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Awareness and acceptability of long-acting injectable pre-exposure prophylaxis for HIV prevention among female students at tertiary learning institutions: a multi-center, institution-based cross-sectional study. 高等院校女生对长效暴露前注射预防艾滋病的认识和接受程度:一项多中心、基于院校的横断面研究
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-22271-9
Martin Kampamba, Pumulo Munawai, Remmy Sioma, Christabel Mwila Hikaambo, Steward Mudenda, Mukumbi Mutenda, Jean M Mukumbuta, Muchindu Hampango, Muzyamba Malambo, Gunet Mwalungali, Audrey Hamachila, Billy Chabalenge, Jimmy Hangoma, Mashebe Innocent Ngula, Bernard Appiah
{"title":"Awareness and acceptability of long-acting injectable pre-exposure prophylaxis for HIV prevention among female students at tertiary learning institutions: a multi-center, institution-based cross-sectional study.","authors":"Martin Kampamba, Pumulo Munawai, Remmy Sioma, Christabel Mwila Hikaambo, Steward Mudenda, Mukumbi Mutenda, Jean M Mukumbuta, Muchindu Hampango, Muzyamba Malambo, Gunet Mwalungali, Audrey Hamachila, Billy Chabalenge, Jimmy Hangoma, Mashebe Innocent Ngula, Bernard Appiah","doi":"10.1186/s12889-025-22271-9","DOIUrl":"10.1186/s12889-025-22271-9","url":null,"abstract":"<p><strong>Background: </strong>Adolescent girls and young women (AGYW) in Zambia face an elevated risk of acquiring HIV. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) is an effective scientific method to prevent new HIV infections. However, awareness and acceptability of LAI-PrEP among AGYW remain limited. Thus, we aimed to assess awareness and acceptability of LAI-PrEP among female students.</p><p><strong>Methods: </strong>This multi-center, institution-based cross-sectional study involved 760 female students from three universities in Lusaka, Zambia. Data were collected using a structured, self-administered questionnaire. Questions on acceptability and awareness were presented in a yes/no format. Data analysis was performed using STATA version 15.1.</p><p><strong>Results: </strong>Of the 760 participants, less than half, 349 (45.9%), were aware of injectable PrEP, with lectures being the most common source of information. In terms of acceptability, 531 (69.9%) of respondents indicated they would be willing to take LAI-PrEP once available. Biomedical science students were significantly less likely to accept injectable PrEP (AOR = 0.10, CI: 0.01-0.94, p = 0.044), as were those not at risk of HIV in the past three months (AOR = 0.41, CI: 0.21-0.81, p = 0.011). Conversely, knowing a partner's HIV status (AOR = 2.52, CI: 1.27-4.98, p = 0.0001) and being at risk of HIV in the past three months (AOR = 3.4, CI: 1.78-7.81, p = 0.011) were significantly associated with LAI-PrEP acceptability.</p><p><strong>Conclusion: </strong>The study revealed a notable gap in awareness of LAI-PrEP among participants, with less than half being informed about its existence. Despite this low awareness, a significant majority expressed a willingness to accept LAI-PrEP if it were made available to them. This indicates a strong potential for adoption of LAI-PrEP, contingent upon improved education and awareness efforts.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2478"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subjective social status among young working women in Sweden: how is it established and how does it affect health and well-being? A qualitative interview study. 瑞典年轻职业妇女的主观社会地位:它是如何确立的?它如何影响健康和福祉?定性访谈研究。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23645-9
Ylva Lindberg, Åsa Andersén, Anna Nyberg, Ulrika Winblad, Ingrid Demmelmaier
{"title":"Subjective social status among young working women in Sweden: how is it established and how does it affect health and well-being? A qualitative interview study.","authors":"Ylva Lindberg, Åsa Andersén, Anna Nyberg, Ulrika Winblad, Ingrid Demmelmaier","doi":"10.1186/s12889-025-23645-9","DOIUrl":"10.1186/s12889-025-23645-9","url":null,"abstract":"<p><strong>Background: </strong>Mental ill-health has increased among young people in Sweden in recent years, particularly among young women. One contributing factor could be a striving for high social status, communicated around the clock on social media platforms. The aim of the study was to explore how young working women in Sweden perceive social status and how it relates to their own health and well-being.</p><p><strong>Methods: </strong>The study sample included 15 women aged 25-35 years, recruited from the Swedish Longitudinal Occupational Survey of Health, a cohort derived from a representative sample of the Swedish working population. Maximum variation purposeful sampling was employed to achieve rich information in the data. Data were collected through individual semi-structured interviews and analysed using thematic analysis.