{"title":"The hidden toll: psychological and physical consequences of providing informal care to adults in China.","authors":"Lu Zhang, Hai Gu, Yun Kou, Jinghong Gu","doi":"10.1093/heapro/daaf110","DOIUrl":"https://doi.org/10.1093/heapro/daaf110","url":null,"abstract":"<p><p>Rapid population ageing and insufficient formal care have led over 80% of Chinese older adults to rely on informal care. Yet, research on caregivers' health costs in developing countries remains scarce and inconclusive. This study aims to assess the relationship between informal caregiving and caregivers' multidimensional health and identify the vulnerable groups. Utilizing data from the Harmonized CHARLS, which includes 16 287 participants from 28 Chinese provinces, we assessed psychological health via the CES-D10 scale and physical health by chronic disease count. Ordinary least squares evaluated the association between informal caregiving and psychological health, and Zero-inflated Poisson regression examined the relationship with physical health. We also applied propensity score matching and placebo tests to mitigate potential endogeneity. Our findings reveal that informal caregivers have significantly higher CES-D10 scores [b = 0.859, SE = 0.339, P = 0.011, confidence interval (CI) (0.194, 1.525)] and a greater likelihood of chronic diseases [odds ratio (OR) = 1.213, SE = 0.039, P < 0.001, CI (1.117, 1.269)] compared with non-caregivers. The negative health effects are especially pronounced among women, rural hukou holders, and the employed. Our study argues that policies should prioritize the health deterioration of informal caregivers over their cost-effectiveness, particularly among vulnerable groups. It calls for adequate support for informal caregivers, including gender-sensitive subsidies for female caregivers, improved primary healthcare for rural caregivers, and flexible working arrangements for employed caregivers to reduce their burdens.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feeling lonely in the online crowd: what TikTok tells us about young people and loneliness.","authors":"Bethan Harries, Marco Zenone, Greg Hartwell","doi":"10.1093/heapro/daaf094","DOIUrl":"10.1093/heapro/daaf094","url":null,"abstract":"<p><p>Loneliness is a pressing public health issue, with young people particularly affected. Given the widespread use of TikTok among younger demographics, the platform plays an influential role in shaping perceptions of health topics. This study examines the self-perceived causes and experiences of loneliness expressed by TikTok users. We built a dataset of the most popular, publicly available English-language TikTok videos globally that used the hashtag #lonely and performed a qualitative content analysis to assess (i) video tone, (ii) self-expressed identities related to loneliness, (iii) unmet desires expressed as the cause of loneliness, (iii) absences expressed as the cause of loneliness, and (v) changes in life circumstance as the cause of loneliness. The included videos (n = 184) generated over 687 million views. Absence (69.6%) was the prevailing theme of self-perceived causes of loneliness. This absence was mostly attributed to a lack of quality in a person's relationships (33.7%) or having no relationship (32.1%). Mental health (26.1%) was the most cited expression of identity related to the experience of loneliness. The overall sentiment of the videos was negative (83.2%). No videos were made by healthcare professionals or healthcare organizations offering health information or support. TikTok is an accessible, underutilized, and valuable data resource to understand the public portrayal and sentiment of pressing health topics in young people. Results reveal a prevalence of negatively toned videos, primarily expressing absence as a root cause of loneliness.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen Jane Senior, Navid Teimouri, Michael Waller, Simon Capewell, Katherine Cullerton
{"title":"How governments influence public health research: a scoping review.","authors":"Helen Jane Senior, Navid Teimouri, Michael Waller, Simon Capewell, Katherine Cullerton","doi":"10.1093/heapro/daaf097","DOIUrl":"10.1093/heapro/daaf097","url":null,"abstract":"<p><p>Governments can become involved in academic research to assist in public health decision-making. However, when governments become involved, the research process can be influenced away from academic research practices, jeopardizing research integrity. This review aimed to improve understanding of this by (i) establishing the extent of literature about government influence on research, (ii) detailing key characteristics of influence, and (iii) identifying gaps meriting future investigation. We conducted a scoping review to identify relevant literature by searching