BMC Public Health最新文献

{"title":"Estimating the cost of and willingness to pay for providing the dapivirine ring for HIV prevention in Kenya.","authors":"Peter Stegman, Steven Forsythe, Urbanus Kioko, Millicent Kiruki, Patriciah Jeckonia, Martha Larson, Delivette Castor, Guy Mahiane, Maryline Mireku, Mike Ekisa, Kristine Torjesen, Mary Mugambi, Daniel Were, Katharine Kripke","doi":"10.1186/s12889-025-22291-5","DOIUrl":"https://doi.org/10.1186/s12889-025-22291-5","url":null,"abstract":"<p><strong>Background: </strong>As Kenya prepared to introduce the PrEP ring (a long-acting product used by women for HIV prevention), the need to understand the resources required became increasingly important. The aim of this study was to determine the costs and preferences of potential ring clients by conducting a normative cost analysis and a contingent valuation study (In the context of willingness to pay literature, \"preference\" is used to refer to an interest in a service or product with specified benefits).</p><p><strong>Methods: </strong>The study incorporates two parts: 1) a normative costing to estimate potential costs of providing the PrEP ring and 2) a willingness to use/pay assessment to evaluate client preference for the PrEP ring. Oral PrEP program managers from 12 facilities were interviewed to assess the direct and indirect resources required to deliver PrEP ring services. 539 women were interviewed (including both younger and older women, as well as female sex workers) using a questionnaire to assess the strength of the expressed interest in PrEP ring use, as reflected by their contingent valuation of the product. Women were presented with payment cards from which they selected the most they would be willing to pay. The primary outcomes of the study were: 1) the annual cost of PrEP ring use and 2) the average willingness to pay for the PrEP ring. Women in the willingness to pay component were selected, using a convenience sample, with approximately equal numbers of oral PrEP users and clients from other health services.</p><p><strong>Results: </strong>The cost to provide a full year of PrEP ring was US$206; 76% (US$156) of that cost was attributed to the PrEP rings. Of the respondents, 78% indicated some interest in using the PrEP ring; among those interested, 83% indicated some willingness to pay for it. Single women and women currently using oral PrEP expressed more interest in using the ring than women who were married or were not currently oral PrEP users. The median willingness to pay per visit was US$1.86.</p><p><strong>Conclusions: </strong>This analysis revealed that costs are predominantly driven by commodities. Attempts to further reduce the cost of the commodities could significantly reduce the overall cost of PrEP ring service. Approximately half the women were willing to pay up to US$2 per month for the PrEP ring. Since the demand for the PrEP ring appears to be higher among current oral PrEP users compared to non-users, women who have initiated oral PrEP but who are unable or unwilling to continue may be good candidates for PrEP ring use. The annual willingness to pay for the PrEP ring (US$11.16) was significantly lower than the ring's cost ($206 per year), which suggests that attempts to fully recover costs would present a significant barrier for Kenyan women and would minimize societal benefits.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1095"},"PeriodicalIF":3.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed opportunities for detection of hypertension in public health facilities of 18 districts in India, 2022.","authors":"Mogan Kaviprawin, Archana Ramalingam, Anu Varghese, Arun Vashishtha, Dogendra Singh Parihar, Inderjit Singla, Jhilam Mitra, Karanpreet Kaur Johal, Madhuri Birbal Nimsatkar, Mrunal Madhukar Mahadik, Muneer Mohd, Pranay Shukla, Rahul Gupta, Rajendran N, Robin C Oommen, Rupali Bharadwaj, Sandeep Singh Gill, Satish Kn, Shrikant Kumar Chandrakar, Vazinder Kaur Dhunna, Sachin Tadas, Ganeshkumar Parasuraman, Sharan Murali, Ramya Nagarajan, Manikandanesan Sakthivel, Kalyani Sailesh, Srinath Ramamurthy, PavanKumar Gollapalli, Mohamed Jainul Azarudeen, Mohankumar Raju, S Yedhu, Aarthy Ramasamy, Abhishek Bicholkar, Prabhdeep Kaur","doi":"10.1186/s12889-025-22284-4","DOIUrl":"https://doi.org/10.1186/s12889-025-22284-4","url":null,"abstract":"<p><strong>Background: </strong>More than half of the individuals with hypertension remain undiagnosed in India. The National Non-Communicable Disease (NCD) program has implemented opportunistic screening to improve diagnoses. In the public health facilities across 18 districts in nine states of India, we estimated the missed opportunity for hypertension detection in routine program settings.</p><p><strong>Methods: </strong>In each of the chosen districts, we conducted a cross-sectional study in one district hospital (DH), one community health centre (CHC), and three primary health centres (PHCs), selected randomly. We collected data from 706 consecutively enrolled eligible out-patient department (OPD) attendees in each facility type and abstracted the data regarding coverage and yield of opportunistic screening for hypertension from the available registers. We then derived the missed opportunity for hypertension detection. We also estimated the median time for Blood Pressure (BP) measurement through observation and derived the staff requirement for BP screening at each facility type.