BMC Public Health最新文献

{"title":"Variation in measles seroprevalence among medical students based on place and year of birth: Ege University experience.","authors":"Dilşah Başkol Elik, Mehmet Buğra Özkara, Pınar Kıran, İrem Nur Şahin, Hüseyin Aytaç Erdem, Meltem Işıkgöz Taşbakan","doi":"10.1186/s12889-025-22480-2","DOIUrl":"10.1186/s12889-025-22480-2","url":null,"abstract":"<p><strong>Background: </strong>Measles, despite being a vaccine-preventable disease, remains a significant global health concern. It is crucial that healthcare workers, who serve as the first line of contact with infected individuals, are properly immunized. This study aimed to investigate changes in measles seroprevalence among Ege University Faculty of Medicine students between 2010 and 2024.</p><p><strong>Methods: </strong>Medical faculty students who underwent anti-measles Immunoglobulin G screening at the Infectious Diseases Clinic of Ege University Faculty of Medicine Hospital, in İzmir, Turkey, between January 1, 2010, and January 31, 2024, were included in this study. The demographic data of the participants were recorded from the electronic patient files.</p><p><strong>Results: </strong>The study included 1,448 medical students, of whom 51.9% (n = 751) were male, with a mean age of 21.28 ± 1.48 years. Measles seropositivity was observed in 46.1% of the participants (n = 668). Among those born between 1998 and 2004, seropositivity was 23.8%, whereas it was significantly higher, at 67.5%, in those born between 1986 and 1997 (p < 0.001). Pearson correlation analysisof measles seroprevalence by birth year revealed a strong negative and statistically significant relationship (r=-0.964, p < 0.001). When analyzed by place of birth, the lowest measles seroprevalence was observed in the Eastern Marmara region (34.5%).</p><p><strong>Conclusions: </strong>Our study emphasizes the substantial number of young healthcare workers who are still vulnerable to measles, posing a potential risk during outbreaks. Early screening and vaccination of medical students against vaccine-preventable diseases are essential during their education. This proactive strategy not only protects individuals but also strengthens herd immunity.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2446"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to accessing healthcare for early diagnosis of prostate cancer for black men-a qualitative exploration in North-East England and Scotland.","authors":"Floor Christie-de Jong, Olugbenga Samuel Oyeniyi, Lawrence Achilles Nnyanzi, Jonathan Ling, Marie K Murphy, Judith Eberhardt, Rawand Jarrar, John Kabuye, Martin Kalemba, Kathryn A Robb","doi":"10.1186/s12889-025-23650-y","DOIUrl":"10.1186/s12889-025-23650-y","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is the most commonly diagnosed cancer in men in the United Kingdom. There are substantial inequalities in prostate cancer, with Black African and Caribbean men at least twice as likely as White men to develop prostate cancer, and twice as likely to die from it. Black men need to be aware of their elevated risk, which can encourage help-seeking behaviour leading to early diagnosis. This study aimed to investigate barriers and facilitators to accessing healthcare for early diagnosis of prostate cancer for Black men.</p><p><strong>Methods: </strong>Barriers and facilitators were explored through online focus groups with Black men (n = 13) from Scotland and North-East England, who formed the Public Involvement and Community Engagement group for a larger study. Purposive and snowball sampling was used. Focus groups were audio-recorded and transcribed verbatim. Data analysis was iterative. Framework analysis was used and data were mapped onto the Integrated Screening Action Model (I-SAM).</p><p><strong>Results: </strong>Participants believed Black men lack prostate cancer knowledge. Additionally, prostate cancer communication needs to use language that Black men could identify with. Participants shared a lack of trust in healthcare providers and perspectives emerged resulting from negative healthcare experiences, including experiences of racism, as barriers to accessing healthcare for early prostate cancer diagnosis. Difficulties with accessing care, including navigating the healthcare system and making appointments, as well as cultural, social and religious factors, were reported as barriers to prostate cancer health checks. Discussing intimate and sensitive issues such as prostate cancer was perceived as difficult for Black men. The involvement of community and religious leaders, along with the collectivist characteristic of the community and the belief in staying healthy for the benefit of the family, were perceived as facilitators.