</p><p><strong>Results: </strong>The analysis identified two main themes. The first theme, the qualities and processes of subjective social status, consisted of the subthemes material and personal resources and interpersonal and contextual interplay, and described aspects affecting social status, such as income, gender, and social life, as well as processes such as external influence and comparison. The second theme, the influence of subjective social status on health and well-being consisted of the subthemes being judged by oneself and others and strategies to reduce negative impact, and encompassed emotional responses to social status and approaches and attitudes to regulate its impact.</p><p><strong>Conclusions: </strong>The results indicate that subjective social status in young working women today is established through dynamic and interactive processes involving several important aspects beyond traditional socioeconomic measures. The findings regarding the impact of gender and foreign background on subjective social status suggest a need for continued efforts to strengthen equality and integration in Swedish society. The impact of processes around establishing and displaying subjective social status on well-being and health appears to vary, depending on each individual's approach and active management of, e.g., social media.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2484"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with low HIV testing rate among people aged 15 to 65 years in Maroua 1 Health District, Far North Region of Cameroon. 喀麦隆远北地区Maroua 1卫生区15至65岁人群中艾滋病毒检测率低的相关因素。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23676-2
Godfroy Rostant Pokam Djoko, Alice Ketchaji, Juluis Visnel Foyet, Béatrice Tengoche, Oussena Nzie Vessah, Raoul Djiala Tawe Nsekalhye, Gwladys Kamwa Tchiemou, Nicole Modeste Ndohi, Dorcas Kamguem Keng, Amandine Koe Ngono
{"title":"Factors associated with low HIV testing rate among people aged 15 to 65 years in Maroua 1 Health District, Far North Region of Cameroon.","authors":"Godfroy Rostant Pokam Djoko, Alice Ketchaji, Juluis Visnel Foyet, Béatrice Tengoche, Oussena Nzie Vessah, Raoul Djiala Tawe Nsekalhye, Gwladys Kamwa Tchiemou, Nicole Modeste Ndohi, Dorcas Kamguem Keng, Amandine Koe Ngono","doi":"10.1186/s12889-025-23676-2","DOIUrl":"10.1186/s12889-025-23676-2","url":null,"abstract":"<p><strong>Background: </strong>The Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) infection continues to cause enormous damage in the world despite the multiple strategies developed for the response. That's why the Joint United Nations Programme on HIV/AIDS (UNAIDS) has adopted an acceleration strategy for this response with a view to eliminating HIV/AIDS by the year 2030. Nevertheless, access to screening, which remains underserved in Cameroon, is the first pillar on which actions must be taken to achieve this objective. This study aimed to identify factors associated with low HIV testing in Maroua 1 Health District (MHD1).</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 808 participants aged 15 to 65 years living in the Maroua 1 Health District between September and December 2022. Data were collected by means of a non-probabilistic survey using a structured questionnaire sutured into socio-demographic characteristics, socio-cultural factors, and factors linked to the healthcare system. These factors were assessed by multiple logistic regression analysis, and associations were established by calculating Odds ratios, confidence intervals, and P-values. Statistical significance was declared at P < 0.05.</p><p><strong>Results: </strong>The results showed that the study participants had a mean age of 32.7 years (SD ± 11) and males (57.18%) outnumbered females (42.82%). A total number of 383 (47.40%) participants had already taken a screening test, and 97 (12%) had done so in the last 12 months. Furthermore, it was noted that being a man (AOR = 2.79; CI = 1.83-4.31; P-value < 0.001), young (AOR = 7.95; CI = 4.02-16.2; p -p-value < 0.001), single (AOR = 1.97; CI = 1.19-3.27; p-value = 0.02), informal education (AOR = 5.25; CI = 2.26-12.45; p-value < 0.001 ), having low knowledge about HIV (AOR = 8.77; CI = 4.60-17.24; p-value < 0.001), having a stigmatizing opinion (AOR = 2.46; CI = 1.36-4.38; p-value < 0.001), not being in a relationship with a partner (AOR = 1.70; CI = 1.04-2.79; p-value = 0.03), never been sensitized by a health worker (AOR = 1.82; CI = 1.21-2.75; p-value = 0.001), and not visiting a health facility during the last 12 months (AOR = 1.75; CI = 1.06-2.75; p-value = 0.02) were associated with low screening.</p><p><strong>Conclusions: </strong>This study identified several factors associated with low HIV testing rates in the Maroua 1 health district in Cameroon, including male gender, young age, celibacy, lack of education, low HIV knowledge, stigmatizing attitudes, absence of a stable partner, lack of awareness by health care workers and low use of health services. Addressing these factors in HIV testing interventions is essential to achieving the UNAIDS 95-95-95 targets and eliminating HIV by 2030. Targeted public health policies and improved access to testing services are needed to combat the epidemic in this region.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2479"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of regional digital transformation on public health: an empirical analysis based on 31 provinces in China. 区域数字化转型对公共卫生的影响——基于中国31个省份的实证分析