</p><p><strong>Results: </strong>Of the 41,012 eligible OPD attendees, 32.1% [31.6%-32.5%]) were screened for hypertension. The yield for hypertension screening was 23.2% (3,050/13,157). Among the OPD attendees, the proportion of missed diagnoses for hypertension among the expected was 57.1% (1,962/3,437), 67.4% (1,860/2,758), and 79.3% (2,597/3,274) in PHCs, CHCs, and DHs, respectively. The minimum number of dedicated staff required for measuring BP was one at PHC/CHC and two at DH.</p><p><strong>Conclusions: </strong>Sixteen out of every 100 eligible OPD attendees miss the opportunity to get diagnosed with hypertension due to inadequate screening coverage. Innovative measures like task-sharing and utilizing trainee nurses for BP measurement to overcome staff shortages can help improve screening coverage.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1082"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring cervical cancer screening awareness, beliefs, barriers, and practices among indonesian muslim women in Japan: a qualitative study.","authors":"Yusi Riwayatul Afsah, Noriyo Kaneko","doi":"10.1186/s12889-025-22285-3","DOIUrl":"https://doi.org/10.1186/s12889-025-22285-3","url":null,"abstract":"<p><strong>Background: </strong>The population of migrant women in Japan is increasing, with a corresponding need for access to health services. Cervical cancer screening (CCS) coverage remains very low within this group. This is an increasingly difficult challenge for Muslim migrant women due to their religious values and beliefs. However, research addressing the awareness, beliefs, barriers, and practices of Muslim migrant women in Japan regarding CCS is lacking. This study aims to fill this gap by exploring CCS awareness, beliefs, barriers, and practices among Indonesian Muslim women in Japan.</p><p><strong>Methods: </strong>A qualitative study was conducted in Osaka, Japan, involving in-depth interviews with 12 Indonesian Muslim women. Data were collected between January and April 2023. All participants were between 20 and 50 years old, Muslim, married, had resided in Japan for a minimum of 3 years, and had no cervical cancer diagnosis.</p><p><strong>Results: </strong>The participants demonstrated awareness regarding cervical cancer and CCS. However, in actual practice, they encountered several obstacles that might have prevented them from undergoing CCS, including language barriers, lack of information, pain, and psychological factors. All participants preferred female doctors for CCS procedures.</p><p><strong>Conclusions: </strong>This research provides information regarding factors that influence Indonesian Muslim migrant women seeking CCS. The need for structured and organized efforts is critical to improve the healthcare system and increase Japan's readiness to accept not only Muslim patients but also migrant patients in general.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1084"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the nonlinear association between cardiometabolic index and hypertension in U.S. Adults: an NHANES-based study.","authors":"Huatao Zhou, Yu Mao, Muyao Ye, Zhongkun Zuo","doi":"10.1186/s12889-025-22231-3","DOIUrl":"https://doi.org/10.1186/s12889-025-22231-3","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a prevalent chronic disease affecting over 1.2 billion people worldwide, representing a major modifiable risk factor for cardiovascular diseases. The Waist-to-Height Ratio (WHtR) and Triglyceride to High-Density Lipoprotein Cholesterol (TG/HDL-C) ratio are established metabolic indicators linked to the risk of cardiovascular and metabolic diseases. Recently, a Cardiometabolic Index (CMI), combining WHtR and TG/HDL-C ratios, has been proposed to provide a comprehensive assessment of metabolic health. This study investigates the association between CMI and hypertension using data from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>The study utilized NHANES data from nine cycles spanning 2001 to 2018, encompassing 20,049 participants aged over 20. Exclusions were made for individuals with incomplete CMI or hypertension data, and pregnant women. CMI was calculated by multiplying the WHtR by the TG/HDL-C ratio. Hypertension was defined according to American Heart Association guidelines. The relationship between CMI and hypertension was evaluated using multivariate logistic regression analyses, with additional subgroup analyses conducted based on demographic factors. Nonlinear relationships were analyzed using smoothing curve fitting techniques.</p><p><strong>Results: </strong>The study identified a significant positive correlation between CMI and hypertension risk, with an increase of one unit in CMI associated with a 9% heightened risk of hypertension (OR: 1.09, 95% CI: 1.05, 1.13). The association remained significant across various demographic subgroups. A nonlinear relationship was observed, with a critical CMI threshold of 2.64. Below this threshold, higher CMI values were associated with a progressively higher prevalence of hypertension, whereas beyond this threshold, further increases in CMI did not significantly correlate with an elevated risk of hypertension.