Public Health最新文献

{"title":"Lifelong associations between childhood multimorbidity and early-onset and late-onset dementia: A multi-cohort study","authors":"Ziyang Ren ,&nbsp;Xuefen Zhang ,&nbsp;Lei Cao ,&nbsp;Linlin Wang ,&nbsp;Leah Li ,&nbsp;Jufen Liu","doi":"10.1016/j.puhe.2025.105768","DOIUrl":"10.1016/j.puhe.2025.105768","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies have investigated associations between childhood illness and health outcomes in early adulthood. Nevertheless, little evidence is available on the associations of childhood chronic conditions and multimorbidity with Alzheimer's disease and related dementias (ADRD) in mid-to-old age.</div></div><div><h3>Study design</h3><div>Multi-cohort study.</div></div><div><h3>Methods</h3><div>We conducted a multi-cohort study using the Survey of Health, Ageing and Retirement in Europe, English Longitudinal Study of Ageing and Health and Retirement Study. We included eight retrospectively reported childhood chronic diseases that were diagnosed by a doctor before 15/16y and defined multimorbidity as≥2 diseases. The associations with new-onset, early-onset (&lt;65y) and late-onset (≥65y) ADRD were estimated using subdistribution hazard ratios (sHRs) and Aalen's additive hazard model (i.e., absolute risk). Results were pooled across cohorts using weighted random-effect meta-analysis.</div></div><div><h3>Results</h3><div>A total of 135,588 participants aged ≥ 50y were followed up for an average of around eight years. Childhood multimorbidity was associated with higher risk of new-onset ADRD: sHR = 1.44 (95 % CI: 1.25–1.66) after adjusting for demographic and early-life factors, corresponding to excess incidence density of 223.3 per 100,000 person-years. The association was stronger with early-onset ADRD than late-onset ADRD: sHR = 2.50 (1.84–3.41) vs 1.25 (1.07–1.47), corresponding to the excess incidence density of 217.1 and 230.7 per 100,000 person-years. Of individual childhood chronic diseases, migraine, epilepsy and psychiatric disorders showed the strongest association with ADRD.</div></div><div><h3>Conclusions</h3><div>Childhood multimorbidity was associated with increased risk of ADRD in late life, highlighting the importance of preventing childhood diseases, especially neuropsychiatric conditions, to mitigate the burden of ADRD in older adults.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105768"},"PeriodicalIF":3.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the EAT-Lancet diet reduces the risk of renal cancer: Results from a population-based prospective study","authors":"Qi Wei ,&nbsp;Mingying Yang ,&nbsp;Zhiyong Zhu ,&nbsp;Ling Xiang ,&nbsp;Yaxu Wang ,&nbsp;Linglong Peng ,&nbsp;Yunhao Tang ,&nbsp;Shijiang Deng ,&nbsp;Haitao Gu","doi":"10.1016/j.puhe.2025.105739","DOIUrl":"10.1016/j.puhe.2025.105739","url":null,"abstract":"<div><h3>Objectives</h3><div>The EAT-Lancet diet (ELD) has shown potential in reducing obesity and type 2 diabetes, both of which are closely associated with the development of renal cancer. However, the specific relationship between this dietary pattern and renal cancer remains largely unexplored. This study aims to address this gap in knowledge by investigating the association between ELD adherence and renal cancer risk.</div></div><div><h3>Study design</h3><div>A population-based prospective study of 101,755 American adults from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.</div></div><div><h3>Methods</h3><div>Cox proportional hazards models were utilized to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between ELD adherence and renal cancer risk, adjusting for potential confounders. Restricted cubic spline plots visualized the dose-response relationship. Subgroup analyses evaluated potential effect modifiers, and sensitivity analyses assessed the robustness of findings.</div></div><div><h3>Results</h3><div>Over 899,337.5 person-years of follow-up, 446 cases of renal cancer were identified. In the fully adjusted model, a significant inverse association was observed between higher ELD adherence and renal cancer risk (HR for highest <em>vs.</em> lowest quartile: 0.65; 95 % CI: 0.49–0.88; <em>P</em> for trend = 0.002). A restricted cubic spline plot revealed a nonlinear, inverse dose-response relationship (<em>P</em> for nonlinearity = 0.046). Subgroup analyses showed consistent findings across participant characteristics. Sensitivity analyses further reinforced the robustness of the primary association.