BMC Public Health最新文献

{"title":"Cardiometabolic outcome of MyBFF@school intervention program among primary schoolchildren: a cluster randomized controlled trial.","authors":"Muhammad Yazid Jalaludin, Ruziana Mona Wan Mohd Zin, Farah Aqilah Roslan, Fazliana Mansor, Fuziah Md Zain, Janet Yeow Hua Hong, Nur Zati Iwani Ahmad Kamil, Abqariyah Yahya, Zahari Ishak, Rusidah Selamat, Abdul Halim Mokhtar","doi":"10.1186/s12889-025-23546-x","DOIUrl":"https://doi.org/10.1186/s12889-025-23546-x","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of obesity is associated with the increase in type 2 diabetes, dyslipidemia and hypertension among children. The MyBFF@school study aimed to assess the effectiveness of a 6-month intervention program on the cardiometabolic markers of the overweight and obese primary schoolchildren.</p><p><strong>Methods: </strong>MyBFF@school is a cluster randomized controlled trial involving 23 of 1196 government schools in Malaysia. Schoolchildren aged <math><mrow><mn>9</mn> <mo>-</mo> <mn>11</mn></mrow> </math> years with a body mass index (BMI) adjusted for gender and age (BMI z-score) > + 1 SD were recruited. This program (incorporating physical activity, nutrition and psychological components) was conducted during school hours. The effect of the intervention on cardiometabolic status was determined both within and between groups using repeated analysis of variance together with analysis of covariance. Out of 1397 schoolchildren, 683 (intervention = 390 and control = 293) had fasting blood taken at baseline and month-6.</p><p><strong>Results: </strong>At the end of the intervention, both the intervention and control groups had significantly increased BMI, however, when adjusted for gender and age, the BMI z-score in the intervention group showed no changes, whereas the control group had a significant increase in BMI z-score (mean difference of 0.03, 95% CI: 0.04, 0.06, p = 0.026). Fasting insulin showed significant reduction in the intervention group (-3.16 μU/mL (95% CI: -4.07, -2.25), p < 0.001) vs control (-1.05 μU/mL (95% CI: -2.28, 0.18), p = 0.095) (p < 0.001 between groups). A significantly greater reduction of HOMA-IR was observed in the intervention group [-0.41 (95% CI: - 0.63, -0.19), p < 0.001] vs control [-0.17 (95% CI: -0.45, 0.11), p = 0.231)] (p < 0.001 between groups). HDL-C also showed significant increment of 0.34 mmol/L [(95% CI: 0.32, 0.36), p < 0.001] in the intervention and 0.11 mmol/L [(95% CI: 0.08, 0.14), p < 0.001] in the control group (p < 0.001 between groups). A significant reduction of TG: HDL-C ratio was observed in both the intervention [-0.17 mmol/L (95% CI: -0.21, -0.12), p < 0.001] and control groups [-0.12 mmol/L (95% CI: -0.17, -0.07), p < 0.001] (p = 0.524 between groups).</p><p><strong>Conclusion: </strong>MyBFF@school resulted in significant improvements of fasting insulin, HOMA-IR and HDL-C in the intervention group. We recommend MyBFF@school program to improve the cardiometabolic markers of the overweight and obese primary schoolchildren.</p><p><strong>Trial registration: </strong>Clinical trial number: NCT04155255, November 7, 2019 (Retrospective registered). National Medical Research Register: NMRR-13-439-16563. Registered July 23, 2013. The Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia and Educational Planning and Research Division (EPRD), Ministry of Education Malaysia approved the intervention program. It was funded by the Min","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"24 Suppl 1","pages":"3630"},"PeriodicalIF":3.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697547","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 affordable and effective pandemic containment measures in lower-income countries with a spatial SEIR model: a case study in South Africa.","authors":"Lingyu Fan, Wenzhong Shi, Qing Pei, Anshu Zhang","doi":"10.1186/s12889-025-23686-0","DOIUrl":"https://doi.org/10.1186/s12889-025-23686-0","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has exposed the vulnerabilities of lower-income countries due to limited healthcare infrastructure and socioeconomic constraints, highlighting the need for effective containment measures that minimize socioeconomic costs and prepare for future pandemics alike, which are expected to become more frequent. Although prior studies have examined various strategies in these regions, a significant gap remains in quantitative research on affordable measures to combat the highly transmissible SARS-CoV-2 Omicron variant, which greatly challenges effective measures for previous strains. Studies on targeted containment measures for Omicron have dramatically declined even in higher-income regions, and their findings could be much less applicable in lower-income regions due to substantial socioeconomic disparities.