</p><p><strong>Conclusion: </strong>The study demonstrates that CMI is significantly associated with hypertension risk and may serve as a valuable tool for early screening and risk assessment, particularly in identifying individuals at higher risk before reaching the critical CMI threshold. These results underscore the importance of addressing metabolic health in the prevention and management of hypertension. Future research should focus on longitudinal studies to establish causality, explore the clinical utility of CMI in hypertension screening, and examine its applicability in diverse populations.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1092"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failed reciprocity in core social roles and cardiovascular disease mortality: prospective results from the U.S. health and retirement study.","authors":"Johannes Siegrist, Timothy A Matthews, Jian Li","doi":"10.1186/s12889-025-22259-5","DOIUrl":"https://doi.org/10.1186/s12889-025-22259-5","url":null,"abstract":"<p><strong>Background: </strong>Several epidemiologic cohort studies documented increased risks of cardiovascular disease (CVD) resulting from exposure to psychosocial stress at work, as measured by theoretical models, such as the demand-control model and effort-reward imbalance (ERI) model. Few studies extended these concepts beyond paid work. With this study, we explore associations of ERI in family and household work, voluntary work and/or partnership with prospective CVD mortality risk, in addition to ERI at work.</p><p><strong>Methods: </strong>In the frame of the U.S. Health and Retirement Study (HRS), 4,642 individuals with mean age 61.5 who were employed at baseline (2006-2008) provided full data on ERI at work and beyond work, sociodemographic factors, lifestyle behaviors, and health conditions. Mortality data through the end of 2018 were available through linkage to the National Death Index. Participants were dichotomized into 'low' and 'high' group for each ERI dimension. Prospective associations of the two types of ERI at baseline with CVD mortality during follow-up were estimated, using competing-risk Cox proportional hazards regression.</p><p><strong>Results: </strong>Independ effects of work ERI and social ERI on CVD mortality risk were observed (HR: 1.66 [1.08; 2.53] and HR: 1.56 [1.02; 2.38], respectively). The hazard ratio of CVD mortality among participants with joint exposure was 2.58 [1.49; 4.45], compared to unexposed participants. This risk was further augmented (HR: 3.38 [1.45; 7.85]) in participants with cardiometabolic disease at baseline.</p><p><strong>Conclusion: </strong>Failed reciprocity in core social roles of adult life is associated with increased CVD mortality risk in this study of older employed persons in the U.S.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1090"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental neighbourhood perceptions and active commuting to school in children according to their sex using a self-organised map approach: a cross-sectional study.","authors":"Javier Molina-García, Xavier García-Massó, Cristina Menescardi, Isaac Estevan, Ana Queralt","doi":"10.1186/s12889-025-22309-y","DOIUrl":"https://doi.org/10.1186/s12889-025-22309-y","url":null,"abstract":"<p><strong>Background: </strong>Built environment attributes can facilitate or represent barriers to active commuting to and from school (ACS). Even though parental perceptions of the built environment and their influence on ACS in children have been extensively studied, there is very limited evidence as to whether these perceptions can vary based on the sex of children. Hence, the present study aimed to analyse the relationships between parental neighbourhood perceptions and ACS, differentiating between boys and girls.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Valencia, Spain. The sample comprised 808 children and one of their parents. Parent-perceived neighbourhood environment, ACS, and socio-demographic data were self-reported through a questionnaire using validated scales. Self-organising map (SOM) analysis was used to describe the interrelationships between parental perceptions and child profiles. These analyses were carried out separately in boys and girls.</p><p><strong>Results: </strong>Parents of daughters perceived their neighbourhoods as less safe from crime compared to parents of sons. The number of ACS trips was similar between boys and girls. The clustering of the SOM outcomes resulted in seven clusters, both in boys and girls. However, cluster membership had significant effects on ACS in boys, but not in girls. Globally, in the group of boys, the highest ACS levels were positively correlated with the most supportive built environments in terms of residential density, land use mix, recreational facilities, accessibility and walking facilities, traffic safety, pedestrian infrastructure, safety from crime, and aesthetics. However, some of these factors had low scores in clusters with high ACS levels (e.g., low levels of accessibility and walking facilities, and land use mix).