Discover public health最新文献

{"title":"Processes of development related with the implementation of the Icelandic prevention model in a rural Canadian community.","authors":"Tanya Halsall, Kianna Mahmoud, Matt Drabenstott, Heather Orpana, Srividya N Iyer, Alfgeir Kristjansson, Kimberly Matheson","doi":"10.1186/s12982-025-00443-7","DOIUrl":"10.1186/s12982-025-00443-7","url":null,"abstract":"<p><p>The Icelandic Prevention Model (IPM) is a sequential 10-step community-driven collaborative intervention that is designed to support the prevention of substance use in youth by establishing healthy developmental contexts. The IPM has been implemented across Iceland for over 20 years and is now being implemented in other countries. Recognizing the need to explore how to adapt the IPM to new contexts and document the implementation of the model, this paper describes a process evaluation of the first three steps of the IPM within a Canadian rural community to capture experiences during the early development. Specifically, this study addresses the following research questions: (1) What are the processes of development and contextual features that influence the implementation of the IPM within Lanark County, Ontario? and (2) What adaptations are needed to successfully implement the IPM in Canada? Semi-structured interviews were conducted to examine experiences and lessons learned through the implementation of the model. Thematic analyses were completed using QSR NVivo. A deductive and inductive approach was applied, whereby some interview guide questions were derived from the IPM implementation steps and others were more exploratory, examining context and processes of development. Nine interviews were conducted with key partners who were leading the implementation of the IPM. Themes highlighting cultural factors that influence implementation, processes of development related to community engagement, and themes relating to youth participation, fidelity issues, fundraising, health equity and challenges related to the COVID-19 pandemic were identified. This paper contributes new scientific knowledge related to implementation processes within upstream prevention of substance use and practical information that is useful for communities interested in implementing the IPM.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing subscale threshold scores for the nutrition literacy assessment instrument (NLit).","authors":"Nicholas J Marchello, Juliana T Camargo, Byron J Gajewski, Debra K Sullivan, Heather D Gibbs","doi":"10.1186/s12982-025-00677-5","DOIUrl":"10.1186/s12982-025-00677-5","url":null,"abstract":"<p><strong>Objective: </strong>Understanding a patient's nutrition literacy weaknesses may aid in improving the patient's nutrition literacy and diet quality. The Nutrition Literacy Assessment Instrument (NLit) was developed to fill this knowledge gap. Global NLit cutoff scores were previously developed; however, subscale NLit cutoff scores are needed.</p><p><strong>Design: </strong>In this secondary analysis, individual post hoc linear regressions were calculated for each NLit subscale to determine scoring thresholds for each NLit subscale. Scoring thresholds were determined for both long- and short-form NLit subscales.</p><p><strong>Setting: </strong>Two University-affiliated general practice clinics and two University-affiliated safety net clinics were used as recruitment sites.</p><p><strong>Participants: </strong>Patients (n = 402) with self-reported hyperlipidemia, hypertension, diabetes, or obesity were included in primary analysis from which data in this secondary analysis were derived.</p><p><strong>Results: </strong>Subscale scores were associated with predicted Healthy Eating Index (HEI)-2010 scores linked to increased risk for mortality. Tenth-percentile NLit scores were associated with HEI-2010 scores between 59.33 and 62.27 (by subscale) for the long-form NLit, and between 60.12 and 61.77 for the short-form NLit.</p><p><strong>Conclusions: </strong>NLit cutoff scores can pinpoint capacity with nutrition information by subscale. Identifying nutrition literacy deficits may allow nutrition professionals to better focus interventions.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s12982-025-00677-5.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"308"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of North American firefighters on navigating interventions and healthcare choices for work-related shoulder disorders.","authors":"Temitope Osifeso, Joy C MacDermid, Dorala Berinyuy, Pulak Parikh, Kenneth Faber","doi":"10.1186/s12982-025-00739-8","DOIUrl":"10.1186/s12982-025-00739-8","url":null,"abstract":"<p><strong>Background: </strong>The unpredictable nature of firefighting, characterized by lifting and carrying of heavy equipment, forceful upper body movements in confined spaces, and exposure to extreme conditions, predisposes firefighters (FFs) to a range of work-related shoulder disorders (WSDs). The unique occupational demand of firefighting underscores the need for targeted intervention and occupational health programs tailored to the demands of firefighting.