Journal of preventive medicine and public health = Yebang Uihakhoe chi最新文献

{"title":"Comparative Risk Perceptions of Alternative Nicotine Products Among People Who Smoke Cigarettes and Dual Products: Findings From the 2024 ITC Korea Survey.","authors":"Hoang Le Tu, Jin-Kyoung Oh, Hong-Gwan Seo, Gil-Yong Kim, Sung-Il Cho, Sungkyu Lee, Yeol Kim, Gang Meng, Anne C K Quah, Geoffrey T Fong, Yoon-Jung Choi","doi":"10.3961/jpmph.26.338","DOIUrl":"10.3961/jpmph.26.338","url":null,"abstract":"<p><strong>Objectives: </strong>Heated tobacco products (HTPs) and electronic cigarettes (ECs) have rapidly expanded in Korea. This study aimed to examine differences in comparative risk perceptions of HTPs and ECs relative to cigarettes among Korean adults and to identify factors associated with these perceptions.</p><p><strong>Methods: </strong>Data were drawn from the KRA4-Cohort 3 dataset of the nationally representative International Tobacco Control Korea Survey and were analyzed for respondents who currently used cigarettes, HTPs, or ECs. Two ordinal outcomes measured perceived comparative harm of HTPs and ECs relative to cigarettes. Multivariable Bayesian ordinal logistic regression models were fitted, and robustness was assessed using Bayesian Metropolis-Hastings and frequentist sensitivity analyses.</p><p><strong>Results: </strong>Compared with cigarette-only users, respondents who used both cigarettes and HTPs had lower odds of perceiving HTPs as equally or more harmful than cigarettes (adjusted odds ratio [aOR], 0.43; 95% credible interval [CrI], 0.36 to 0.50). Similarly, respondents who used both cigarettes and ECs had lower odds of perceiving ECs as equally or more harmful than cigarettes (aOR, 0.31; 95% CrI, 0.19 to 0.47). Adults aged 40-59 years had higher odds of perceiving both products as equally or more harmful than cigarettes (HTPs: aOR, 1.35; 95% CrI, 1.12 to 1.61; ECs: aOR, 1.42; 95% CrI, 1.18 to 1.73). Noticing tobacco advertising was associated with lower perceived harm. Findings were consistent across the 3 analytic approaches.</p><p><strong>Conclusions: </strong>Lower perceived harm of HTPs and ECs relative to cigarettes was common among Korean adults who smoked cigarettes, especially among dual-product users and those exposed to marketing. Stronger advertising regulation, standardized warnings, and comparative risk education are needed to address misperceptions about relative harmfulness and support cessation.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"519-530"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890038","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":"Interactive Effects of Parental Age on Adverse Birth Outcomes in Japan: An Investigation of Nationwide Birth Data.","authors":"Tasuku Okui","doi":"10.3961/jpmph.26.044","DOIUrl":"10.3961/jpmph.26.044","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the interactive effects of parents' ages, as well as the overall effects of paternal age, on adverse birth outcomes using nationwide data from Japan.</p><p><strong>Methods: </strong>Live birth data from the Vital Statistics Surveys in Japan from 2010 to 2023 were analyzed. Preterm birth, low birth weight, macrosomia, small-for-gestational-age (SGA) status, and large-for-gestational-age status were defined as adverse birth outcomes. Log-binomial regression models were used to examine associations between maternal and paternal ages and adverse birth outcomes. In addition to regression analyses using maternal and paternal age groups separately, we conducted regression analyses using combined parental age groups to assess interactive effects.</p><p><strong>Results: </strong>Data from 12 279 842 live births were analyzed. Overall, the risk ratio (RR) increased significantly with an increase in the paternal age categories for all adverse birth outcomes. In contrast, among mothers aged ≥30 years, the RRs for preterm birth, low birth weight, and SGA status were higher for infants of fathers aged ≤24 years than for those of fathers aged ≥35 years. In particular, the RRs for these outcomes, as well as macrosomia, were highest for the combination of the youngest paternal age group (≤24 years) and the oldest maternal age group (≥40 years).</p><p><strong>Conclusions: </strong>Analysis of nationwide birth data indicated that the effects of paternal age on adverse birth outcomes varied according to maternal age, underscoring the importance of assessing pregnancy risk according to combined parental age.