BMC Public Health最新文献

{"title":"Digital healthy eating literacy: its role in sustainable food choices and mediterranean diet adherence.","authors":"Busra Aslan Gonul, Zeynep Caferoglu Akin","doi":"10.1186/s12889-025-23353-4","DOIUrl":"https://doi.org/10.1186/s12889-025-23353-4","url":null,"abstract":"<p><strong>Background: </strong>The rise of digital platforms as sources of nutrition information has highlighted the need for digital healthy eating literacy to ensure informed dietary choices. Understanding the role of digital healthy eating literacy in shaping sustainable dietary behaviours is crucial for promoting both individual and planetary health. This study aimed to examine the associations between digital healthy eating literacy, environmentally responsible food choices, and adherence to the Mediterranean diet (MedDiet), a sustainable dietary model, among adults in Türkiye.</p><p><strong>Methods: </strong>A total of 1,516 adults (mean age: 28.9 ± 9.8 years) residing in Türkiye were recruited through an online survey distributed via social platforms. Participants completed an online questionnaire comprising the e-Healthy Diet Literacy (e-HDL) Questionnaire, the Environmentally Responsible Food Choice Scale, and the 14-item Mediterranean Diet Adherence Screener (MEDAS). This cross-sectional study employed multivariable regression analyses to examine the associations between digital healthy eating literacy, environmentally responsible food choices, and adherence to the MedDiet.</p><p><strong>Results: </strong>Higher e-HDL scores were significantly associated with increased environmentally responsible food choices (β = 0.283, 95% CI: 0.233-0.333, p < 0.001) and a 1.039-fold increase in the odds of adherence to the MedDiet (95% CI: 1.021-1.058, p < 0.001). The strength of the association between e-HDL and the outcomes varied by subgroup, with stronger associations observed for environmentally responsible food choices among non-smokers, non-drinkers, daily exercisers, and higher-income individuals, and for adherence to the MedDiet among women, non-smokers, non-drinkers, and those with lower or equal income levels. Among the MedDiet adherents, e-HDL explained 10.5% of the variance in environmentally responsible food choices (p < 0.001).</p><p><strong>Conclusions: </strong>This study highlights the potential importance of digital healthy eating literacy in relation to sustainable dietary behaviours and environmental health. Targeted digital nutrition education programmes may help support improvements in digital healthy eating literacy and encourage sustainable diets, supporting planetary health. Future policies should focus on increasing awareness and accessibility of reliable nutrition information on digital platforms to improve dietary practices and environmental sustainability.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2109"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233021","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":"Influences on college health provider practice for routinely screening female college students' HPV vaccination status.","authors":"Erica Liebermann, Bing Si, M Katherine Hutchinson, Bo Li, Melissa A Sutherland","doi":"10.1186/s12889-025-23234-w","DOIUrl":"https://doi.org/10.1186/s12889-025-23234-w","url":null,"abstract":"<p><strong>Background: </strong>HPV vaccination is highly effective in preventing HPV infection and subsequent precancers and invasive cancers related to HPV. Unfortunately, vaccine coverage in the U.S. lags behind national and global targets. College students are an important audience for catch-up vaccination given suboptimal population coverage in adolescents. This study examined factors associated with college healthcare provider (HCP) practices for routinely screening HPV vaccination history of female college students.</p><p><strong>Methods: </strong>One thousand two hundred twenty-one U.S. college HCPs completed surveys and reported on a variety of screening practices in college health centers, including assessing the HPV vaccination status of female college students. Participants included nurse practitioners, physicians, and physician assistants.</p><p><strong>Results: </strong>Forty-five percent of college HCPs reported routinely screening the HPV vaccination histories of most (≥ 70%) of their female students. Nurse practitioners (NPs) were more likely than other providers to consistently assess HPV vaccination status. In multivariable logistic regression modeling, high rates of routine HPV vaccination screening were associated with NP role, more positive provider attitudes and self-efficacy toward screening, larger institutions, college-level policies, in-service trainings and electronic health record prompts that supported HPV vaccination history screening. No differences were found by other provider demographic factors, institution type or region.</p><p><strong>Conclusions: </strong>College health centers present unique opportunities to identify unvaccinated female students and offer or refer them for vaccination. Future research needs to examine HPV vaccination status and screening among other types of college students and identify the multi-level factors that act as facilitators and barriers to assessing HPV vaccination status and offering the HPV vaccine.