</p><p><strong>Objective: </strong>To explore the: (1) Management strategies that FFs employ after WSDs (2) Needs and preferences of FFs with WSDs in relation to their occupational health and recovery.</p><p><strong>Methods: </strong>Using an interpretive descriptive methodology, we interviewed 14 firefighters (males, <i>n</i> = 9; females, <i>n</i> = 5) with an average age of 47 years, who experienced WSDs in their careers. Semi-structured one-on-one virtual interviews were conducted using online video conference software and were transcribed verbatim. Data was analyzed using thematic analysis.</p><p><strong>Result: </strong>Four themes emerged from firefighters as management strategies following WSDs: (1) Appropriate diagnostic precision and tailored management; (2) The critical role of early medical and physiotherapy intervention; (3) Comprehensive social support systems; (4) Adaptive coping mechanisms. Two themes also emerged as needs and preferences in relation to their occupational health and recovery: (1) Formal and targeted training exercise programs; (2) Mandatory health and wellness monitoring programs.</p><p><strong>Conclusion: </strong>The unique occupational demands of firefighting necessitate a multifaceted and holistic approach to shoulder injury management and prevention. This approach encourages the development of tailored intervention programs that address the specific challenges and perceived needs of firefighters with WSDs.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s12982-025-00739-8.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"342"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing challenges for psychotherapy supervision in global mental health through experiential learnings from rural Nepal.","authors":"Pragya Rimal, Srijana Shrestha, Rekha Khatri, Sabitri Sapkota, Sikhar Bahadur Swar, Madhur Basnet, Kripa Sigdel, Sunita Jirel, Bibhav Acharya","doi":"10.1186/s12982-025-00645-z","DOIUrl":"10.1186/s12982-025-00645-z","url":null,"abstract":"<p><p>As the field of global mental health grows, many psychotherapy trainees will work across cultures in low-resource settings in high-income countries or in low- and middle-income countries. Mentors and supervisors, including faculty members, may face several challenges in providing supervision for psychologists in low-resource settings. As such, there is a need to develop best practices for psychotherapy supervision in global mental health. We describe the common challenges and potential strategies in psychotherapy supervision based on our research, clinical, and academic partnerships between academic institutions, a nonprofit organization, and the Nepali government. The strategies and considerations we have found helpful include focusing on therapies with strong behavioral and interpersonal (rather than emotional or cognitive) components and using locally validated therapies or standard manuals that have been endorsed by the WHO for low-resource settings. Other strategies include providing psychotherapy training for local psychiatrists who may be in supervisory roles using the train-the trainer models to help them gain competence in navigating different expectations of social structures and family dynamics. Supervisors face many challenges while supporting trainees and early psychologists in global mental health settings. While ensuring local adaptation, key considerations can be developed into best practices to support supervisors, particularly psychiatrists and other faculty members based in high-income settings, and trainees based in low- and middle-income countries.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"246"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A holistic approach to community health in the latino/x population: the intersection of environment and health.","authors":"Olivia Croskey, Jackie Curnick, Brandi Janssen","doi":"10.1186/s12982-025-00830-0","DOIUrl":"10.1186/s12982-025-00830-0","url":null,"abstract":"<p><p>This quality improvement project used a Community Health Worker model and tailored environmental health information to deliver a 4-week program with the intention of improving environmental health literacy to a group of Latina women in a group setting. A mixed methods approach showed meaningful themes emerging amongst the groups, including a sense of empowerment and overall concern for the environment, as well as a sense of community amongst them. Surveys supported an overall positive impact on their knowledge, attitudes, beliefs, and actions. Projects like these may help empower the Latina community and create a greater sense of belonging while improving overall health.