Public Health最新文献

{"title":"Digital interventions in tobacco prevention for school-aged children: results of systematic review","authors":"Vincenza Gianfredi ,&nbsp;Chiara Barbati ,&nbsp;Alice Clara Sgueglia ,&nbsp;Paola Bertuccio ,&nbsp;Laura Traverso ,&nbsp;Anna Odone","doi":"10.1016/j.puhe.2025.105799","DOIUrl":"10.1016/j.puhe.2025.105799","url":null,"abstract":"<div><h3>Objectives</h3><div>Smoking continues to be a major preventable contributor to global morbidity and mortality. Conventional prevention strategies have not fully succeeded in reducing smoking rates among youth. Digital interventions (DI) present an innovative approach to engage and educate this demographic.</div></div><div><h3>Study design</h3><div>This systematic review evaluates the effectiveness of digital interventions in preventing smoking among school-aged children (6–12 years).</div></div><div><h3>Methods</h3><div>PubMed/MEDLINE, Scopus, and PsycINFO were searched on April 4, 2024, and updated on April 10, 2025. PRISMA 2020 guidelines were followed to conduct the review. Protocol was registered in PROSPERO (CRD 42024534528).</div></div><div><h3>Results</h3><div>From 3330 identified records, 19 studies were reviewed. These studies utilized DIs, such as mobile applications, web-based programs, and multimedia campaigns, targeting knowledge enhancement, attitude shifts, and behavioral changes related to tobacco use. The findings reveal that DIs significantly improve knowledge about smoking risks and positively influence attitudes, particularly through interactive and gamified approaches. However, the effectiveness varied depending on factors such as intervention design, participant demographics, and follow-up duration. Behavioral outcomes, such as reduced smoking intentions and prevalence, showed mixed results, with sustained engagement being a critical factor for long-term success. Family-based and culturally tailored interventions demonstrated additional potential for reinforcing preventive behaviors.</div></div><div><h3>Conclusions</h3><div>Despite methodological diversity and moderate bias risks in some studies, the evidence supports DI as a scalable and accessible strategy for tobacco prevention among youth, particularly in underserved populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105799"},"PeriodicalIF":3.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185391","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":"Evaluating the co-creation process in public health interventions: the PROSECO framework","authors":"Giuliana Raffaella Longworth ,&nbsp;Danielle Marie Agnello ,&nbsp;Sebastien Chastin ,&nbsp;Aaron Davis ,&nbsp;Enric Senabre Hidalgo ,&nbsp;Sergio Villanueva Baselga ,&nbsp;Lauren McCaffrey ,&nbsp;Jorge Zapata Restrepo ,&nbsp;Laura Coll-Planas ,&nbsp;Maria Giné-Garriga","doi":"10.1016/j.puhe.2025.105783","DOIUrl":"10.1016/j.puhe.2025.105783","url":null,"abstract":"<div><h3>Objectives</h3><div>To date, there is a lack of evaluation frameworks to guide the planning and conducting of the evaluation of co-creation in public health. This study aims to identify and set the components of the PROSECO framework (PROcesS Evaluation framework for CO-creation) to support the evaluation of co-creation processes in public health interventions.</div></div><div><h3>Study design</h3><div>A multi-step, iterative approach combining the outcomes of two scoping reviews, expert validation, and design refinement.</div></div><div><h3>Methods</h3><div>The PROSECO framework was developed in three steps. Firstly, collecting results from two scoping reviews on process evaluation for co-creation and evaluation of co-creation methods. The scoping review results were analysed and refined by a selected group of experts and through a three-round anonymous survey. Based on those findings, the framework visualisation was developed and designed through multiple design iterations.</div></div><div><h3>Results</h3><div>The PROcesS Evaluation framework for CO-creation, called the PROSECO framework, was developed to assist researchers and stakeholders in evaluating a co-creation process. The framework comprises a list of 37 components grouped under the five dimensions of Delivery, Participation, Experiential, Context, and Impact.</div></div><div><h3>Conclusions</h3><div>PROSECO is the first framework to offer a systematic approach to evaluating co-creation. By integrating a diverse set of evaluation components, encompassing delivery, participation, experiential, impact, and context, it offers a flexible and comprehensive approach to address the complex nature of co-creation.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105783"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169653","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 Maputo Declaration - A call for National Public Health Institutions and resilient health systems","authors":"Eduardo Samo Gudo ,&nbsp;Ilesh Jani ,&nbsp;Sofia Viegas ,&nbsp;Anne-Catherine Viso ,&nbsp;Neil Squires","doi":"10.1016/j.puhe.2025.105785","DOIUrl":"10.1016/j.puhe.2025.105785","url":null,"abstract":"","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105785"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169650","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 independent and moderator role of communicative health literacy on health, health behaviour and health care utilisation: a population based cross-sectional study","authors":"F. Vincze ,&nbsp;F.E.A. Israel ,&nbsp;R. Ádány ,&nbsp;É. Bíró","doi":"10.1016/j.puhe.2025.105794","DOIUrl":"10.1016/j.puhe.2025.105794","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of the present study is to investigate the association between communicative health literacy, health behaviour and health care utilisation, as well as the moderation effect of communicative health literacy on various health-related outcomes.