</p><p><strong>Conclusion: </strong>Barriers to accessing healthcare for early prostate cancer diagnosis are complex and multifaceted, requiring complex solutions. Asset-based, participatory, and culturally tailored interventions have the potential to be effective in addressing barriers, and thus ultimately reduce morbidity and mortality through earlier diagnosis of prostate cancer in Black communities.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2454"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between life's essential 8 score and the risk of abdominal aortic aneurysm: a prospective cohort study from UK Biobank data.","authors":"Sixu Chen, Zegui Huang, Dachuan Guo, Chang Guan, Zhiteng Chen, Tingfeng Chen, Haifeng Zhang, Yangxin Chen, Jingfeng Wang","doi":"10.1186/s12889-025-22758-5","DOIUrl":"10.1186/s12889-025-22758-5","url":null,"abstract":"<p><strong>Background: </strong>The healthy lifestyle factors have been closely associated with the risk of abdominal aortic aneurysm. The American Heart Association (AHA) recently released a checklist of health factors known as Life's Essential 8 (LE8) to optimize cardiovascular health. The aim of this study was to test the hypothesis that greater adherence to the LE8 score was associated with a decreased risk of new-onset abdominal aortic aneurysm (AAA).</p><p><strong>Methods: </strong>This study included 279,251 UK Biobank participants without a history of AAA. LE8 score was calculated using 8 metrics according to the AHA's definition, and the study population was divided into four groups based on LE8 quartile. The Cox proportional hazard model was used to assess the association between LE8 score and risk of AAA.</p><p><strong>Results: </strong>During a median follow-up of 12.77 years, 1042 cases of incident AAA were identified. After adjustment for potential confounders, the hazard ratio (95% confidence interval) of AAA was 0.52 (0.43, 0.64) for the Q2 group, 0.39 (0.32, 0.49) for the Q3 group, and 0.20 (0.12, 0.28) for the Q4 group, when compared with the Q1 group (the lowest LE8 score). When analyzed as a continuous variable, each 5-point increase in LE8 score was associated with a 20% lower risk of AAA. The association between LE8 score and risk of AAA remained robust after sensitivity and subgroup analyses.</p><p><strong>Conclusion: </strong>Higher LE8 score was associated with lower risk of AAA in the general population, emphasizing the importance of maintaining a healthy lifestyle to prevent AAA.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2456"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the outdoor personal thermal index (OPTI) for evaluating heat strain risk using personal, observational, geographical, and meteorological data.","authors":"Zahra Ordudari, Saeid Yazdanirad, Habibollah Dehghan, Mohammadreza Azhdari","doi":"10.1186/s12889-025-23632-0","DOIUrl":"10.1186/s12889-025-23632-0","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous thermal indices have been developed to assess heat stress among workers. This study aimed to develop and validate a new and accurate index for outdoor workplace environments, utilizing personal, observational, meteorological, and geographical parameters as well as eliminating the need for instruments.</p><p><strong>Methods: </strong>This study involved 201 men working outdoors, encompassing environments that are both hot and dry, as well as hot and humid. Measurements of tympanic temperature and heart rate were taken both at rest and 90 min after the start of work. Environmental conditions were assessed using suitable instruments, while relevant data were also gathered from meteorological and geographical databases. Estimates were made regarding the metabolic rate and the insulation value of the clothing worn by the subjects, with information on other observational parameters also recorded.</p><p><strong>Results: </strong>The findings revealed that main factors, and personal factors exerted a significant and direct influence on tympanic temperature. Among the main factors, environmental variables displayed the most substantial indirect effects; specifically, globe temperature, dry temperature, and relative humidity. The overall index score was divided into four categories based on established optimal cut-off points of 18.41, 21.44, and 22.61. Linear regression analysis indicated that the OPTI based on instrumental and meteorological data could account for 72% and 63% of the variance in tympanic temperature respectively.</p><p><strong>Conclusions: </strong>The OPTI index, which was developed based on personal, observational, geographical, and meteorological data, proved to be a simple, accurate, and reliable index for predicting thermal strain, demonstrating compatibility with human physiological responses.