</p><p><strong>Conclusions: </strong>These findings support the idea that ACS behaviour depends on the interaction of diverse built environment factors. Our results also suggest that parental perceptions had different effects according to the sex of the child, with ACS in boys being more influenced by these perceptions. In the case of girls, it is possible that ACS interventions should emphasise generating child-friendly social environments in addition to strategies to improve the built environment. Future interventions to encourage ACS should consider these sex-specific differences and address parental concerns through improved infrastructure and safety measures.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1089"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda - a cross-sectional population-based study.","authors":"Albert Ndagijimana, Kristina Elfving, Aline Umubyeyi, Torbjörn Lind","doi":"10.1186/s12889-025-22329-8","DOIUrl":"https://doi.org/10.1186/s12889-025-22329-8","url":null,"abstract":"<p><strong>Background: </strong>Childhood stunting, defined as height-for-age below - 2 standard deviations (SD), disproportionately affects the Northern Province of Rwanda. We investigated risk factors contributing to stunting in this region at individual, household, and societal/community levels to inform future interventions.</p><p><strong>Methods: </strong>We conducted a population-based, cross-sectional study using a quantitative questionnaire in households with children aged 1-36 months in the Northern Province. Anthropometric measurements of children and mothers were taken to estimate nutritional status. Multivariable logistic regressions were performed to identify independent risk factors of stunting, reporting odds ratios, 95% confidence intervals and p-values.</p><p><strong>Results: </strong>Overall, stunting prevalence was 27.1% in children aged 1-36 months. At the individual level, boys exhibited 82% higher risk of stunting compared to girls (aOR: 1.82, 95% CI: 1.19, 2.78). Household-level factors such as maternal height and BMI were inversely associated with the risk of childhood stunting (aOR: 0.94, 95% CI: 0.90, 0.97 and aOR: 0.92, 95% CI: 0.86, 0.99, respectively). Other risk factors included no breastfeeding at the time of interview (aOR: 2.00, 95% CI: 1.23, 3.25), presence of twins or triplets aged 1-36 months (aOR: 2.60, 95% CI: 1.21, 5.57), female-headed (single parent) households (aOR: 2.07, 95% CI: 1.00, 4.26), and absence of handwashing facilities near the toilet (aOR: 3.30, 95% CI: 1.36, 7.98). No societal/community factors were significantly associated with childhood stunting in the Northern Province.</p><p><strong>Conclusion: </strong>Childhood stunting in the Northern Province of Rwanda is associated with several factors that could lend themselves to interventions, e.g., improved handwashing facilities, improved childcare practices and targeting vulnerable groups such as boys, households with twins or single parents. Additionally, a thorough exploration of identified risk factors through qualitative approaches involving all stakeholders in child and maternal nutrition is warranted.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1087"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network analysis of anxiety and depressive symptoms among patients with cardiovascular disease.","authors":"Qiuge Zhao, Yuzhen Zhang, Lili Ji, Zhaoqian Pan","doi":"10.1186/s12889-025-22269-3","DOIUrl":"https://doi.org/10.1186/s12889-025-22269-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with cardiovascular disease (CVD) often experience anxiety and depression. However, the central and bridge symptoms of anxiety and depression among patients with CVD remain unclear. Network analysis is a statistical method that can reveal and visualise complex relationships between multiple variables. This study aimed to identify the central and bridge symptoms in the anxiety-depression network, which may provide potential targets for preventing and intervening in anxiety and depression.</p><p><strong>Methods: </strong>A total of 1180 patients with CVD were selected from the Psychology and Behavior Investigation of Chinese Residents. The survey was conducted from July 10 to September 15, 2021. Face-to-face electronic questionnaires were distributed to respondents by the investigators. The Generalized Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depressive symptoms among patients with CVD. Network analysis was conducted using R4.02 to identify central and bridge symptoms in the anxiety-depression network.</p><p><strong>Results: </strong>Among the 1180 patients with CVD included in this study, 673 (57%) were male and 507 (43%) were female. More than half (53.5%) of patients were under 60 years old. The mean GAD-7 score was 4.66 ± 4.38, and 169 (14.3%) patients had anxiety symptoms. The mean PHQ-9 score was 6.29 ± 5.29, and 235 (19.9%) had depressive symptoms. Furthermore, 144 (12.2%) patients people had both anxiety and depressive symptoms. In the network of anxiety and depressive symptoms, \"unable to sit still because of anxiety\", \"feeling afraid that something terrible is about to happen\", and \"feeling bad or like a failure, or disappointing oneself or family\" were the most influential and central symptoms. We also found that \"feeling afraid that something terrible is about to happen\" and \"thoughts of dying or hurting oneself in some way\" were pivotal bridge symptoms between anxiety and depression.