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2099"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring physical, sexual and mental health consequences of gender-based violence among women and girls during conflict in Tigray, Ethiopia.","authors":"Girmatsion Fisseha Abreha, Hadgay Hagos Adhanu, Abera Berhe Aregawi, Alem Desta Wuneh, Freweni Tesfay, Gebretsadik Kiros Lema, Balem Demstu, Hale Teka, Awol Yemane, Hagos Gidey, Kibrom Berhanu Gebreselassie, Tigist Hagos, Helen Bitew Tareke, Tensay Kahsay W/Gebriel, Yemane Berhane Tesfau, Brhane Ayele, Ataklti Hailu Atsbaha, Teame Zegeye, Yaynshet Gebreyohannes Redda, Abrahim Hassen, Hagos Godefay, Afework Mulugeta","doi":"10.1186/s12889-025-23349-0","DOIUrl":"https://doi.org/10.1186/s12889-025-23349-0","url":null,"abstract":"<p><strong>Background: </strong>Gender-based violence is becoming an increasing during conflict, with negative short and long-term consequences for the victims, their families, and communities. Since the eruption of war in November 2020 in Tigray, many women reported sexual violence. Thus, this study aimed to explore the physical, sexual and mental health consequences of gender-based violence among female survivors in severely war-affected areas of the Tigray region of Ethiopia.</p><p><strong>Methods: </strong>This study employed mixed methods including quantitative and qualitative studies during the war in Tigray, Ethiopia. A total of 528 sexually abused women and girls were included in the quantitative study from a community-based survey conducted in August 2021. Moreover, six in-depth interviews with rape survivors were conducted to share their experiences. A standardized interviewer-administered questionnaire was used for the community survey and a semi-structured checklist recorded by audio was used for qualitative study. Descriptive statistics and the Pearson chi-square test were used to assess the relationship between health consequences, different socio-demographics, and types of sexual violence. Thematic analysis was performed after the recorded audios were transcribed.</p><p><strong>Results: </strong>Of the survivors, 435 (82.4%) had been raped and 404 (76.5%) had experienced a triple trauma burden of sexual, physical, and psychological violence. Most survivors had experienced consequences ranging from mild (34.5%) to severe injuries (42.1%), mental health and behavioral problems (75.6%) like posttraumatic stress disorder (12.1%), stress (63.5%), anxiety (38.6%), depression (27.5%), sleeping disturbance (35.2%), nightmare (29.0), flashbacks and social isolation. More than one-fifth (21.8%) of rape survivors experienced sexual and reproductive health problems such as exposure to STIs, unwanted pregnancy, abortion, and HIV. Survivors encountered the worst rape scenarios such as gang rape by troops and combatants.</p><p><strong>Conclusions: </strong>Survivors experienced severe forms of physical injuries, posttraumatic stress disorder, and sexual and reproductive health problems. Humanitarian agencies and civic organizations need to provide immediate medical and psychological support to victims to reduce further health consequences and harm.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2103"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233043","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":"Research on the capability, opportunity, and motivation of schools to conduct physical activities in China: a cross-group validation.","authors":"Jingtao Wu, Yi Yang, Yanhong Shao, Xiaolin Zhang, Wanli Zang, Jun Hu","doi":"10.1186/s12889-025-23231-z","DOIUrl":"https://doi.org/10.1186/s12889-025-23231-z","url":null,"abstract":"<p><strong>Background: </strong>Insufficient physical activity among adolescents is a major global public health concern, and schools are considered key venues for promoting physical activity. Teachers play a crucial role in the implementation of policies. This study adapted and validated the COM-PASS scale, based on the COM-B model, to assess its reliability and validity in the Chinese context.</p><p><strong>Methods: </strong>This study validates the appropriateness of the COM-PASS scale based on the COM-B model, assessing its reliability and validity within the Chinese cultural context. A three-phase design was employed: (1) A Delphi method involving three rounds of surveys with 15 experts to refine the questionnaire's relevance and validity; (2) Cognitive interviews with 10 primary and secondary school teachers to evaluate item comprehensibility; (3) Confirmatory factor analysis of 4,033 questionnaires across China's seven major administrative regions to verify structural validity and internal consistency.</p><p><strong>Results: </strong>The CFA results showed that the three-factor model fit well (χ² = 3179.436, df = 518, CFI = 0.964, TLI = 0.956, RMSEA = 0.036), with factor loadings for all items exceeding 0.750. The Cronbach's α coefficients for the three dimensions were 0.957, 0.947, and 0.965, respectively. Path coefficient tests indicated strong explanatory power of the latent variables on the observed variables (standardized path coefficients ranged from 0.781 to 0.951). Cross-group validation demonstrated the scale's stability and applicability across different administrative regions in China.