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"412"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing and documenting cultural adaption of evidence-based practice strategies to reduce opioid overdose deaths: examples and lessons from the HEALing communities study.","authors":"Erin B Gibson, LaShawn Glasgow, Monica Nouvong, Margaret McGladrey, Darcy Freedman, Deborah Chassler, Rachel Vickers-Smith, Madeline D'Onfro, Dawn A Goddard-Eckrich, Timothy Hunt, Avik Chatterjee, JaNae Holloway, Katie Fain, Rachel Sword Cruz, Linda Sprague Martinez","doi":"10.1186/s12982-025-00696-2","DOIUrl":"10.1186/s12982-025-00696-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Addressing the opioid overdose crisis requires developing contextually specific strategies promoting the adoption of evidence-based practices (EBPs) to prevent and treat opioid use disorder (OUD), including overdose education and naloxone distribution (OEND) and medications for OUD (MOUD). To effectively reach the groups most affected by the opioid crisis, EBP strategies must be adjusted to fit the culture and contexts of different communities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The HEALing Communities Study engaged coalitions in 67 communities across four states to select and implement EBP strategies to reduce opioid overdose mortality. Coalitions were encouraged to culturally adapt EBP strategies for \"special populations,\" which were defined as groups that are highly impacted by OUD and face unique challenges in accessing prevention and treatment services. EBP strategies, and any efforts to culturally adapt them, were documented in coalition action plans. We collected quantitative and qualitative details from coalitions' action plans. Following the first wave of the intervention (January 2020 - June 2022), we utilized the DATA (Describe, Analyze, Theorize, and ACT) model to evaluate the HEALing Communities Study approach to reaching special populations and identify areas for improvement. Finally, we identified variations across states in how cultural adaptation was interpreted and implemented. We provide strategies to improve how cultural adaption strategies are developed, documented, implemented, and monitored in future studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Coalitions selected and implemented a variety of culturally tailored EBP strategies. However, complete understanding of the nature and effectiveness of cultural adaptation was limited by varying interpretations of what counts as cultural adaptation, inconsistent use of reporting guidance across research sites, and lack of data on the reach of each EBP strategy. Examples of cultural adaptation that successfully reached special populations included locating EBP strategies near each other to reduce transportation barriers, funding community-based organizations to help unhoused individuals meet basic needs, and hiring a bilingual and bicultural workforce to support prevention and treatment for OUD. Future studies should improve reporting of intersectional identities, measure EBP strategies' reach, utilize real-world evidence of successful implementation strategies for cultural adaptation, and incorporate qualitative methods to contextualize cultural adaptation at local levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We call on funders, researchers, evaluators, and implementers to invest in training and technical assistance, robust documentation and monitoring protocols, and thoughtful community engagement to support cultural adaptation of EBP strategies to reduce overdose for the most vulnerable populations.&lt;i&gt;Trial registration&lt;/i&gt;: ClinicalTrials.gov Identifier: N","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"296"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles outbreak investigation in Kakumiro District, Uganda, February-May 2024.","authors":"Emmanuel Okiror Okello, Richard Migisha, Immaculate Ampaire, Fred Nsubuga, Joanita Nalwanga, Patrick Kwizera, Paul Edward Okello, Lilian Bulage, Benon Kwesiga, Alex Riolexus Ario","doi":"10.1186/s12982-025-00446-4","DOIUrl":"10.1186/s12982-025-00446-4","url":null,"abstract":"<p><strong>Background: </strong>On April 7, 2024, the Uganda Ministry of Health was notified of a measles outbreak in Kakumiro District involving death of a suspected case. We investigated to determine the scope of the outbreak, assess risk factors for disease transmission, and recommend evidenced-based interventions.