Public Health最新文献

{"title":"Investigating the contextual drivers and factors impacting child growth failure in mining communities: A Structural Equation Modeling approach","authors":"Herbert Tato Nyirenda,&nbsp;David Mulenga,&nbsp;Hilda Nyambe-Silavwe","doi":"10.1016/j.puhe.2025.105801","DOIUrl":"10.1016/j.puhe.2025.105801","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate contextual drivers impacting child growth-failure.</div></div><div><h3>Study design</h3><div>Employed a cross-sectional study design.</div></div><div><h3>Methods</h3><div>The study Comprised a random sample of 781 under-five children and their caregivers. Structured interviews were conducted with caregivers, and anthropometric measurements were taken from the children. Bivariate chi-square, Structural Equation Modeling and multivariate logistic regression analyses were performed.</div></div><div><h3>Results</h3><div>Over half (51 %) of the children were female. On average, households consisted of 6.1 ± 2.7 SD persons. Primary caregivers had an average age of 24.2 ± 9.4 while the children's average age was 21.3 ± 15.7 SD months. The average height of children was 80.4 ± 13.7 SD with a height-for-age Z-Score of 0.2 ± 4.9 SD. Further, 35 % of children experience child growth failure. Drivers include; age-caregiver [AOR = 1.04, 95 % CI = 1.028–1.056], high-school education [AOR = 0.24, 95 % CI = 0.089–0.677], unemployment-housewife [AOR = 0.45, 95 % CI = 0.226–0.901], feeding-strategies [AOR = 0.39, 95 % CI = 0.226–0.663] and cooking-duration [AOR = 2.16, 95 % CI = 1.131–4.129].</div></div><div><h3>Conclusion</h3><div>Child growth failure remains a concern, with individual and contextual-level factors identified as significant contributors and thus crucial to take them into account when designing nutrition interventions in vulnerable communities.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105801"},"PeriodicalIF":3.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242662","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":"Pre-pandemic national immunisation programme strength and health workforce capacity improved routine immunisation resilience during the COVID-19 pandemic","authors":"Beth Evans ,&nbsp;Laurent Kaiser ,&nbsp;Olivia Keiser ,&nbsp;Thibaut Jombart","doi":"10.1016/j.puhe.2025.105813","DOIUrl":"10.1016/j.puhe.2025.105813","url":null,"abstract":"<div><h3>Objectives</h3><div>The adverse impact of the COVID-19 pandemic on Routine Immunisation (RI) coverage has been well-documented: most countries experienced backsliding or stagnation in coverage. Qualitative surveys indicated potential causes of declines, including reduced health care seeking behaviour, lockdowns, and overwhelmed health systems. We investigate country-level determinants of RI resilience during COVID-19 globally to inform the evidence base on maintaining robust immunisation systems in times of crises.</div></div><div><h3>Study design</h3><div>Ecological, secondary data analysis with multivariate modelling.</div></div><div><h3>Methods</h3><div>We employ two methods: stepwise linear regression based on a causal inference framework, and Random Forest regression on a dataset comprising 13 potential determinants (spanning pre-pandemic immunisation programme performance, health workforce capacity, health systems strength, financing, global health security preparedness, COVID-19 burden, COVID-19 policy responses) and covering 151 countries from 2020 to 2022.</div></div><div><h3>Results</h3><div>We provide evidence that stronger pre-pandemic immunisation programmes (<em>p</em> &lt; 0.0001) and more health workers (<em>p</em> = 0.0065), once above minimum thresholds (78 % Diphtheria-Tetanus-Pertussis third-dose coverage and 58 health workers per 10,000 people), are associated with improved RI resilience. Random Forest analysis suggests health financing and health system strength impact RI resilience. Reassuringly, we do not find evidence that COVID-19 vaccination campaigns nor pandemic containment policies impacted RI – counter to qualitative survey indications.</div></div><div><h3>Conclusion</h3><div>Our findings underscore the role of robust immunisation programmes and sufficiently sized health workforces in mitigating RI disruption during global health crises, once above minimum thresholds. A large fraction of variation in pandemic RI resilience remained unexplained through our population-level analyses.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105813"},"PeriodicalIF":3.