</div></div><div><h3>Study design</h3><div>A total of 1205 Hungarian adults aged 18 years and older participated in this nationwide cross-sectional survey, which was part of the international Health Literacy Population Survey 2019–2021 (HLS₁₉).</div></div><div><h3>Methods</h3><div>Data collection was carried out at the end of 2020, using a multistage probability sample of the Hungarian adult population representative by age, sex, and settlement type. Multivariate logistic regression models were performed to examine whether communicative health literacy affects the main outcomes, followed by a moderation analysis.</div></div><div><h3>Results</h3><div>Better communicative health literacy was associated with increased odds of physical activity (OR = 2.68; 95% CI = 1.39–5.17), fruit and vegetable consumption (OR = 2.05; 95% CI = 1.13–3.70), and decreased odds of emergency (OR = 0.40; 95% CI = 0.21–0.76) and inpatient care use (OR = 0.36; 95% CI = 0.16–0.82) and limitations due to health problems (OR = 0.41; 95% CI = 0.21–0.80). Furthermore, we found a significant moderation effect between communicative health literacy and socio-demographic variables on self-perceived health status, smoking habits, use of inpatient care and limitations due to health problems.</div></div><div><h3>Conclusions</h3><div>The study confirmed that communicative health literacy has an independent main and moderating effect on health outcomes, health behaviours and health care utilisation. The results contribute to a better understanding of the complex pathways between health literacy and health.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105794"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169652","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":"Impact of metabolic health and weight transition on COVID-19 risk: A population-based cohort study","authors":"Yujin Park ,&nbsp;Su Hwan Kim ,&nbsp;Ahnul Ha ,&nbsp;Young Kook Kim ,&nbsp;Hyung-Jin Yoon ,&nbsp;Jae-Heon Kang ,&nbsp;So-Eun Kim ,&nbsp;Yoon Ji Kim ,&nbsp;Ye Seul Bae","doi":"10.1016/j.puhe.2025.105777","DOIUrl":"10.1016/j.puhe.2025.105777","url":null,"abstract":"<div><h3>Objectives</h3><div>Obesity and metabolic health are known factors influencing COVID-19 severity. However, the effect of changes in metabolic health and weight status on COVID-19 outcomes remains unclear. To investigate the association between changes in metabolic health and weight status over time and COVID-19-related risks.</div></div><div><h3>Study design</h3><div>Retrospective population-based cohort study.</div></div><div><h3>Methods</h3><div>This retrospective population-based cohort study used data from South Korea's National Health Information Service collected between January 2014 and December 2021. A total of 284,719 participants who underwent health screening both in 2014–2015 and 2016–2017 were divided into the metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO) groups.</div></div><div><h3>Results</h3><div>Among initial MHNO participants, those who became MHO (hazard ratio (HR) 1·082, 95 % confidence intervals 1·01–1·16) and MUO (1·18, 1·11–1·26) had elevated risk for COVID-19 compared with those who remained MHNO. Conversely, participants who transitioned from MUO to MUNO (0·89, 0·84–0·95) were associated with a lower risk of COVID-19. Improvements in metabolic health did not mitigate COVID-19-related risks. Transitioning from MHNO to MHO (3·57, 1·38–9·26) was associated with a significantly higher risk of death due to COVID-19.</div></div><div><h3>Conclusions</h3><div>Changes in metabolic health and obesity status significantly influence COVID-19 outcomes. Addressing obesity and promoting metabolic health are critical for mitigating the impact of COVID-19.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105777"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169651","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":"Temporal trends in prevalence of violence in Wales: analysis of a national victimisation survey","authors":"P. Obolenskaya ,&nbsp;A. Fadeeva ,&nbsp;E.R. Barton ,&nbsp;A. Walker ,&nbsp;L.C. Snowdon ,&nbsp;S. McManus","doi":"10.1016/j.puhe.2025.105775","DOIUrl":"10.1016/j.puhe.2025.105775","url":null,"abstract":"<div><h3>Objectives</h3><div>Monitoring violence trends and distribution is key for a public health approach to violence prevention. However, national survey estimates for Wales have not been disaggregated from those for England and Wales combined. We therefore aim to examine whether the trends in violence in Wales differ from trends in England.</div></div><div><h3>Study design</h3><div>Descriptive analysis of repeated cross-sectional data.</div></div><div><h3>Methods</h3><div>Using data from the Crime Survey for England and Wales, a nationally representative household victimisation survey, for years 2002–2020, we compare trends in prevalence of violence victimisation between Wales and England, for all adults and by gender.