BMC Public Health最新文献

{"title":"COVID-19 and anxiety in pregnancy and postpartum: a longitudinal survey.","authors":"Susan Ayers, Rose Meades, Andrea Sinesi, Helen Cheyne, Margaret Maxwell, Catherine Best, Stacey McNicol, Fiona Alderdice, Julie Jomeen, Judy Shakespeare","doi":"10.1186/s12889-025-22257-7","DOIUrl":"https://doi.org/10.1186/s12889-025-22257-7","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is estimated to affect between 15 and 20 per cent of women during pregnancy and postpartum. The COVID-19 pandemic resulted in wide-ranging changes to how people lived, worked and socialised around the world. COVID and pandemic-related restrictions to maternity services may have exacerbated anxiety during pregnancy and the postnatal period. This study aimed to determine: (1) levels of COVID exposure and perceived risk; (2) adherence to Government guidelines and restrictions; and (3) the impact of COVID and COVID-related restrictions on perinatal anxiety and mental health in the UK.</p><p><strong>Methods: </strong>A longitudinal survey (n = 2122) of COVID and anxiety in women during early pregnancy, mid-pregnancy, late pregnancy and postpartum.</p><p><strong>Results: </strong>38.41% of participants had COVID before or during the study. Perinatal anxiety was predicted by participants having poor general health, being of Asian or mixed ethnicity, having previous mental health problems, believing that COVID would make them severely ill, and reporting that COVID had impacted on their mental health. Over time, more women were infected with COVID, and the perceived severity of COVID decreased. Experiencing mild COVID was associated with decreased anxiety at the subsequent time point (mean difference -0.72, 95% CI -1.38 to -0.07, p = 0.030). Very few participants in this sample had severe COVID (2.9%) or reported it having a severe impact on their mental health (5.66%). Most participants (75.3%) said the pandemic had 'no' or a 'slight' impact on their mental health. Pandemic-related restrictions to maternity care affected more women, with around 40% reporting anxiety about being separated from baby, their partner not being with them in labor, or having to leave shortly after the birth. Level of adherence to guidelines was variable, depending on the restriction.</p><p><strong>Conclusions: </strong>Findings suggest pandemic-related restrictions caused anxiety for more women than COVID per se. Adherence to guidelines was variable yet the prevalence of COVID infections was low compared to the general population. Findings can be used to inform policy and practice for future pandemics and health-related crises.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1146"},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717831","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":"Feasibility of a prison-based test-and-treat model for enhancing hepatitis C care in Kedah, Malaysia.","authors":"Mohd Azri Mohd Suan, Ahmad Muaz Zulkifli, Noor Hidayati Ani, Azlina Azlan, Mohamad Faiz Mustafa, Siti Maisarah Md Ali, Siti Aishah Aris, Nur Aisyah Sakinah Muhamad Nizar, Fatihah Fahami Mohd Najib Fahami, Amizah Othman, Huan-Keat Chan, Muhammad Radzi Abu Hassan","doi":"10.1186/s12889-025-22296-0","DOIUrl":"https://doi.org/10.1186/s12889-025-22296-0","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) infection remains a public health concern, significantly affecting vulnerable populations including people who use drugs and in prisons. This study assessed the feasibility of a new prison-based test-and-treat model for HCV in two prisons in Kedah, Malaysia.</p><p><strong>Methods: </strong>The model was tested on participants newly admitted between June 2022 and December 2023 to one of the two selected prisons, one for pretrial detention and the other for serving sentences. It features a streamlined test-and-treat procedure within prisons, encompassing anti-HCV (exposure) testing, HCV ribonucleic acid (RNA) (current infection) testing, pretreatment assessments, and treatment initiation. The outcome assessment focused on (I) screening coverage, (II) implementation success across the HCV care cascade, ranging from anti-HCV detection, HCV RNA confirmation, treatment initiation, and completion to a sustained virological response rate and (III) practicality within resource-limited prison environments.</p><p><strong>Results: </strong>All 18,811 (100%) newly admitted participants were screened for HCV during the study period, with 4,054 (21.6%) of them testing positive for anti-HCV (HCV exposure). A total of 793 (19.6%) participants underwent HCV RNA testing, with 655 (82.6%) confirmed to have HCV infection. Those with HCV RNA test results were mainly male (98.1%), with nearly half (48.2%) aged 40-49 years. A vast majority (95.7%) reported at least one HCV risk factor, primarily injection drug use (95.2%). Of the 655 participants with a positive HCV RNA test, 648 (98.9%) completed pretreatment assessments. Antiviral treatment was initiated in 319 (49.2%) of them, with 165 (51.7%) completing the full course. Among those who completed treatment, 80 (48.5%) underwent HCV RNA testing 12 weeks after treatment, with 77 (96.3%) achieving a sustained virologic response.