Public HealthPub Date : 2025-05-20DOI: 10.1016/j.puhe.2025.105736
H.A. Snooks , A. Akbari , L. Bethell , A. Carson-Stevens , J. Dale , L. Dixon , A. Edwards , H. Emery , A. John , G. John , S. Jolles , J. Lyons , R.A. Lyons , M.R. Kingston , R. Parab , A. Porter , B. Sewell , A. Watkins , V. Williams
{"title":"Evaluation of the UK's COVID-19 public health policy “Shielding: Results of a linked data matched cohort study","authors":"H.A. Snooks , A. Akbari , L. Bethell , A. Carson-Stevens , J. Dale , L. Dixon , A. Edwards , H. Emery , A. John , G. John , S. Jolles , J. Lyons , R.A. Lyons , M.R. Kingston , R. Parab , A. Porter , B. Sewell , A. Watkins , V. Williams","doi":"10.1016/j.puhe.2025.105736","DOIUrl":"10.1016/j.puhe.2025.105736","url":null,"abstract":"<div><h3>Objective</h3><div>To assess outcomes associated with shielding, introduced during the COVID-19 pandemic across the UK to protect those at highest risk of harm.</div></div><div><h3>Study design</h3><div>Linked data and questionnaires in matched cohorts from the population of Wales, UK.</div></div><div><h3>Methods</h3><div>We compared individual-level linked routine and self-reported outcomes between people identified for shielding (n = 123,293) and comparators (n = 120,997) matched by age, sex, and previous health service utilisation. We sent questionnaires to 1500 randomly sampled people in each cohort.</div></div><div><h3>Results</h3><div>At one year 6·1 % of shielded people had contracted SARS-CoV-2 compared to 6·2 % in the matched cohort (Adjusted Odds Ratio [AOR] 0·970; 95 % confidence interval [CI] 0·937 to 1·004). Suspected healthcare associated infections were more likely in shielded people (1·1 % vs 0·6 %; AOR 1·678; 95 % CI 1·529 to 1·842). All-cause and COVID-19 related deaths were higher in the shielded cohort (7·0 % vs 3·5 %; AOR 2·280; 95 % CI 2·190 to 2·374; and 1·1 % vs 0·8 %; AOR 1·430; 95 % CI 1·308 to 1·563, respectively).</div><div>About 1/3 completed questionnaires (n = 1015), with linkage possible in 752 cases (shielded: n = 411; matched: n = 341). Shielded respondents reported lower physical and mental health (SF12 PCS difference: −3·752; 95 % CI -4·823 to −2·682; SF12 MCS difference: −1·217; 95 % CI -2·580 to 0·145). They were more likely to have strictly avoided contact; stayed at home; felt scared to go outside; and were less likely to have gone out for shopping, leisure or travel.</div></div><div><h3>Conclusion</h3><div>We found no evidence of a protective effect of shielding on SARS-CoV-2 infections or COVID-19 related mortality, an increased rate of hospital acquired infections and increased self-isolation. Shielding during a future pandemic should only be considered alongside effective measures to reduce healthcare associated infections.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105736"},"PeriodicalIF":3.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105442","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}
Public HealthPub Date : 2025-05-20DOI: 10.1016/j.puhe.2025.105772
Alex Bawuah, Joshua Wednesday Edefo
{"title":"Suicidal ideation and clinical breast examination among rural women aged 25 to 49 in Senegal","authors":"Alex Bawuah, Joshua Wednesday Edefo","doi":"10.1016/j.puhe.2025.105772","DOIUrl":"10.1016/j.puhe.2025.105772","url":null,"abstract":"<div><h3>Objectives</h3><div>Breast cancer is a significant public health concern and early detection through screening is crucial for improved outcomes. Previous studies have highlighted the influence of socio-demographic and economic factors on the uptake of breast cancer examination. An often-overlooked dimension influencing clinical breast examination (CBE) in the literature is mental health. This study investigates the relationship between suicidal ideation and CBE uptake among rural women in Senegal.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>A sample of 4532 rural women (25–49 years) was drawn from the 2023 Senegal Continuous Demographic and Health Survey data. Clinical breast examination (CBE) and having suicidal thoughts were the outcome and explanatory variables of interest, respectively. We applied a binary logistic multivariable regression model to assess the relationship between suicidal thoughts and CBE.</div></div><div><h3>Results</h3><div>Only 19.49 % of the women had a health professional examine their breasts for cancer. Also, 20.08 % of the women have had suicidal thoughts. The study revealed that women with suicidal thoughts were 41 % less likely to undergo CBE compared to those without (AOR = 0.59, 95 % CI: 0.44–0.79). The study further revealed that an increase in wealth, being employed, and frequently listening to the radio are positively associated with the uptake of CBE, whereas older age is negatively associated.</div></div><div><h3>Conclusions</h3><div>The negative relationship between suicidal ideation and the uptake of CBE underscores the need to integrate mental health services with preventive health programs like cancer screenings.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105772"},"PeriodicalIF":3.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088685","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}
Public HealthPub Date : 2025-05-20DOI: 10.1016/j.puhe.2025.105786
Xuewei Chen , Carrie Winterowd , Ming Li , Gary L. Kreps
