BMC Public Health最新文献

{"title":"Exploring the dynamics between homelessness and healthcare access for Aboriginal and Torres Strait Islander women with traumatic brain injury from family violence: a qualitative study.","authors":"Michelle Fitts, Karen Soldatic","doi":"10.1186/s12889-026-26458-6","DOIUrl":"https://doi.org/10.1186/s12889-026-26458-6","url":null,"abstract":"<p><strong>Background: </strong>Homelessness is a significant issue in the context of violence, particularly for Indigenous women in settler colonial countries, as are the long-lasting impacts of violence such as traumatic brain injury (TBI) including concussion. Understanding of the relationship between homelessness and healthcare access for TBI from violence among Indigenous women is critical for informing service delivery; however, research in this area remains limited. Situated within the broader experiences of accessing healthcare following violence-related TBI, this study aimed to explore the relational dynamics between violence, homelessness, healthcare access, and the implications for long term recovery and wellbeing.</p><p><strong>Methods: </strong>Using purposive and snowball sampling, semi-structured interviews and focus groups were completed with 18 Indigenous women who have experienced TBI from violence, 28 community members, and 90 community-based frontline workers to gather insights into the experiences of living with TBI family violence or supporting someone with this injury. All data were transcribed verbatim and analyzed using thematic analysis.</p><p><strong>Results: </strong>Two themes were identified regarding how responses to family violence-related homelessness created barriers for Indigenous women to access healthcare for TBI: (1) Housing service barriers affect access to healthcare and TBI management, and (2) The (in)visibility of TBI within crisis accommodation and housing services. The dominant experience for Indigenous women who had experienced violence and homelessness was characterized by complexity, uncertainty, and distress, largely due to service delays and barriers encountered across housing pathways. Some Indigenous women were required to relocate away from their home region to secure temporary accommodation. While crisis accommodation services were widely viewed as places of safety, many did not consider TBI in environmental design or service delivery. Multi-agency case management and outreach were identified as valuable approaches for improving healthcare access.</p><p><strong>Conclusions: </strong>The findings illustrate the importance of TBI-informed policy and practice within housing and homelessness services, especially for Indigenous women in rural and remote regions, alongside strengthened workforce training. Stronger linkages between women's shelters, housing services, and healthcare systems - including concussion clinics - are critical for supporting both immediate and long-term care. Needs-based funding is required to ensure regional and remote housing systems can support women-led responses, including more streamlined transitions from crisis or short-term accommodation to secure housing.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855746","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":"Masticatory function and frailty: insights from NHANES and CHARLS.","authors":"Ronghui Xiang, Jiaqi Wu, Yunan Zhang, Gongwei Wen, Haiyan Zhao, Xuan Zhang, Ziyang Zheng","doi":"10.1186/s12889-026-27510-1","DOIUrl":"https://doi.org/10.1186/s12889-026-27510-1","url":null,"abstract":"<p><strong>Background: </strong>The association between oral health and frailty has been established. This study aimed to examine the association between masticatory function (assessed by functional tooth units (FTU) and edentulism), and frailty status with mortality risk among frail individuals.</p><p><strong>Methods: </strong>Data from National Health and Nutrition Examination Survey (NHANES) and China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Masticatory function was assessed using FTU and edentulism. Frailty was defined using a 49-item and 32-item index in NHANES and CHARLS respectively. Multivariate logistic regression and Cox proportional hazards models, and restricted cubic spline analyses were used to examine associations between mastication, frailty, and mortality. Sensitivity analyses were conducted.