":null,"abstract":"<p><p>Outdoor time is positively associated with improved physical and mental health in adults. Little is known about the specific effects of outdoor time on health outcomes for parents and educators of preschool-aged children. Early childhood is a critical window for growth and development, as parental and educator stress negatively impacts young children; thus, it is of paramount importance to systematically support parents and educators during these developmental years. The objectives of this research were to use a cross-sectional natural experiment to (1) evaluate the association between outdoor time and physical and mental health in caregivers and educators who engage with preschool-aged children; (2) evaluate the association between income and physical and mental health in caregivers and educators who engage with preschool-aged children; and (3) identify benefits and barriers of outdoor time and the importance, availability, and accessibility of community resources for outdoor time. Participants were recruited from three stakeholder groups: preschool educators, parents of children attending an outdoor preschool, and parents of preschool-aged children in the local community. Participants completed a health needs assessment (<i>n</i> = 46) to assess demographics, mental and physical health outcomes, and benefits, barriers, and resources for outdoor time. Caregivers and educators in the higher income group (≥USD 70,000) were 41% (95% CI: 12%, 70%) more likely to report very good or excellent self-reported health. Mean anxiety, depression, and perceived stress were lower in the higher-income group. Caregivers and educators in the higher outdoor time group had lower body mass index (-5.5 kg/m²; 95% CI: -11.6, 0.7), and outdoor time appeared to be protective for general health independent of income. Thus, outdoor time may be a critical protective factor to enhance biological resilience for caregivers and educators, especially for those facing financial adversity.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505411","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":"Combined Effects of Arsenic, Cadmium, and Mercury with Cardiovascular Disease Risk: Insights from the All of Us Research Program.","authors":"Oluwatobi L Akinbode, Emmanuel Obeng-Gyasi","doi":"10.3390/ijerph22020239","DOIUrl":"10.3390/ijerph22020239","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Environmental exposures to heavy metals/metalloids such as arsenic, cadmium, and mercury have been implicated in adverse cardiovascular health outcomes. Using data from the All of Us research program, we investigated the associations between these metals/metalloids and six cardiovascular-related biomarkers: systolic blood pressure (SBP), HDL cholesterol, LDL cholesterol, C-reactive protein (CRP), total cholesterol, and triglycerides.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study explored the relationship between outcome cardiovascular variables (SBP, CRP, LDL, HDL, triglycerides, and total cholesterol) and predictor metal/metalloid variables (cadmium, mercury, and arsenic) among 136 participants (53.4 percent women). We initially conducted linear regression to determine the association between variables of interest. Bayesian Kernel Machine Regression (BKMR) analysis was subsequently performed to capture potential non-linear relationships, as well as interactions among metal/metalloid exposures. In the BKMR analysis, posterior inclusion probabilities (PIPs) quantified the contribution of each metal/metalloid to the outcomes, with higher PIP values indicating a greater likelihood of a specific exposure being a key predictor for a given cardiovascular biomarker. Within the BKMR framework, univariate, bivariate, and overall exposure-response analyses provided insights into the individual and combined effects of metal/metalloid exposures. These analyses identified the factors with the strongest associations and highlighted interactions between exposures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this study, the average age of male participants was 58.2 years, while female participants had an average age of 55.6 years. The study population included 104 individuals identifying as White (mean age: 57.5 years), 10 as Black or African American (mean age: 63.2 years), 7 as Hispanic (mean age: 48.2), 3 as Asian (mean age: 49.7 years), and 12 as Other race (mean age: 48.8 years). In our study, men exhibited higher levels of SBP, triglycerides, mercury, and arsenic, while women had higher levels of CRP, LDL cholesterol, HDL cholesterol, total cholesterol, and cadmium. Black people exhibited higher levels and greater variability in markers of cardiovascular risk and inflammation (e.g., blood pressure and CRP), Asians consistently showed the lowest levels across most biomarkers, while White people, Hispanics, and the \"Other\" group demonstrated moderate levels with some variability. In linear regression, we identified