</p><p><strong>Conclusions: </strong>This study provides new insights into the network structure of anxiety and depression in patients with CVD. These identified central and bridge symptoms may be potentially effective targets for preventing anxiety and depression in patients with CVD, and may provide treatment strategies for patients with anxiety and depression.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1085"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and cognitive function among community-dwelling older adults: a mediating role of functional fitness.","authors":"Qing Yi, Chengwei Yang, Yufei Qi, Xiaowei Feng, Jingyun Tan, Xiaolong Song, Victor Selvarajah Selvanayagam, Jadeera Phaik Geok Cheong","doi":"10.1186/s12889-025-22321-2","DOIUrl":"https://doi.org/10.1186/s12889-025-22321-2","url":null,"abstract":"<p><strong>Background: </strong>The positive correlation between physical activity and cognitive function has been increasingly documented, while the underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>This study aimed to investigate the association among physical activity (PA), functional fitness, and cognitive function in community-dwelling older adults, and to examine whether functional fitness mediates this association. This study utilized a cross-sectional design, encompassing 224 participants aged 65 or above, with 41.07% male and 58.93% female. The data were collected in 2023 using the Mini-Mental State Examination, Physical Activity Scale for the Elderly, and Senior Fitness Test. Pearson correlation analysis was conducted to assess associations among the variables, and mediation analysis was performed using the PROCESS macro for SPSS.</p><p><strong>Results: </strong>The results indicated that PA had a moderate positive correlation with cognitive function (r = 0.437, p < 0.01) and with most functional fitness domains. In addition, significant positive correlations were found among most functional fitness domains and cognitive function. The association between PA and cognitive function was partially mediated by cardiorespiratory endurance (Effect = 0.0519, 95% CI= [0.0205, 0.0889]).</p><p><strong>Conclusion: </strong>This study demonstrated a positive correlation between PA and cognitive function in older adults, with cardiorespiratory endurance mediating this association. Our study provides valuable preliminary evidence that cardiorespiratory endurance exerts a mediating role between PA and cognitive function. Future longitudinal research is warranted to elucidate the causal relationship and underlying mechanisms between PA and cognitive function.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1081"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the Chinese version of the adult sedentary behavior reduction intention questionnaire based on the theory of planned behavior.","authors":"Jing Ye, Yaqin Li, Lili Yang","doi":"10.1186/s12889-025-22301-6","DOIUrl":"https://doi.org/10.1186/s12889-025-22301-6","url":null,"abstract":"<p><p>PROM: The Chinese version of the Adult Sedentary Behavior Reduction Intention Questionnaire, a 16-item self-reported tool based on the Theory of Planned Behavior (TPB), was developed to assess adults' intentions to reduce sedentary behavior.</p><p><strong>Measurement property: </strong>Internal consistency is used to measure the reliability of the questionnaire, while content and structural validity are studied to assess its validity.</p><p><strong>Design: </strong>A mixed-methods exploratory sequential design with two phases.</p><p><strong>Sample: </strong>Adults aged over 18 years diagnosed with coronary heart disease, with a total daily sedentary time exceeding 6 h, normal cognitive function, and willingness to participate in the study were included.</p><p><strong>Methods: </strong>The study was conducted in two phases. In Phase 1, an initial item pool was developed through a literature review and refined using two rounds of Delphi expert consultation. Expert positivity, authority levels (Cr), coefficients of variation (CV), and Kendall's W coefficient were calculated to assess representativeness, credibility, and consensus. A pilot study evaluated face validity and finalized the scale. In Phase 2, a cross-sectional study involving 316 participants was conducted to assess psychometric properties. Reliability was evaluated using Cronbach's α and split-half reliability, while content validity was assessed using the content validity index (I-CVI). Construct validity was examined through confirmatory factor analysis (CFA).</p><p><strong>Results: </strong>Phase 1 resulted in a preliminary questionnaire with four dimensions and 16 items. Sixteen experts completed two rounds of Delphi consultation, with high response rates (85% and 94.1%) and authority levels (Cr = 0.88 and 0.91). Consensus was strong (CV = 0.05 ~ 0.23; Kendall's W = 0.338 and 0.382, p < 0.001). Phase 2 validation showed a Cronbach's α of 0.967, with individual dimensions ranging from 0.911 to 0.950. I-CVI ranged from 0.813 to 1. The adjusted model indices met the fitting criteria.</p><p><strong>Conclusions: </strong>The developed questionnaire is a reliable and valid tool for assessing Chinese adults' intentions to reduce sedentary behavior. Grounded in TPB, it provides a theoretical foundation for future intervention studies aimed at addressing sedentary lifestyles.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1093"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}