</p><p><strong>Results: </strong>The prevalence of frailty was 29.97% and 10.66% in NHANES and CHARLS respectively. Individuals having FTU of 10-12 showed a 24% lower risk of frailty compared to those with FTU of 0-3 in NHANES, and edentulism had 88% higher risk in CHARLS. Among frail participants, higher FTU scores were linked to lower all-cause (HR = 0.73, 95% CI: 0.60-0.89) and cancer-related mortality (HR = 0.51, 95% CI: 0.33-0.80), but not cardiovascular mortality in NHANES, and edentulism had 56% higher mortality in CHARLS. The association between FTU and frailty was linear, subgroups and sensitivity analyses confirmed robustness.</p><p><strong>Conclusions: </strong>Better masticatory function, as indicated by higher FTU, is associated with lower frailty prevalence and improved survival among frail individuals, while edentulism linked to higher prevalence and mortality. These findings emphasize the importance of maintaining functional dentition and oral rehabilitation in geriatric care.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855829","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":"Policy challenges in the provision of COVID-19 border screening: evidence from eight countries.","authors":"James Bates, Joshua R Moon, Sibylle Gaisser, Anne Nikiforov, James G Ryan, Choon Key Chekar, Robyn Meurant, Etienne Vignola-Gagné, Collins Iwuji, Erofili Grapsa, David Barbéra-Tomás, Enrique Meseguer, Gail Davey, Michael M Hopkins","doi":"10.1186/s12889-026-27355-8","DOIUrl":"https://doi.org/10.1186/s12889-026-27355-8","url":null,"abstract":"<p><strong>Background: </strong>While border screening measures were widely adopted by countries during the COVID-19 pandemic, a lack of consensus on the utility of border screening created a gap in best practice for its implementation. As such, countries adopted a diversity of approaches, providing an opportunity to evaluate the configuration and evolution of border screening systems. The article addresses three questions: (i) how did countries configure their border screening systems for COVID-19? (ii) In what contexts did countries rely on public or private providers of these services? (iii) what do policies and narratives reveal about the perceived role of border screening in global public health? The article contributes to long-standing debates over the private sector's role in public health and the perceived value of border screening measures.</p><p><strong>Methods: </strong>This article presents results from an international comparative study based on tracking the organisation of border screening in eight countries. Secondary data was collected between July 2021 - June 2022 from official government websites and policy publications, private sector sources where relevant, and trusted media sources in each study country. The countries included are Australia, Canada, Germany, Ireland, South Africa, South Korea, Spain, and the United Kingdom.</p><p><strong>Results: </strong>All study countries used private provision for pre-departure diagnostic testing for international travellers. In contrast, screening of arriving travellers was more diverse. Countries that opted for private sector post-arrival screening saw governance challenges around accreditation and monitoring of providers, while public service provision saw challenges in capacity and high resource costs. Travel was often framed as a 'luxury,' allowing states to shift responsibility for obtaining tests onto individuals; especially in the context of individuals travelling from low income to high income countries.</p><p><strong>Conclusions: </strong>The different approaches countries followed for screening of departing and incoming travellers suggests wealthy countries were more oriented towards defending their populations against disease importation, rather protecting the international community from disease exportation. These findings provide an opportunity to reflect on the purpose and implementation of border screening. We emphasise a need for further discussion on the efficacy of border screening from both perspectives, given the tendency for countries to rely on these measures.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855877","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":"Estimated burden of acute gastroenteritis and foodborne gastroenteritis caused by non-typhoidal Salmonella enterica, Shigella and norovirus in Gansu Province, Northwest China.","authors":"Xiang-Lai Sang, Yu-Fang Fan, Xiao-Cheng Liang, Jian-Dong Li, Yan Chen","doi":"10.1186/s12889-026-27563-2","DOIUrl":"https://doi.org/10.1186/s12889-026-27563-2","url":null,"abstract":"<p><strong>Background: </strong>Information on the burden of disease caused by foodborne pathogens in Northwest China is limited. This study aims to estimate the burden of acute gastroenteritis (AGE) and foodborne salmonellosis, shigellosis and norovirus gastroenteritis in Gansu Province.