</p><p><strong>Methods: </strong>This study addresses this gap by focusing on South Africa. A spatial Susceptible-Exposed-Infected-Recovered (SEIR) model was developed to simulate the virus spread during the country's first Omicron wave from November 2021 to April 2022, integrating multisource statistics to overcome the typical scarcity of inter-city mobility data in lower-income countries. Three affordable containment measures were examined: (1) restricting inter-city mobility in epicenter provinces, while allowing nationwide intra-city movement for livelihood activities; (2) home isolation for positive cases, alongside quarantine for co-residents, accounting for high rates of asymptomatic cases, underreporting, and delays of self-isolation; and (3) prioritizing booster vaccinations for high-risk healthcare workers.</p><p><strong>Results: </strong>The findings indicate that restricting inter-city mobility in the epicenter Gauteng, which only accounted for 3.6% of national mobility, could reduce national infections by 15.0%. Quarantining households with positive cases could reduce infections by 10.9%, despite the high rates of asymptomatic cases and presymptomatic transmission. Prioritizing booster vaccinations was also effective when healthcare workers had a much higher infection risk than others. Meanwhile, these measures incurred minimal socioeconomic costs compared to earlier pandemic strategies. Additionally, the spatial variation of containment measure effectiveness suggests that timely implementation of these measures before the infection rate escalates is critical for ensuring their effectiveness.</p><p><strong>Conclusions: </strong>This research provides essential insights for lower-income countries to manage current and future pandemics within their economic and healthcare constraints, especially regarding targeted mobility restriction, quarantine, prioritized vaccination, and timing of containment measures.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2526"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697597","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":"The impact of loneliness on depression among college students: the mediating role of problematic internet use and the moderating role of perceived social support.","authors":"Zhang-Lian Xie, Kai-Peng Gan, Jun Li, Long-Wei Qin, Yi-Ting Wu","doi":"10.1186/s12889-025-23759-0","DOIUrl":"https://doi.org/10.1186/s12889-025-23759-0","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2534"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697603","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":"Prevalence and factors associated with physical activity in adolescents from five secondary schools in northern Peru.","authors":"Mario J Valladares-Garrido, Palmer J Hernández-Yépez, Sebastián Arámbulo-Castillo, Luz A Aguilar-Manay, Jassmin Santin Vásquez, Darwin A León-Figueroa, Víctor J Vera-Ponce, Danai Valladares-Garrido, Edwin Aguirre-Milachay, Virgilio E Failoc-Rojas, César J Pereira-Victorio","doi":"10.1186/s12889-025-23596-1","DOIUrl":"https://doi.org/10.1186/s12889-025-23596-1","url":null,"abstract":"<p><strong>Introduction: </strong>With the persistence of global challenges related to the COVID-19 pandemic, it has become essential to explore the dynamics of physical activity in adolescents. Although knowledge exists on the importance of physical activity for overall health, understanding the factors influencing adolescent physical activity patterns remains a less explored terrain. This study aims to determine the prevalence and factors associated with physical activity in adolescents in Lambayeque, Peru.</p><p><strong>Methods: </strong>An analytical cross-sectional study with secondary data analysis was conducted in adolescents from five secondary schools. Physical activity was assessed using the PAQ-A questionnaire. Its association with various factors was investigated, such as bullying (EBIPQ questionnaire), self-esteem (Rosenberg questionnaire), family dysfunctionality (APGAR Family questionnaire), resilience (abbreviated CD-RISC questionnaire), insomnia (ISI questionnaire), depressive-anxious symptoms and stress (DASS21 questionnaire), suicidal risk (Plutchik Suicide Risk Scale), eating disorder (SCOFF questionnaire), acne (Spanish Acne Severity Scale-EGAE), and quality of life (DLQI questionnaire).</p><p><strong>Results: </strong>Of 1266 adolescents, the mean age was 14.6 years, and 54.6% were male. The prevalence of active physical activity was 33.8% (95% CI: 31.20-36.49). In multiple regression analysis, factors associated with physical activity included male sex (PR: 1.51), having a very frequent family approach (PR: 1.26), a high level of resilience (PR: 1.15), having a crush (PR: 1.19), and mild anxious symptoms (PR: 1.30). In contrast, frequent use of social networks (PR: 0.72), moderate (PR: 0.64) or severe (PR: 0.66) family dysfunctionality, medium (PR: 0.85) and low (PR: 0.80) levels of self-esteem, and an extreme effect on quality of life due to acne (PR: 0.66) were negatively associated with physical activity.</p><p><strong>Conclusions: </strong>The findings reveal a relatively low prevalence of active physical activity among adolescents. The positive association with resilience, family closeness, and mild anxious symptoms highlights the importance of strengthening protective factors to encourage physical activity in this vulnerable group. Conversely, the negative influence of family dysfunctionality, low self-esteem, and the impact of acne on quality of life underscores the need to address these psychosocial aspects to promote a healthy lifestyle in adolescents in the post-COVID era. These findings inform more effective intervention strategies, thus contributing to the holistic well-being of youth in the current global health landscape.