five electronic databases and grey literature. Two reviewers independently screened titles, abstracts, and full-text. Extracted data included the source, characteristics of the research projects, and the influence reported. Results were categorized and analysed using numerical summaries and narrative synthesis. The literature search yielded 6890 documents, with 71 eligible for full-text review. Seventeen documents met the inclusion criteria. Published between 2007 and 2021, most came from the UK (n = 8) and/or Australia (n = 11), with two coming from both. 126 modes of influence were reported, which could take multiple forms within one document and occur at any stage of the research process. The modes of influence were categorized as 'Direct' in 11 documents, 'Indirect' in 14, and/or 'Subtle' in 4. Influence was predominantly negative in 13 documents, with one reporting solely positive influences. This review summarizes reported instances of governments influencing the public health research process. The results highlight a need for deeper understanding of government-academic interactions and more transparent mechanisms for good practice. By fostering positive interactions, we can support beneficial population health outcomes. The protocol was registered on the Open Science Framework on 20 Aug 2023 (https://doi.org/10.17605/OSF.IO/YB7FE).</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail K Winiker, Laura N Sisson, Kristin E Schneider, Saba Rouhani, Emily M Martin, Danielle Friedman Nestadt, Bradley E Silberzahn, Leanne Zhang, Katherine Footer, Susan G Sherman
{"title":"Navigating US illicit drug market volatility: harm reduction strategies employed by people who inject drugs.","authors":"Abigail K Winiker, Laura N Sisson, Kristin E Schneider, Saba Rouhani, Emily M Martin, Danielle Friedman Nestadt, Bradley E Silberzahn, Leanne Zhang, Katherine Footer, Susan G Sherman","doi":"10.1093/heapro/daaf125","DOIUrl":"10.1093/heapro/daaf125","url":null,"abstract":"<p><p>The US illicit drug market is increasingly unreliable, with new and often harmful adulterants contributing to overdose risk among people who use drugs. In this context, it is crucial to examine whether people who inject drugs (PWID) are aware of these changes and if so, how they are adapting to inform harm reduction interventions and programs. In-depth interviews were conducted with 23 PWID between July 2022 and January 2023. Interviews explored participants' substance use behaviors and perspectives on harm reduction interventions. A combined deductive and inductive thematic analysis was conducted to identify emergent themes. This analysis focuses upon participants' discussions around drug market activity/changes, drug-related harms, drug use risk perceptions, and harm reduction strategies. Participants demonstrated awareness of the increasing volatility and risk associated with illicit substance use. They reported engaging a range of strategies to reduce the risk of these harms, motivated by individual-level cognitions and behaviors, as well as external-level interpersonal relationship dynamics. These findings highlight that perceived risk translates to behavior change amid a changing market, suggesting the need for universal drug testing access, responsive health education/harm reduction programming, peer-based interventions, and structural changes to reduce barriers to harm reduction behavior change.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health literacy and its influencing factors among the chronically ill: insights from a population survey.","authors":"Suwon Hwang, Hae-Young Kim, Mankyu Choi","doi":"10.1093/heapro/daaf124","DOIUrl":"10.1093/heapro/daaf124","url":null,"abstract":"<p><p>Health literacy (HLIT) is critical for effective self-care in managing chronic illnesses and their outcomes, necessitating targeted interventions. However, existing research is limited in size and scope. This study analysed the status and influencing factors of HLIT among chronically ill individuals in South Korea using a population-based national survey from the Korea Health Panel Survey. From March to July 2021, data were collected from 5652 respondents who reported at least one chronic condition. HLIT was assessed using the 16-item European Health Literacy Survey Questionnaire adapted for the Korean context. Bivariate and multiple linear regression analyses were performed. The mean HLIT score was 10.48, which is slightly lower than those of the general population of Korea and other countries. Bivariate results indicated that individuals aged 70 years or older, females, those with lower socioeconomic status, those living in rural areas, and those with three or more chronic conditions had the lowest HLIT levels. Multivariate analysis revealed that older age, female sex, unemployment, single status, lower education and income, and a higher number of chronic diseases were associated with lower HLIT levels. Additionally, the most significant challenge facing chronically ill individuals with relatively low HLIT was finding or using information to manage their conditions. These findings suggest that people with chronic illnesses experience heightened HLIT-related challenges, compounded by managing multiple chronic conditions, broader disparities, and social determinants of health. Future interventions should address the specific barriers chronically ill individuals face to promote HLIT and improve health outcomes in this vulnerable population.