</p><p><strong>Methods: </strong>Using data from population surveys conducted during 2011-2015, the burden of AGE was estimated in Gansu Province. By determining the number of pathogen-specific cases from sentinel hospital surveillance conducted during 2014-2019, with adjustments applied for healthcare-seeking behavior and stool specimen submission based on data from population surveys, the burden of foodborne gastroenteritis caused by non-typhoidal Salmonella enterica, Shigella and norovirus in Gansu Province was calculated. A multiplier calculation model was developed, using Monte Carlo simulation to perform uncertainty estimation.</p><p><strong>Results: </strong>The adjusted monthly prevalence of AGE was 4.0%, equivalent to an average of 0.53 episodes of AGE per person-year in the region. The multiplier for salmonellosis was estimated at 1,739, for shigellosis at 1,646, and for norovirus gastroenteritis at 2,787. The estimated annual incidence of foodborne salmonellosis, shigellosis and norovirus gastroenteritis were 242, 36, and 567 cases per 100,000 population, respectively, which substantially exceeded the incidence of reported foodborne disease.</p><p><strong>Conclusions: </strong>We concluded that AGE and foodborne gastroenteritis caused by non-typhoidal S. enterica, Shigella and norovirus constitute a significant health burden in Gansu Province. By continuously implementing population survey and enhanced sentinel hospital surveillance, with constructing a multiplier calculation model to estimate the burden of disease, we may gain a better understanding of the food safety situation in Northwest China.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855731","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":"Impact of trimester-specific nutrition counseling on maternal vitamin D status, and perinatal outcomes in India: a quasi-experimental cohort study.","authors":"Mohd Faisal Khan, Mohammed Al-Zharani, Ashok Khurana, K Aparna Sharma, Aruna Nigam, Sana Alam, Fahd A Nasr, Wajhul Qamar, Md Ghaznavi Idris, Shakilur Rahman, Kapil Dev","doi":"10.1186/s12889-026-27315-2","DOIUrl":"https://doi.org/10.1186/s12889-026-27315-2","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency affects more than 90% of Indian pregnant women, yet its isolated impact on perinatal outcomes remains unclear amid multifactorial nutritional challenges. These pose a challenge to achieving SDG 3.2 targets for reducing neonatal mortality. This study evaluated the effects of trimester-specific nutritional counseling on maternal vitamin D status, nutritional practices, and perinatal outcomes in an Indian cohort.​ METHODS: A quasi-experimental prospective cohort study was conducted among 173 (88 intervention, 85 control) pregnant women (8-14 weeks of gestation) at a tertiary hospital in New Delhi between October 2023 and May 2025. The intervention included individualized counseling on vitamin D-rich foods, protein, lipids, and weight management at 8-14, 24-28, and 32-36 weeks, along with supplementation. Controls received standard care. Outcomes included serum 25(OH)D, nutrient intake, gestational weight gain, birth weight, and mode of delivery. Analyses used t-tests, correlations, and multivariate regression (p < 0.05, FDR-adjusted).​ RESULTS: A total of 173 participants completed the study. Baseline severe vitamin D deficiency improved significantly more in the intervention group than in the control group, with a large effect size (Cohen's d = 0.97). Protein intake increased, and nutrition knowledge scores improved substantially following the intervention (p < 0.05). Birth weights were comparable between groups, and no significant association was observed between maternal vitamin D levels and birth weight. Instead, gestational weight gain, protein intake, and caloric intake emerged as significant predictors of low birth weight (OR 0.73-0.995), while vitamin D was not a significant factor. Higher maternal BMI was associated with an increased likelihood of cesarean delivery (OR 0.87, p < 0.05).</p><p><strong>Conclusion: </strong>Trimester-specific nutritional counseling improved maternal vitamin D status and dietary practices but was not significantly associated with birthweight. Overall nutritional adequacy, particularly protein intake and gestational weight gain, appeared more closely related to fetal growth. These findings should be interpreted in light of the study design and warrant confirmation in larger studies.