Social Science & Medicine最新文献

{"title":"Strategies for recruiting participants underrepresented in clinical research: A scoping review","authors":"Abigail Helm ,&nbsp;Marinna Kaufman ,&nbsp;Nathaniel Glassy ,&nbsp;Camilo Posada Rodríguez ,&nbsp;Paige Shaffer ,&nbsp;Becky Baltich Nelson ,&nbsp;David Smelson","doi":"10.1016/j.socscimed.2025.118603","DOIUrl":"10.1016/j.socscimed.2025.118603","url":null,"abstract":"<div><div>Despite the 1993 National Institutes of Health Revitalization Act's mandate regarding underrepresented groups in clinical research, broad representation in clinical research is still lacking, making generalizability more difficult. Additionally, the extent of research that defines actionable strategies to encourage participation of a variety of patients in clinical research is unclear. This scoping review aimed to map evidence-based strategies for clinical research recruitment of underrepresented groups identified in the 1993 NIH Revitalization Act. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework, articles were included if they: (1) reported strategies used for adult patient recruitment, selection, or enrollment in human subjects research; (2) focused on recruiting underrepresented groups; (3) took place within the United States; and (4) were either randomized controlled trial designs, prospective or retrospective cohort studies, cross-sectional designs, quasi-experimental designs, or qualitative studies. We selected 67 articles which reported efforts to recruit underrepresented groups to have broad generalizability of treatment effects. The most successful strategies reported in the literature included recruiting in clinical/healthcare and community settings; using electronic health records and health/disease registries to identify patients; snowball sampling; newspaper and social media advertising; and mass mailing of letters. This paper offers a comprehensive review of the evidence-based recruitment strategies and materials for recruitment of groups that are historically underrepresented in a variety of clinical research studies, thus providing a set of recommendations for future researchers who aim to conduct scientifically rigorous clinical research studies with broad patient samples.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118603"},"PeriodicalIF":5.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between macro-level structural discrimination and alcohol outcomes: A systematic review","authors":"Sophie Bright ,&nbsp;Charlotte Buckley ,&nbsp;Daniel Holman ,&nbsp;Madeleine Henney ,&nbsp;Loni Philip Tabb ,&nbsp;Robin Purshouse","doi":"10.1016/j.socscimed.2025.118596","DOIUrl":"10.1016/j.socscimed.2025.118596","url":null,"abstract":"<div><div>Alcohol consumption is a major risk factor for death and disability, disproportionately harming disadvantaged groups. While a positive association between interpersonal discrimination and alcohol use is established, structural discrimination's impact remains unclear. We conducted a systematic review of the association between macro-level structural discrimination and alcohol consumption or related health outcomes. We searched four databases and grey literature, identifying 25 eligible studies, which considered racism (n = 11), sexism (n = 7), heterosexism (n = 4), and intersectional discrimination (n = 3). Most considered alcohol consumption (n = 17); fewer addressed harm (n = 4) or both (n = 4). The majority were US-based (n = 21), with four making cross-country comparisons. Associations varied by discrimination type, exposure measurement, alcohol outcome, and sociodemographic factors, though differential effects by sociodemographic factors remain understudied.</div><div>Most structural racism studies considered segregation as the exposure, but findings were inconsistent, even when grouped by outcome. Emerging evidence suggests increased race-based poverty ratios and incarceration gaps are associated with higher consumption and harm, especially for Black and Hispanic populations. Studies of structural sexism often used composite measures, like state-level gender inequality indices. Evidence suggests that as gender equality increases, women are more likely to drink, while greater structural sexism may be linked to higher rates of risky drinking and alcohol-related mortality. Findings on heavy episodic drinking and drinking frequency were mixed, while associations with volume and quantity were mostly non-significant. The limited available evidence suggests structural heterosexism may be positively associated with high intensity drinking and alcohol use disorders among sexually minoritized groups. The simultaneous impact of multiple forms of structural discrimination remains underexplored. Advancing this field requires consensus on how to operationalize structural discrimination within alcohol studies and greater adoption of intersectional and longitudinal approaches.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118596"},"PeriodicalIF":5.