</div></div><div><h3>Results</h3><div>Country-disaggregated data shows that the prevalence of violence was generally lower in Wales than in England for the first decade of the century. Analyses by gender shows further disparities between countries. Males in Wales and England and females in England experienced a decline in violence victimisation between 2002 and 2015. However, no decline in violence was evident for females in Wales until after 2016.</div></div><div><h3>Conclusions</h3><div>Given differences in prevalence and trends in violence between Wales and England, relying on estimates based on the countries combined to inform strategic planning in Wales is problematic. Using Wales-specific estimates and trends in violence is therefore recommended.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105775"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169475","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":"Socioeconomic gradients and inequalities in all-cause mortality and cardiovascular diseases: A retrospective cohort study using Korean NHANES-mortality linkage data","authors":"Chaiho Jeong ,&nbsp;Kyu-Na Lee ,&nbsp;Jin-Hyung Jung ,&nbsp;Tae-Seo Sohn ,&nbsp;Hyuk-Sang Kwon ,&nbsp;Kyungdo Han ,&nbsp;Seung-Hwan Lee","doi":"10.1016/j.puhe.2025.105767","DOIUrl":"10.1016/j.puhe.2025.105767","url":null,"abstract":"<div><h3>Objectives</h3><div>Rapid economic growth in South Korea provides a valuable context for investigating how socioeconomic status (SES) impacts mortality and cardiovascular disease (CVD) risk in an emerging high-income Asian country. The objective of this study was to examine these associations in a general population and a subgroup with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Data from the Korea National Health and Nutrition Examination Survey (KNHANES) linked to mortality records was used. A total of 48,190 participants including 6,382 patients with T2DM from the 2011–2020 KNHANES cohort were included and followed until death, a cardiovascular event (myocardial infarction or ischemic stroke), or the study endpoint.</div></div><div><h3>Results</h3><div>Participants in the lowest income quintile had higher risks of mortality (Hazard ratio [HR]: 1.44, 95 % CI: 1.19–1.76) and CVD (HR: 1.35, 95 % CI: 1.05–1.74) compared to the highest quintile. Unemployed individuals had a higher mortality risk (HR: 1.34, 95 % CI: 1.19–1.51) than employed ones. Non-homeowners also had a higher mortality risk (HR: 1.46, 95 % CI: 1.20–1.77) than multi-homeowners. Participants with elementary school education or less had higher risks of mortality (HR: 1.59, 95 % CI: 1.32–1.93) and CVD (HR: 1.71, 95 % CI: 1.31–2.24) compared to college graduates. Among those with T2DM, unemployment (HR: 1.43, 95 % CI: 1.16–1.77) and low education (HR: 1.53, 95 % CI: 1.07–2.17) were associated with higher mortality.</div></div><div><h3>Conclusions</h3><div>This analysis revealed significant associations of low SES with increased risks of mortality and CVD. Similar associations were observed in T2DM population for mortality outcomes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105767"},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154347","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":"Health literacy, perceived stress, and dietary quality among Danish women with recent gestational diabetes mellitus","authors":"Kamilla Horn Diedrichsen ,&nbsp;Majken Lillholm Pico ,&nbsp;Elina Sofie Rasmussen ,&nbsp;Karoline Kragelund Nielsen ,&nbsp;Inger Katrine Dahl-Petersen ,&nbsp;Per Ovesen ,&nbsp;Peter Damm ,&nbsp;Dorte Møller Jensen ,&nbsp;Ulla Kampmann ,&nbsp;Elisabeth R. Mathiesen ,&nbsp;Christina Anne Vinter ,&nbsp;Helle Terkildsen Maindal","doi":"10.1016/j.puhe.2025.105787","DOIUrl":"10.1016/j.puhe.2025.105787","url":null,"abstract":"<div><h3>Objectives</h3><div>Adhering to dietary recommendations after gestational diabetes mellitus (GDM) can mitigate the risk of early-onset type 2 diabetes. Psychosocial aspects, such as health literacy and perceived stress, may affect adherence to these recommendations; yet this remains underexplored in women with recent GDM. This study aimed to examine the association between health literacy and dietary quality 10–14 weeks postpartum and to assess the influence of perceived stress.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>This study used baseline data from the Face-it trial, including 283 Danish women with recent GDM 10–14 weeks postpartum. Dietary quality was measured using the Dietary Quality Score (DQS), health literacy using two domains of the Health Literacy Questionnaire: HLQ-2 (Having sufficient information to manage my health) and HLQ-3 (Actively managing my health), and stress using the Perceived Stress Scale (PSS). Multiple linear regression examined the association between HLQ-2 and DQS, and HLQ-3 and DQS, adjusting for age, education, and country of birth. Additional analyses examined the influence of perceived stress.</div></div><div><h3>Results</h3><div>Among women with recent GDM, reporting Having sufficient information to manage their health (HLQ-2) and Actively managing their health (HLQ-3) were positively associated with dietary quality, with βadjusted = 0.55 [95 % CI: 0.22–0.87] and βadjusted = 1.12 [95 % CI: 0.84–1.41], respectively. Perceived stress did not affect these associations.