significant positive associations between mercury and HDL cholesterol, arsenic and triglycerides, and arsenic and total cholesterol. In BKMR analysis, PIP results revealed that mercury had the highest predictive contribution for SBP, HDL cholesterol, and triglycerides; cadmium for CRP; and arsenic for LDL and total cholesterol. Univariate and bivariate exposure-response analyses in BKMR demonstrated non-linear exposure-response","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505382","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":"Overall Observed Survival of Female Breast, Cervical, Colorectal, and Prostate Cancers in Antigua and Barbuda, 2017-2021: Retrospective Data from Four Study Sites.","authors":"Andre A N Bovell, Adrian Rhudd, Jabulani Ncayiyana, Themba G Ginindza","doi":"10.3390/ijerph22020235","DOIUrl":"10.3390/ijerph22020235","url":null,"abstract":"<p><p>Understanding cancer survival is important for countries such as Antigua and Barbuda, where female breast, cervical, colorectal, and prostate cancers are burdensome to the healthcare system. This study therefore aimed to estimate the survival probabilities of patients diagnosed with these cancers between 2017 and 2021. A retrospective analytical study design was used to evaluate cancer cases abstracted from medical records at key study sites. Estimates of observed survival probabilities were determined using a Kaplan-Meier analysis. Significant differences between survival curves were assessed using the log-rank test. Hazard ratios were calculated using Cox regression. A <i>p</i>-value < 0.05 indicated significance. A total of 391 diagnosed cases were included in this study (2017-2021): female breast cancer accounted for 42%, cervical cancer accounted for 10%, colorectal cancer accounted for 20%, and prostate cancer accounted for 28%. Overall, the mean age of the participants was 61.5 (±12.9) years; 62% were female, 73% were aged > 55 years, 56% were from St. John's, and 82% were alive at the end of 2021. The median overall survival (years) was 4.8 for female breast cancer, 4.1 for cervical cancer, 4.5 for colorectal cancer, and not reached for prostate cancer. The cancer-specific overall observed 5-year survival probabilities were 44.9% for female breast cancer, 10.8% for cervical cancer, 19.6% for colorectal cancer, and 69.0% for prostate cancer. Significant associations between disease stage and overall survival were observed in female breast and colorectal cancers. This study provides important evidence for the 5-year observed survival probabilities of the studied cancers. Healthcare improvements that support cancer survival are required.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505265","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":"Smartphone Addiction, Screen Time, and Physical Activity of Different Academic Majors and Study Levels in University Students.","authors":"Wannisa Kumban, Salila Cetthakrikul, Anoma Santiworakul","doi":"10.3390/ijerph22020237","DOIUrl":"10.3390/ijerph22020237","url":null,"abstract":"<p><p>Smartphone addiction is increasing among university students. This study aims to explore the differences in screen time and physical activity among university students with and without smartphone addiction, considering their study majors and levels. One hundred and twenty participants from sixteen faculties were included, divided into three academic majors (health sciences, social sciences and humanities, and science and technology). Data were collected using a screen time behavior questionnaire and a screen time application. Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). This study demonstrated that the smartphone addiction group had higher screen time on both smartphones (<i>p</i> = 0.02) and other devices (<i>p</i> = 0.04). Students in the social sciences and humanities majors had insufficient physical activity according to WHO recommendations. The results showed no correlation between screen time and physical activity, study time, academic major, or study level (<i>p</i> ≥ 0.05). However, a low correlation was observed between physical activity and study time (r² = 0.27; <i>p</i> < 0.05), as well as study level (r² = -0.31; <i>p</i> < 0.05). Our findings show that the total screen time for university students with and without smartphone addiction exceeded 8 h per day. Real-life activities should be promoted to reduce screen time. Encouraging physical activity among senior students and those in social science and humanities majors is crucial for fostering healthy behaviors in the future. Physical education and recreational activities should be emphasized in these groups, along with the development of programs or class activities designed to promote physical activity and reduce screen time.