</p><p><strong>Conclusion: </strong>This new prison-based test-and-treat model for HCV infection demonstrates promising feasibility, as indicated by high screening coverage and successful implementation across the HCV care cascade using existing resources. These findings suggest the potential for broader adoption of this model in correctional facilities. Further research is needed to improve treatment completion and address factors contributing to dropout.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1152"},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717843","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 of anxiety disorder and its association with BMI: an analysis of women's experiences in Bangladesh using BDHS-2022 data.","authors":"Farhana Afrin Duty, Md Habibur Rahman, Nahid Salma","doi":"10.1186/s12889-025-22427-7","DOIUrl":"https://doi.org/10.1186/s12889-025-22427-7","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are a significant and growing public health concern, impacting individuals' daily lives and professional development. Women exhibit higher rates compared to men. Changes in body mass index (BMI) can affect the mental health of an individual. However, the relationship between BMI and anxiety is unclear. The purpose of this study was to investigate the association between BMI and anxiety disorder.</p><p><strong>Methods: </strong>BDHS 2022 data were used. Binary logistic regression, restricted cubic spline analysis (RCS), and subgroup analyzes were performed to explore the relationship between BMI and anxiety disorder.</p><p><strong>Results: </strong>The prevalence of anxiety disorders among ever-married women was approximately twenty one percent. A non-linear, U-shaped relationship between BMI and anxiety disorder was observed, with the lowest risk at a BMI of 22.78 kilograms per square meter. Obesity, as well as underweight, increased the risk of anxiety among the participants, especially in subgroups of participants who were older adults, less educated, lower wealth status, greater age at marriage, and longer cohabitation. For older women, with the lowest risk at a BMI of 25.6 kilograms per square meter, being slightly overweight might serve as a psychological buffer against anxiety. The highest prevalence rate was in formerly married women as well as in the women in the Rangpur division.</p><p><strong>Conclusion: </strong>This study identified a significant association between BMI and anxiety disorder, revealing a U-shaped relationship where both underweight and obesity were correlated with higher odds of anxiety disorder. Although the results indicate that maintaining a healthy BMI could be associated with a decrease in anxiety levels, the cross-sectional nature of the study prevents establishing a causal relationship. This implies that BMI and anxiety may be correlated, but one does not necessarily cause the other. Future longitudinal studies are needed to explore potential causal mechanisms. The observed association highlights the importance of considering body weight extremes in mental health interventions. These findings underscore the need for integrated public health strategies that address both mental health and nutritional well-being among ever-married women in Bangladesh.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1144"},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708379","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":"Determinants, behaviour change techniques and pedagogical approaches used in secondary school-based food and nutrition programmes: a qualitative study of the SWITCH project.","authors":"Anouk Mesch, Madelief Engels, Sanne Raghoebar, Laura H H Winkens, Judith Gulikers, Renate Wesselink, Annemien Haveman-Nies","doi":"10.1186/s12889-025-22155-y","DOIUrl":"https://doi.org/10.1186/s12889-025-22155-y","url":null,"abstract":"<p><strong>Background: </strong>Food and nutrition programmes at secondary schools have the potential to improve public and planetary health, as they target a wide range of adolescents. Nevertheless, it is currently unclear what mechanisms are underlying such educational interventions in order to aim for behaviour change. This qualitative study therefore aims to identify determinants and behaviour change techniques (BCTs) incorporated in secondary school-based food and nutrition programmes. Better understanding of determinants and BCTs can identify points of improvements to facilitate long-term dietary behaviour change.</p><p><strong>Methods: </strong>Fifteen online semi-structured interviews were conducted between November 2021 and January 2022 with representatives of 14 Dutch programmes, supplemented by a document analysis of scientific and grey literature related to the included programmes (e.g., evaluation reports, teacher manuals). Transcripts and literature were analysed deductively, using the terminology of Mechanisms of Action (MOAs) and the BCT Taxonomy v1, followed by an inductive coding phase.</p><p><strong>Results: </strong>Determinants knowledge (n = 13), skills (n = 12), awareness (n = 9), and beliefs about consequences (n = 7) were identified most, as well as BCTs Knowledge transfer (n = 13), Natural consequences (n = 7) and Goals and planning (n = 5). Inductive coding led to the identification of pedagogical approaches that were considered important for successful delivery of programmes, such as the use of activating learning methods.