Public Health最新文献

{"title":"The association between increasing levels of gambling harm and emotional health outcomes for individuals who are below the threshold of disordered gambling: A secondary analysis of health data.","authors":"S Tipping, H Wardle, R Pryce","doi":"10.1016/j.puhe.2025.105899","DOIUrl":"10.1016/j.puhe.2025.105899","url":null,"abstract":"<p><strong>Objectives: </strong>This paper examines the relationship between increasing gambling harm and emotional wellbeing and mental health amongst individuals below the threshold typically used to define high-risk gambling.</p><p><strong>Study design: </strong>Combined data from the Health Survey for England (HSE) and Scottish Health Survey (SHeS), covering 2012, 2015, 2016, 2017 (SHeS only), and 2018 (HSE only). 24,898 individuals aged 16+ in private households.</p><p><strong>Methods: </strong>Mental health and emotional wellbeing were assessed using four self-reported measures: long-term mental health condition (binary), life satisfaction, the General Health Questionnaire (GHQ-12), and the Warwick Edinburgh Mental Health and Wellbeing Scale (WEMWBS). Gambling harm was measured using the Problem Gambling Severity Index (PGSI), only individuals with a PGSI score lower than eight was included in the analysis. The relationship between PGSI and each measure of mental health was explored by plotting risk curves and running regression analysis. The regression models included controls for demographics, gambling participation, and non-lottery gambling in the past 12 months.</p><p><strong>Results: </strong>The plots and regression results indicated r-shaped risk curves for gambling harms on three of the measures of mental health (WEMWBS, GHQ-12 and life satisfaction) for individuals with PGSI scores lower than eight. Associations persisted after adjusting for gambling participation and demographics. No clear evidence linked PGSI scores to long-term mental health conditions.</p><p><strong>Conclusions: </strong>While PGSI scores below eight are typically considered low-risk, small increases in scores at the lower end of the risk spectrum correlate with reduced emotional wellbeing. The r-shaped risk curve suggests associated harms increase most sharply at the lowest levels of the PGSI score, between 1 and 3. Evidence of an association between PGSI scores lower than eight and having a long-term mental health condition was inconclusive.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"247 ","pages":"105899"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812576","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":"Diabetes incidence before and after the pandemic onset in adult subgroups with prediabetes","authors":"Luis A. Rodriguez ,&nbsp;Maher Yassin ,&nbsp;O. Kenrik Duru ,&nbsp;Romain S. Neugebauer ,&nbsp;Brandon Towns ,&nbsp;Tainayah W. Thomas ,&nbsp;Susan D. Brown ,&nbsp;Yelba Castellon-Lopez ,&nbsp;Julie A. Schmittdiel","doi":"10.1016/j.puhe.2025.105969","DOIUrl":"10.1016/j.puhe.2025.105969","url":null,"abstract":"<div><h3>Objectives</h3><div>During the COVID-19 pandemic, type 2 diabetes (T2D) incidence increased, but it remains unclear if different groups were disproportionately affected. We evaluated overall changes in T2D incidence before and during the pandemic and by insurance type, sex, and race/ethnicity subgroups.</div></div><div><h3>Study design</h3><div>Retrospective dynamic cohort.</div></div><div><h3>Methods</h3><div>We included 323,609 adults (≥18–89 years) with prediabetes and BMI ≥25 kg/m² (or ≥23 if Asian) using electronic health record data from Kaiser Permanente Northern California (2019–2021). T2D was defined comprehensively with diagnosis codes, glycemic tests and/or filled diabetes medications. In secondary analyses, T2D was defined by the first diabetes-range lab test among screened adults. Sensitivity analyses addressed screening bias using inverse probability weighting and propensity scores. An interrupted time-series analysis assessed T2D incidence changes following the pandemic onset (March 2020).</div></div><div><h3>Results</h3><div>Before the pandemic, monthly T2D incidence was stable. After the pandemic onset, the monthly trend increased by 6.5 % (−0.2 %, 10.3 %) for comprehensive and 3.2 % (0.6 %, 5.1 %) for lab-only; both trends persisted through 2021. After accounting for differential screening bias this increase remained but was not significant given wider confidence intervals. T2D incidence level for lab-only increased 51 % more among Hispanic vs. White adults and persisted through 2021. No other group differences were observed.</div></div><div><h3>Conclusions</h3><div>The pandemic onset was followed by an increase in T2D incidence overall and with sharper increases among Hispanic adults. This highlights the broader health changes of the pandemic and underscores the need for public health strategies to manage this growing burden.