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2445"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system.","authors":"Safa Elkefi, Alana Steffen, Alicia K Matthews","doi":"10.1186/s12889-025-23597-0","DOIUrl":"10.1186/s12889-025-23597-0","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms.</p><p><strong>Methods: </strong>We used data from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to assess the association between long-term COVID symptoms and ACEs, adjusting for demographic characteristics (race/ethnicity, age, and sex). Survey weights were applied.</p><p><strong>Results: </strong>Of the 14,560 participants, 46.73% experienced 1-3 ACEs, and 26.81% experienced 4 + ACEs-23.38% experienced long-term COVID-19 symptoms. Blacks (OR = 0.76, P =.002) and Asians (OR = 0.56, P =.009) were less likely than Whites to experience long-term COVID-19, but American Indians (OR = 1.72) were more likely. Adults aged 35-69 had a higher likelihood of long-term symptoms than younger adults (OR = 1.24), whereas those aged 70 or older did not differ from younger adults. Females were also more likely to experience them (OR = 1.61). Exposure to ACEs was positively associated with long-term COVID-19 symptoms. The more adverse events individuals were exposed to, the more risk of long-term COVID-19. Specifically, experience of household substance abuse (OR = 1.14, 95%, P =.008), physical abuse (OR = 1.18, 95%, P =.001), emotional abuse (OR = 1.13, 95%, P =.014), sexual abuse (OR = 1.43, 95%, P <.001), and household mental illness (OR = 1.35, 95%, P <.001) were positively associated with the long-term COVID-19 experience.</p><p><strong>Conclusions: </strong>Study findings contribute to the extensive literature demonstrating the negative health consequences of childhood adversities. More adverse events resulted in more risk to experience long term COVID-19 symptoms. Additional research is needed to better understand and intervene in the biological vulnerabilities associated with childhood adversities.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2448"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and geographical disparities in disability distribution among Tanzanian population: insights from the 2022 demographic and health survey and malaria indicator survey.","authors":"Pankras Luoga, Gladys Reuben Mahiti, Oliva Kapinga, Blandina Herzon, Syabo M Mwaisengela, Patricia A Materu, Chrisogone J German, Amalberga Alex Kasangala, Grace Edward Mtulo, Erick S Kinyenje, Joseph C Hokororo, Teresia Lipyana Ngonyani, Godfrey Kacholi, Ntuli A Kapologwe, Claud J Kumalija, Mackfallen G Anasel, Eliudi S Eliakimu","doi":"10.1186/s12889-025-23152-x","DOIUrl":"10.1186/s12889-025-23152-x","url":null,"abstract":"<p><strong>Background: </strong>Disability is a significant public health issue globally, especially in sub-Saharan Africa, including Tanzania, where its prevalence is high. Effective health service planning requires reliable data on disability prevalence and distribution. However, Tanzania lacks sufficient empirical data, hindering social service planning. This study aims to examine socioeconomic and geographical disparities in disability among Tanzanians aged 15-95 years.</p><p><strong>Methodology: </strong>This study utilized secondary data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS), comprising a weighted sample of 58,425 individuals. The dependent variable was disability status, while independent variables included demographic and socioeconomic factors. Descriptive analysis, chi-square tests, and modified Poisson regression were employed to assess associations, with p-values < 0.05 indicating significance.</p><p><strong>Results: </strong>The overall disability prevalence was 11%. Older individuals (≥ 50 years) had a higher prevalence ratio (Adjusted prevalence ratio (APR): 3.85; 95% CI: 3.33, 4.52) compared to those aged 15-29. Females had a higher prevalence ratio (APR: 2.67; 95% CI: 2.63, 2.71) than males. Individuals with secondary education (APR: 2.58; 95% CI: 2.51, 2.65) and separated/widowed individuals (APR: 2.91; 95% CI: 2.74, 3.09) were more likely to report disability. Wealthiest households (APR: 2.74; 95% CI: 2.75, 2.9) and those with health insurance (APR: 2.83; 95% CI: 2.86, 2.99) had higher disability prevalence. Regional disparities showed the Northern zone had a higher prevalence ratio (APR: 2.77; 95% CI: 2.87, 3.00) compared to the Lake zone.</p><p><strong>Conclusion: </strong>This study highlights significant disability prevalence in Tanzania, with older age, female gender, higher education, wealth, and marital separation as key risk factors for disability. The counterintuitive findings on wealth and education may indicate improved access to diagnosis. Regional disparities warrant further investigation. These findings emphasize the need for targeted interventions and further research into underlying mechanisms to improve support systems for vulnerable populations.