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255303","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 jab is not a vaccine; it's a ‘shot’","authors":"Zsófia Demjén ,&nbsp;Elena Semino ,&nbsp;Richard Gleave","doi":"10.1016/j.puhe.2025.105815","DOIUrl":"10.1016/j.puhe.2025.105815","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous work identified a new type of vaccine scepticism on social media centred around questioning the status of the COVID-19 vaccine as a vaccine, partly by contrasting ‘vaccine’ with ‘shot’. This study aimed to investigate whether this scepticism also manifests with a contrast between ‘vaccine’ and ‘jab’, a term more commonly used in parts of the United Kingdom.</div></div><div><h3>Study design</h3><div>Corpus-based discourse analysis.</div></div><div><h3>Methods</h3><div>Using a corpus of 261,203 tweets focused on the MMR vaccine, we used collocations and concordancing to identify instances of ‘jab’ and its variants that co-occurred with references to COVID-19. We qualitatively examined 50 % of the relevant tweets (n = 319) to identify any that undermined the status of the COVID-19 vaccines as vaccines.</div></div><div><h3>Results</h3><div>18 % (n = 59) of the examined tweets used ‘jab’ to undermine the status of the COVID-19 vaccine as a vaccine. A ‘jab’ was seen as inferior to a ‘vaccine’ on the basis that it did not prevent infection. Although this contrast mostly focused on the COVID-19 vaccine, some tweets also referenced the flu vaccine as another example that is therefore not a vaccine.</div></div><div><h3>Conclusions</h3><div>Our analysis showed that ‘jab’ and its variants are seen to indicate an intervention that is inferior to vaccination, similarly to ‘shot’ in previous work. This evidence suggests that ‘jab’ and its variants are best avoided in public health campaigns designed to encourage uptake of vaccinations in the UK.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105815"},"PeriodicalIF":3.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242663","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":"Cigarettes, pints, and sports: Do they moderate or mediate the association between workload and well-being of healthcare providers?","authors":"Zilong Li ,&nbsp;Xidong Guo ,&nbsp;Yanrong He ,&nbsp;Lijun Shen ,&nbsp;Hange Li ,&nbsp;Peicheng Wang ,&nbsp;Jiming Zhu","doi":"10.1016/j.puhe.2025.105793","DOIUrl":"10.1016/j.puhe.2025.105793","url":null,"abstract":"<div><h3>Objectives</h3><div>This study studied how health-related behaviours moderated or mediated the potential negative impacts of workload on well-being of healthcare providers, and examined their dynamic and heterogeneous effects on primary care physicians and residents.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>The study population was junior healthcare providers, who enrolled in a standardised primary care training track in China. A total of 14,315 surveys were distributed between December 2021 and February 2022, resulting in 9,208 valid responses from 17 provinces. The outcome variable was well-being, which was measured on a scale ranging from 1 to 5. The main explanatory variable was weekly working hours. Health-related behaviours included drinking, smoking, and exercising. OLS regression was used for moderation and mediation analyses.</div></div><div><h3>Results</h3><div>Healthcare providers reported an average of 50.86 working hours weekly, with a mean well-being score of 3.3. The proportions of providers who drinking alcohol, smoking, and exercising were 45 %, 6.9 %, and 63 %, respectively. Moderation analysis revealed that drinking had positive moderating effects in mitigating the adverse impact of workload on well-being, but these diminished as drinking frequency increased. Exercising also had positive moderating effects, with greater magnitudes. Smoking showed no moderating effect. Only exercising functioned as a mediator.</div></div><div><h3>Conclusions</h3><div>Regular exercising and low frequency of drinking both positively moderated the negative effects of workload on well-being, with exercise showing a stronger effect. Heavy workloads limited providers’ time for exercise, which further reduced their well-being. Smoking should be avoided, as it showed no beneficial effects on well-being.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105793"},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203308","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":"Teachers’ experiences in co-creating an implementation plan for a public health intervention: a Health CASCADE study","authors":"Janneke de Boer ,&nbsp;Lea Rahel Delfmann ,&nbsp;Lauren McCaffrey ,&nbsp;Greet Cardon ,&nbsp;Teatske Altenburg ,&nbsp;Benedicte Deforche ,&nbsp;Veerle Van Oeckel ,&nbsp;Maïté Verloigne","doi":"10.1016/j.puhe.2025.105784","DOIUrl":"10.1016/j.puhe.2025.105784","url":null,"abstract":"<div><h3>Objectives</h3><div>When co-creating school-based public health interventions, it is crucial to involve teachers alongside students as they are often deliverers of the school-based intervention (components), and fulfil a key role in the implementation of the intervention. This study investigates teachers’ experiences during the co-creation process of developing an implementation plan of a healthy sleep intervention.