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505403","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 Interplay of Politics and Conspiracy Theories in Shaping Vaccine Hesitancy in a Diverse Cultural Setting in Italy.","authors":"Christian J Wiedermann, Barbara Plagg, Patrick Rina, Giuliano Piccoliori, Adolf Engl","doi":"10.3390/ijerph22020230","DOIUrl":"10.3390/ijerph22020230","url":null,"abstract":"<p><p>Vaccine hesitancy presents a significant challenge to public health, particularly in culturally diverse regions, such as South Tyrol, Italy. This article examines the interplay between political influences, conspiracy theories, and vaccine hesitancy in South Tyrol, an autonomous province characterised by its linguistic diversity and historical scepticism toward central authority. This study aimed to identify the important drivers of vaccine hesitancy and propose targeted strategies to enhance vaccine acceptance. Peer-reviewed and grey literature was examined to explore the sociocultural factors, political dynamics, and conspiracy narratives influencing vaccine hesitancy in South Tyrol. The analysis incorporated publicly available materials, including propaganda from anti-vaccine organisations, and regional public health data to contextualise the findings. Vaccine hesitancy in South Tyrol was influenced by historical tensions with the central government, cultural alignment with Austrian healthcare practices, and politically motivated opposition to vaccination. Conspiracy theories disseminated by local organisations and political entities exploit concerns regarding governmental overreach and personal autonomy. These dynamics are compounded by the selective misrepresentation of scientific discourse, which further polarises public opinion. Addressing vaccine hesitancy in South Tyrol requires culturally sensitive communication, community engagement through trusted local figures, transparency in health policies, and the proactive monitoring of misinformation. These strategies can mitigate mistrust and promote vaccine acceptance in regions with similar sociopolitical complexities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505438","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":"An Evaluation of Dental Caries Status in Children with Oral Clefts: A Cross-Sectional Study.","authors":"Lucimara Teixeira das Neves, Beatriz Costa, José Roberto Pereira Lauris, Ana Lídia Ciamponi, Marcia Ribeiro Gomide","doi":"10.3390/ijerph22020227","DOIUrl":"10.3390/ijerph22020227","url":null,"abstract":"<p><p>Oral health is a prerequisite for the rehabilitation of children with oral cleft (OC). Thus, caries negatively affects individuals with OC. This study aimed to investigate dental caries in children with OC, determining the first period of the most significant susceptibility to caries. This cross-sectional study evaluated caries' prevalence and mean dmft in the primary dentition of 300 children with OC, distributed among ten groups at six-month intervals. The exams were carried out using the WHO diagnostic criteria. Fisher's exact test and Student's <i>t</i>-test were used for statistical comparisons with a significant level of 5%. The caries prevalence in the total group was 59.4%, and the dmft was 3.4. The first period of susceptibility occurred between 13 and 18 months and 19 and 24 months, with a prevalence ranging from 6.6% to 40% (<i>p</i> < 0.05) and a dmft ranging from 0.1 to 1.0 (<i>p</i> < 0.05). The prevalence and dmft increase with age. Our findings suggest that in children with OC, the first period of susceptibility to caries occurs from 13 to 18 months. These findings demonstrate the need for pediatric dentistry to establish an early preventive protocol for children with clefts during the first year.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505351","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":"Comparing Barriers and Facilitators to Physical ActivityAmong Underrepresented Minorities: Preliminary Outcomes from a Mixed-Methods Study.","authors":"Rafael A Alamilla, Navin Kaushal, Silvia M Bigatti, NiCole R Keith","doi":"10.3390/ijerph22020234","DOIUrl":"10.3390/ijerph22020234","url":null,"abstract":"<p><p>Physical activity (PA)'s benefits are well established, yet many U.S. adults fail to meet PA guidelines. This is especially true for minorities facing social inequities. This study explored PA's barriers and facilitators among urban Midwestern minorities using a mixed-methods approach framed on the socio-ecological model. A cross-sectional survey was conducted between January and June 2024 among community-dwelling minorities. Participants were grouped as completing low (LLPA) or high (HLPA) weekly leisure-time PA for comparison. Quantitative analysis included MANOVA, follow-up ANOVAs, and calculation of effect sizes. Qualitative data were assessed using inductive thematic analysis. Twenty-nine adults (44.83% Black, 41.37% Latino) participated in the study. The HLPA group (n = 18) reported higher leisure-time PA (<i>p</i> = 0.001, <i>d</i> = 2.21) and total PA (<i>p</i> = 0.02, <i>d</i> = 1.00) compared to the LLPA group (n = 11). LLPA participants faced more personal barriers to