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105969"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201993","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":"Computational ethnography and public health: Scaling and deepening lived experience research on social determinants of health with large language models","authors":"Francis McKay","doi":"10.1016/j.puhe.2025.105973","DOIUrl":"10.1016/j.puhe.2025.105973","url":null,"abstract":"<div><div>This paper examines whether large language models (LLMs) can address a tension in public health between ethnographic research on lived experiences (obtained, for example, through participant observation) and scalable interventions based on quantitative analysis. It puts forward the idea of “computational ethnography” as a potential way to bridge this divide. Computational ethnography is an emerging research paradigm exploring how computational tools, including natural language processing tools like LLMs, might complement traditional ethnographic workflows to improve insights around socio-cultural phenomena including lived experiences of health. This paper reflects on the theoretical and practical potential of LLMs for such purposes, focusing on two key applications: LLM-assisted interviewing and LLM-based analysis. It suggests that LLMs offer opportunities for both scaling and deepening ethnographic research by supplementing interviewing capacities and providing computational assistance for inductive, deductive, and abductive processes of ethnographic analysis. In doing so, it offers potential to identify social determinants of health that traditional population-level studies miss in structured datasets while preserving the contextual understanding that characterises small-scale qualitative studies. However, realising this possibility requires addressing significant ethical, epistemic, and resource challenges that warrant further investigation by the public health community.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105973"},"PeriodicalIF":3.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201985","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":"From individual interventions to structural change: Why public health leadership is needed to engage men and boys in violence prevention","authors":"L.C. Snowdon ,&nbsp;A. Walker ,&nbsp;E.R. Barton ,&nbsp;B. Parry ,&nbsp;S. Pike","doi":"10.1016/j.puhe.2025.105972","DOIUrl":"10.1016/j.puhe.2025.105972","url":null,"abstract":"<div><h3>Objectives</h3><div>To review practice in Wales for engaging men and boys in violence prevention and examine how public health can support effective and coordinated efforts as part of a whole system approach.</div></div><div><h3>Study design</h3><div>A mixed-methods study combining a national mapping survey and qualitative focus group research.</div></div><div><h3>Methods</h3><div>A mapping survey (n = 36) was conducted to identify programmes across Wales aimed at engaging men and boys in violence prevention. In addition, a focus group was held with leads from eight ‘Test and Learn’ pilot projects. Data were analysed thematically to identify key enablers, barriers, and features of promising practice.</div></div><div><h3>Results</h3><div>Programmes varied in focus, target age group, geographical reach, and tier of prevention. Practitioners highlighted the effectiveness of trauma-informed, strengths-based, and culturally relevant approaches. Staff empathy, relationships and coproduction were identified as critical success factors. However, the review also found limited evidence of strategic coordination, evaluation, or long-term investment in this area.</div></div><div><h3>Conclusions</h3><div>Engaging men and boys in violence prevention is vital to addressing the gendered dynamics of perpetration and maximising opportunities for prevention. This research reveals a developing landscape of interventions that, while showing promising elements of trauma-informed, strengths-based practice, remains fragmented and inconsistent in its strategic coordination and evaluation. Realising the full potential of this approach will require public health leadership to move beyond individual behaviour change towards a whole-system approach that addresses the structural drivers of gendered violence.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105972"},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158216","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":"Global strategies to achieve SDG 3.2 for ending preventable deaths of children under-five: A realist review","authors":"William Qian","doi":"10.1016/j.puhe.2025.105967","DOIUrl":"10.1016/j.puhe.2025.105967","url":null,"abstract":"<div><h3>Objectives</h3><div>At current trends, 59 countries are at risk of missing the sustainable development goal (SDG) target of bringing the under-five mortality rate to as low as 2.5 % per live birth by 2030. This article aims to identify effective global strategies for reducing under-five mortality and achieving SDG 3.2 targets.