</div></div><div><h3>Study design</h3><div>Qualitative observational study.</div></div><div><h3>Methods</h3><div>Experiences of teachers involved in the action group (<em>n</em> = 6) were derived from transcripts of all co-creation sessions (<em>n</em> = 6) and one semi-structured focus group. Reflexive thematic analysis (RTA) in NVivo 14 was performed.</div></div><div><h3>Results</h3><div>The co-creation process took place within the highly demanding school context, which influenced teachers' co-creation experience. Teachers preferred a guided process, to make efficient use of their time. Positive experiences were principal support, the ability to share their opinion, and decision-making power. Negative experiences were inter-role conflict, low group cohesion due to the high absence level, and lacking support of their fellow colleagues. In addition, misunderstanding the aim of the co-creation process impacted teachers’ motivation, as they expected to focus on the health problem rather than developing an implementation plan to tackle the health problem among adolescents.</div></div><div><h3>Conclusions</h3><div>Since teachers are not trained as health promotors, co-creation processes for implementing school-based public health interventions should be guided by researchers. These processes should incorporate capacity-building activities to enhance teachers’ knowledge and skills in the health topic and intervention implementation, while minimising time demands to facilitate their participation.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105784"},"PeriodicalIF":3.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194861","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":"Educational interventions for the adoption of healthy lifestyles and improvement of health literacy: a systematic review","authors":"Marta Estrela ,&nbsp;Catarina Leitão ,&nbsp;Vanessa Neto ,&nbsp;Beatriz Martins ,&nbsp;João Santos ,&nbsp;Ana Branquinho ,&nbsp;Adolfo Figueiras ,&nbsp;Fátima Roque ,&nbsp;Maria Teresa Herdeiro","doi":"10.1016/j.puhe.2025.105788","DOIUrl":"10.1016/j.puhe.2025.105788","url":null,"abstract":"<div><h3>Objectives</h3><div>Health literacy constitutes an array of skills and knowledge that has the potential to empower one's ability to actively – and effectively - engage in their own health. Educational interventions can play a fundamental role in improving people's health literacy, which is, in turn, associated with the adoption of healthier lifestyles and a significant predictor of positive health outcomes. This study aimed to analyse the effect of educational interventions on both health literacy and the adoption of healthier lifestyles.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>The search was performed in PubMed, EMBASE, Scopus and Web of Science in April 2023. The screening was performed by three independent reviewers, following the PRISMA guidelines. All the included articles were critically evaluated through Cochrane's RoB 2 and ROBINS-I quality assessment tools.</div></div><div><h3>Results</h3><div>11290 records were obtained through database searches, of which 12 studies were found to be eligible as they agreed with the inclusion criteria. These 12 interventions included a total of 3407 participants, (n = 2757 who received the educational interventions, n = 650 belonging to the control groups). While the impact of educational interventions on health literacy was explored in all the included studies, lifestyle variables differed from study to study, ranging from nutrition and to physical activity to mental health, social and environmental well-being, among others.</div></div><div><h3>Conclusions</h3><div>This review provides evidence supporting the effectiveness and relevance of educational interventions containing interactive strategies, in positively changing health literacy levels, lifestyle behaviors such as diet, physical activity, and other health outcomes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105788"},"PeriodicalIF":3.