</p><p><strong>Methods: </strong>We defined a suspected case as onset of fever and maculopapular generalized rash with ≥ 1 of cough, coryza, or conjunctivitis in any resident of Kakumiro District during February<b>-</b>May 2024. A confirmed case was a suspected case with laboratory confirmation for measles Immunoglobulin M (IgM) antibody. We line-listed cases, performed descriptive analysis, and conducted a 1:1 case-control study with 100 randomly selected cases and village-matched controls. We identified risk factors using logistic regression and estimated vaccine coverage using the percentage of eligible controls who had received ≥ 1 dose of measles vaccine. We calculated Vaccine Effectiveness (VE) as VE = 1 - <i>OR</i> _<i>adj</i>  × 100%, where OR_adj is the adjusted odds ratio associated with having received ≥ 1 dose of measles vaccine.</p><p><strong>Results: </strong>We identified 188 suspected cases, including 6 (3.2%) confirmed and 1 (0.5%) death. The overall attack rate (AR) was 67/100,000 persons. Children aged < 9 months (AR = 232/100,000) and those aged 9 months-≤ 5 years (AR = 177/100,000) were the most affected. The most affected sub-counties were Kisengwe (AR = 313/100,000), Kasambya (AR = 126/100,000) and Kakumiro Town Council (AR = 110/100,000). Non-vaccination (aOR = 2.9, 95%CI 1.1-7.6), exposure to a measles case in a health facility during exposure period (aOR = 47, 95%CI 6.09-369) and exposure to measles case in the same household during exposure period (aOR = 9.3, 95%CI 2.9-30) were associated with measles infections. Vaccine coverage was 88% (95%CI 79%-94%) and vaccine effectiveness was 65% (95%CI 13%-91%). We observed crowding and lack of triaging/isolation in health facilities.</p><p><strong>Conclusions: </strong>This outbreak was facilitated by non-vaccination and propagated by exposure to infected persons in health facilities and households. We recommended to MoH to conduct a supplementary immunization activity that included children < 9 months in the target group. Triaging and isolation of cases might help to reduce the spread of measles in future outbreaks. There is also need to develop strategies to improve vaccine effectiveness in the district.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of the COVID-19 pandemic on supervised consumption service delivery in Vancouver and Surrey, Canada from the perspective of service providers.","authors":"Tyson Singh Kelsall, Michelle Olding, Tara Myketiak, Nitasha Puri, Kanna Hayashi, Thomas Kerr, Mary Clare Kennedy","doi":"10.1186/s12982-025-00393-0","DOIUrl":"10.1186/s12982-025-00393-0","url":null,"abstract":"<p><p>Following the onset of the COVID-19 pandemic, an ever-increasing number of people have died from the toxic drug supply in Canada. Emerging evidence suggests that reduced access to harm reduction services has been a contributing factor. However, the precise impacts of the pandemic on supervised consumption service (SCS) delivery have not been well characterized. The present study sought to explore the impacts of the pandemic on SCS delivery in Vancouver and Surrey, Canada. Between October 2021 and March 2022, in-depth, semi-structured interviews were conducted with staff from two SCS: SafePoint in Surrey (n = 12) and Insite in Vancouver (n = 9). Thematic analysis focused on key changes to SCS delivery after the emergence of the COVID-19 pandemic, with a focus on associated challenges and emergent staff responses. Participants described key challenges as: capacity restrictions hindering service access and compromising care quality; exclusion of frontline staff perspectives from evolving SCS policy and practice decision-making; intensified power dynamics between staff and service users; and modified overdose response procedures, combined with a rise in complex overdose presentations, undermining service accessibility and quality. Emergent staff responses to these challenges included: collective staff organizing for changes to policy; individual frontline staff non-compliance with emerging policies; and staff experiencing burnout in their roles. This study highlights how COVID-19-related changes to service delivery produced challenges for SCS staff and service users, while identifying strategies employed by staff to address these challenges. Additionally, the findings point to opportunities to improve care for people who use drugs during intersecting public health crises.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community perspectives on cancer and cancer research: findings from listening sessions with diverse groups in Philadelphia.","authors":"Karen Glanz, Emma Adelia Soliva, Krista Scheffey, Yawei Song, Charnita Zeigler-Johnson, Evelyn T González, Thierry Fortune, Nilsa Graciani, Amy E Leader","doi":"10.1186/s12982-025-00713-4","DOIUrl":"10.1186/s12982-025-00713-4","url":null,"abstract":"<p><strong>Background: </strong>Listening sessions are useful for understanding community perspectives on cancer disparities. The Philadelphia Communities Conquering Cancer (PC3) coalition conducted listening sessions to identify community priorities for cancer prevention and control research among diverse communities in Philadelphia.