Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Social Media and E-Cigarette Use in Youth: Does Depression Play a Mediating Role?","authors":"Soumya Upadhyay, Mohammad Karim, Shivank Chhaya","doi":"10.1177/00469580261422435","DOIUrl":"10.1177/00469580261422435","url":null,"abstract":"<p><p>About 28% of middle and high school students report the use of e-cigarettes per the 2019 NYTS survey. Social media can seclude a youth into limited set of beliefs, including affirmation for e-cigarette use. Internalizing problems like depression may be due to overuse of social media, and youth with depressive symptoms are more likely to use e-cigarettes to cope. National Youth Tobacco Survey (NYTS) 2023 data was used (n = 18 143) in a cross-sectional design. Ever e-cigarette use was the binary (Y/N) dependent variable. Independent variable, social media use, was categorized as \"never,\" \"nondaily,\" \"daily.\" Mediator variable, presence of recent depression was binary (Y/N). Survey weight adjusted logistic regression and path analysis were employed to identify direct and indirect effects (mediated via recent depression) of social media use on ever e-cigarette use. Social media use (nondaily, aOR = 1.58, <i>P</i> = .032; daily, aOR = 1.91, <i>P</i> < .001; both vs never) and recent depression (yes vs no, aOR = 2.00, <i>P</i> < .001) were independently associated with ever e-cigarette use. In the path analysis, likelihood of social media use (nondaily, aOR = 1.58, <i>P</i> = .037; daily, aOR = 1.88, <i>P</i> < .001; both vs never) and depression (yes vs no, aOR = 1.99, <i>P</i> < .001) being associated with e-cigarette use remained similar to findings of logistic regression. In the mediation analysis, direct effect estimates (nondaily, aOR = 1.52, <i>P</i> = .065; daily, aOR = 1.84, <i>P</i> < .001; both vs never) were consistent with the path analysis results. Compared to direct effect, lower effect size estimates were observed for depression mediated indirect effect (nondaily, aOR = 1.09, <i>P</i> = .057; daily, aOR = 1.10, <i>P</i> < .001; both vs never). We observed that policy changes regarding monitoring of youth's social media use is needed to prevent youth from e-cigarette use.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261422435"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319025","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":"Negative Perceptions, Low Knowledge, and Social Stigma as Barriers to Preconception Care in Primary Health Care.","authors":"Luh Seri Ani, Luh Mertasari, I Gede Gawandhi Arrya","doi":"10.1177/00469580261434470","DOIUrl":"10.1177/00469580261434470","url":null,"abstract":"<p><p>Preconception care (PCC) is an important prevention strategy in primary health care to optimize maternal and fetal health outcomes by addressing pre-pregnancy risks. Although it is beneficial, utilization rates remain very low among women of reproductive age (WRA) in low- and middle-income countries (LMICs), including Indonesia. This qualitative study aims to explore perceptions, knowledge, barriers, and implementation strategies related to pre-pregnancy health screening among WRA who utilize PHC. In-depth interviews were conducted on 21 informants recruited by the purposive method from the Primary Health Center (PHC) in Denpasar City, Bali, Indonesia. Thematic analysis is used to identify the main themes of the transcribed data. Four main themes emerged that are (1) perceptions of pre-pregnancy screening vary from WRA, (2) knowledge levels that tend to be low about PCC, (3) the existence of barriers to access to services, social stigma and screening time constraints, and (4) the integration of screening services as a strategy to increase service coverage. These findings conclude that negative perceptions, low levels of knowledge and access barriers, social stigma and time constraints are related to the low utilization of preconception health screening. These findings contribute to the improvement of global health status. Future policies are implemented to prioritize stigma reduction, knowledge enhancement and expand access through the integration of pre-pregnancy health screening services with Community Clinic to increase the coverage of PCC.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261434470"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534552","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":"Diverse Faces of Saudi Arabia: In-Depth Profiles of Contemporary Older Adults in Riyadh Region.","authors":"Jose Colin C Yee, Nahed Alquwez, Khalaf Alotaibi, Hanaa Diab Khalfallha, Abdulellah Alsolais, Ahmed Mohammed Almoghairi","doi":"10.1177/00469580251403398","DOIUrl":"10.1177/00469580251403398","url":null,"abstract":"<p><p>Graceful aging involves the harmonious development of physical, emotional, social, spiritual, and overall well-being, all of which contribute to successful aging. The demographic shift has moved the focus of policymakers, healthcare providers, and researchers from how to extend the lifespan of individuals to the improvement of the quality of life of the person in later years. The study aims to explore the lives of Saudi older adults holistically. The descriptive phenomenological research design was used. A purposive sampling and snowball were utilized. An interview-guide question was applied to examine the lives of 24 Saudi older adults living in the Riyadh Region, Saudi Arabia. The interview was conducted in October 30, 2024 to March 15, 2025. The study generated seven (7) emergent themes: (1) Proper management of physical frailty and recurring sickness; (2) Attentiveness to health and nutritional limitations; (3) Keeping intimate family bond and interpersonal relationship; (4) Acknowledging increased dependence and support from others; (5) Profound and sincere religious and cultural practices; (6) Appreciating and valuing the meaning of life; and (7) Recalling the most memorable moments in life. The research manifests implications primarily in relation to public and private utilities and facilities, healthcare services, and older adults' health special programs and activities. Additionally, the study bears implications on nursing education, nursing practice, and research in gerontology nursing.