</div></div><div><h3>Conclusions</h3><div>In this large prospective study, adherence to the EAT-Lancet diet was inversely associated with the risk of developing renal cancer, suggesting the potential benefits of this dietary pattern in mitigating renal cancer burden.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105739"},"PeriodicalIF":3.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal health checkup access pattern following a triple disaster using latent class growth analysis: The Fukushima Health Management Survey","authors":"Yurie Kobashi ,&nbsp;Yoshitake Takebayashi ,&nbsp;Masaharu Tsubokura ,&nbsp;Tetsuya Ohira ,&nbsp;Akira Sakai ,&nbsp;Kanako Okazaki ,&nbsp;Michio Shimabukuro ,&nbsp;Hitoshi Ohto ,&nbsp;Seiji Yasumura","doi":"10.1016/j.puhe.2025.105755","DOIUrl":"10.1016/j.puhe.2025.105755","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to assess the longitudinal patterns of access to health checkups among residents of municipalities most affected by the triple disaster in Fukushima, Japan.</div></div><div><h3>Study design</h3><div>A prospective cohort study.</div></div><div><h3>Methods</h3><div>Participants included residents in 12 municipalities in Fukushima, Japan. All residents in these municipalities were eligible for the Comprehensive Health Check between 11 March 2011 and 1 April 2012. Data were sourced from the Fukushima Health Management Survey in 2021. A total of 167,479 participants aged ≥20 years at the time of the Great East Japan earthquake disaster, with complete data on age, sex, municipality (2011, 2017) and health checkup visits between 2011 and 2018, were analysed. Annual health checkup participation rates were also reported. Latent class growth analysis was performed to classify the trajectory of access to health checkups, and multinomial logistic regression analysis was performed to determine factors associated with each group.</div></div><div><h3>Results</h3><div>In total, 29.7 % of participants accessed the health checkup in 2011, decreasing to 19.9 % in 2018. This study identified the following three longitudinal health checkup pattern groups: (1) frequent access to health checkups (15.2 %); (2) declining access to checkups (19.3 %); and (3) rare access to checkups (65.5 %). Notably, females and older adults were positively associated with frequent health checkup participation.</div></div><div><h3>Conclusions</h3><div>Participation in health checkups declined over time following the disaster. Comprehensive strategies are needed to promote participation in health checkups.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105755"},"PeriodicalIF":3.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of health literacy intervention on reducing sugar or sugar-sweetened beverage consumption in Asian populations: A systematic review","authors":"Yuan Yi Chew ,&nbsp;Mari Kannan Maharajan ,&nbsp;Divya Gopinath ,&nbsp;Kingston Rajiah","doi":"10.1016/j.puhe.2025.105750","DOIUrl":"10.1016/j.puhe.2025.105750","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the effectiveness of health literacy interventions aimed at reducing sugar and sugar-sweetened beverage (SSB) intake among Asian populations and identified the common characteristics of effective interventions through a systematic review of randomised and non-randomised studies.</div></div><div><h3>Study design</h3><div>Systematic review of randomised and non-randomised trials.</div></div><div><h3>Methods</h3><div>A systematic search of five databases identified randomised and non-randomised studies on health literacy interventions aimed at reducing sugar and SSB intake among Asian populations. Screening followed predefined criteria, and data extraction captured the intervention type, delivery, duration, and outcomes. Quality was assessed using the Cochrane Risk of Bias-2 and ROBINS-I tools for bias, and the findings were synthesised to identify effective intervention traits and research gaps.</div></div><div><h3>Results</h3><div>Of the eight included studies, three were face-to-face educational, one behavioural, one online, one mobile text messaging, and two front-of-pack (FOP) labelling interventions. Six out of eight studies measured sugar intake, with four assessing SSB intake. Seven studies reported significant dietary improvements. Overall, bias risk was present, with three rated high. Significant inconsistencies in the two studies were further explored.</div></div><div><h3>Conclusion</h3><div>The effectiveness of health literacy interventions in reducing sugar or sugar-sweetened beverage intake was positive, particularly for face-to-face interventions and FOP labels. Available evidence may inform policymaking for the implementation of health promotion for disease prevention and complement standards of care practices for disease management.