{"title":"Mental health literacy and patient-mental health provider relationships among American Indian/Alaska Native/Native American people","authors":"Xuewei Chen , Carrie Winterowd , Ming Li , Gary L. Kreps","doi":"10.1016/j.puhe.2025.105786","DOIUrl":"10.1016/j.puhe.2025.105786","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the relationship between mental health literacy and the patient-mental health provider relationships, particularly American Indian/Alaska Native/Native American (AI/AN) patients’ access to, trust in, and utilization of mental health professionals and their services.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional online survey to collect data on mental health literacy and its impact on AI/AN patients' trust and interactions with their mental health providers.</div></div><div><h3>Methods</h3><div>A total of 563 AI/AN adult patients completed the survey, which was disseminated using snowball sampling. We assessed mental health literacy using a multi-component measure and performed linear regressions to examine its associations with key factors including socio-demographic characteristics, mental health care access, trusting in mental health providers/specialists, the frequency of using mental health services, trusting in mental health providers/specialists for general health information and for COVID-19 information, as well as their level of satisfaction with the services received from mental health providers/specialists.</div></div><div><h3>Results</h3><div>We identified mental health literacy as a major factor associated with patient-mental health provider relationships among AI/AN patients. Patients reporting lower levels of mental health literacy were likely to report having no regular access to mental health care, lower levels of trust in mental health providers/specialists, less satisfaction with the services received from mental health providers/specialists, and less trust in mental health specialists for COVID-19 information.</div></div><div><h3>Conclusions</h3><div>Mental health literacy is a key factor influencing the patient-mental health provider relationships among AI/AN patients. Interventions to enhance mental health literacy may improve trust and satisfaction with mental health services in this population.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105786"},"PeriodicalIF":3.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098339","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}
Public HealthPub Date : 2025-05-19DOI: 10.1016/j.puhe.2025.105761
Marina Gonzalez-Del-Rio , Miguel Merchan-Ruiz , Anna Reñé-Reñé , Carme Bertran-Noguer , Lluís Ramió-Torrentà , Edurne Zabaleta-Del-Olmo
{"title":"Cognitive interviewing study to assess the content validity of a Spanish version of the Multiple Sclerosis Health Literacy Questionnaire","authors":"Marina Gonzalez-Del-Rio , Miguel Merchan-Ruiz , Anna Reñé-Reñé , Carme Bertran-Noguer , Lluís Ramió-Torrentà , Edurne Zabaleta-Del-Olmo","doi":"10.1016/j.puhe.2025.105761","DOIUrl":"10.1016/j.puhe.2025.105761","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop a Spanish version of the Multiple Sclerosis Health Literacy Questionnaire (MSHLQ) and assess its content validity from the perspective of people with multiple sclerosis (MS).</div></div><div><h3>Study design</h3><div>Cognitive interviewing study.</div></div><div><h3>Methods</h3><div>We used a step-by-step process to translate the MSHLQ into Spanish and employed purposive sampling to achieve a representative sample of the target population. We invited people aged 18 and older with MS who are users of a public healthcare service to participate. We carried out two rounds of interviews, both conducted by the same skilled interviewer. Two coders independently assessed the interview transcriptions using the Question Appraisal System.</div></div><div><h3>Results</h3><div>Thirteen interviews were analysed in the first round, reaching saturation. The sample comprised people with MS, with a balanced gender distribution and varied educational backgrounds, and with MS diagnosis durations ranging from 1 to 24 years. Problematic issues found in the pre-final MSHLQ-SPA included 15 out of 22 items. We identified 45 clarity issues and 23 assumption-related problems, plus two overlapping responses. After amendments, only five issues were found in the second round.</div></div><div><h3>Conclusions</h3><div>Over two-thirds of items in the pre-final MSHLQ-SPA version had problematic issues, mostly clarity-related. This study contributes to the body of evidence regarding MSHLQ content validity, an essential instrument property for ensuring its accurate interpretation and use across different countries or contexts. Tailored health literacy measurement instruments for people with MS have the potential to improve health outcomes and reduce health inequalities.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"245 ","pages":"Article 105761"},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088686","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}
Public HealthPub Date : 2025-05-17DOI: 10.1016/j.puhe.2025.105768
Ziyang Ren , Xuefen Zhang , Lei Cao , Linlin Wang , Leah Li , Jufen Liu
{"title":"Lifelong associations between childhood multimorbidity and early-onset and late-onset dementia: A multi-cohort study","authors":"Ziyang Ren , Xuefen Zhang , Lei Cao , Linlin Wang , Leah Li , 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 (<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}
Public HealthPub Date : 2025-05-17DOI: 10.1016/j.puhe.2025.105739
Qi Wei , Mingying Yang , Zhiyong Zhu , Ling Xiang , Yaxu Wang , Linglong Peng , Yunhao Tang , Shijiang Deng , Haitao Gu
{"title":"Adherence to the EAT-Lancet diet reduces the risk of renal cancer: Results from a population-based prospective study","authors":"Qi Wei , Mingying Yang , Zhiyong Zhu , Ling Xiang , Yaxu Wang , Linglong Peng , Yunhao Tang , Shijiang Deng , 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 , Yoshitake Takebayashi , Masaharu Tsubokura , Tetsuya Ohira , Akira Sakai , Kanako Okazaki , Michio Shimabukuro , Hitoshi Ohto , 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}
Public HealthPub Date : 2025-05-15DOI: 10.1016/j.puhe.2025.105750
Yuan Yi Chew , Mari Kannan Maharajan , Divya Gopinath , Kingston Rajiah
{"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 , Mari Kannan Maharajan , Divya Gopinath , 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}
Public HealthPub Date : 2025-05-15DOI: 10.1016/j.puhe.2025.105760
Shufang Leng , Dongjian Yang , Wenlian Li , Zhiwei Liu , Hong Li
{"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 , Dongjian Yang , Wenlian Li , Zhiwei Liu , 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 , Veronica Traversini , Omer Kocak , Yuksel Goktas , Sevda Kucuk , 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 < 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}