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855796","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 quality of video information related to smoking cessation on mainstream short-video platforms in China: a cross-sectional study.","authors":"Xingwang Qiu, Yuancen Shi, Xia Luo, Shixuan Yuan, Jin Zhang, Hua Guan","doi":"10.1186/s12889-026-27667-9","DOIUrl":"https://doi.org/10.1186/s12889-026-27667-9","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use remains one of the greatest public health challenges worldwide. Social short-video platforms have become the primary channel through which the public obtains smoking-cessation information. Grounded in the Health Belief Model and the Theory of Planned Behavior, this study evaluates the information quality of smoking-cessation short videos on Chinese short-video platforms.</p><p><strong>Methods: </strong>We analyzed 262 video samples from four major platforms-TikTok, Kwai, Bilibili, and BuzzVideo. Two researchers who received standardized training independently evaluated each video using the Medical Quality Video Evaluation Tool (MQ-VET), the Global Quality Scale (GQS), and the mDISCERN score. Finally, we performed multiple linear regression to identify factors influencing video quality and user interaction.</p><p><strong>Results: </strong>Of the 262 videos included, only 17.6% were produced by medical experts. Overall information quality was low: median MQ-VET was 44 (41-47), median GQS was 2 (2-3), and median mDISCERN was 2 (1-2). In multivariable regression, videos produced by Medical experts (β = 0.586, p < 0.001) and by Public welfare organizations (β = 0.130, p = 0.001) had significantly higher quality than those produced by Individual users. For user engagement, measured by number of likes, information quality (MQ-VET) (β = 0.215, p = 0.009), TikTok as the platform (β = 0.358, p < 0.001), and Bilibili as the platform (β = 0.485, p < 0.001) were significant positive predictors. Quality scores correlated positively with user interaction (ρ = 0.14-0.35, p < 0.005), whereas video duration correlated negatively with interaction (ρ = -0.14 to -0.29, p < 0.01).</p><p><strong>Conclusion: </strong>Content about smoking cessation on mainstream Chinese short-video platforms is predominantly user-generated, and it is often fragmented, scientifically weak, and lacking elements of behavior-change psychology. Despite these shortcomings, high-quality videos still attract substantial user engagement. To harness the broad reach of these platforms, we propose constructing a four-party cooperation framework among government, platforms, experts, and users grounded in the \"Healthy China 2030\" initiative, establishing a quality-certification system, and incentivizing medical experts to produce rigorous, high-quality content.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855821","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":"Association between digestive diseases and symptomatic knee osteoarthritis in Chinese participants: a prospective cohort study.","authors":"Shile Chen, Youdi Liu, Daocheng Zhu, Wei Xu, Mingxuan Zheng, Aiwu Liu, Bing Wang, Suipeng Chen, Lin Jiao","doi":"10.1186/s12889-026-27690-w","DOIUrl":"https://doi.org/10.1186/s12889-026-27690-w","url":null,"abstract":"<p><strong>Background: </strong>Digestive diseases and symptomatic knee osteoarthritis (OA) frequently occur in older adults, yet prospective evidence clarifying their temporal relationship remains limited, particularly in Asian populations. This study examined the relationship between digestive diseases and the risk of incident symptomatic knee OA in a nationally representative cohort of middle‑aged and older Chinese adults.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. A total of 6,281 adults without symptomatic knee OA at baseline were included. Digestive diseases were defined as exposure, and incident symptomatic knee osteoarthritis was the outcome of interest. Kaplan-Meier survival curves with log‑rank tests were used to compare cumulative incidence, and multivariable Cox proportional hazards models were applied to estimate hazard ratios. Sensitivity analyses included propensity score matching (PSM), prespecified subgroup analyses presented as forest plots, and E-value calculations.