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23670-8
Xingjuan Xu, Yuanyuan Zhang, Yadong Wang, Chenjian Zhao, Yuhang Zhang, Xuefeng Xie
{"title":"Impact of regional digital transformation on public health: an empirical analysis based on 31 provinces in China.","authors":"Xingjuan Xu, Yuanyuan Zhang, Yadong Wang, Chenjian Zhao, Yuhang Zhang, Xuefeng Xie","doi":"10.1186/s12889-025-23670-8","DOIUrl":"10.1186/s12889-025-23670-8","url":null,"abstract":"<p><strong>Background: </strong>With the rapid development of digital transformation driven by big data and artificial intelligence in China, the field of public health is undergoing profound transformations. This study introduces technological innovation as a mediating variable into an analytical framework to systematically explore the impact of digital transformation on public health and the underlying mechanism.</p><p><strong>Methods: </strong>Using panel data from 31 provinces in mainland China from 2010 to 2019, this study empirically investigated the impact of digital transformation on public health via two-way fixed-effect analysis. Moreover, the internal mechanism was determined by testing the mediation effect of technological innovation.</p><p><strong>Results: </strong>The research findings showed a significant positive relationship between digital transformation and improvements in public health. Mediation effect analysis indicated that digital transformation enhances public health by fostering technological innovation. Additional analysis revealed that the promoting effect in the central and western regions of China is more pronounced than that in the eastern regions.</p><p><strong>Conclusion: </strong>This study unveils that digital transformation significantly improves public health, especially through enhanced technological innovations that achieve health improvement, and proposes specific recommendations for future health development strategies. It not only offers a scientific foundation for government digital health policies but also provides a forward-looking perspective for academics engaged in the field of digital transformation and public health. Additionally, it empirically verifies the differential impacts of digital technology on public health across regions, provides scientific references for optimizing health resource allocation and narrowing regional health gaps, and contributes empirical findings toward achieving a Healthy China.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2485"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infertility trends in China: analyzing temporal changes, public demand, and demographic differences based on Baidu index. 中国不孕趋势:基于百度指数的时间变化、公众需求和人口差异分析。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23655-7
Xun Li, Mengmeng Wei, Jingrui Zou, Jin Wei, Xin Lai, Xun Gong, Hong Hu, Xuanxuan Wang
{"title":"Infertility trends in China: analyzing temporal changes, public demand, and demographic differences based on Baidu index.","authors":"Xun Li, Mengmeng Wei, Jingrui Zou, Jin Wei, Xin Lai, Xun Gong, Hong Hu, Xuanxuan Wang","doi":"10.1186/s12889-025-23655-7","DOIUrl":"10.1186/s12889-025-23655-7","url":null,"abstract":"<p><strong>Background: </strong>Infertility is a critical public health issue, imposing significant psychological and financial burdens on individuals and healthcare systems. This study analyzes internet search behavior related to infertility using Baidu Index data, examining trends, demographic characteristics, and geographic patterns. The goal is to provide evidence to inform policy development and improve intervention strategies.</p><p><strong>Methods: </strong> Using Baidu Index data from 2015 to 2024, this study investigates search trends for \"infertility\" and \"In vitro fertilization (IVF)\" over time. It focuses on three aspects: temporal trends in search volume, demand patterns, and demographic characteristics of searchers, including age, gender, and regional differences.</p><p><strong>Results: </strong>The implementation of the two-child policy in late 2016 resulted in a short-lived baby boom. However, searches for \"infertility\" sharply declined from late 2017 to early 2018 before stabilizing. Searches for \"IVF\" followed a similar pattern, peaking in 2017 before decreasing. The main topics searched were related to IVF costs, online consultations, treatment procedures, and hospital selection. Significant regional differences were observed, with higher search volumes in economically developed areas. Additionally, women aged 20-39 were more likely to search for infertility-related information than men.</p><p><strong>Conclusion: </strong>This study reveals the fluctuating public interest in infertility and the significant impact of economic factors on reproductive decisions. Despite the two-child policy, the fertility decline persists, and high IVF costs continue to pose barriers to reproductive health. Regional, age, and gender variations emphasize the need for targeted public health interventions and policy support to improve accessibility to infertility services.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2481"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the impact of a participatory organizational intervention on reducing occupational stress in an emergency department setting: a one group pretest-posttest design. 评估参与性组织干预对减少急诊科环境中职业压力的影响:一组前测后测设计