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ava Chaplin, Liza McGuinness, Anne Gadermann, Brenda T Poon, Emily K Jenkins
{"title":"Contributors to positive mental health among youth: a qualitative study in British Columbia, Canada.","authors":"Ava Chaplin, Liza McGuinness, Anne Gadermann, Brenda T Poon, Emily K Jenkins","doi":"10.1093/heapro/daaf127","DOIUrl":"10.1093/heapro/daaf127","url":null,"abstract":"<p><p>The mental health of youth aged 15-25 is a growing public health concern worldwide, signalling the need for expanded and innovative responses. Approaches to addressing this issue have prioritized treatment and recovery at the individual level, with limited attention to the broader contexts that shape mental health and illness. This study sought to explore youths' perspectives on positive mental health and its determinants. Drawing on in-depth, semi-structured interviews with a diverse sample of youth aged 15-25 (n = 35) from British Columbia, Canada, data underwent thematic analysis guided by a socio-ecological mental health promotion (MHP) framework. Analysis yielded three interconnected themes: (i) perspectives shaped by broader social discourses, (ii) cultivating belonging, and (iii) creating meaning. Participants articulated varying perspectives regarding factors that shape mental health, some of which were grounded in notions of individual responsibility, while others encompassed a wider range of social and political influences. Participants also identified several key contributors to positive mental health, including peer connections that encourage trust, reciprocity, and growth; supportive familial relationships that provide a foundation for wellbeing; access to safe and affirming community spaces for intellectual or creative expression; and engagement in volunteerism or advocacy to establish a sense of purpose and meaning. These findings offer new insights that can extend current responses to youth mental health, including evidence to inform MHP efforts to build and strengthen positive mental health and wellbeing. Findings have the potential to guide policies and programming to enhance wellbeing among youth across the life course.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interactions between registered dietitians and the food industry in Canada: results from a cross-sectional survey.","authors":"Virginie Hamel, Mélissa Mialon, Jean-Claude Moubarac","doi":"10.1093/heapro/daaf118","DOIUrl":"10.1093/heapro/daaf118","url":null,"abstract":"<p><p>In recent years, relationships between nutrition professionals and the food industry have raised concerns over the risks they may pose to the profession's credibility and integrity. However, empirical research on the nature and frequency of these interactions, as well as how professionals manage them, is limited. An online cross-sectional survey was conducted among 167 Registered Dietitians (RDs) from Quebec, Canada, regarding (i) the nature and frequency of their interactions with the industry, (ii) their perceptions of existing risks and benefits of those interactions, (iii) the strategies they employed to manage these interactions, and (iv) their confidence levels in managing those interactions. RDs in Quebec have experienced, on average, 1.7 interactions per month with the industry over the past year (May 2022-May 2023). The three most frequently reported interactions were (i) receiving targeted communications from the industry, (ii) participating in continuing education provided by the industry, and (iii) receiving educational materials for professionals and consumers created by the industry. Overall, RDs acknowledged benefits associated with interacting with the industry (e.g. improving the food quality of products on the market) but also identified risks (e.g. compromising professional independence) and discussed strategies to mitigate these risks, including referring to their Code of Ethics (56.9%). In conclusion, RDs in Quebec engage with the food industry in various ways. Perceptions of risks and benefits related to these interactions vary considerably, highlighting the need for training and standardized strategies to minimize conflicts of interest and manage these interactions effectively.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simone M Schmid, Carrie Soo Hoo, Catherine M Pirkle, Michael M Phillips, Mika Thompson, Ann Yoshida, Heidi Hansen Smith, Lance Ching, Julia Finn, Tetine Sentell