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105750"},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The longitudinal association between second-hand smoke exposure and maternal depression among non-smoking pregnant women in East China: A prospective birth cohort study","authors":"Shufang Leng ,&nbsp;Dongjian Yang ,&nbsp;Wenlian Li ,&nbsp;Zhiwei Liu ,&nbsp;Hong Li","doi":"10.1016/j.puhe.2025.105760","DOIUrl":"10.1016/j.puhe.2025.105760","url":null,"abstract":"<div><h3>Objectives</h3><div>Second-hand smoke (SHS) exposure during pregnancy is common and may negatively impact maternal mental health. Recent evidence on the association between SHS exposure and depression during pregnancy remains inconsistent. This study aims to examine the longitudinal association between SHS exposure and maternal depression.</div></div><div><h3>Study design</h3><div>A prospective birth cohort study.</div></div><div><h3>Methods</h3><div>From October 2017 to September 2021, we conducted a prospective birth cohort study including 5311 pregnant women. We applied mixed-effects models and group-based multivariate trajectory modeling to estimate the longitudinal association between SHS exposure and depression during pregnancy.</div></div><div><h3>Results</h3><div>The prevalence of depression during pregnancy was 40.61 %, 19.00 %, and 20.35 % in the first, second, and third trimesters, respectively; 50.52 % of the women were exposed to SHS during pregnancy. Compared to unexposed women, those with SHS exposure had higher odds of depression in the first (OR: 1.34, 95 % CI: 1.19–1.51), second (OR: 1.70, 95 % CI: 1.45–1.98), and third trimesters (OR: 1.71, 95 % CI: 1.47–1.99). Exposure in one, two, or three trimesters showed progressively stronger associations (ORs: 1.37, 1.89, 2.08, respectively). SHS exposure was associated with an increased trajectory of depression (OR: 1.38, 95 % CI: 1.05–1.81). The association between SHS and depression was more pronounced among unemployed mothers who had good sleep quality during pregnancy.</div></div><div><h3>Conclusions</h3><div>Exposure to SHS during pregnancy affects current and subsequent depression. Addressing SHS exposure is essential to promote mental health and improve the health outcomes of mothers and offspring.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105760"},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing occupational health literacy in the context of SDGs: Evidence from Sicilian workers","authors":"Ginevra Malta ,&nbsp;Veronica Traversini ,&nbsp;Omer Kocak ,&nbsp;Yuksel Goktas ,&nbsp;Sevda Kucuk ,&nbsp;Emanuele Cannizzaro","doi":"10.1016/j.puhe.2025.105738","DOIUrl":"10.1016/j.puhe.2025.105738","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the levels of Occupational Health Literacy (OHL) among workers in Sicilian companies and identify key predictors of elevated OHL. The research also seeks to highlight the role of OHL in promoting workplace health, reducing inequalities, and contributing to the Sustainable Development Goals (SDGs), particularly SDG 3 (Health and well-being) and SDG 4 (Quality education).</div></div><div><h3>Study design</h3><div>A cross-sectional study was conducted over a three-month period, from September to December 2024, involving a sample of 796 workers from various Sicilian companies.</div></div><div><h3>Methods</h3><div>Participants completed three validated questionnaires: the Occupational Health Literacy Scale (OHLS), the Work Productivity and Activity Impairment Questionnaire (WPAI-GH), and the EQ-5D for assessing quality of life. Logistic regression models were employed to analyze the data and identify predictors associated with elevated OHL levels.</div></div><div><h3>Results</h3><div>Among the participants, 28.8 % demonstrated high levels of OHL, whereas 71.1 % exhibited insufficient levels. Key determinants of elevated OHL included age, gender, and education. Higher education was significantly associated with high OHL levels (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The study underscores the importance of targeted educational interventions to enhance OHL, thereby fostering workplace health and supporting the achievement of SDGs. These findings call for further research to address regional disparities and promote sustainable occupational health and safety practices.