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23540-3
Hendrik Van Simaeys, Lore Mannaerts, Brecht Serraes, Els Clays
{"title":"Evaluating the impact of a participatory organizational intervention on reducing occupational stress in an emergency department setting: a one group pretest-posttest design.","authors":"Hendrik Van Simaeys, Lore Mannaerts, Brecht Serraes, Els Clays","doi":"10.1186/s12889-025-23540-3","DOIUrl":"10.1186/s12889-025-23540-3","url":null,"abstract":"<p><strong>Background: </strong>Occupational stress among healthcare professionals, especially those in emergency departments, is associated with high job demands and inadequate resources, impacting both service delivery and worker well-being. This study explored a participatory organizational intervention intended to reduce stress and improve working conditions among emergency department staff.</p><p><strong>Methods: </strong>A one-group pretest‒posttest design was used to examine changes in outcomes among healthcare professionals (n = 59). Standardized self-report questionnaires administered before and after the intervention assessed perceived stress levels, psychosocial work factors, and general satisfaction. The nine-week intervention consisted of structured group discussions to identify stressors and co-develop solutions, followed by targeted adjustments in work processes and the environment. The primary outcome was perceived stress (Perceived Stress Scale-10, PSS-10). Secondary outcomes included working conditions (Danish Psychosocial Work Environment Questionnaire, DPQ). Paired samples t-tests compared pre- and posttest scores, and Pearson correlations assessed associations between process indicators and changes in perceived stress.</p><p><strong>Results: </strong>Postintervention findings indicated a marginally significant reduction in perceived stress and improvements in several aspects of the psychosocial work environment, including work‒life balance and supervisory recognition. These results suggest that the participatory intervention may be associated with improvements in the perceived work environment. Process evaluation results indicated moderate employee engagement, with generally positive perceptions of involvement and overall satisfaction. A marginally significant negative correlation was found between employee involvement and stress reduction, suggesting that greater involvement was associated with greater decreases in perceived stress.</p><p><strong>Conclusions: </strong>While the absence of a control group limits causal inference, the study offers exploratory evidence that participatory organizational approaches may be linked to perceived improvements in staff well-being and working conditions in emergency care settings. Further research using comparative designs is needed to confirm these preliminary findings and to better understand how participatory interventions might contribute to workforce sustainability in healthcare.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2480"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
All-cause and cause-specific mortality attributable to educational inequalities in Spain. 西班牙教育不平等导致的全因死亡率和特定原因死亡率。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-17 DOI: 10.1186/s12889-025-23661-9
Sergi Trias-Llimós, Tim Riffe, Unai Martín
{"title":"All-cause and cause-specific mortality attributable to educational inequalities in Spain.","authors":"Sergi Trias-Llimós, Tim Riffe, Unai Martín","doi":"10.1186/s12889-025-23661-9","DOIUrl":"10.1186/s12889-025-23661-9","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic inequalities in mortality give key information for public health preventive policies. We aim to assess the magnitude of educational inequalities in cause-specific mortality in Spain (2016-21).</p><p><strong>Methods: </strong>We use mortality register and population exposure data for Spain for individuals aged 35-99 years for 2016-21. These data included information on age, sex, educational attainment, and causes of death. We estimated all-cause and age- and cause-specific mortality attributable to educational inequality (death counts, attributable fractions (AF), and years of life lost (YLL)) by treating the high education group as a counterfactual benchmark.