</p><p><strong>Conclusions: </strong>It seems promising for food and nutrition programmes at secondary schools to expand their current focus beyond knowledge and skills, to also target environmental, social and other essential individual determinants during adolescence which are now under-reported, such as identity. Moreover, our study revealed the importance for programmes to be tailored to adolescents' worldviews and to stimulate adolescents to be actively involved.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1131"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707960","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":"Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador.","authors":"Marta Puig-García, Cintia Caicedo-Montaño, Mónica Márquez-Figueroa, Elisa Chilet-Rosell, Blanca Lumbreras, Abraham Beltrán-Pérez, Lucy Anne Parker","doi":"10.1186/s12889-025-22324-z","DOIUrl":"https://doi.org/10.1186/s12889-025-22324-z","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a pressing public health challenge in Latin America, with an increasing prevalence and negative impacts on population health. Achieving optimal blood glucose levels is critical for preventing complications, yet significant socioeconomic inequities persist in disease management and optimal glucose control. We aimed to investigate the patient characteristics associated with optimal fasting capillary glucose in individuals living with T2DM in a hard-to-reach setting in Esmeraldas, Ecuador.</p><p><strong>Methods: </strong>We carried out a cross-sectional study of individuals with T2DM in the Eloy Alfaro health district of Esmeraldas, using a complex sample design with some limitations. Data collection took place between October 2020 and May 2022 and involved face-to-face interviews to collect sociodemographic and clinical data and a Fasting Capillary Blood Glucose test. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). We estimated the prevalence of optimal glucose levels according to patient characteristics and calculated odds ratios (OR) with 95% confidence intervals using multivariable logistic regression.</p><p><strong>Results: </strong>Of the 474 participants surveyed, only 18.1% (86; 95%CI: 14.9-21.9) had optimal fasting capillary glucose levels. In this sample, optimal glucose was nearly four times more frequent among men compared to women (aOR = 3.92, 95%CI: 2.08-7.40, p < 0.001). Furthermore, older age (aOR = 1.03, 95%CI: 1.01-1.05, p = 0.006), living in an urbanised setting (aOR = 2.04, 95%CI: 1.22-3.40, p = 0.006) and unemployment (aOR = 0.48, 95%CI: 0.25-0.94, p = 0.031) were also linked to optimal blood glucose levels. While perceived social support in this population was moderate (median = 2.33, on a scale of 1 to 4), high family support appeared to reduce optimal glycaemic levels (aOR = 0.35, 95%CI: 0.18-0.70, p = 0.003).</p><p><strong>Conclusions: </strong>The intricate interplay of factors influencing diabetes management and optimal blood sugar suggests that targeted, context-specific and gender-sensitive public health strategies may be needed to address diabetes disparities in vulnerable populations.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1133"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708480","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":"Using participatory video to generate active agents of change at community level to address the drivers of antimicrobial resistance in two settings in Nepal.","authors":"Nichola Jones, Abriti Arjyal, Rebecca King, Jessica Mitchell, Ines Soria-Donlan, Sushil Baral, Paul Cooke","doi":"10.1186/s12889-024-21181-6","DOIUrl":"https://doi.org/10.1186/s12889-024-21181-6","url":null,"abstract":"<p><strong>Background: </strong>We present a community-based videomaking project that used Participatory Video (PV) to co-produce community-led resources to address the issue of antimicrobial resistance in Nepal. Specifically, this paper highlights the potential of PV as a way of generating community champions that can become active 'agents of change'.</p><p><strong>Methods: </strong>A total of 20 participants took part in PV workshops in Nepal across two settings; one urban and one peri-urban site. Participants were trained in video production and took part in interactive learning sessions on AMR. Participants were supported to create and showcase their own videos on AMR in their community. All workshops were recorded and a series of focus group discussions and interviews were undertaken to evaluate the project.</p><p><strong>Results: </strong>Participants considered PV to be a positive experience, both in terms of personal development and their ability to understand and address community-level drivers of AMR. They emphasised how the project helped them to become proactive in addressing AMR and also to be 'seen' by policy makers and other members of their community who they did not feel would generally take notice of them. Conversely, policymakers, as well as other members of the participants' communities, were impressed by the quality of the work produced, which, in turn, made them pay attention to the messages communicated in the videos.</p><p><strong>Conclusions: </strong>CARAN highlights the potential of PV as a way of creating community-level champions to help address the drivers of AMR. More work is required to understand the longer-term value of creating such champions.