</p><p><strong>Results: </strong>A total of 6,281 participants were included in the analytical cohort (mean age, 58.6 ± 8.8 years; 53.5% women), with a median follow‑up of 84 months. Over the observation period, participants reporting digestive diseases experienced a markedly higher cumulative incidence of symptomatic knee OA compared with those without digestive conditions (31.4% versus 20.9%; log‑rank p < 0.01). After adjustment for potential confounders, multivariable Cox models indicated a higher risk of symptomatic knee OA among participants with digestive diseases (adjusted HR = 1.40; 95% CI: 1.25-1.57; p < 0.001). Similar effect estimates were obtained in the PSM (HR = 1.42; 95% CI: 1.23-1.64; p < 0.001). Subgroup analyses showed similar associations, with no statistically significant interactions detected. E‑value was 2.17.</p><p><strong>Conclusion: </strong>Digestive diseases are linked to a higher likelihood of symptomatic knee OA in this prospective cohort, supporting a temporal relationship between digestive disorders and the development of symptomatic knee OA.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855689","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":"Impact of a mobile health education program on blood pressure and lipid profiles: a cohort study.","authors":"Jae-Sik Jang, Jaehoon Chung, Kang Hee Kim, Eun Mi Lee, Jong Seon Park, Hwee-Soo Jeong, Joeun Kim, Kyoung-Myoung Chun, Yong-Chol Kwon, Moo-Yong Rhee","doi":"10.1186/s12889-026-27656-y","DOIUrl":"https://doi.org/10.1186/s12889-026-27656-y","url":null,"abstract":"<p><strong>Background: </strong>Hypertension and dyslipidemia are major risk factors for cardiovascular disease, and effective management of these conditions is essential for reducing long-term morbidity. Mobile health (mHealth) education has emerged as a widely used strategy to enhance disease awareness and encourage lifestyle modification. This study evaluated the impact of an mHealth-based education on cardiovascular risk factors and disease awareness among individuals with hypertension.</p><p><strong>Methods: </strong>This single-arm retrospective cohort study analyzed health screening data collected in 2022 (baseline), 2023 (Phase I), and 2024 (Phase II). Participants received a series of mobile-delivered educational materials focused on hypertension and dyslipidemia, emphasizing lifestyle modification, self-management, and improved understanding of chronic disease risks. Primary outcomes were changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Secondary outcomes included changes in triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS). Annual prevalence rates of hypertension and dyslipidemia were also assessed.</p><p><strong>Results: </strong>A total of 408 participants were included in the final analysis. SBP declined from 131 mmHg (IQR: 125-138) at baseline to 130 mmHg (IQR: 124-136) in 2023 and 128 mmHg (IQR: 120-136) in 2024 (P < 0.001). DBP decreased from 84 mmHg (IQR: 81-89) to 84 mmHg (IQR: 80-89) in 2023 and 82 mmHg (IQR: 75-89) in 2024 (P < 0.001). Hypertension prevalence decreased from 27% to 23.5% and 23%, though changes were not statistically significant. TG levels significantly decreased from 141 mg/dL (IQR: 96-206) to 138 mg/dL (IQR: 91-193) and 127 mg/dL (IQR: 92-185) (P < 0.001). LDL showed a statistically significant but small reduction (127 → 128 → 126 mg/dL; P = 0.003), while HDL remained unchanged. FBS increased slightly but significantly across the study period (98 → 99 → 99 mg/dL; P = 0.01). Dyslipidemia prevalence declined modestly (45.1% → 43.6% → 43.4%) without statistical significance.</p><p><strong>Conclusion: </strong>This study supports the feasibility of mobile health education as a low-cost strategy for improving blood pressure and lipid control. Strengthening education program content and enhancing participant engagement may further amplify its impact on population cardiovascular health.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855803","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":"Socioenvironmental determinants of polypharmacy in mental health disorders: a systematic review.","authors":"Gobezie Temesgen Tegegne, Hossein Tabatabaei-Jafari, Theophile Niyonsenga, Saba Ghiasvand, Yassamin Bagheri, Nasser Bagheri","doi":"10.1186/s12889-026-27658-w","DOIUrl":"https://doi.org/10.1186/s12889-026-27658-w","url":null,"abstract":"<p><strong>Background: </strong>Over the past decades, the role of socioenvironmental determinants (SEDs) on shaping mental health outcomes has gained increasing attention. However, their relationship with antipsychotic and psychotropic polypharmacy (PP) remains unknown.</p><p><strong>Aim: </strong>This systematic review aimed to synthesise evidence on the association between SEDs and PP, as well as summarising PP prevalence in patients with mental health disorders (MHDs).