</p><p><strong>Conclusion: </strong>The Chinese version of the COM-PASS scale has shown good reliability and validity among the population of Chinese primary and secondary school teachers, and it can effectively assess main factors affecting the development of school physical education activities. The results provide a targeted scientific basis for optimizing school physical education policies, addressing regional resource differences, and teacher training strategies. The scale demonstrates strong cultural applicability and provides practical guidance for enhancing the 'Double Reduction' policy and advancing school-based physical education activities across China.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2102"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233061","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":"Factors influencing parents' food-purchasing decisions in the Pacific: a qualitative study in Tonga.","authors":"Sela Ki Folau Fusi, Alessandro Crocetti, Adrian J Cameron, Megan Ferguson, Kathryn Backholer, Jennifer Browne","doi":"10.1186/s12889-025-23210-4","DOIUrl":"https://doi.org/10.1186/s12889-025-23210-4","url":null,"abstract":"<p><strong>Background: </strong>An unhealthy diet is the leading preventable risk factor for the development of diet-related non-communicable diseases, and the food environment is considered a major determinant of dietary intake. Food-purchasing decisions in retail settings are influenced by a range of individual, environmental, and interpersonal factors. The aim of this study was to explore the perceived influences on food-purchasing decisions among Tongan parents.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews in 2023 with 21 Tongan parents aged 27 to 51 years in Tongatapu, Tonga, a Pacific Island country. Parents were asked questions about the factors that determine where they do their grocery shopping and what influences their food-purchasing decisions. Interview transcripts were analysed using reflexive thematic analysis, informed by the socio-ecological model of food and beverage intake.</p><p><strong>Results: </strong>Four themes were constructed from the interview data across the different levels of the socio-ecological model of food and beverage intake, each of which represented parents' perceived influences on how they purchased foods from retail outlets. At the micro level, we found that parents often struggle to prioritise healthy food when balancing financial and time constraints, as well as family and cultural expectations regarding food provision. At the meso level, we found that food availability in local retail outlets was important, while at the macro level, the cost of healthy food relative to unhealthy food was a key factor driving purchasing decisions.</p><p><strong>Conclusions: </strong>Health promotion efforts and public health policies should recognize the multi-dimensional nature of the factors influencing Tongan parents' food-purchasing decisions. Given the prevalence of diet-related non-communicable diseases in Tonga, the social, cultural, commercial and environmental factors driving unhealthy food-purchasing and population diets in Tonga should be a priority for governments and health promotion practitioners.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2096"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233045","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":"A concept mapping approach to explore the perceived facilitating factors in shifting sedentary behavior into (more) physical activity: perspectives of healthcare professionals versus sedentary and/or inactive adults.","authors":"Iris Willems, Vera Verbestel, Teatske Altenburg, Dorothea Dumuid, Patrick Calders, Marieke De Craemer","doi":"10.1186/s12889-025-23223-z","DOIUrl":"https://doi.org/10.1186/s12889-025-23223-z","url":null,"abstract":"<p><strong>Purpose: </strong>Healthcare professionals (HCPs) such as Physical Activity on Prescription (PAP)-coaches and physiotherapists might play a crucial role in activating sedentary and/or inactive adults, which in turn might benefit their health. We aimed to explore the perceived facilitating factors to shift sedentary behavior (SB) into more physical activity (PA) comparing two perspectives 1) sedentary and/or inactive adults and 2) HCPs in their role to activate these adults.</p><p><strong>Methods: </strong>A mixed method approach, i.e. concept mapping, was used to explore the facilitating factors among 1) HCPs (n = 10) and 2) adults (n = 40). During a brainstorm, perceived facilitating factors were gathered in response to one seeding statement 'what help(s) you/your clients to shift SB into (more) PA?'. Thereafter, all answers were sorted by relatedness into different piles and each answer was rated on effectiveness, feasibility, changeability and enjoyment (5-point Likert scale). Data analysis was done via RCMap.</p><p><strong>Results: </strong>Clusters identified by both HCPs and adults included 'social networks', 'everyday activities as opportunities for PA', 'awareness of PA benefits', 'motivation regarding PA', 'integration of PA into daily routines', 'goal-setting to facilitate PA', 'environmental facilities', 'financial resources', and 'technology, digital tools and external tools to facilitate PA'. Each group created unique clusters such as factors related to the 'work environment' by adults and factors related to 'tailored support to facilitate PA' by HCPs. The average rating for each cluster was higher for HCPs compared to adults for effectiveness (4/5 vs 3.5/5), feasibility (3.8/5 vs 3.1/5), and changeability (3.7/5 vs 3.2/5).