</p><p><strong>Results: </strong>There were 426,449 average annual deaths in Spain in 2016-21, and we estimated 82,815 average annual deaths (42,867 males and 39,948 females) attributable to education inequality (AF of 19.5%). Deaths attributable to inequality were highly concentrated at ages 75 and over, yet the proportion of deaths attributable to educational inequality was higher at young ages (50% and 31% at ages 35-39 for males and females, respectively). Circulatory system causes of death were the leading cause in terms of deaths attributable to inequality in females (16,051 deaths, AF = 25.9%, YLL = 174,195) and the second cause in males (10,542 deaths, AF = 19.2%, YLL = 179,744). Neoplasms were the leading cause of death in males (10,868 deaths, AF = 16.1%, YLL = 230,958) but not in females (1,520 deaths, AF = 3.4%, YLL = 45,011).</p><p><strong>Conclusions: </strong>Educational inequality remains a major public health challenge; its population-level impact on mortality is higher compared to the impact of smoking. Public health interventions addressing gender-specific social determinants of inequalities in health have a great potential for reducing mortality.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2486"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"They tossed me up like a ball": informal settlement residents' experiences in accessing healthcare in Kampala, Uganda. “他们像扔球一样把我扔起来”:乌干达坎帕拉非正式定居点居民获得医疗保健的经历。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-16 DOI: 10.1186/s12889-025-23643-x
Julia Dickson-Gomez, Kirsten Beyer, Arthur Kiconco, Ronald Anguzu, Agnes Nyabigambo
{"title":"\"They tossed me up like a ball\": informal settlement residents' experiences in accessing healthcare in Kampala, Uganda.","authors":"Julia Dickson-Gomez, Kirsten Beyer, Arthur Kiconco, Ronald Anguzu, Agnes Nyabigambo","doi":"10.1186/s12889-025-23643-x","DOIUrl":"10.1186/s12889-025-23643-x","url":null,"abstract":"<p><strong>Background: </strong>Most urban dwellers (55%) in low- and middle-income countries (LMICs) live in informal settlements. Informal settlement dwellers have higher disease risk and poorer quality of life than residents of formal urban environments, yet they have less access to healthcare. Despite benefits of most international health aid delivered through Global Health Initiatives (GHIs) such as the WHO, USAID, and PEPFAR in rapidly addressing specific conditions such as HIV, TB, malaria, many GHI have created parallel structures to existing health systems. This paper examines the experiences residents of informal settlements have in trying to access basic healthcare in the context of global health aid.</p><p><strong>Methods: </strong>In this community-based study, we conducted focus group interviews (FGI) among 165 residents of six purposively selected informal settlements in Kampala, Central Uganda. Participants were purposively sampled to reflect participant demographics such as gender and age, with separate groups for males, females, youth and refugees. FGI asked residents about settlement formation, community challenges, governmental and non-governmental responsiveness, and health service delivery. Interviews were audio-recorded, transcribed verbatim and translated as needed. Inductive and deductive coding were used to merge codes into a final codebook, identifying emergent sub-themes and overarching themes summarized with supporting quotes.</p><p><strong>Results: </strong>Residents described barriers to accessing three separate healthcare systems: the public health system (national and regional referral hospitals and district health centers), the private health system, and the international donor healthcare system. Dimensions of affordability and approachability limited healthcare access in both the public and private systems, while most residents were excluded from disease-specific international donor funded care. The focus group interviews indicated that private healthcare systems have created incentives to draw resources away from already depleted public healthcare systems, further decreasing access to the most vulnerable.</p><p><strong>Conclusions: </strong>Our study reveals important and substantial gaps in the current healthcare system in Uganda. The main perceived health system challenges were its affordability and 'approachability' among residents of informal settlements. GHIs drain resources from the national health system and neglect coverage for non-priority diseases. We call upon policymakers to re-prioritize and respond to these health system challenges.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2475"},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experienced poverty stigma is associated with food insecurity, mental health, and resource utilization among Southern US mothers with low income. 在美国南部低收入母亲中,经历过的贫困耻辱与食物不安全、心理健康和资源利用有关。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-16 DOI: 10.1186/s12889-025-23615-1
Rachel A Liebe, Tuba Khan, Rimsha Azad, Leah M Adams, Ashlea C Braun, Heather A Davis, Sarah A Misyak