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203309","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 effectiveness of orienteering exercise on improving physical fitness and cognitive functions in non-athletes: a systematic review and meta-analysis","authors":"Hsin-Yen Yen ,&nbsp;Hao-Yun Huang ,&nbsp;Tzu-Yu Lin","doi":"10.1016/j.puhe.2025.105789","DOIUrl":"10.1016/j.puhe.2025.105789","url":null,"abstract":"<div><h3>Objectives</h3><div>Orienteering exercise combines physical and cognitive function training, but its interventional effects remain unclear. Hence, in this study, we examined the effectiveness of orienteering exercise interventions in improving physical fitness and cognitive functions by a systematic review, meta-analyses, subgroup analyses, and meta-regression.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Nine electronic databases were searched in September 2024; after evaluation, 1360 studies were initially selected, but only ten studies were ultimately included in the systematic review and meta-analysis. Random-effect models were used for all analyses.</div></div><div><h3>Results</h3><div>The meta-analytical results revealed significant large effects of orienteering exercise interventions on physical fitness and memory, and a medium effect on spatial skills in all included studies. Results of the moderator analysis showed a significant difference in attention improvement across all moderators, including the study design, population, teaching experiments, and various orientation types. Regarding orientation types of interventions, the introductory teaching strategy showed a significantly better effect on physical fitness, and memory training strategies showed a significantly better effect on attention.</div></div><div><h3>Conclusions</h3><div>The effects of orienteering exercise interventions on improving physical fitness and cognitive functions are promising. Orienteering exercise interventions are recommended for all age groups across various settings, including in schools for children and adolescents and in community settings for older adults. Additionally, a well-designed and identified intervention course could be a valuable resource for health-promotion scholars and policymakers.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105789"},"PeriodicalIF":3.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194862","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 comparative analysis of integrated comprehensive care models: Lessons Canada can learn from East Africa","authors":"Sumenjit Waraich,&nbsp;Sarrah Lal","doi":"10.1016/j.puhe.2025.105795","DOIUrl":"10.1016/j.puhe.2025.105795","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigates integrated comprehensive care (ICC) models in different geographical contexts reflecting diverse population needs. Using a target innovation profile framework, it describes fundamental ICC building blocks to create a universally adaptable ICC model. This mode presents opportunities for enhancing public health service delivery in Canada and East Africa.</div></div><div><h3>Study design</h3><div>A descriptive comparative study that uses qualitative methods to determine critical success factors of ICC models.</div></div><div><h3>Methods</h3><div>Researchers completed a literature review of 14 international ICC models and validated findings through surveys with 29 healthcare professionals from Canada, the United States, Uganda, the Democratic Republic of the Congo, and Australia. Interviews were conducted with 7 health professionals to deepen insights for ICC in East Africa and Canada.</div></div><div><h3>Results</h3><div>Literature indicated that timely accessibility, patient and family involvement, partnerships with community partners, a single healthcare team, resources in preventative care, and consideration of social determinants of health were essential aspects of ICC models. Surveys and interviews highlighted opportunities to increase preventative care resource allocation and to improve community-level health accessibility in the Canadian context through knowledge sharing from East African advanced community care approaches.</div></div><div><h3>Conclusion</h3><div>By establishing the essential elements of ICC models and differences across geographic contexts, we demonstrate a specific example where knowledge mobilization efforts would enhance public health systems globally. With integration of health systems being of interest globally, there is a compelling reason to continue learning from each other to enhance health service delivery.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105795"},"PeriodicalIF":3.