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating behavioural change: insights from prompts self-authored by individuals during a digital multiple health behaviour intervention trial","authors":"Elizabeth S. Collier ,&nbsp;Elin A. Karlsson ,&nbsp;Joel Crawford ,&nbsp;Preben Bendtsen ,&nbsp;Marcus Bendtsen","doi":"10.1016/j.socscimed.2025.118599","DOIUrl":"10.1016/j.socscimed.2025.118599","url":null,"abstract":"<div><div>Digital multiple health behaviour interventions could reduce the prevalence of behavioural risk factors for several non-communicable diseases, but their design could be improved through better understanding of how individuals navigate behavioural change. Using a mixed-methods approach, this study evaluated 2657 prompts that were written by individuals (N = 722) for their personal use while taking part in a digital multiple health behaviour intervention trial. This unique data reflects individuals’ thoughts and feelings whilst actively trying to change, rather than post-hoc descriptions or explanations thereof. Inductive qualitative analysis was used to evaluate the prompts and extract themes within the material; then correspondence analysis was used to test whether these themes manifested differently across four behavioural categories (alcohol consumption, tobacco use, healthy diet, physical activity). Six main themes, each with subthemes, were identified (Encouragement &amp; Motivation, Implementing Change, Self-Focus, Mindset, Negotiation Style, and Specific Motives), which reflect nuances in the concept of self-regulation and align well with behavioural change theory. People favoured different approaches to change depending on the target behavioural category, which were broadly discriminated by dimensions of action vs inaction and external/impersonal vs internal/personal focus. This work reveals the various ways individuals approach and navigate changing their health behaviours. Inclusion of self-authoring modules in digital interventions may offer individuals an opportunity to develop skills and know-how gained through intervention engagement, and remind themselves of personal reasons to change.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118599"},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving numerical measures of human feelings: The case of pain","authors":"Michele Garagnani ,&nbsp;Petra Schweinhardt ,&nbsp;Philippe N. Tobler ,&nbsp;Carlos Alós-Ferrer","doi":"10.1016/j.socscimed.2025.118472","DOIUrl":"10.1016/j.socscimed.2025.118472","url":null,"abstract":"<div><div>Numerical self-report scales are extensively used in economics, psychology, and medicine to quantify subjective feelings, ranging from life satisfaction to the experience of pain. These scales are often criticized for lacking an objective foundation, and defended on the grounds of empirical performance. We focus on the case of pain measurement, where existing self-reported measures are the workhorse but known to be inaccurate and difficult to compare across individuals. We provide a new measure, inspired by standard economic elicitation methods, that quantifies the negative value of acute pain in monetary terms, making it comparable across individuals. In three preregistered studies (completed between June 7th to Sept 26th, 2022), 330 healthy participants were randomly allocated to receive either only a high- or only a low-pain stimulus or a high-pain stimulus after having double-blindly received a topical analgesic or a placebo. In all three studies, the new measure greatly outperformed the existing self-report scales at distinguishing whether participants were in the more or the less painful condition, as confirmed by effect sizes, Bayesian factor analyses, and regression-based predictions. We conclude that standard economic methods can greatly improve the measurement of experienced pain across individuals. The new measure can be used in experimental studies and random parallel-assignment clinical trials, and opens the door to potential improvements in pain management.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118472"},"PeriodicalIF":5.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of norms and acculturation in migrants’ willingness to seek mental health care: Results from a large preregistered study","authors":"Samantha M. Harris ,&nbsp;Hege H. Bye ,&nbsp;Jonas R. Kunst","doi":"10.1016/j.socscimed.2025.118598","DOIUrl":"10.1016/j.socscimed.2025.118598","url":null,"abstract":"<div><h3>Aims</h3><div>This study investigated the role of perceived social norms and acculturation orientations in shaping migrants' willingness to seek mental health care. Specifically, we examined perceptions of help-seeking norms, presumed approval by family and friends, and the moderating role of migrants’ acculturation orientations.</div></div><div><h3>Methods</h3><div>The study used a preregistered design with a sample of 2768 people with a migrant background from six countries (Afghanistan, Eritrea, Lithuania, Poland, Syria, and Ukraine). Participants completed a web-based survey assessing their willingness to seek help, perceived approval by family and friends, perceived help-seeking norms among people from their own group (same country of origin and gender) and among Norwegian majority members, and acculturation orientations. We used multilevel regression models to test our predictions.