</p><p><strong>Conclusions: </strong>HCPs and sedentary and/or inactive adults identified factors at the intra- and interpersonal level which were rated as feasible, effective and changeable, as well as factors at the responsibility of external stakeholders such as employers or policy makers. These results highlight that future interventions aimed at shifting SB into PA include a multilevel challenge.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2094"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233019","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":"Evaluation of the COVID-19 testing strategy in PHC of a high-vulnerability health district in Brazil, 2020-2022.","authors":"Sandra Garrido de Barros, Thais Regis Aranha Rossi, Ana Clara de Rebouças Carvalho, Denise Nogueira Cruz, Sisse Figueiredo de Santana, Camila Ramos Reis, Laio Magno, Inês Dourado, Ligia Maria Vieira-da-Silva","doi":"10.1186/s12889-025-23229-7","DOIUrl":"https://doi.org/10.1186/s12889-025-23229-7","url":null,"abstract":"<p><strong>Background: </strong>Considering the potential role of primary health care (PHC) in the response to COVID-19, a formative evaluation (FE) was carried out between December 2021 and February 2022 to understand its work process against COVID-19 in a high-vulnerability health district in Brazil, identifying the difficulties in carrying out tests and the best practices for the implementation of the intervention \"Expansion of testing, quarantine, e-health and telemonitoring strategies to combat COVID-19 in Brazil\" (TQT).</p><p><strong>Methods: </strong>FEs are used to guide the implementation of health interventions. This FE was based on a situational diagnosis of the territories and PHC health units of the health district under study, with approximately 400,000 inhabitants, in which the TQT Project would later be implemented. A qualitative study was conducted based on 22 semistructured interviews and three focus groups (FGs) involving 19 PHC professionals. The interviews and FGs were analysed in terms of their thematic content.</p><p><strong>Results: </strong>There was a lack of coordination in implementing actions; COVID-19 testing was concentrated in a few PHC units, generating work overload and weakness of other health programs in these units; the health units' physical structure was inadequate, and human resources were insufficient; and no criteria were identified for defining the number of tests offered per day per unit.</p><p><strong>Conclusions: </strong>The FE identified barriers to testing and supported the design of the TQT, including the adaptations needed to implement actions. The concentration of testing in a few units is an important barrier to access; it is suggested that testing actions should be deconcentrated in as many health units as possible.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2101"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233042","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":"Systematic description of the development of a complex health intervention of information and support in a new pregnancy after pregnancy loss.","authors":"Emily Koert, Sarah Fredsted Villadsen, Rebecca Mackel, Helene Cagara, Tanja Schlaikjær Hartwig, Henriette Svarre Nielsen, Lone Schmidt","doi":"10.1186/s12889-025-22163-y","DOIUrl":"https://doi.org/10.1186/s12889-025-22163-y","url":null,"abstract":"<p><strong>Background: </strong>In this paper, we present a systematic description of the development method of a complex health intervention (PREGAFTERPL) for couples with prior pregnancy loss (PL) to provide information and support in a new pregnancy using co-production and prototyping.</p><p><strong>Methods: </strong>A three-stage method described by Hawkins et al. and informed by O'Cathain et al. was tested to develop the PREGAFTERPL intervention for couples over a 24 month period. We used a combination of the partnership and theory and evidence based approaches of O'Cathain's nine categories of intervention development approaches. The stages included: (1) Evidence review, needs assessment and stakeholder consultation, (2) Co-production with stakeholders (health care professionals, researchers and couples with prior pregnancy loss) via consultations and focus groups, and (3) Prototyping using focus group and online survey. The three stage co-production and prototyping process was iterative and cumulative with refinements occurring at each stage before progressing to the next stage.</p><p><strong>Results: </strong>Using the three-stage method we co-produced and prototype-tested the intervention content and delivery methods for the PREGAFTERPL intervention. In stage 1 we identified the needs of pregnant women and their partners and potential content of the intervention to include information, coping strategies and tools and resources. In stage 2, multiple refinements of the content and delivery resulted from an action research cycle with input from stakeholders including the decision to divide the tool into one for women and another for partners. Initial prototyping in stage 3 showed that the tools were acceptable, useful and relevant and it was suitable to proceed with full-scale feasibility testing, implementation and evaluation.