</div></div><div><h3>Study design</h3><div>A realist synthesis method was used to systematically review the literature for evidence in accordance with the “Realist and MEta-narrative Evidence Syntheses: Evolving Standards” (RAMESES) publication standards. The context-mechanism-outcome (CMO) framework was applied to identify how global strategies function across settings.</div></div><div><h3>Methods</h3><div>Studies were identified through systematic searches of MEDLINE, Embase, and Cochrane databases from September 2000 to September 2024, scanning reference lists, and citation searching of key papers. Studies for inclusion described global strategies that contribute to ending preventable deaths in children under-five and achieving SDG 3.2 targets by 2030. Data were extracted using standardised forms and analysed for CMO configurations to identify, analyse, and produce an evidence-based framework of global strategies that contribute to ending preventable deaths in children under-five.</div></div><div><h3>Results</h3><div>Global strategies identified revolved around three core themes: leadership, health sector, and non-health sector factors. Key global strategic areas included increased governance, accountability for resources and results, community-based approaches, and prioritisation of interventions.</div></div><div><h3>Conclusion</h3><div>Multiple global strategies to reduce under-five mortality exist. This evidence-based synthesis of successful strategies, mapped using realist principles, provides a practical guide for policymakers worldwide to prioritise and adapt interventions across diverse country settings to accelerate progress towards achieving SDG 3.2.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105967"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151727","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 interplay of social and family environments in shaping adolescent health behaviours: a population-based study","authors":"Roxane Dumont ,&nbsp;Geraldine Blanchard-Rohner ,&nbsp;Viviane Richard ,&nbsp;Mayssam Nehme ,&nbsp;Klara M. Posfay-Barbe ,&nbsp;Rémy P. Barbe ,&nbsp;Silvia Stringhini ,&nbsp;Idris Guessous ,&nbsp;Elsa Lorthe","doi":"10.1016/j.puhe.2025.105931","DOIUrl":"10.1016/j.puhe.2025.105931","url":null,"abstract":"<div><h3>Objectives</h3><div>Adolescent health behaviours are key determinants of long-term health. We aimed to explore the associations between clusters of families with similar socio-familial characteristics and health behaviours in both adolescents and their parents.</div></div><div><h3>Study design</h3><div>The design of the study is a cross-sectional analysis.</div></div><div><h3>Methods</h3><div>We enrolled adolescents aged 14–17 years and their parents from the SEROCoV-KIDS cohort study (December 2021–June 2022), based in the Canton of Geneva, Switzerland. Marginal logistic regressions were used to compute the sex- and age-adjusted prevalence differences (ΔaPrev) in smoking, alcohol and soda consumption, sport activity, unprotected intercourse, social media addiction, and adherence to COVID-19 vaccination guidelines between socio-familial clusters identified with K-means clustering (disadvantaged vs advantaged).</div></div><div><h3>Results</h3><div>Among 508 adolescents, two socio-familial clusters were identified: a disadvantaged group of 133 individuals characterised by lower socioeconomic status and social support, and an advantaged group of 375 individuals with more favourable socio-familial conditions. Adolescents in the disadvantaged cluster had a significantly higher prevalence of smoking (ΔaPrev 7.4 %; 95 % CI: 1.1; 14.1), daily soda consumption (ΔaPrev 12.9 %; 95 % CI: 2.6; 23.2), reduced sport activity, and lower adherence to COVID-19 vaccination guidelines. Similar patterns were observed among parents. No differences were found in alcohol use, social media addiction, or unprotected intercourse.</div></div><div><h3>Conclusion</h3><div>Large disparities in health behaviours associated with socio-familial environments emerge early in adolescence. It is crucial to adopt a holistic health strategy that recognises the interplay between socio-demographic context, family dynamics, and health behaviours.