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194857","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 future patterns of displacement and its escalating global health needs","authors":"Saverio Bellizzi ,&nbsp;Shatha Elnakib ,&nbsp;Mohammad Darwish","doi":"10.1016/j.puhe.2025.105800","DOIUrl":"10.1016/j.puhe.2025.105800","url":null,"abstract":"<div><h3>Objectives</h3><div>The Global Displacement Forecast Report 2025 aims to project trends in forced displacement globally, with a specific focus on the health outcomes of displaced populations. This article aims to offer primary drivers of displacement, assess the associated health impacts, and propose policy and operational responses to address the humanitarian and public health consequences.</div></div><div><h3>Study Design</h3><div>This is a brief report that reflects a policy analysis leveraging quantitative modeling with qualitative assessments.</div></div><div><h3>Methods</h3><div>The report reflects on future displacement trends through 2026. It analyzes conflict data, climate indicators, humanitarian funding trends, and health system capacities to assess displacement risks and impacts.</div></div><div><h3>Results</h3><div>The report forecasts an increase of 6.7 million forcibly displaced persons by the end of 2026, bringing the global total to over 130 million. Key displacement drivers include armed conflict, targeted violence (including attacks on healthcare), climate-related disasters, and shrinking humanitarian funding. Displacement is found to significantly exacerbate health crises, with rising rates of malnutrition, infectious diseases, and mental health disorders.</div></div><div><h3>Conclusions</h3><div>Displacement is evolving into a long-term structural phenomenon, driven by interconnected factors of conflict, climate change, and governance failure. Addressing its health dimensions requires integrated, anticipatory approaches, including the inclusion of displaced populations in national health systems, expansion of mobile and cross-border health services, and restoration of humanitarian funding.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105800"},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185392","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":"Interventions to reduce wait times in emergency departments in Canadian hospitals: A scoping review","authors":"Dipika Shankar Bhattacharyya ,&nbsp;Elena Neiterman ,&nbsp;Christina Mac ,&nbsp;Kylem Cheung ,&nbsp;Emily Dang ,&nbsp;Armaan Jaffer ,&nbsp;Brent McCready-Branch ,&nbsp;Alisha Gauhar ,&nbsp;Zahid A. Butt","doi":"10.1016/j.puhe.2025.105778","DOIUrl":"10.1016/j.puhe.2025.105778","url":null,"abstract":"<div><h3>Objectives</h3><div>Prolonged wait times in Canada's Emergency Departments (EDs) adversely impact patients, hospital staff, and the healthcare system. Despite the growing literature on ED wait times in Canada, our understanding of what strategies work to reduce wait time remains sporadic due to the absence of a current, comprehensive mapping of the interventions implemented within EDs. This scoping review aims to address this gap and map ED interventions in Canada, which may be useful for policymakers and healthcare professionals to make evidence-informed decisions.</div></div><div><h3>Study design</h3><div>Scoping Review.</div></div><div><h3>Methods</h3><div>Utilizing Arksey and O'Malley's methodological framework, we summarized peer-reviewed articles on interventions in Canadian EDs from January 2010 to May 2024. To categorize and interpret the diverse interventions, we conducted a narrative synthesis using Braun and Clark's thematic analysis method.</div></div><div><h3>Results</h3><div>We identified 21 articles, predominantly focusing on Ontario (n = 16). Most studies utilized retrospective evaluations (n = 16), followed by cluster randomized trials (n = 2), quasi-experimental design (n = 1), prospective survey (n = 1), and before-after design (n = 1). Nearly all were in high-volume urban EDs, with one in a rural setting. Interventions were categorized into five themes: Alternative Location, Financial Incentives, Health Workforce Enhancement, Process Improvement, and Integrated Intervention. While alternative ED locations, health workforce enhancement, and integrated approaches showed promise in reducing ED wait times, financial incentives and process improvement initiatives showed mixed results.</div></div><div><h3>Conclusions</h3><div>The reviewed interventions focused on strengthening ED operational efficiencies, but sustainable wait time reduction necessitates multifaceted, context-specific approach. Future research should consider broader health system challenges and ED contextual issues.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105778"},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185393","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}