</div></div><div><h3>Conclusion</h3><div>Health literacy was positively associated with dietary quality among Danish women with recent GDM. Stress did not affect this association.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105787"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138159","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":"Insights from stakeholders in Sydney's diverse ethnic communities during the COVID-19 Delta phase","authors":"Maria Gabriela Uribe Guajardo ,&nbsp;Kanchan Marcus ,&nbsp;Andrew Milat ,&nbsp;Michelle Cunich ,&nbsp;John Eastwood ,&nbsp;Carmen Huckel Schneider ,&nbsp;Danielle Greene","doi":"10.1016/j.puhe.2025.105790","DOIUrl":"10.1016/j.puhe.2025.105790","url":null,"abstract":"<div><h3>Objectives</h3><div>Ethnic diverse communities were disproportionately impacted with increased COVID-19 morbidity and mortality. The dearth of access to timely and reliable, culturally appropriate communications regarding COVID-19 and routes of transmission was particularly damaging. This study reflects diverse communities’ communication needs and recognises strategies implemented by the communities to fill these gaps that should be applied to future public health emergencies. This study aims to describe culturally and linguistically diverse (CALD) communications challenges, and the strategies used by health, social and community services to mitigate the negative impacts of the COVID-19 Delta wave in Greater Sydney.</div></div><div><h3>Study design</h3><div>Exploratory qualitative study.</div></div><div><h3>Methods</h3><div>Qualitative interviews and thematic analysis were used to explore challenges encountered and strategies used during the COVID-19 pandemic (Delta wave in June 2021 and the aftermath) and the vaccination program (began in January 2021 and reached the Government's target by February 2022) across health, social, Ministry and CALD community sectors.</div></div><div><h3>Results</h3><div>Twenty-seven participants from 24 social and health care programs were part of the study. Themes were mixed messaging, antivaccination and other misinformation/disinformation, and cross-cultural misunderstandings, while strategies used coalesced under the themes of Ministry-community collaboration, health-community collaboration and community-led actions.</div></div><div><h3>Conclusions</h3><div>Public health information should be disseminated in ways that are equally understandable to different groups, being mindful of the vast variety of ethnicities residing in Greater Sydney.</div><div>The development of a sustainable collective that aims at developing precise public health messaging policies must be sought early in future pandemics.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105790"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147320","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":"Spatio-temporal patterns of prostate-specific antigen testing in asymptomatic men: a population-based cohort study, Australia, 2002–2018","authors":"A. Kohar ,&nbsp;J. Cameron ,&nbsp;P.D. Baade ,&nbsp;K. Pickles ,&nbsp;B.D. Montgomery ,&nbsp;D.P. Smith ,&nbsp;S.M. Cramb","doi":"10.1016/j.puhe.2025.105769","DOIUrl":"10.1016/j.puhe.2025.105769","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate-specific antigen (PSA) testing rates vary by small geographical area in Australia, yet little is known about how these variations have changed over time. This study aims to examine spatio-temporal patterns in Australia during 2002–2018.</div></div><div><h3>Study design</h3><div>Retrospective population-based cohort study.</div></div><div><h3>Methods</h3><div>We obtained Medicare Benefit Schedule data on PSA testing (n = 9,342,134) during 2002–2018 from the Commonwealth Department of Health, Australia for men aged 50–79 years. Postcodes were mapped to statistical areas level 2 (n = 2133) using a probability-based correspondence file and multiple (n = 50) iterations. Bayesian spatio-temporal models were used to generate indirectly standardized incidence ratios for each small area over time compared to the national average.</div></div><div><h3>Results</h3><div>The annual percentage of men aged 50–79 who received a PSA test for asymptomatic testing increased from 15·6 % up to 24·5 % in 2008, before declining to 14·8 %. Geographical patterns of PSA testing varied substantially over time, with many areas deviating from the national trend. Between 2002 and 2008, 80 % of small areas had testing rates increase, while 93 % of areas decreased from 2008 to 2018. East coast and southwest regions of Australia, primarily major cities and regional areas, exhibited the most divergent temporal trends, while many remote areas maintained consistently low testing rates.</div></div><div><h3>Conclusion</h3><div>The extent and patterns of geographic variation in PSA testing rates across small areas has changed over time. Understanding the reasons for this variation remains a priority, to help ensure all men at risk have equitable access to relevant decision-making process and information about PSA testing.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105769"},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123627","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}