</p><p><strong>Methods: </strong>Guided by a Stakeholder Advisory Committee, PC3 partnered with community-based organizations to conduct 8 listening sessions with diverse communities (including Black, Hispanic, Asian, Russian, LGBTQ + , and veterans) to learn about perceptions of cancer, research priorities, and training and communication preferences. Sessions were facilitated by community members or PC3 members in the primary language of participants. Sessions were audio recorded, transcribed, and coded. NVivo analysis software was used to confirm main themes.</p><p><strong>Results: </strong>There were 126 participants who ranged in age from 21 to 90. Participants were primarily female (78.6%), 60 + years of age (61%), and non-white (80%), with less than college education (75%). Participants' general views of cancer were negative and shrouded in helplessness and burden. Cancer research was viewed both positively and negatively. Hesitation to participate in research was related to negative experiences, language barriers, distrust, and lack of information. Participants preferred receiving information about research from sources that they considered to be reputable and in their preferred languages. Participants thought that community researcher trainings could be facilitated by incentives, transportation, and flexibility in scheduling.</p><p><strong>Conclusions: </strong>Common themes and perspectives about cancer, research, and barriers to cancer care were shared across groups. Identifying and implementing community-derived strategies for overcoming barriers can increase cancer research participation among diverse populations and help reduce cancer disparities.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s12982-025-00713-4.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"329"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demography Integrated Surveillance for Health Assessment-Geriatric (DISHA-G), a rural cohort of older adults in Odisha, India.","authors":"Jaya Singh Kshatri, Tanveer Rehman, Daisy J A Janssen, Susan D Shenkin, Subrata Kumar Palo, Sanghamitra Pati","doi":"10.1186/s12982-025-00686-4","DOIUrl":"10.1186/s12982-025-00686-4","url":null,"abstract":"<p><p>With an increasing number of older people across low and middle income countries such as India, longitudinal observational research is required to understand the processes of aging, care seeking behaviours and outcomes in such groups. As most of the older adults in such regions live in rural areas with limited resources, and with no such cohorts available to carry out such studies, we have establied a first of its kind geriatric rural cohort in eastern India. This study describes the profile of a large cohort of 18,389 rural older adults, aged 50 years or more, that was built within a Health, Demography and Environment Surveillance System (HDESS). The study primarily focuses on profiling older adults' sociodemographic and health characteristics, as well as their healthcare-seeking behavior patterns. We use exploratory regression analysis to understand factors influencing care-seeking preferences. We use R software packages for analysis and data management. The entire population of HDESS is 76,391 which has been establihed in 50 villages of Tigiria, Odisha state in eastern India, between 2021 and 2022. This cohort provides a valuable longitudinal platform for studying aging processes, chronic disease progression, and intervention implementation. Self-reported prevalence of chronic conditions and multimorbidity was 9.5%, with diabetes (10.6%) and hypertension (22.0%) the most common ones. Most rural older adults, irrespective of their wealth status, preferred public to private healthcare facilities (91%) for either mild illness, general care or emergency/severe illness. To reduce informal healthcare seeking behaviour (8.3%) of older adults in rural India, services need to be available, but social factors must also be addressed. The DISHA-G cohort provides a unique longitudinal platform to study aging and healthcare-seeking behaviors in rural India. Key findings reveal significant reliance on public healthcare and significant informal care-seeking, influenced by insurance coverage and socioeconomic status, highlighting barriers to formal care. Policy initiatives should focus on expanding health insurance coverage, improving accessibility to public healthcare, and addressing socioeconomic barriers to reduce reliance on informal care among rural older adults.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s12982-025-00686-4.</p>","PeriodicalId":520283,"journal":{"name":"Discover public health","volume":"22 1","pages":"282"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}