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2528"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697600","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":"The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia.","authors":"Aaron Kobina Christian, Egerson Daniel, Olutobi Adekunle Sanuade","doi":"10.1186/s12889-025-23769-y","DOIUrl":"https://doi.org/10.1186/s12889-025-23769-y","url":null,"abstract":"<p><strong>Introduction: </strong>Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment.</p><p><strong>Methodology: </strong>Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants.</p><p><strong>Results: </strong>Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups.</p><p><strong>Conclusion: </strong>NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2535"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697604","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":"Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus.","authors":"Hanyi Lee, Hyeon Sik Chu","doi":"10.1186/s12889-025-23765-2","DOIUrl":"https://doi.org/10.1186/s12889-025-23765-2","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2530"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697599","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":"Effects of air pollution and noise exposure on occupational hearing loss in oil workers: a prospective cohort study.","authors":"Zheng Li, Haoruo Zhang, Nan Wang, Shangmingzhu Zhang, Zhenghao Luo, Xiaoqing Xuan, Mingyue Liu, Xinyang Chen, Xiaoming Li, Ling Xue, Jianhui Wu","doi":"10.1186/s12889-025-23677-1","DOIUrl":"https://doi.org/10.1186/s12889-025-23677-1","url":null,"abstract":"<p><strong>Background: </strong>Occupational Hearing Loss (OHL) is a significant health concern among oil workers, influenced by environmental and occupational factors. This study investigates the independent and synergistic effects of air pollution and noise exposure on OHL risk in this high-risk population.</p><p><strong>Methods: </strong>A prospective cohort study included 1,179 oil workers from Hebei Province, China, with baseline data (2017-2019) and follow-up until 2023. Air pollution exposure (PM_2.5, PM₁₀, SO₂, NO₂, CO, and the Air Quality Comprehensive Index, AQCI) was assessed using monitoring station data, while cumulative noise exposure (dB(A)-year) was calculated from workplace measurements. Multivariable-adjusted Modified Poisson regression and Restricted Cubic Splines (RCS) analyzed associations and dose-response relationships.</p><p><strong>Results: </strong>The OHL incidence was 34.5% (n = 407). Air pollutants exhibited significant nonlinear associations with OHL: PM_2.5 showed a U-shaped curve, SO₂ an inverted U-shape, and NO₂ an S-shaped curve. Noise exposure ≥ 85 dB(A)-year tripled OHL risk (Relative Risk, RR = 2.361, Confidence Interval, 95%CI: 1.861-2.994). Synergistic effects were robust for AQCI (RR = 5.776, 95%CI:3.225-10.345) and NO₂ (RR = 4.297, 95%CI:1.879-9.825) with high noise exposure, while PM₁₀ demonstrated antagonistic effects.</p><p><strong>Conclusions: </strong>Air pollution and noise exposure independently and synergistically increase OHL risk in oil workers. AQCI and NO₂, combined with noise, are critical risk factors. These findings underscore the need for integrated exposure monitoring, optimized ventilation, and enhanced personal protective measures in high-risk occupational settings.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2527"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697595","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":"Do psychosocial factors affect the (occupational) well-being of German police officers? A cross-sectional study.","authors":"Yunes Nazzal, Faiz Dogru, Janna Schlenke, Fabian Holzgreve, Ioannis Karassavidis, Verena Komanek-Prinz, Rejane Golbach, Eileen M Wanke, Gerhard Oremek, David A Groneberg, Daniela Ohlendorf","doi":"10.1186/s12889-025-23772-3","DOIUrl":"https://doi.org/10.1186/s12889-025-23772-3","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2531"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697594","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":"Sickness absence > 14 days following sport-related traumatic brain injuries: a nationwide register-based study in Sweden.","authors":"Christian Oldenburg, Linnea Kjeldgård, Helena Stigson, Emilie Friberg","doi":"10.1186/s12889-025-23711-2","DOIUrl":"https://doi.org/10.1186/s12889-025-23711-2","url":null,"abstract":"<p><strong>Background: </strong>Sport-related traumatic brain injuries (SR-TBI) have received increasing concerns regarding potential long-term consequences. For adults in the general population, one of these consequences is inability to resume daily activities, most notably sickness absence (SA) from work. The aim of this study was to investigate how often SR-TBI is followed by a registered period of SA.