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105738"},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not all traders gamble, but some gamblers trade: a latent class analysis of trading and gambling behaviors among retail investors","authors":"Ainhoa Coloma-Carmona ,&nbsp;José Luis Carballo ,&nbsp;Fernando Miró-Llinares ,&nbsp;Jesús C. Aguerri","doi":"10.1016/j.puhe.2025.105742","DOIUrl":"10.1016/j.puhe.2025.105742","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify subgroups of retail investors based on their engagement in trading and gambling activities, and to examine differences in involvement, demographics, substance use, impulsivity, cognitive biases, problem gambling, and disordered trading.</div></div><div><h3>Study design</h3><div>Cross-sectional, population-based study using panel data. Quota sampling and post-stratification weights were applied using data from a prior population-based random digital dial telephone survey.</div></div><div><h3>Methods</h3><div>Data were collected from 1,429 Spanish adults (aged 18–64). Participants reported involvement in trading of 8 financial instruments (e.g., cryptocurrencies, stocks, ETFs) and 12 gambling (e.g., lotteries, sports betting) and gambling-like activities (e.g., loot boxes, skin betting). 28.6 % of respondents engaged in non-professional trading.</div></div><div><h3>Results</h3><div>Using weighted latent class analysis we identified three distinct subgroups of retail investors: <em>crypto-traders</em> (52.4 %), focused on cryptocurrency trading with minimal gambling; <em>stock-traders</em> (32 %), involved in stocks/ETFs and lotteries, and <em>gambling-traders</em> (15.6 %), heavily involved in high-risk trading and various gambling activities. Although <em>gambling-traders</em> were not the highest investors in terms of trading volume, this class exhibited the highest frequency of trading and gambling, impulsivity, gambling-related cognitive biases, rates of disordered trading, and illicit substance use. 24.9 % of <em>gambling-traders</em> scored for problem gambling (PGSI≥8), compared to 0.5 % of <em>crypto-traders</em> and 3.5 % of <em>stock-traders</em>. <strong>Conclusions</strong>: Not all retail investors seem to extend their gambling behaviors to financial markets; however, those with higher impulsive traits and gambling-related cognitive biases tend to combine trading with gambling. This combination is strongly associated with problem gambling and disordered trading.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105742"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of anxiety and associated factors among pregnant women in East Africa: A systematic review and meta-analysis, 2023","authors":"Selam Yibeltal Desalegn ,&nbsp;Asres Eshetie Feleke ,&nbsp;Betelhem Fekadu Germame ,&nbsp;Alemtsehay Wossen Samuel","doi":"10.1016/j.puhe.2025.105759","DOIUrl":"10.1016/j.puhe.2025.105759","url":null,"abstract":"<div><h3>Objectives</h3><div>This review aimed to assess the prevalence of anxiety among pregnant women in East Africa. Additionally, the review seeks to identify the associated risk factors contributing to anxiety during pregnancy within this region.</div></div><div><h3>Study design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted to examine anxiety among pregnant women in East Africa. PubMed, HINARI, Google scholar, and direct Google were searched to retrieve relevant studies. The pooled magnitude of anxiety during pregnancy was estimated using DerSimonian and Laird's random-effects model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were used. Data were extracted in Microsoft Excel sheet and STATA/SE 17 was used for meta-analysis. Using Q and the I² test, heterogeneity among the studies was assessed. Funnel plot and Egger's test were used to test the small study effect.</div></div><div><h3>Results</h3><div>A total of 64 studies were initially identified and evaluated. Of these, ten eligible articles with 4023 participants were included. The overall pooled prevalence of anxiety in East Africa was 29 % (95 % CI; 17 %–40 %).</div></div><div><h3>Conclusions</h3><div>This review demonstrated the high prevalence of anxiety during pregnancy among East African women. and it was significantly associated with having intimate partner violence, primary education status, having unwanted pregnancy, unmarried marital status, poor social support, history of depression, and prim gravidity. It is highly recommended that mental health and maternity services be integrated.