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"458-467"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671717","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":"Effect of Education Based on the Common-sense Model of Self-regulation on Illness Perception Among Older Patients With Hypertension in Iran: A Randomized Controlled Clinical Trial.","authors":"Saeed Hamidizadeh, Mohammad-Rafi Bazrafshan, Omid Barghi, Saleh Vadipeima, Mohammadreza Razavi, Ali Mohammad Parviniannasab","doi":"10.3961/jpmph.26.136","DOIUrl":"10.3961/jpmph.26.136","url":null,"abstract":"<p><strong>Objectives: </strong>Effective blood pressure management requires sustained medication adherence and health-related behavior change. However, limited research has examined hypertension management from the patient's perspective. This study aimed to evaluate the effect of an educational program based on the Common-Sense Model (CSM) on illness perception among older adults with hypertension.</p><p><strong>Methods: </strong>This randomized controlled clinical trial included 62 patients with hypertension who were referred to Khalil-Azad Health Center in Larestan, Iran, from March 2024 to July 2024. Participants were selected and randomly assigned to the intervention group (n=31) or control group (n=31). The intervention group participated in a CSM-based educational program consisting of five weekly 45-60-minute sessions, whereas the control group received routine care only. Participants completed the Brief Illness Perception Questionnaire before the intervention and 8 weeks after the start of the intervention.</p><p><strong>Results: </strong>Before the intervention, illness perception subscale scores did not differ significantly between the intervention and control groups (p>0.05). After the intervention, illness perception subscale scores improved in the intervention group compared with the control group, except for illness consequences, illness concern, and emotional representation (p<0.05 for the remaining subscales).</p><p><strong>Conclusions: </strong>A CSM-based educational program may help nurses and health care providers improve illness perception among patients with primary hypertension.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"468-475"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671628","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":"Non-restorative Sleep and Functional Limitation in United States Adults Aged 25-74 Years: A Propensity Score-matched Analysis.","authors":"Philips Okeagu, Godisgreat Okeke, Yabets Kebede","doi":"10.3961/jpmph.26.293","DOIUrl":"10.3961/jpmph.26.293","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the association between non-restorative sleep (NRS) and functional limitation among United States adults aged 25-74 years, assessed dose-response patterns, and estimated the population attributable fraction (PAF).</p><p><strong>Methods: </strong>This cross-sectional study used national sample Midlife in the United States Refresher 2 data from 2022-2024 (n=1699). NRS was categorized as none or rare (never/rarely), intermediate (sometimes), or frequent (often/almost always). A secondary exposure quantified cumulative sleep burden as the count of 3 problems-trouble falling asleep, night waking, and feeling unrested-reported as often or almost always. Functional limitation comprised difficulty with basic or instrumental activities of daily living. Propensity score matching balanced 15 covariates. The PAF was estimated using a generalized Miettinen approach.</p><p><strong>Results: </strong>Frequent NRS was associated with higher odds of functional limitation than no or rare NRS (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.61 to 3.18). Each 1-category increase was associated with 45% higher odds (OR, 1.45; 95% CI, 1.24 to 1.70). Odds also increased with cumulative sleep problems: 1 problem (OR, 1.66; 95% CI, 1.14 to 2.41), 2 problems (OR, 2.50; 95% CI, 1.63 to 3.81), and 3 problems (OR, 2.50; 95% CI, 1.51 to 4.11), suggesting a plateau at higher burden levels. Under causal assumptions, the PAF was 23.9% (95% CI, 14.3 to 34.3), corresponding to an exploratory estimate of approximately 6.9 million affected United States adults.</p><p><strong>Conclusions: </strong>NRS and cumulative sleep problems were associated with functional limitation in graded patterns that plateaued at higher levels. Sleep disturbance may represent a scalable target for intervention when addressed in middle adulthood.