</p><p><strong>Method: </strong>A systematic search was conducted in PubMed, Web of Science, CINHAL, PsycINFO and Scopus databases. Literature was also sourced from Google, Google Scholar and the reference lists of included studies. The review included all studies reporting on sociodemographic and SEDs on psychotropic and antipsychotic PP in patients with MHDs. The prevalence rates were computed using medians and interquartile ranges (IQR), while factors associated with PP were summarised in a table.</p><p><strong>Results: </strong>A total of 65 findings from 57 studies were analysed, 45 examining antipsychotic PP and 20 studied psychotropic PP. The median prevalences of psychotropic and antipsychotic PP were 30.5% (IQR: 18.0-39.5) and 28.1% (IQR: 18.7-42.9), respectively. Additionally, studies targeting inpatients, patients with schizophrenia and those utilising medical records had higher median prevalence rates. Moreover, our review found that family income to poverty ratios, family adverse consequences, Childhood Opportunity Index, social deprivation and area of residence (e.g. rural, metropolitan) were reported to be significant factors of PP in patients with MHDs.</p><p><strong>Conclusion: </strong>Though the reported PP prevalence estimates varied, our systematic review showed that psychotropic and antipsychotic PPs are widespread in clinical practices. Additionally, a few SEDs were reported to be significantly associated with PP in patients with MHDs. This highlights the importance of investigating these modifiable factors. Hence, further in-depth exploration of the relationships between SEDs and polypharmacy is required. Evidence generated through such studies informs population-level strategies to reduce PP, improve equity in mental healthcare, and ultimately enhance patient outcomes.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855863","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":"Environmental Restriction Questionnaire: cross-cultural adaptation, reliability and validity of Turkish version in young children with developmental disabilities.","authors":"Seda Ayaz Taş, Sezen Tezcan, Demet Gözaçan Karabulut, Hande Şenol","doi":"10.1186/s12889-026-27650-4","DOIUrl":"https://doi.org/10.1186/s12889-026-27650-4","url":null,"abstract":"<p><strong>Background: </strong>Children with developmental disabilities often face environmental barriers that limit their participation in daily activities. Environmental Restriction Questionnaire (ERQ) requires cross-cultural adaptation and validation to be used in Turkish populations. The aim of this study was to evaluate cross-cultural adaptation, reliability, and validity of the Turkish version of the Environmental Restriction Questionnaire (ERQ) in young children with developmental disabilities.</p><p><strong>Methods: </strong>Participants were a total of 220 children, aged between 4 and 6 years, who had developmental disabilities (mean age: 4.95 ± 0.9) and their parents. The Environmental Restriction Questionnaire (ERQ) was translated from English into Turkish and underwent cross-cultural adaptation. Construct validity was evaluated using confirmatory factor analysis, and concurrent validity was determined using the correlation between ERQ and CASP with Spearman's correlation analysis. For reliability of ERQ, Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC) were used.</p><p><strong>Results: </strong>For reliability of ERQ, high Cronbach's α and intraclass correlation coefficient (ICC) values were found for the ERQ total and subscale scores (ICC = 0.80-0.90) (Cronbach's α = 0.84-0.93). Construct validity showed poor model fit (Root Mean Square Error of Approximation (RMSEA) = 0.112; Goodness of Fit Index (GFI) = 0.648) suggesting that the proposed factor structure was not adequately supported. Concurrent validity analyses revealed weak to moderate negative correlations between ERQ and CASP scores (r = - 0.351 to - 0.135; p < 0.05).</p><p><strong>Conclusion: </strong>The ERQ appears to be a reliable, cross-culturally adapted instrument; however, its structural validity was not adequately supported, and its applicability should be interpreted with caution. While the Turkish version of the ERQ demonstrates good reliability, construct validity analysis indicated poor model fit, suggesting that the factor structure requires further investigation.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833248","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}