</div></div><div><h3>Results</h3><div>Participants perceived their own group as less willing to seek help than themselves; in the Ukrainian sample, this tendency was attenuated among women. All perceived norms had a significant and positive association with own willingness to seek help, but family and friends’ approval had the strongest association. Exploratory analyses showed that participants rated the majority group as more willing to seek help than both participants themselves and members of their own group. Critically, acculturation orientations moderated the associations.</div></div><div><h3>Conclusions</h3><div>Our results suggest that participants may show more willingness to seek help than they believe others in their own group do. This misperception of norms may contribute to hindering help-seeking. While all group norms played a role in own willingness to seek help, presumed approval from family and friends may play a more pivotal role. The role of own group and majority group norms depends on individuals’ acculturation orientations. Tailored interventions should consider these factors when aiming to facilitate access to mental health services among diverse migrant populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118598"},"PeriodicalIF":5.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From disorder to distress: Investigating neighborhood change and mental health with Streetview and longitudinal survey data","authors":"Yi Zhang ,&nbsp;Jia Miao","doi":"10.1016/j.socscimed.2025.118589","DOIUrl":"10.1016/j.socscimed.2025.118589","url":null,"abstract":"<div><div>Neighborhood physical disorder, a prominent negative aspect of the residential environment, is expected to adversely affect mental health. However, the limited use of longitudinal designs with objective measures of physical disorder hinders the establishment of causal effects and the generalizability of findings, particularly in rapidly changing urban contexts. This study integrates Streetview data with the Shanghai Urban Neighborhood Survey from 2017 to 2019 to examine changes in physical disorder and their association with psychological distress in Shanghai. Analysis of Streetview data reveals a decline in physical disorder over the study period. Employing fixed-effects models and generalized propensity score matching, we find that this decline is associated with reduced psychological distress. The association is significant among residents with lower socioeconomic status (SES), while it is less pronounced among high-SES residents. These findings contribute to the understanding of the effect of physical disorder by providing more robust evidence from a rapidly transforming urban context. They also shed light on the effectiveness of residential environment improvements in Shanghai and other cities experiencing rapid neighborhood change.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118589"},"PeriodicalIF":5.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital consolidation and quality: Opening the behavioral black box","authors":"Mark V. Pauly ,&nbsp;Lawton Robert Burns ,&nbsp;Alejandra Benitez,&nbsp;Michael Sielski","doi":"10.1016/j.socscimed.2025.118593","DOIUrl":"10.1016/j.socscimed.2025.118593","url":null,"abstract":"<div><div>Compared to its impact on price and cost, much less is known about the impact of hospital consolidation on quality. This is remarkable given that prospective quality improvements are often the main benefit cited by consolidation proponents. This paper develops a two-part conceptual model that explores the circumstances and motivations under which consolidating hospitals would also decide to take actions which increase quality. It briefly reviews more than three decades of research findings that provide little evidence for claims of improved quality from consolidation. It analyzes four sets of circumstances that might predict such quality-improving actions, and finds little evidence that any of them follow mergers. The paper explores firm profit maximization as the hospital's objective but then considers an alternative model in which any financial surplus generated by consolidation is be invested in quality improvement by a utility-maximizing nonprofit firm.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"386 ","pages":"Article 118593"},"PeriodicalIF":5.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the relationship between depressive symptoms, allostatic load, and income inequality in US adults aged 20 and older","authors":"Khushbu Balsara ,&nbsp;Ali Iftikhar ,&nbsp;Emmanuel Animashaun ,&nbsp;Shervin Assari ,&nbsp;Hossein Zare","doi":"10.1016/j.socscimed.2025.118594","DOIUrl":"10.1016/j.socscimed.2025.118594","url":null,"abstract":"<div><h3>Background</h3><div>Allostatic load, reflecting the cumulative physiological impact of persistent stress on the body, has been recognized as a correlate of physical health outcomes. Despite well-documented associations between allostatic load and physical health, there is limited understanding of its connections to depressive symptoms. In particular, less is known about how socioeconomic status (SES) may moderate this relationship, despite theoretical rationale for such an interaction.</div></div><div><h3>Objective</h3><div>This study utilizes large diverse nationally representative data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between allostatic load, depression, and poverty-to-income-ratio (PIR).