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580251403398"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312752","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":"Social and Behavioral Determinants of Healthcare-Seeking and Satisfaction Among Rural Adults in Bangladesh: A Propensity Score Analysis.","authors":"Syed Billal Hossain, Md Mizanoor Rahman, Kapashia Binte Giash, Md Hazrat Ali, Abm Alauddin Chowdhury","doi":"10.1177/00469580261418132","DOIUrl":"10.1177/00469580261418132","url":null,"abstract":"<p><p>In rural Bangladesh, financial protection is limited, and care seeking occurs across government and non-government sectors. This study investigated how social and behavioral factors-family monthly income, education, and adherence to prescribed treatment-relate to the usual source of care and patient satisfaction. A cross-sectional survey was conducted among 374 adults in Sirajganj district. Propensity scores were estimated and analyzed using 1:1 nearest-neighbor matching (caliper 0.20) and inverse probability of treatment weighting (IPTW). We used both propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to reduce confounding and to check the robustness of the estimated associations. Primary outcomes were the usual treatment source and satisfaction with that source; exposures included income, education, and adherence. Adjusted odds ratios (AORs) and 95% confidence intervals (CI) were derived from matched and weighted logistic models. Prespecified interactions and sensitivity analyses assessed robustness. Higher family income strongly predicted use of non-government providers (matching AOR 8.50; weighted AOR 10.11) but showed no significant association with satisfaction. Adherence to prescribed treatment was associated with lower use of non-government care (matching AOR 0.35) and greater satisfaction (matching AOR 3.50), with comparable IPTW estimates. Education above the primary level was not related to provider type but was linked to lower satisfaction (matching AOR 0.30). The positive association between adherence and satisfaction persisted across income and education strata. Sensitivity analyses yielded similar findings. In rural Bangladesh, higher income primarily drives private-sector care use; treatment adherence predicts higher satisfaction and reduced private use; and higher education is associated with lower reported satisfaction. Integrating financial protection with adherence support and experience-of-care improvements may advance equity and patient-reported outcomes toward universal health coverage.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261418132"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229871","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":"Relative Deprivation and Health Among Chinese Adults: The Mediating Role of Subjective Well-Being.","authors":"Yingying Cai","doi":"10.1177/00469580261444668","DOIUrl":"10.1177/00469580261444668","url":null,"abstract":"<p><p>Relative deprivation has been associated with adverse health outcomes, yet the psychological pathways linking perceived socioeconomic disadvantage to health remain insufficiently understood, particularly in the Chinese context. This study therefore examines whether subjective well-being mediates the relationship between relative deprivation and health among Chinese adults. This cross-sectional study analyzed 5604 adults aged ≥ 18 using data from the 2023 Chinese General Social Survey (CGSS) conducted in China. After computing descriptive statistics and correlations, stepwise regression models tested whether subjective well-being mediated the relationship between relative deprivation and health. Indirect effects were estimated using bias-corrected bootstrap procedures (5000 replications). Urban-rural stratification examined geographic heterogeneity in mediation pathways, while robustness checks included ordered logit models and a sensitivity analysis that dichotomized subjective well-being into low and high categories. STATA 18.0 was used throughout. The results indicated that relative deprivation demonstrated a significant negative association with Chinese adults' health. Furthermore, subjective well-being was independently associated with better health outcomes. Mediation analysis revealed that subjective well-being significantly mediated 20.5% of the total effect between relative deprivation and health. Regional stratification showed that the indirect pathway through subjective well-being did not differ significantly between urban and rural residents, whereas the direct effect of relative deprivation on health was significantly stronger among rural residents. These findings highlight the potential role of subjective well-being as a psychological mechanism linking perceived relative deprivation to health. While this pathway appears comparable across urban and rural contexts, the association between relative deprivation and health is stronger among rural residents. Addressing health disparities therefore requires attention to both psychosocial processes and the broader structural conditions that shape socioeconomic inequality.