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105759"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive exploration of the impact and contribution of polygenic risk score on age at onset of 30 complex diseases","authors":"Yuxin Liu ,&nbsp;Yu Yan ,&nbsp;Yuchen Jiang ,&nbsp;Xinyi Wang ,&nbsp;Hua Lin ,&nbsp;Keying Chen ,&nbsp;Shuo Zhang ,&nbsp;Fengjun Guan ,&nbsp;Pan Zhang ,&nbsp;Ting Wang ,&nbsp;Ke Wang ,&nbsp;Chu Zheng ,&nbsp;Yue Xu ,&nbsp;Ping Zeng","doi":"10.1016/j.puhe.2025.105754","DOIUrl":"10.1016/j.puhe.2025.105754","url":null,"abstract":"<div><h3>Objectives</h3><div>Polygenic risk score (PRS) has increasingly shown promise in predicting disease risk; however, studies examining the influence of PRS on age at onset remain limited. This study aimed to systematically assess the impact of PRS on age at onset across multiple diseases.</div></div><div><h3>Study design</h3><div>Prospective cohort study</div></div><div><h3>Methods</h3><div>We calculated PRS with two methods (C+T and PRS-CS) and compared their predictive capability in age at onset of 30 diseases in the UK Biobank. We next evaluated the effect of PRS on age at onset and quantified the influence of PRS on disease risk across early and late onset cases.</div></div><div><h3>Results</h3><div>PRS-CS behaved better in predicting age at onset of most diseases (except for Alzheimer's disease) compared to C+T. Higher PRS was associated with earlier age at onset for 23 diseases, with the average age at onset advanced by 1.94 years. Compared to women, men faced an advanced onset for 5 diseases. Compared to average PRS (20–80 %), individuals in the top 2.5 % of the PRS distribution displayed a significantly earlier age at onset for 19 diseases, ranging from 2.85 (1.68–4.03) years advancement for gout to 13.70 (9.88–17.52) years advancement for Crohn's disease. Compared to the late-onset group, the early-onset group exhibited a greater onset risk in 21 diseases, with the early-onset risk of colon cancer being 2.78-fold higher than the late-onset risk (OR = 11.42 [9.77–12.45] vs. 3.95 [3.85–4.06], <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Higher PRS generally leads to earlier age at onset, which supports the potential role of PRS in screening high early-onset risk individuals susceptible to chronic diseases.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105754"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving care pathways through evidence-based modeling strategies: a scoping review","authors":"Benjamin du Sartz de Vigneulles ,&nbsp;Romain Lan ,&nbsp;Gérard Mick ,&nbsp;Claude Dussart ,&nbsp;Florence Carrouel","doi":"10.1016/j.puhe.2025.105751","DOIUrl":"10.1016/j.puhe.2025.105751","url":null,"abstract":"<div><h3>Objectives</h3><div>Noncommunicable and communicable diseases represent significant public health problems, heavily straining healthcare systems. The care pathway (CP) concept has emerged as a promising framework to improve care coordination and delivery, but its complexity often hinders implementation. Modeling, with its various methodologies, represents a valuable approach to address this challenge. Systematizing these methodologies is essential for enhancing CPs. This scoping review aims to describe and analyze CP modeling methodologies.</div></div><div><h3>Study design</h3><div>Scoping review.</div></div><div><h3>Methods</h3><div>Following PRISMA-ScR guidelines, searches were performed in PubMed, Web of science and Embase. Inclusion criteria were: (i) publications in English; (ii) human studies, (iii) published between January 1, 2019 and April 3, 2024 and (iv) use of modeling to analyze CPs. For each publication included, data were extracted and categorized based on modeling goals, methods used, functions of the techniques and their respective strengths and limitations.</div></div><div><h3>Results</h3><div>Analysis of the 41 included articles revealed that the main goals of CP modeling were quality of care (46.3 %), continuous improvement (31.7 %), and process optimization (22.0 %). The methods used for modeling were qualitative (41.5 %), quantitative (34.1 %), or mixed (24.4 %). Technical goals were description (48.8 %), decision support (36.6 %), and prediction (14.6 %). Qualitative methods (68.5 %) were common in studies focused on quality of care. Only 11 articles shared similar methodologies across at least two studies. Key weaknesses of CP modeling were data availability and implementation acceptance.</div></div><div><h3>Conclusions</h3><div>This scoping review identified key categories and commonly used methodologies in CP modeling, offering a framework to help researchers and healthcare professionals improve CP design and implementation, leading to better patient outcomes and more efficient healthcare systems.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105751"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}