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1137"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708325","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":"Patterns of health-risk behaviors among Chinese adolescents during the COVID-19 pandemic: a latent class analysis.","authors":"Mingxiu Liu, Xiaolei Tang, Qingyun Xia, Xiaoman Wu, Yinmei Yang, Hong Xiang, Jun Hu","doi":"10.1186/s12889-025-22089-5","DOIUrl":"https://doi.org/10.1186/s12889-025-22089-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescent health-risk behaviors are prevalent and tend to co-occur. This study aimed to identify patterns of health-risk behaviors among Chinese adolescents during the COVID-19 pandemic and explore the effects of individual and social factors on health-risk patterns.</p><p><strong>Methods: </strong>This cross-sectional study investigated 1607 adolescents from four high schools in 2021 through stratified cluster random sampling. Latent class analysis was conducted to identify patterns of health-risk behaviors and logistic regression was used to examine the risk and protective factors of latent class membership.</p><p><strong>Results: </strong>Four latent classes were identified: \"Low risk\" (81.6%), \"Problematic Internet use\" (7.8%), \"Alcohol use\" (8.5%), and \"High risk\" (2.1%). Relative to the \"Low risk\", adolescents with higher levels of sensation seeking, deviant peer affiliation, and childhood abuse were more likely to be assigned to the \"Problematic Internet use\" class, while those with high degrees of parental monitoring and school connectedness were less likely to be in the \"Problematic Internet use\" class. Those with higher levels of sensation seeking and deviant peer affiliation, lower scores of parental monitoring and school connectedness were more likely to be assigned to the \"Alcohol use\" class, compared to the \"Low risk\". Students in the \"High risk\" class were more likely to report higher levels of sensation seeking, deviant peer affiliation, and childhood abuse, but lower degrees of parental monitoring and school connectedness than the \"Low risk\" class.</p><p><strong>Conclusions: </strong>This study identified patterns of multiple risk behaviors among Chinese high school students during the COVID-19 pandemic and found that multi-level individual and social factors affected latent classes of adolescent health-risk behaviors. These findings provide clues for designing effective interventions to reduce health-risk behaviors among adolescents.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1141"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708197","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":"Interventions to reduce inequalities for pregnant women living with disadvantage in high-income countries: an umbrella review.","authors":"Nicola Vousden, Dorothea Geddes-Barton, Stephanie J Hanley, Nia Roberts, Marian Knight","doi":"10.1186/s12889-025-22283-5","DOIUrl":"https://doi.org/10.1186/s12889-025-22283-5","url":null,"abstract":"<p><strong>Background: </strong>Women facing multiple disadvantage such as financial poverty, poor mental health or domestic abuse, may experience inequalities in health prior to and during pregnancy, as well as into early motherhood. This can have lifelong intergenerational impacts. The primary aim of this overview was to identify the breadth and efficacy of interventions that work across health and social care to reduce inequalities in maternal or child health. The second aim was to explore their relevance to women with lived experience.</p><p><strong>Methods: </strong>An overview of systematic reviews and meta-analyses from high-income countries that aim to reduce inequalities for women with social disadvantage during pregnancy was performed. Searches were conducted in eight electronic databases up to August 2023 and supplemented with grey literature searches. We included any individual, hospital, or community level activities specific to women during the pre-conception, antenatal or postpartum period up to one year after. The protocol was registered. Two workshops with women with lived experience of disadvantage explored the relevance of identified interventions, and gaps in evidence, in relation to their experiences.</p><p><strong>Results: </strong>A total of 36 reviews, including 734 primary studies, were included in the narrative synthesis. The majority of reviews included studies undertaken in North America and were of critically low or low quality. Interventions were grouped into 11 categories. The majority of interventions were aimed at single social exposures and targeted individual behavior during pregnancy and the postnatal period. Some at risk populations were excluded from all reviews. There was potential benefit of home-based interventions, psychosocial interventions, models of maternity care and interdisciplinary programs of care for some population groups, across a range of maternal and child health outcomes. Our lived experience group felt these interventions had potential to meet their shared needs for advocacy, support and information, but they should also consider culture, past trauma and factors underpinning pregnancy such as housing and finances.</p><p><strong>Conclusions: </strong>Further high-quality research is required to demonstrate efficacy and cost-effectiveness of potentially effective interventions in the European health systems. Additional research gaps include interventions prior to pregnancy, culture informed care and upstream determinants of health (PROSPERO: CRD42023455502).