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261444668"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220957","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":"Implementing Indicator Condition-Guided HIV Screening Alerts in the Emergency Department: Lessons Learned from a Case Study.","authors":"Francisco Fanjul, Maria Dolores Macià Romero, Pablo Fraile, Alexandra Guiu, Antoni Campins, Adrià Ferré, Sophia Pinecki, Melchor Riera","doi":"10.1177/00469580261468834","DOIUrl":"10.1177/00469580261468834","url":null,"abstract":"<p><p>IntroductionIndicator condition (IC)-guided HIV testing is recommended internationally as a cost-effective strategy but remains inconsistently implemented, particularly in emergency departments (EDs). Electronic health record (EHR) alerts may improve adherence; however, real-world uptake depends on organizational and specialty-level determinants.MethodsProspective case study conducted between August 2023 and April 2025. A non-interruptive EHR alert was triggered by predefined IC-related laboratory orders and antimicrobial prescriptions. Crucially, the alert was only fired if HIV serology was not already requested, meaning that the accepted tests represented true additional screening. Clinicians could accept or decline testing with a single click. Acceptance patterns were analyzed by age group, clinical service, weekday versus weekend, and diurnal versus nocturnal shifts. The analysis employed descriptive stratification to evaluate confounding between patient age and clinical service volume.ResultsAmong 3,240 alert activations, 523 were accepted (16.1%), resulting in 398 completed tests. Eight patients tested positive (2.01%), including four actionable cases (1.01%). Two declined alerts were followed by subsequent diagnoses of advanced HIV infection. The apparent lower uptake in younger patients was service-level confounded by the concentration of alerts within gynecology/obstetrics (53.7% of all alerts in 18-37-year-olds; global gynecology uptake 3.5%). Outside gynecology, baseline acceptance was consistently higher (15-38%) across all age categories, demonstrating that the apparent age gradient was profoundly confounded by service distribution.ConclusionApparent age-related differences in alert uptake were attenuated after stratification by service distribution rather than intrinsic clinician bias regarding patient age. Specialty culture, workflow alignment, and ownership of preventive tasks appear to be central to the adoption of digital alerts in ED settings.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261468834"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581201","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":"Income and Time Poverty and Metabolic Syndrome in Korea: Sex-Specific Patterns After Hierarchical Adjustment.","authors":"Ji In Lee, Kyung Hee Kim, Jae Wook Choi","doi":"10.1177/00469580261439103","DOIUrl":"10.1177/00469580261439103","url":null,"abstract":"<p><p>This study examined how multidimensional poverty-combining income deprivation and time poverty (working >52 paid hours per week)-is associated with metabolic syndrome (MetS), and whether these associations vary after accounting for employment structure and behavioral risk factors. We conducted a pooled cross-sectional analysis of the Korea National Health and Nutrition Examination Survey data (2013-2023), including 34 650 economically active adults aged ≥19 years. Sex-stratified hierarchical logistic regression models sequentially adjusted for employment type and behavioral risk factors. Among men, time poverty was associated with a higher probability of metabolic syndrome in partially adjusted models (+3.22 pp, <i>P</i> = .009), but this association attenuated after full adjustment (+1.86 pp, <i>P</i> = .125). Among women, dual poverty (+4.53 pp, <i>P</i> = .001) and income-poverty-only (+2.73 pp, <i>P</i> < .001) remained significantly associated with metabolic syndrome in fully adjusted models, whereas time poverty was attenuated (+2.79 pp, <i>P</i> = .065). Self-employment was independently associated with metabolic syndrome in both sexes (<i>P</i> < .001). Associations between poverty type and metabolic syndrome differed by sex and varied across levels of adjustment. The findings indicate that employment structure and behavioral factors are important in interpreting observed associations between multidimensional poverty and metabolic risk.