</p><p><strong>Conclusions: </strong>This framework presented in the PREGAFTERPL case study provides a practical example on how to co-produce and prototype a complex healthcare intervention in collaboration with key stakeholders including health care professionals and couples with prior pregnancy loss in order to meet an unmet need for information and support in a new pregnancy after PL. Through such case study, we hope that future researchers will be inspired to include co-production in their own intervention development projects by seeing that it is valuable and can be feasible and done with limited resources.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2097"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233063","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":"Factors influencing HIV testing choices among Chinese undergraduates: insights from a discrete choice experiment.","authors":"Hangjing Zhang, Xuan Zhu, Yuting Zhang, Juyang Xiong","doi":"10.1186/s12889-025-23366-z","DOIUrl":"https://doi.org/10.1186/s12889-025-23366-z","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, HIV infection rates continue to be a significant public health concern. In China, undergraduates are particularly vulnerable to HIV infection. Despite multiple prevention and control measures, HIV testing rates among undergraduates remain low. This study aims to elicit undergraduates' preferences for key characteristics of HIV testing options. Understanding their preference will help raise testing rates.</p><p><strong>Methods: </strong>A discrete choice experiment (DCE) was conducted among undergraduates in Wuhan, China. They were asked to make eight choices between two unlabeled alternatives that differed in five attributes (testing location, testing sample, additional services, testing cost, and minimum travel time). Data were analyzed using a mixed logit model.</p><p><strong>Results: </strong>A total of 461 undergraduates provided valid responses for analyses. Most undergraduates were heterosexual (78.5%) and non-medical majors (81.8%). Testing location was the most important non-monetary attribute, followed by testing sample and whether additional services were offered with the test. Undergraduates preferred qualified medical institutions for HIV testing than self-testing at home (β = 1.640, P < 0.001). They favored oral fluid as a method to obtain the sample, relative to urine samples (β = 0.821, P < 0.001). Free health checks offered at HIV testing was the most significant driving factor for their choice of HIV testing services (β = 0.460, P < 0.001). Undergraduates preferred free tests (β=-0.020, P < 0.001). Additionally, gender, years at the university and sexual orientation were statistically significant in the preference choices of HIV testing services for undergraduates.</p><p><strong>Conclusions: </strong>Understanding undergraduates' preferences for HIV testing services is the first step in designing future HIV prevention and control policies. Testing location was the most important non-monetary attribute in HIV testing services. Qualified medical institutions could regularly train campus doctors and establish partnerships to address undergraduates' needs and promote their participation in HIV testing.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2107"},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the influencing factors affecting the operational effectiveness of public health emergency response mechanism: a DEMATEL-ISM-MICMAC mixed methods study.","authors":"Qunkai Wang, Nan Meng, Yunxia Ma, Yanping Wang, Kexin Wang, Ruiqian Zhuge, Yuxuan Wang, Peng Wang, Huan Liu, Qunhong Wu","doi":"10.1186/s12889-025-23268-0","DOIUrl":"https://doi.org/10.1186/s12889-025-23268-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore key factors and identify root factors influencing the Public Health Emergency Response Mechanism (PHERM) to ensure timely and effective responses to emerging infectious disease crises and enhance the efficiency of emergency operations.</p><p><strong>Methods: </strong>We employed a mixed-method approach using DEMATEL-ISM-MICMAC to analyse the interrelationships among factors affecting PHERM. The DEMATEL method established the hierarchical structure of the factors, ISM determined the relational paths, and MICMAC further characterized the attributes of the factors.</p><p><strong>Results: </strong>The analysis revealed that PHERM's influencing factors are organized into four levels, with the conscientiousness of emergency leadership action (X15) identified as the most profound and influential factor, exhibiting a strong causality with a high driving force. The decision-making and command feedback capability (X8) emerged as a significant outcome factor in the transition layer, highly influenced by other factors and with the highest node degree.</p><p><strong>Conclusions: </strong>The proactive emergency response awareness and actions of leaders is crucial for the mechanism's smooth and efficient operation. It is essential to prioritise ideological education and simulation training to instill such awareness. Moreover, proactive preparation for factors associated with decision-making and command capabilities is necessary to mitigate potential hesitation and panic during actual epidemic prevention, thereby enhancing the operational effectiveness of PHERM.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2078"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224258","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}