{"title":"Experienced poverty stigma is associated with food insecurity, mental health, and resource utilization among Southern US mothers with low income.","authors":"Rachel A Liebe, Tuba Khan, Rimsha Azad, Leah M Adams, Ashlea C Braun, Heather A Davis, Sarah A Misyak","doi":"10.1186/s12889-025-23615-1","DOIUrl":"10.1186/s12889-025-23615-1","url":null,"abstract":"<p><strong>Background: </strong>The role of poverty stigma, defined as negative stereotyping based on socioeconomic status, in the relationship between food security and mental health has not been well explored. This study aimed to develop and test a theory to explain the role of internalized and experienced poverty stigma in the relationship between food security and mental health among mothers in the Southern US.</p><p><strong>Methods: </strong>A cross-sectional survey was administered in December 2023. The survey was delivered electronically via Qualtrics to mothers living in the southern US who reported a household income below 185% of the federal poverty level. Food security, stigma, and symptoms of anxiety and depression were assessed using previously validated tools. A path analysis was conducted based on the initial conceptual framework and adapted to remove nonsignificant variables. Linear regression was used to assess stigma by resource utilization.</p><p><strong>Results: </strong>Mean poverty stigma scores among mothers (n = 1,008) were moderate for internalized (3.1 ± 0.8) and experienced stigma (3.1 ± 1.1). Lower food security was associated with higher internalized (β = 0.10, p < 0.001) and experienced stigma (β = 0.34, p < 0.001). Experienced stigma had a small association with both anxiety and depressive symptoms (β = 0.20, 0.23, p < 0.001). Participation in food pantries (+ 0.17) and the Temporary Assistance for Needy Families (TANF) program (+ 0.45) was associated with higher experienced stigma (p < 0.05).</p><p><strong>Conclusions: </strong>Poverty stigma may be a potential area for intervention to address the relationship between food insecurity and mental health among mothers and improve resource utilization.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2469"},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of intermittent Islamic fasting in management of metabolic syndrome: a randomized control trial. 间歇性伊斯兰禁食对代谢综合征管理的影响:一项随机对照试验。
IF 3.5 2区 医学
BMC Public Health Pub Date : 2025-07-16 DOI: 10.1186/s12889-025-23493-7
Hanaa A Nofal, Abdellatif Abd-El Rahman Elmor, Amany M AbdAllah, Nermeen A Zaitoun, Shaherah Yousef Andargeery, Mahmoud A Sharafeddin, Radwa Ibrahim Ali Hassan, Lamiaa Lotfy Elhawy
{"title":"Effect of intermittent Islamic fasting in management of metabolic syndrome: a randomized control trial.","authors":"Hanaa A Nofal, Abdellatif Abd-El Rahman Elmor, Amany M AbdAllah, Nermeen A Zaitoun, Shaherah Yousef Andargeery, Mahmoud A Sharafeddin, Radwa Ibrahim Ali Hassan, Lamiaa Lotfy Elhawy","doi":"10.1186/s12889-025-23493-7","DOIUrl":"10.1186/s12889-025-23493-7","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome doubles the risk of developing cardiovascular diseases and type II diabetes mellitus. Intermittent Islamic fasting is an effective health strategy associated with various benefits.</p><p><strong>Objectives: </strong>to compare effect of intermittent Islamic fasting with lifestyle modification versus lifestyle modification only on weight management, blood pressure, blood glucose and lipid profile among a group of metabolic syndrome patients.</p><p><strong>Methods: </strong>A Randomized control trial was conducted on (54 patients) with metabolic syndrome, their ages range from (30-45 years) attending the clinical nutrition outpatient clinic in the Zagazig University hospital from 1st of August (2023) to the end of February (2024). Intervention group (27 patients) followed Islamic fasting with lifestyle modification (Islamic fasting means: fasting two days per week (Monday and Thursday) with fasting (13, 14, 15) middle of lunar months) and control group (27 patients) followed lifestyle modification only.</p><p><strong>Results: </strong>There is statistically non-significant difference between groups regarding healthy lifestyle score, clinical or laboratory parameters. There is statistically significant difference between the studied groups regarding percent of change in weight (p-value < 0.001), waist circumference (P-value < 0.001), systolic ( p-value = 0.042), diastolic blood pressure (P < 0.001), Fasting blood glucose (p-vale < 0.001), triglycerides (p-value < 0.001), HDL(p-value < 0.001) and total cholesterol (p-value = 0.023) with better improvement in intervention group, although no significant difference between them regrading lifestyle before or after intervention but both groups showed significant improvement after intervention.</p><p><strong>Conclusion: </strong>Intermittent Islamic fasting (ISF) demonstrated a statistically significant enhancement in weight regulation, systolic blood pressure, triglyceride levels, total cholesterol, and HDL concentrations when compared to lifestyle modification alone.</p><p><strong>Trial registration: </strong>Retrospectively registered on ClinicalTrials.gov, registered at 22/1/ 2025, Identifier NCT06805526.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2476"},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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