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2455"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promotion mechanism of physical and mental health of the elderly in China: the impact of the digital divide and social capital.","authors":"Jia Xiang, Hongfei Xing","doi":"10.1186/s12889-025-23411-x","DOIUrl":"10.1186/s12889-025-23411-x","url":null,"abstract":"<p><p>With the deep integration of population aging and digital transformation, the society has benefit from digital dividend, while also giving rise to the issue of the aging population's digital divide.This study is based on the three-level digital divide theory analysis framework, concentrating on the impact of the digital divide on elderly people's health during the Covid-19 pandemic in China, conducts multiple regression analysis, and uses the instrumental variable method and PSM propensity matching for robustness testing. Constructs a multiple mediation model of digital skill-social capital-elderly health, and applies Bootstrap-based structural equation model(SEM) to analyze and examine the influencing mechanism and pathway of digital skill on elderly people's physical and mental health. The research results indicate that: (1) From self-rated health, physical health, and mental health three aspects, digital skill significantly promotes elderly people's health, moreover, the elderly health is negatively impacted by the digital divide. (2) Among the elderly, their physical and psychological health are linked by a \"cyclic cumulative causal effect\". (3) The effect of digital skill on elderly people's health exists urban-rural difference. (4) A mediating effect of social capital in the connection between digital skill and elderly people's health. Digital skill enhances the state of elderly people's health by enriching relational and structural social capital, and aged adults' health is negatively impacted by a reduction in cognitive social capital. Therefore, in the future, it is necessary to fully leverage the health promotion function of digital skill, broaden senior citizens' social network, promote their social participation, bridge the senior citizens' digital divide, so then realize healthy aging and sustainable development.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2457"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of child physical health development in Bangladesh: a study of key socioeconomic and cultural influences.","authors":"Riyadh Hossain, Mohammad Omar Faruk, Najma Begum","doi":"10.1186/s12889-025-22843-9","DOIUrl":"10.1186/s12889-025-22843-9","url":null,"abstract":"<p><p>Physical health is the overall well-being of the body, ensuring the proper functioning of organs, muscles, and systems. It includes fitness, nutrition, disease prevention, and healthy lifestyle choices. This study investigates the physical health development of children in Bangladesh and identifies key influencing factors. The data of this study was collected through a two-stage sampling approach, with trained interviewers administering structured questionnaires. A total of 401 children aged 6 to 10 years were included in the analysis. To examine the associations between variables, the Mann-Whitney U and Kruskal-Wallis H tests were conducted for bivariate analysis, while a generalized log-normal regression model was employed to assess the impact of various socioeconomic and demographic factors on children's physical health development. The findings indicate that early childhood diseases negatively affect physical development (OR: 0.95, CI: 0.92-1.83, p < 0.05). Conversely, access to outdoor play opportunities (OR: 0.96, CI: 0.93-0.99, p < 0.05) and the provision of supplementary food (OR: 1.05, CI: 1.02-1.09, p < 0.05) significantly enhance children's physical health. Additionally, gender (OR: 0.96, CI: 0.94-0.99, p < 0.05), regional division (OR: 1.04, CI: 0.98-1.07, p < 0.05), and monthly family income (OR: 0.92, CI: 0.98-1.09, p < 0.05) were identified as significant determinants of physical health outcomes. These findings underscore the need for targeted public health interventions to promote children's physical well-being in Bangladesh. Policymakers should prioritize strategies that mitigate the effects of early childhood diseases, enhance access to outdoor activities, and ensure adequate nutritional support to foster improved health outcomes among children.