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105931"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118612","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":"Principles and attributes of evidence-based co-creation: From naïve praxis toward a trustworthy methodology - A Health CASCADE study","authors":"S.F.M. Chastin ,&nbsp;N. Smith ,&nbsp;D.M. Agnello ,&nbsp;Q. An ,&nbsp;T.M. Altenburg ,&nbsp;G. Balaskas ,&nbsp;J. de Boer ,&nbsp;G. Cardon ,&nbsp;M.J.M. Chinapaw ,&nbsp;R. Chrifou ,&nbsp;P.M. Dall ,&nbsp;A. Davis ,&nbsp;B. Deforche ,&nbsp;L.R. Delfmann ,&nbsp;M. Giné-Garriga ,&nbsp;K. Goh ,&nbsp;S.C. Hunter ,&nbsp;C.F. Leask ,&nbsp;S. Lippke ,&nbsp;Q.E.A. Loisel ,&nbsp;K. Wadell","doi":"10.1016/j.puhe.2025.105922","DOIUrl":"10.1016/j.puhe.2025.105922","url":null,"abstract":"<div><h3>Objectives</h3><div>Co-creation is recognised as a promising methodology for addressing complex public health issues by leveraging the collective intelligence of multiple stakeholders to develop tailored solutions. However, there is a lack of clarity and significant fragmentation in the concept. This study aims to define the fundamental attributes and guiding principles of co-creation to establish it as a rigorous, evidence-based, and trustworthy methodology.</div></div><div><h3>Study design</h3><div>A participatory concept mapping process based on the Differentiae Principle was employed.</div></div><div><h3>Methods</h3><div>The study consisted of four stages: 1) systematic extraction of attributes and their definition from traditional scientific and participatory research methodological literature, 2) screening, 3) semantic analysis and clustering into principles using Natural Language Processing and Large Language Models and 4) selection of a final set of attributes and development of principles. The study involved 50 participants with diverse backgrounds within and outside the Health CASCADE Network over 18 months.</div></div><div><h3>Results</h3><div>The study identified 105 candidate attributes. A set of 38 was selected from which 10 key principles were derived (open access, recognised contribution, ethics and legal, transparency, rigorous evaluation, clear problem, plural evidence, critical reflection, diversity, and structured and flexible processes) across three domains: Governance, Scientific and Methodological Rigour, and Collective Intelligence Processes.</div></div><div><h3>Conclusions</h3><div>The attributes and guiding principles provide a comprehensive foundations for evidence-based co-creation, enhancing its trustworthiness, transparency, reliability, and impact in public health and other fields. Future research and practice should use these principles and attributes to refine and implement co-creation effectively.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105922"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118611","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":"Factors affecting public health follow up of acute hepatitis B cases in England","authors":"Leifa Jennings ,&nbsp;Will Morton ,&nbsp;Roberto Vivancos ,&nbsp;Helen Clough ,&nbsp;Merav Kliner","doi":"10.1016/j.puhe.2025.105959","DOIUrl":"10.1016/j.puhe.2025.105959","url":null,"abstract":"<div><h3>Objectives</h3><div>Acute hepatitis B affects over a million people a year globally. Follow up for public health purposes involves vaccination or advising prophylaxis of contacts to reduce transmission. Those lost to follow up are more likely to transmit infection. This study investigated the socio-demographic factors potentially associated with being lost to public health follow up in cases with acute hepatitis B infection.</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study of all acute hepatitis B cases in England followed up by UKHSA in 2022 and 2023.</div></div><div><h3>Methods</h3><div>We reviewed case notes from the UKHSA case management system. The outcome variable was the completion of public health follow up. Independent variables were index of multiple deprivation quintile, age, gender, ethnicity, history of sex between men or sex between women, intravenous drug usage, and geographical region.</div></div><div><h3>Results</h3><div>Out of 226 cases with acute hepatitis B infection, 6.6 % of cases were lost to follow up. Exploratory analyses suggested that males and cases in two regions may be at greater risk of being lost to follow up, although these findings were based on small numbers.</div></div><div><h3>Conclusions</h3><div>This study found that in England most cases of acute hepatitis B are appropriately followed up from a public health perspective. The study suggests that males had a marginally increased risk of being lost to follow up.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105959"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118608","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":"Intimate partner violence against women through the Woman Abuse Screening Tool (WAST): pre- and post-COVID-19 evolution","authors":"Myrian Pichiule-Castañeda ,&nbsp;María Felícitas Domínguez-Berjón ,&nbsp;María Luisa Martínez-Blanco ,&nbsp;Clara Benedicto-Subira ,&nbsp;Ana Gandarillas Grande","doi":"10.1016/j.puhe.2025.105966","DOIUrl":"10.1016/j.puhe.2025.105966","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyse the temporal trend of the intimate partner violence (IPV) against women, based on the <em>Woman Abuse Screening Tool</em> (WAST) short form within the public health surveillance system, in the pre-and post-COVID-19 periods.