</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1140"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708050","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":"Trajectories of health status and their association with rheumatoid arthritis risk: insights from a national prospective cohort study.","authors":"Mengjun Tao, Xin Guo, Xiancan Ji, Liang Xu, Hui Yuan","doi":"10.1186/s12889-025-22303-4","DOIUrl":"https://doi.org/10.1186/s12889-025-22303-4","url":null,"abstract":"<p><strong>Background: </strong>The association between trajectories of different health states and rheumatoid arthritis (RA) is unknown. Our cohort study aimed to investigate the impact of various trajectories (including depressive symptoms, physical activity and multimorbidity status) on subsequent RA risk.</p><p><strong>Methods: </strong>A prospective cohort study was conducted using seven waves of national data from the Health and Retirement Study (HRS 2004-2018) involving 9,795 US adults. A growth mixture model identified 6-year trajectories from 2004 to 2010, and participants were screened for RA by self-reported physician diagnosis in the subsequent four waves (2010-2018). Cox proportional hazards model calculated hazard ratios (HR).</p><p><strong>Results: </strong>Trajectories of depressive symptoms, physical activity, and multimorbidity status were all associated with the risk of RA. Specifically, keeping a low trajectories (HR = 0.649, 95%CI = 0.533-0.790) or maintaining a moderate rating trajectories (HR = 0.798, 95%CI = 0.644-0.988) for depressive reduced the risk of RA. For physical activity, both high and descending trajectories (HR = 1.456, 95%CI = 1.170-1.812) and high and rising trajectories (HR = 1.244, 95%CI = 1.016-1.522) increased the risk. High multimorbidity trajectories (HR = 1.305, 95%CI = 1.094-1.556) and highest multimorbidity trajectories (HR = 1.393, 95%CI = 1.131-1.715) increased the risk.</p><p><strong>Conclusion: </strong>The results suggest that tracking trajectories of depressive symptoms, physical activity, and multiple disease states may be a potential and feasible screening method for identifying those at risk for RA.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1132"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708323","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":"Longitudinal assessment of smoking-related knowledge, attitude, and practice for cancer prevention: an analysis of data from the Korean National Cancer Prevention Awareness and Practice Survey.","authors":"Jeoung A Kwon, Naeun Kim, Jin-Kyoung Oh, Bohyun Park, Yoon-Jung Choi, Yoonjoo Choi, Byungmi Kim","doi":"10.1186/s12889-025-22258-6","DOIUrl":"https://doi.org/10.1186/s12889-025-22258-6","url":null,"abstract":"<p><strong>Background: </strong>This study examined the influence of knowledge and attitudes on smoking cessation behaviors among Koreans-including both individuals who have quit smoking and those who continue to smoke-using an extended KAP (knowledge, attitude, and practice) model.</p><p><strong>Methods: </strong>Data for this study were drawn from the Korean National Cancer Prevention Awareness and Practice Survey conducted between 2014 and 2023, encompassing 12,400 participants. After excluding responses lacking data on KAP questions and individuals who had never smoked, the final analytic sample comprised 4,794 participants. To evaluate the associations among knowledge (that smoking causes cancer), attitudes (regarding smoking cessation for cancer prevention), and practice (the decision to stop smoking), we employed multiple logistic regression and mediation analyses to assess both the direct and indirect effects of these variables on smoking behavior.</p><p><strong>Results: </strong>Most participants demonstrated awareness that smoking causes cancer. In assessing the associations among knowledge, attitude, and practice, a decline in odds ratios was observed in 2023 compared with 2021. Attitudes toward smoking cessation for cancer prevention exerted a direct influence on the decision to quit smoking, with effect sizes of 0.23 in 2014, - 0.10 in 2016, 0.50 in 2018, 0.42 in 2021, and 0.40 in 2023. Furthermore, knowledge about smoking indirectly influenced the decision to quit smoking via its effect on attitudes toward cessation, with indirect effects of 0.12 in 2018, 0.10 in 2021, and 0.09 in 2023. Notably, knowledge did not directly affect practice; thus, attitudes toward smoking cessation emerged as the primary mediator between knowledge and the decision to quit smoking.</p><p><strong>Conclusions: </strong>Our findings indicate that the decision to quit smoking is significantly influenced by individuals' attitudes toward smoking. Consequently, smoking cessation policies and interventions should integrate strategies that address attitudes in tandem with knowledge and practice components among Koreans. Moreover, the gradual weakening of the relationships among knowledge, attitudes, and practices over time underscores the need to reinforce these associations through innovative smoking cessation policies.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1134"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708075","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}