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2447"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do users of a mental health app conceptualise digital therapeutic alliance? A qualitative study using the framework approach.","authors":"Theresa Taylor, Simon D'Alfonso, Maria João Tralhão Dolan, Jenny Yiend, Pamela Jacobsen","doi":"10.1186/s12889-025-23603-5","DOIUrl":"10.1186/s12889-025-23603-5","url":null,"abstract":"<p><strong>Background: </strong>Self-guided mental health smartphone applications (apps) have the potential to increase access to evidence-based psychological interventions and reduce the burden on staff resources in strained mental health services. Within human-delivered therapy, the working relationship (therapeutic alliance) between the client and therapist is well studied and has been consistently linked to effective and engaging therapy. However, less is known about whether a digital therapeutic alliance exists, what its components may be, and how it can be fostered to improve engagement and adherence to smartphone applications. This study explored the experiences of users of a mental health app to better understand digital therapeutic alliance and how persuasive systems design may help us understand which features of app design influence this relationship.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews with 13 participants who had recent experiences of using the STOP app which targets paranoia. Data were analyzed using framework analysis with therapeutic alliance and persuasive systems design as deductive theoretical frameworks.</p><p><strong>Results: </strong>We constructed five dimensions of digital therapeutic alliance: 1) Humanness of the app, 2) Personal meaningfulness, 3) Progression towards goals, 4) How is it to use the app, and 5) Flexibility enhances relationship. Themes 1-4 map onto the existing dimensions of therapeutic alliance, and Theme 5 (Flexibility enhances relationship) provides the context within which a digital therapeutic alliance forms. Persuasive systems design features were found to reinforce and enhance aspects of digital therapeutic alliance.</p><p><strong>Conclusions: </strong>This study provides valuable insight into the existence of digital therapeutic relationships (alliance) and its dimensions. From our findings, there are indicators that digital therapeutic alliance is a digital analogue of therapeutic alliance and is enhanced by persuasive features of the app. Findings from this study could be used to inform the design of mental health apps to enhance their capacity to foster digital therapeutic alliance with users, with the supposition that as with the traditional therapeutic alliance, its digital counterpart is also conducive to better efficacy in mental health apps.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2450"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The joint association between sleep quality, moderate-to-vigorous physical activity, cardiorespiratory fitness, and working memory in Chinese adolescents.","authors":"Jun Hong, Yuan Liu, Yaru Guo, YuQiang Li, Feng Zhang, Pengwei Sun, Yanyan Hu, He Liu, Xiaojian Yin","doi":"10.1186/s12889-025-23567-6","DOIUrl":"10.1186/s12889-025-23567-6","url":null,"abstract":"<p><strong>Background: </strong>Poor sleep quality is a prevalent health concern among Chinese adolescents. Although significant focus has been given to the impact of sleep problems on cognitive function, research on the association between sleep quality and working memory in typically developing adolescents remains limited. The aim of this study is to examine this association in Chinese adolescents.</p><p><strong>Methods: </strong>The present study randomly recruited 2428 adolescents aged 12-18 years from four schools in Shanghai and Suzhou, eastern China in 2023 through two-stage cluster sampling. Information on sleep quality was collected using the questionnaire (Pittsburgh Sleep Quality Index). Adolescents' working memory was evaluated using the N-back task. A general linear regression analysis was conducted to evaluate the association between sleep quality and working memory, adjusted for potential confounders. Interaction terms, representing the product of sleep quality and each modifier, were included to test for interaction effects.</p><p><strong>Results: </strong>In the adjusted model, adolescents with good sleep quality served as the reference group. Those with poor sleep quality had increased reaction times by 0.11 s (95%CI:0.09-0.13) during the 1-back task and by 0.10 s (95%CI:0.08-0.12) during the 2-back task. Moderate-to-vigorous physical activity (MVPA) time, cardiorespiratory fitness (CRF) and age significantly modified the associations between sleep quality and working memory (P for interaction < 0.05).</p><p><strong>Conclusions: </strong>Chinese Adolescents with poor sleep quality exhibited poorer working memory, particularly among those who were younger, had insufficient MVPA time, and lower CRF. Good sleep quality is significant in improving cognition function among Chinese adolescents.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2453"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}