{"title":"Culturally relevant physical activity in Hawai'i: outrigger canoeing across an adapted social-ecological model.","authors":"Simone M Schmid, Carrie Soo Hoo, Catherine M Pirkle, Michael M Phillips, Mika Thompson, Ann Yoshida, Heidi Hansen Smith, Lance Ching, Julia Finn, Tetine Sentell","doi":"10.1093/heapro/daaf130","DOIUrl":"https://doi.org/10.1093/heapro/daaf130","url":null,"abstract":"<p><p>Outrigger canoe paddling (\"paddling\") is a culturally and regionally relevant physical activity (PA) in Hawai'i and the Pacific with potential for public health promotion and disease prevention, yet paddling remains understudied from a public health perspective. This study explored the meaning of paddling across levels of the social-ecological model (SEM) using qualitative methods. The study goal was to develop a research base and inform scholarship about participation in paddling for public health. A total of 1066 Hawai'i residents (18 + years) completed an online or phone survey about culturally relevant PA. Among them, 362 self-identified as current or former paddlers and responded to the open-ended question: 'What does outrigger canoe paddling mean to you?'. Qualitative analysis was conducted using a deductive-inductive approach. Findings revealed themes spanning an adapted SEM: (i) intrapersonal-fun, relaxation, PA; (ii) proximal connections-relationships with people past and present; (iii) distal connections-teams, canoe(s), and the ocean \"humanized\" as part of the community; (iv) environmental-immersion in the natural world; (v) macrosocial-culture, traditions, ancestral knowledge; and (vi) spiritual-life symbolism and spirituality. Many respondents reported multiple levels of the SEM in their responses, which can be seen in this illustrative quote, sharing that padding meant: '…physical health, emotional balance, spiritual connection with ocean and self, building trust and communication with a team.' Paddling fosters health, well-being, and community across SEM levels, making it a strong candidate for PA interventions aligned with best-practice public health guidelines.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha L Thomas, Ilona Kickbusch, Mihály Kökény, Orkan Okan
{"title":"40 years of the Ottawa Charter for Health Promotion-Reaffirming Health for All.","authors":"Samantha L Thomas, Ilona Kickbusch, Mihály Kökény, Orkan Okan","doi":"10.1093/heapro/daaf143","DOIUrl":"https://doi.org/10.1093/heapro/daaf143","url":null,"abstract":"","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maeve Murray, Stephen Behan, Craig Smith, Hannah Goss
{"title":"Health literacy research on the island of Ireland: a systematic review.","authors":"Maeve Murray, Stephen Behan, Craig Smith, Hannah Goss","doi":"10.1093/heapro/daaf138","DOIUrl":"https://doi.org/10.1093/heapro/daaf138","url":null,"abstract":"<p><p>Consistently, low health literacy has been found to lead to poorer health outcomes, both internationally, and in Ireland. Given this knowledge, there is a need to understand key thematic trends, methodological approaches and evidence gaps in policy and practice. Seven electronic databases (Science Direct, MEDLINE, CINAHL Complete, Web of Science, Scopus, PsychoINFO, and SPORTDiscus) were searched between October and December 2023 focusing on studies published in English between 2013 and 2023. Initial peer reviewed records (N = 551) were screened resulting in 37 studies included in this review. Narrative analysis indicated that across the island of Ireland many studies had narrow populations of focus (e.g. Dublin based, adults, chronic illness populations), limited research design and methodologies (e.g. cross-sectional, narrative, and primary research with short time frames), and lacked rigorous monitoring and evaluation of health literacy as a primary or secondary outcome. Future health literacy research in Ireland should consider: (i) contextual and sociodemographic factors (age, sex, ethnicity, socioeconomic status) when aiming to improve health literacy in different populations, (ii) exploring health literacy beyond the clinical domain, (iii) advocating for sustainability of effective programmes, and (iv) rigorous, longitudinal evaluation of health literacy. Quality research in these areas will support the meaningful and sustainable development of health literacy in Ireland, with findings that can be transferred internationally.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}