</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional secondary analysis of NHANES data (2005–2018) for adults (defined as 20-year or older), exploring the link between allostatic load (AL), measured through various physiological markers, and depressive symptoms assessed with the Patient Health Questionnaire (PHQ). The analysis included weighted binomial regressions to report Incidence Rate Ratio (IRR) that controlled socioeconomic status and health-related behaviors.</div></div><div><h3>Results</h3><div>After controlling socioeconomic status and health-related behaviors, our findings demonstrate a significant association between high allostatic load and increased depressive symptoms (IRR: 1.22, CI = 1.13–1.32). This suggests that the physiological toll of chronic stress, as captured by allostatic load, is independently linked to elevated levels of depressive symptoms in a nationally representative sample.</div></div><div><h3>Conclusion</h3><div>This study contributes to the understanding of the association between physiological stress, allostatic load and PIR on a national scale. It underscores the importance of recognizing allostatic load as a potential target for interventions aimed at preventing or mitigating depressive symptoms in the population.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118594"},"PeriodicalIF":5.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood affluence and cognitive decline: Moderation by race?","authors":"Mallory J. Bell","doi":"10.1016/j.socscimed.2025.118595","DOIUrl":"10.1016/j.socscimed.2025.118595","url":null,"abstract":"<div><div>Prior research indicates that neighborhood affluence is associated with better cognitive function in later life, yet we are relatively unaware if this benefit extends equally to White and Black adults. In the current study, I use three-level growth curve models and data from the Health and Retirement Study geocoded to data from the National Neighborhood Data Archive (N = 13,384) to examine the relationship between neighborhood affluence, race, and changes in cognitive function over a decade. Results indicate that neighborhood affluence was associated with higher baseline levels of cognitive function, and this relationship was more pronounced for Black adults. Cognitive function declined as respondents aged over the study period, yet neighborhood affluence, as well as its interaction with race, was not related to change in cognitive function. These findings suggest that neighborhood affluence is a salient contextual resource linked to racial disparities in cognitive function.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118595"},"PeriodicalIF":5.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It seems that climate change is already harming us all”: Complex climate change, health, and socio-ecological risks for Mexican fishing communities","authors":"M. Banuet-Martinez ,&nbsp;A.J. Hernandez-Velasco ,&nbsp;C.A. Dominguez-Sanchez ,&nbsp;M.J. Espinosa-Romero ,&nbsp;F. Vera-Velazquez ,&nbsp;S.A. Sandoval-Arauz ,&nbsp;S.C. Vazquez-Murillo ,&nbsp;S.C.P.P. Ensenada ,&nbsp;S.C.P.P. Buzos y Pescadores de la Baja California ,&nbsp;S.S. Yamamoto ,&nbsp;S.L. Harper","doi":"10.1016/j.socscimed.2025.118548","DOIUrl":"10.1016/j.socscimed.2025.118548","url":null,"abstract":"<div><div>Climate change impacts on the ocean increasingly challenge coastal communities’ livelihoods, food security, cultural heritage, health, and well-being. While these impacts are unfolding in real time for small-scale fisheries (SSF) in the Global South, research examining the human health dimensions of these climate-induced disruptions is nascent. Therefore, we documented diverse experiences of climate change impacts on marine ecosystems, characterized climate-socio-ecological factors that shape health and wellbeing, and identified barriers and enablers of health-related climate change adaptation in Mexican fishing communities.</div><div>Drawing on a community-based approach and prioritizing the voices of fishing communities, we partnered with two fishing cooperatives on the Pacific coast of Baja California. We employed an integrative qualitative methodology, combining daily-routine accompaniment methods, open-ended interviews, and photo-elicitation techniques to capture community members' perspectives, emotions, and local knowledge (n = 54). Data were analysed using reflexive thematic analysis and are presented through detailed narratives. Fishers explained how environmental changes impacted local livelihoods, intergenerational knowledge systems, and challenged cultural identities and ways of life. Community members described the importance of ecosystem interactions and public health, including how the ocean underpins mental and physical health, and overall well-being. Finally, fishers noted different adaptation barriers, including local to national challenges such as infrastructure, regulations, and gender roles, as well as international pressures. They also described adaptation enablers, including ecosystem-based and social-based strategies, particularly related to conservation efforts. This study highlights how fishing communities’ experiences and knowledge, enduring cultural narratives, and collective sustainability efforts shape local climate change responses and resilience, supporting health and well-being.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118548"},"PeriodicalIF":5.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}