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"509-518"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671697","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":"Dual Use of Electronic and Combustible Cigarettes and Stroke Risk: A Systematic Review and Meta-analysis.","authors":"Ah-Ram Sul, Tae-Hyeok Kim, Heejin Kimm, Yu-Jin Paek","doi":"10.3961/jpmph.26.243","DOIUrl":"10.3961/jpmph.26.243","url":null,"abstract":"<p><strong>Objectives: </strong>Dual use of electronic and combustible cigarettes is increasing, but its association with cardiovascular outcomes, including stroke, remains unclear. This systematic review and meta-analysis evaluated associations of dual use with stroke and other cardiovascular outcomes compared with study-specific reference groups.</p><p><strong>Methods: </strong>Ovid-MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, KoreaMed, and the International Clinical Trials Registry Platform were searched for studies published from 2003 through September 2025. Comparative studies of adults reporting adjusted effect estimates for cardiovascular or cerebrovascular outcomes were eligible. When ≥5 methodologically comparable studies were available, random-effects meta-analysis with restricted maximum likelihood estimation was performed. Heterogeneity was assessed using the Cochran's Q test and Higgins I² statistic. Leave-one-out analyses assessed the robustness of the pooled estimates.</p><p><strong>Results: </strong>Ten observational studies were included: 4 prospective cohort studies and 6 cross-sectional studies. Seven studies reported stroke outcomes. In pooled analyses of cross-sectional studies, dual use was associated with higher odds of stroke than never smoking (adjusted odds ratio, 1.90; 95% confidence interval [CI], 1.50 to 2.40), with substantial heterogeneity (I²=91.3%). Leave-one-out analyses yielded consistent results. Composite cardiovascular outcomes suggested elevated risk but were not pooled because outcome definitions varied substantially. One prospective cohort study reported increased all-cause mortality risk (adjusted hazard ratio, 2.44; 95% CI, 1.90 to 3.13).</p><p><strong>Conclusions: </strong>Dual use of electronic and combustible cigarettes was associated with higher odds of stroke than never smoking; however, evidence was predominantly cross-sectional and heterogeneous. Prospective studies using standardized exposure definitions and validated cardiovascular outcomes may clarify long-term cardiovascular risk.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"448-457"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842756","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":"Global, Regional, and National Burden of Heart Failure Attributable to Chronic Obstructive Pulmonary Disease From 1990 to 2021, With Projections to 2050.","authors":"Xiaojing Deng, Huiqing Xu, Yeping Bian, Yunting Xu, Guofeng Ao, Luyan Yang, Ying Ji, Jian Xu, Fei Xu","doi":"10.3961/jpmph.26.200","DOIUrl":"10.3961/jpmph.26.200","url":null,"abstract":"<p><strong>Objectives: </strong>Heart failure (HF), a common comorbidity of chronic obstructive pulmonary disease (COPD), is associated with an increased risk of death among patients with COPD. However, no systematic assessment has quantified the population-level burden of comorbid COPD and HF, worldwide. This study assessed the global, regional, and national HF burden attributable to COPD from 1990 to 2021 and projected this burden to 2050.</p><p><strong>Methods: </strong>Data on the non-fatal burden of COPD-attributable HF, including prevalence and years lived with disability (YLDs), were obtained from the Global Burden of Disease Study 2021. Temporal trends in age-standardized rates (ASRs) for COPD-attributable HF from 1990 to 2021 were examined using joinpoint models. Bayesian age-period-cohort models were used to project ASRs to 2050.</p><p><strong>Results: </strong>From 1990 to 2021, the absolute numbers of prevalent cases and YLDs for COPD-attributable HF increased globally, and the ASRs for prevalence and YLDs also increased. These upward trends were projected to continue to 2050. The burden of HF attributable to COPD was consistently higher in males than in females and higher in older adults than in younger individuals. By severity level, the burden of HF attributable to COPD was mainly driven by the treated and severe subtypes of HF. The burden varied substantially across regions, with low-socio-demographic index regions had the highest age-standardized burden.</p><p><strong>Conclusions: </strong>The global non-fatal burden of HF attributable to COPD was substantial from 1990 to 2021 and may continue to increase to 2050. Public health interventions targeting HF attributable to COPD may help reduce this burden.