</p><p><strong>Methods: </strong>A nationwide register-based study was conducted. Source population: working aged individuals (18-63 years), living in Sweden during 2014-2016. Using the national patient register we included patients with a TBI diagnosis with the ICD-10 activity code 'while engaged in a sporting activity', excluding those with a TBI diagnosis in the preceding 365 days. Information on type of injury (e.g., concussion), cause of injury (e.g., falls, strikes by objects) and received healthcare (outpatient and/or inpatient) was collected. Basic sociodemographic variables were fetched from Statistics Sweden (age, sex, education level, marital status, type of living area, country of origin, receiving income from work). The Swedish Social Insurance Agency provided data on SA episodes lasting longer than 14 days. We calculated the incidence of new SA and estimated risk ratios (RRs) with 95% confidence intervals using modified Poisson regression (log link, robust variance) for both crude and multivariable models. Multinomial logistic regression assessed factors associated with SA duration (< 30 days, 30-90 days, > 90 days).</p><p><strong>Results: </strong>2826 individuals were identified. The majority (91%) had suffered a concussion. A new SA was found for 7% of the individuals with concussion and 32% for those with other intracranial injuries. Higher risk of a new SA was observed for other intracranial injuries compared to concussion (RR 2.76, 95% CI 2.15-3.53), inpatient care versus outpatient only (RR 1.92, 95% CI 1.50-2.46), and transport accidents versus strikes by living forces (RR 2.14, 95% CI 1.43-3.19). Higher odds for longer spells (> 90 days) were found for those with other forms of intracranial injuries than concussion, OR 10.20 (5.80-17.95) and those who had received inpatient healthcare, OR 3.68 (2.10-6.46).</p><p><strong>Conclusion: </strong>The vast majority of all SR-TBIs are concussions and seldom followed by a new SA. For patients with other types of SR-TBI and for those who required inpatient healthcare a new, and often longer SA were more frequent. Additionally, injuries from transport-accidents (e.g., horseback riding, bicycling) elevated the risk of a new SA, potentially indicating the presence of other physical injuries.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2532"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697601","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":"Labeling in a California Latinx community: public health implications for youth and role in community narratives.","authors":"Elodia Caballero, Alexandra Minnis, Deepika D Parmar, Melissa Zerofsky, Megan Comfort, Marissa Raymond-Flesch","doi":"10.1186/s12889-025-23598-z","DOIUrl":"https://doi.org/10.1186/s12889-025-23598-z","url":null,"abstract":"<p><strong>Background: </strong>Prior research demonstrates that Latinx youth disproportionately receive negative labels from parents, peers, and teachers. Negative labels are stigmatizing and often result in rejection or devaluation of the labeled person which can be pivotal within the developmental window of adolescence. Prior research has already shown that experiences of exclusion and social rejection can have detrimental impacts on mental and physical health. To this end, it is paramount to understand how labeling is wielded, especially among those most vulnerable, to devise thoughtful solutions. This study examines how labeling is operationalized within a Latinx community and consequences of such labels on health-protective behaviors, wellbeing, peer networks and school engagement.</p><p><strong>Methods: </strong>In-depth interviews were conducted with 39 adolescents and 20 mothers from a predominantly Latinx and immigrant agricultural community in California. Teams of coders completed iterative rounds of memoing and team meetings to identify themes and develop a code book of inductive and deductive codes. The team completed iterative rounds of coding to refine the codebook and review code discrepancies to ensure fidelity of coding. After coding of mother and adolescent transcripts an additional round of memos and team meetings focused on similarities and differences in youth and mothers' perspectives about labeling.</p><p><strong>Results: </strong>Dichotomous labeling of \"good\" and \"bad\" arose spontaneously in all mothers and most youth interviews and were pervasive within schools and the broader community. Youth labeled as \"bad\" experienced limited educational opportunities, exclusion from peers, and community disengagement. While \"good kid\" labels resulted in educational opportunity and community acceptance these labels also limited health protective-behaviors in some youth, including foregoing contraception. Participants pushed back on negative labeling when it was applied to close family or community acquaintances.</p><p><strong>Conclusions: </strong>Targeted interventions that foster social belonging and connection rather than exclusion may facilitate health protective behaviors and have positive implications for future trajectories among youth.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2536"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697598","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}