</div></div><div><h3>Study design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>The source of information was the Non-communicable Disease Risk-Factor Surveillance System (18–64 years) of the community of Madrid. The WAST short form includes two questions. WAST positive scoring (WAST+) was considered when woman reported that she had experienced some/a lot of tension in the couple's relationships and some/great difficulty in working out arguments. WAST+ was considered a proxy for IPV. Prevalence rates were obtained for years prior to the COVID-19 (2018, 2019), pandemic years (2020, 2021, 2022), and beyond (2023). Also, we analysed some health indicators included depression (according PHQ-8 questionnaire), self-perceived health, and alcohol and tobacco use with WAST+. Prevalence rates were calculated with 95 % confidence intervals (95 % CI) and crude and adjusted for year of study and socioeconomic variables prevalence ratios (aPR) were estimated using Poisson regression models.</div></div><div><h3>Results</h3><div>Among 4791 women surveyed, the prevalence of WAST+ was 13.5 % (95 % CI: 12.5–14.5), with an annual range from 10.7 % (95 % CI: 8.7–13.0) to 16.7 % (95 % CI: 14.2–19.4). No differences were found between the pre- and post-COVID-19 periods. WAST+ was associated with depression (aPR: 2.54; 95 % CI: 2.16–2.98), self-perceived health as bad or very bad (aPR: 1.94; 95 % CI: 1.39–2.71), high-risk alcohol consumption (aPR: 1.54; 95 % CI: 1.10–2.17) and tobacco consumption (aPR: 1.44; 95 % CI: 1.23–1.68).</div></div><div><h3>Conclusions</h3><div>No changes in IPV were identified in the pre- and post-COVID-19 periods. The association of a positive WAST score with indicators of poor health reinforces its usefulness for monitoring IPV in population-based public health surveillance surveys.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105966"},"PeriodicalIF":3.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095814","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":"Association between screen time and overweight/obesity: A meta-analysis of 393,743 women from 36 low- and middle-income countries","authors":"Abdur Rahman ,&nbsp;Khorshed Alam ,&nbsp;Benojir Ahammed","doi":"10.1016/j.puhe.2025.105955","DOIUrl":"10.1016/j.puhe.2025.105955","url":null,"abstract":"<div><h3>Objectives</h3><div>The global prevalence of overweight and obesity has surged, particularly in low- and middle-income countries (LMICs), where sedentary behaviors such as mobile device use and television watching are becoming increasingly common. This study explores the relationship between these behaviors and overweight/obesity among women in LMICs.</div></div><div><h3>Study design</h3><div>Meta-analysis.</div></div><div><h3>Methods</h3><div>A meta-analysis was performed using data from 393,743 women across 36 LMICs, collected through the Demographic and Health Surveys (DHS) between 2015 and 2023. Women's overweight/obesity status was defined as a body mass index (BMI) of 25 kg/m² or higher. Statistical analyses included univariate, bivariate, and random-effects meta-analyses, with subgroup analyses to explore regional variations.</div></div><div><h3>Results</h3><div>The overall prevalence of women with overweight/obesity was 30.1 %. Media use was frequent, with 60.8 % on mobile, 44.9 % watching television weekly, and 34.5 % doing both. The findings indicate a significant positive association between mobile use and women with overweight/obesity, with pooled odds ratio (OR) of 2.72 (95 % CI: 2.37–3.12). Television watching was also significantly associated with overweight/obesity of women (OR = 1.95; 95 % CI: 1.70–2.25). Combined exposure to both mobile devices and television further increased the likelihood of being overweight or obese (OR = 2.41; 95 % CI: 2.09–2.79). Subgroup analyses revealed that African women were particularly vulnerable, with higher odds of overweight/obesity compared to non-African women.</div></div><div><h3>Conclusions</h3><div>Excessive screen time increases the risk of overweight/obesity among women in LMICs, particularly in Africa. Culturally tailored policies promoting reduced screen time and active lifestyles are crucial for fostering healthier habits and reducing related health risks.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105955"},"PeriodicalIF":3.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095815","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}