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"476-488"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671657","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":"Agreement Between Artificial Intelligence Platforms and the UpToDate Lexidrug Database in Identifying Antihypertensive Drug-drug Interactions in Older Adults.","authors":"Januarius Tomi Kiik, Agung Endro Nugroho, Soni Siswanto","doi":"10.3961/jpmph.26.359","DOIUrl":"10.3961/jpmph.26.359","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the agreement and consistency of classifications generated by ChatGPT-4.5 and Meta AI (Llama 4 Scout) with those of the UpToDate Lexidrug reference standard for identifying potential drug interactions involving antihypertensive medications in older adults.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using electronic medical record data from January 2024 to December 2024. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess agreement between classifications generated by ChatGPT-4.5 or Meta AI and those of UpToDate Lexidrug as the reference standard. In addition, Cohen's kappa values were used to assess inter-rater agreement regarding the severity of the identified drug interactions.</p><p><strong>Results: </strong>ChatGPT-4.5 showed greater agreement with the reference standard (UpToDate Lexidrug), with an accuracy of 80.5%, sensitivity of 86.2%, specificity of 78.0%, PPV of 62.8%, and NPV of 92.9%, compared with Meta AI, which had an Should be 70.6%, sensitivity of 75.0%, specificity of 68.7%, PPV of 51.0%, and NPV of 86.3%. Cohen's kappa analysis showed fair agreement between both platforms and the reference standard (0.367 and 0.359, respectively).</p><p><strong>Conclusions: </strong>ChatGPT-4.5 demonstrated greater alignment with the UpToDate Lexidrug classification compared to Meta AI across all evaluated metrics. However, both artificial intelligence platforms showed only fair agreement in severity classification, indicating substantial differences between the classifications generated by the platforms and those of the reference database.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"531-541"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842751","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":"Social Capital in Digitally Mediated Communities: Conditional Associations With Depressive Mood in Korea.","authors":"Kyungmin Baek","doi":"10.3961/jpmph.26.305","DOIUrl":"10.3961/jpmph.26.305","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined whether engagement with different online community environments moderates the association between social capital and depressive mood.</p><p><strong>Methods: </strong>Using the 2023 Korea Social Integration Survey (n=8221), a nationally representative survey conducted by the Korea Institute of Public Administration, social capital was measured as an index of participation in 9 types of voluntary and community organizations, and depressive mood was assessed using a single-item measure of day-to-day emotional distress. Ordinary least squares regression models with interaction terms were used to determine whether the association between social capital and depressive mood varied across 3 types of online community environments: messenger services, social networking services (SNS), and membership-based online communities.</p><p><strong>Results: </strong>Higher levels of social capital were associated with higher levels of depressive mood (b=0.327), contrary to the conventional assumption that social participation is uniformly beneficial. Interaction analyses indicated that this association varied across online community environments. Frequent messenger service use was associated with a weaker positive association between social capital and depressive mood (b=-0.084), whereas SNS use showed a smaller and more conditional moderating effect (b=-0.042). Use of membership-based online communities was not a statistically significant moderator.</p><p><strong>Conclusions: </strong>The mental health implications of social participation depend on how social engagement is organized across offline and online contexts. Relationally oriented digital environments, particularly messenger services, may attenuate the emotional burden associated with extensive social participation. These findings underscore the need to consider digitally mediated community environments in public mental health research and interventions.