PA (<i>p</i> = 0.02, <i>d</i> = -0.92). Common barriers identified in the interviews included a lack of time and financial costs. Facilitators included social support and available PA facilities. Both groups achieved the USPA guidelines through different PA domains. Increasing social support and lowering PA-related costs could enhance participation. Addressing barriers and leveraging existing facilitators are crucial to increasing PA among minorities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505385","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":"Perceptions of Nurse-Surgeon Communication in the Operating Room: A Q-Methodology Study.","authors":"Jeong Hwa An, Eun Ja Yeun, Sul Hee Lee, Ho Young Kim","doi":"10.3390/ijerph22020229","DOIUrl":"10.3390/ijerph22020229","url":null,"abstract":"<p><p>Inadequate communication between nurses and surgeons can lead to patient injuries and increased healthcare costs. This study aimed to identify and understand subjective perceptions of communication between Korean nurses and surgeons in operating rooms (ORs), focusing on their values, beliefs, and attitudes. The Q-methodology was employed in this research, as it integrates the strengths of both quantitative and qualitative approaches. A convenience sample of 46 participants classified 45 Q-statements by using a nine-point forced normal grid. The collected data were analyzed by using by-person factor analysis with the pc-QUANL program. This study revealed four distinct types of nurse-surgeon communication in the OR: professional communication, cynical conflict, passive task-oriented communication, and relationship-oriented endurance. These four types accounted for 58.7% of the total variance, distributed as follows: type 1 (38.7%), type 2 (9.8%), type 3 (5.4%), and type 4 (4.8%). The eigenvalues were 15.8, 4.1, 2.2, and 1.9, respectively. Based on these findings, tailored strategies to enhance nurse-surgeon communication according to each type are essential. Enhancing communication dynamics can lead to more effective interactions, improve patient care and safety, and boost job satisfaction among healthcare professionals. The results have significant implications for healthcare organizations and nursing managers aiming to improve nurses' communication skills. Additionally, this study provides insights for healthcare organizations in other countries regarding the communication competence traits among Korean health professionals.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505409","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":"Effects of Climate Change on Health and Health Systems: A Systematic Review of Preparedness, Resilience, and Challenges.","authors":"Vasileios Gkouliaveras, Stavros Kalogiannidis, Dimitrios Kalfas, Stamatis Kontsas","doi":"10.3390/ijerph22020232","DOIUrl":"10.3390/ijerph22020232","url":null,"abstract":"<p><p>Climate change has a significant impact on the population's health and negatively affects the functioning of healthcare systems. Health systems must be operationally prepared to handle the challenges posed by environmental change. Resilience is required to adapt quickly to critical environmental conditions and reduce carbon emissions. In this systematic review strategies, for health system preparedness and resilience are examined to address the impacts of climate change, and the barriers and challenges faced when implementing them. To identify studies, the Scopus, PubMed and Google Scholar databases were searched three times (from April to October 2024, 21 April, 15 June, and 9 September) for the years 2018 to 2024, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Specifically, the search identified 471 articles, of which the specified inclusion and exclusion criteria (secondary studies with inclusion criteria, being in English, etc.) were met by sixteen (16) studies. According to the findings of the studies reviewed, adaptation strategies focus on structural changes, the development of training programs, the development of surveillance systems, and appropriate operational plans. The leader's ability to motivate employees to achieve defined goals, continuous evaluation of goals and interventions, and learning from previous disasters play an important role in their implementation. Similarly, key policies and strategies for mitigation include the adoption of sustainable practices, such as recycling and cultural change. However, lack of resources (human, material, financial) and increased demand for health services make it difficult to implement adaptation and mitigation strategies. The findings of the review are mainly theoretical in nature and are confirmed by other studies. It is suggested that further research on resilience and preparedness of health systems should be pursued, leading to their sustainability and the formulation of appropriate policies.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505196","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}