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261439103"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678165","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":"Artificial Intelligence Applicability in the Pharmaceutical Industry: Present Perspectives and Future Formations.","authors":"Maimuna Hasan, Md Faiazul Haque Lamem, Muaj Ibne Sahid, Md Rifat Sarker","doi":"10.1177/00469580261422674","DOIUrl":"10.1177/00469580261422674","url":null,"abstract":"<p><p>Artificial intelligence (AI), like ChatGPT, Microsoft copilot, and Google Gemini, is transforming pharmaceutical research, production, and healthcare delivery. Despite global adoption, the level of AI awareness, readiness, and application among pharmaceutical professionals remains unclear. This study aimed to evaluate the awareness, knowledge, attitudes, and perceptions of AI among pharmaceutical professionals and to identify factors influencing its adoption. A cross-sectional survey was conducted among professionals from various pharmaceutical sectors using a structured online questionnaire. Descriptive statistics were applied to analyze demographic characteristics, AI familiarity, usage, and perceptions. Most respondents (81.8%) were aware of AI, but only 2.3% reported extensive familiarity. ChatGPT was the most frequently used AI tool (63.6%), while only 27.3% reported organizational adoption. Support for AI adoption was high (86.4%), yet only 22.7% considered the industry fully ready. Perceived benefits included improved efficiency (86.4%) and quality (70.4%), while major concerns involved automation dependency (36.4%) and implementation costs (34.1%). Pharmaceutical professionals show strong interest in AI despite limited organizational readiness and formal training. Structured education, regulatory guidance, and ethical frameworks are critical for effective AI integration in the sector.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261422674"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379668","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":"Strengthening Community-Based Mental Health Through Local Governance and <i>Barangays</i> in the Philippines.","authors":"Rowalt Alibudbud","doi":"10.1177/00469580261427075","DOIUrl":"10.1177/00469580261427075","url":null,"abstract":"<p><p>The Slovenian experience of establishing community-based mental health (CBMH) services, including expanding CBMH centers, securing funding, enhancing training, and involving mental health workers, offers a valuable example for the Philippines and other LMICs. It shows that community-based mental health reform needs professionals, empowered communities, and capable local leaders. This paper emphasizes the applicability of Slovenian insights in LMICs, using the Philippines as an example. It highlights the roles of barangay officials and BHWs in implementing CBMH, as they can bridge policy and practice, clinic and community, and stigma and understanding. Their effectiveness depends on clear mandates, ongoing funding, and culturally sensitive training that respects local beliefs and evidence-based care. Overall, the future of community mental health in the Philippines and other LMICs could involve transforming community resources, such as barangays, into recovery centers in which mental well-being is integrated into governance, culture, and community life.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261427075"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464330","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":"Network Analysis of Healthcare Worker Burnout: Organizational Factors Show Highest Centrality.","authors":"Javier A Flores-Cohaila, Brayan Miranda-Chávez, Cesar Copaja-Corzo","doi":"10.1177/00469580261433856","DOIUrl":"10.1177/00469580261433856","url":null,"abstract":"<p><p>Healthcare worker burnout is a complex phenomenon that traditional linear models fail to fully explain. This study uses network analysis to map the associative interactions between organizational factors, mental health symptoms, and burnout dimensions in a national sample of Peruvian physicians and nurses. Cross-sectional network analysis using data from the 2016 National Healthcare Worker Survey, comprising 4951 healthcare professionals (2125 physicians, 2826 nurses). Twenty-two variables spanning burnout dimensions (MBI-GS), mental health symptoms, work satisfaction, and organizational factors were analyzed using Gaussian Graphical Models with bootstrap validation (1000 iterations). Expected Influence, Betweenness, Closeness, and Strength centrality indices were calculated. Network invariance testing compared structural differences between professions. The network comprised 22 nodes with 82 non-zero edges (density = 0.355). Health services management satisfaction showed the highest expected influence (EI = 2.14), followed by monthly income (EI = 1.49). Emotional exhaustion showed substantial negative influence (EI = -0.46). Network invariance testing revealed statistically significant structural differences between professions (<i>M</i> = 0.2289, <i>P</i> = .0099), though overall similarity was moderate to high (ρ = 0.685). Nurses showed higher expected influence for job stability (EI = 0.619 vs 0.375), while physicians showed higher expected influence for marital status (EI = 0.659 vs 0.416). Bootstrap stability coefficients exceeded recommended thresholds (CS = 0.67-0.75). Burnout components showed network patterns consistent with complex adaptive systems, with organizational factors (management satisfaction, income) displaying higher expected influence than individual mental health symptoms. Network structures differed statistically between professions, though with moderate-to-high overall similarity. We propose a preliminary exploratory framework (SPIRAL model) identifying 6 network-based patterns that require prospective longitudinal validation before clinical application.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261433856"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354677","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}