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"489-497"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671733","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":"Physical Inactivity and Non-communicable Disease Burden in Five ASEAN Countries: A 12-Year Panel Analysis Using Structural Equation Modeling and Machine Learning Projections.","authors":"Moch Yunus, Mahalul Azam, Endang Sri Wahjuni, Ronal Surya Aditya, Reem Lafi AlMutairi, Supriyadi Supriyadi","doi":"10.3961/jpmph.26.543","DOIUrl":"10.3961/jpmph.26.543","url":null,"abstract":"<p><strong>Objectives: </strong>Non-communicable diseases (NCDs) are a leading cause of preventable mortality in Southeast Asia, but population-level evidence linking physical inactivity to NCD burden across the Association of Southeast Asian Nations (ASEAN) remains limited. This study quantified associations between physical inactivity prevalence and NCD-related disability-adjusted life years (DALYs), cardiovascular mortality, and diabetes prevalence across five ASEAN countries from 2010 to 2021 and projected 2025 NCD burden trajectories under an exploratory business-as-usual scenario.</p><p><strong>Methods: </strong>A longitudinal panel dataset of 60 country-year observations was analyzed using fixed-effects regression with Driscoll-Kraay standard errors, partial least squares structural equation modeling, and XGBoost machine learning with Shapley additive explanations. Missing data (2.1-6.4%) were handled using multiple imputation by chained equations.</p><p><strong>Results: </strong>Physical inactivity was independently associated with NCD DALYs (β=0.421; 95% confidence interval, 0.251 to 0.591; p<0.001). A significant attenuating interaction with the universal health coverage (UHC) index was observed (β=-0.183; 95% CI, -0.358 to -0.008; p=0.041). Because the UHC index was rescaled to 10-point units, this indicates that for every 10-point increase in the UHC index, the regression coefficient for physical inactivity decreased by 0.183 units (DALYs per 100 000 population), demonstrating a significant buffering effect of health system coverage on the inactivity-NCD association. The structural equation model explained 78.2% of the variance in NCD burden and identified a significant exploratory longitudinal indirect association through health system resilience, with 19.8% of the total association mediated through this pathway. Under the exploratory business-as-usual scenario, NCD DALYs were projected to increase by 7.8-20.9% by 2025, with Indonesia and the Philippines showing the highest projected increases.</p><p><strong>Conclusions: </strong>UHC expansion may attenuate inactivity-related NCD burden. For ASEAN countries undergoing rapid epidemiological transition, coordinated investment in health system capacity and multisectoral physical activity promotion may help limit projected DALY increases and support progress toward Sustainable Development Goal 3.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"542-554"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890088","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":"When Deepfakes Meet Herd Immunity: Artificial Intelligence, Vaccine Avoidance, and the Next Infodemic Threat.","authors":"Minsoo Jung","doi":"10.3961/jpmph.26.549","DOIUrl":"10.3961/jpmph.26.549","url":null,"abstract":"<p><p>Vaccination remains among the most effective public health interventions, but its impact increasingly depends on public trust and a reliable information environment. During the coronavirus disease 2019 (COVID-19) pandemic, misinformation became a major obstacle to vaccine uptake and disease control. The rapid development of generative artificial intelligence (AI)-including synthetic text generators, conversational chatbots, deepfake images, synthetic audio, and AI-generated videos-has changed how misinformation can be produced, personalized, and disseminated. This Perspective argues that AI-generated misinformation may represent a new stage in the evolution of the infodemic. Compared with earlier forms of vaccine misinformation, AI-generated content can be produced automatically, tailored to individual audiences, made visually persuasive, and distributed at unprecedented speed and scale. Drawing on historical vaccine controversies, health communication research, and epidemiological principles of herd immunity, we propose that AI-driven misinformation should be examined not only as a communication problem but also as a potential epidemiological risk factor that may weaken population immunity. The implications extend beyond vaccine hesitancy to the preparedness and resilience of public health systems during future pandemics. We discuss how anti-vaccination movements may change in the AI era and propose responses centered on trust-building, digital health literacy, information surveillance, and community engagement to support vaccine confidence and pandemic preparedness.</p>","PeriodicalId":520687,"journal":{"name":"Journal of preventive medicine and public health = Yebang Uihakhoe chi","volume":" ","pages":"555-559"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842764","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}