BMC Public Health最新文献

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139187/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139191/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139150/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139358/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142933/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135300/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight underestimation and high cardiovascular disease risk among South African adults with obesity: implications for integrated obesity prevention.","authors":"Kufre Joseph Okop, Yusuf Amuda Agabi, Victoria Joseph","doi":"10.1186/s12889-025-23378-9","DOIUrl":"10.1186/s12889-025-23378-9","url":null,"abstract":"<p><strong>Background: </strong>The contribution of body size perception to cardiovascular disease risk among persons with inherent negative body image perceptions in African settings has not been established. This study describes body image, weight discordance and absolute 10-year CVD risk score among predominantly obese black South African adults.</p><p><strong>Methods: </strong>A cohort study involving 920 adults aged 35-78 years in an urban township, a rural community, and South Africa. Medical history, anthropometrics and blood pressure were taken at baseline and follow-up. Body image perceptions were obtained using a validated body shape questionnaire at follow-up, and each participant's absolute 10-year CVD risk scores were also determined. Descriptive and mean comparison analyses were undertaken using SPSS version 26.</p><p><strong>Results: </strong>A higher proportion of women (84.1%) compared to men (32.2%) were overweight (BMI > 25 kg/m²). Increasing weight underestimation was associated with relative weight gain in both genders. Body weight underestimation had a weak, significant association with 10-year absolute CVD risk scores. About a quarter of men, compared to 58.3% of women, 42% of those with normal weight, and 30% with obesity, had a 'high' 10-year CVD risk score (i.e. score ≥ 20%). In both the urban (62% vs. 30%) and the rural (53% vs. 20%) communities, men had higher CVD risk scores than women, and these comparisons were statistically significant (p < 0.05).</p><p><strong>Conclusion: </strong>Obesity and CVD risk prevention programmes targeting black South Africans should consider a sustained healthy weight maintenance intervention focusing on personalised self-assessments of weight gain intentions and body size preferences.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2087"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal-derived foods, physical activities, and mild cognitive impairment among Chinese older adults: findings from CLHLS (2008-2018).","authors":"Boyu Si, Keqing Zhang","doi":"10.1186/s12889-025-23382-z","DOIUrl":"10.1186/s12889-025-23382-z","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study investigates the relationship between dairy-egg-meat (DEM) consumption, physical exercise, and mild cognitive impairment (MCI) among Chinese older adults, focusing on gender-specific patterns and potential moderating effects.</p><p><strong>Methods: </strong>Using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we conducted a longitudinal analysis of 14,640 participants aged 55 and above, followed from 2008 to 2018. The study utilized Cox Proportional Hazard Models to examine the associations between baseline DEM consumption and MCI incidence. A composite DEM consumption measure, ranging from 0 to 3, with exercise assessed as a binary interaction variable. Cognitive function was evaluated using the Chinese version of the Mini-Mental State Exam, with MCI diagnosed using aging-associated cognitive decline (AACD) criteria.</p><p><strong>Results: </strong>The overall MCI prevalence was 11.54%, with significant gender differences. The proportion of MCI among females (13.68%) was higher compared to males (8.85%). Moderate to high DEM consumption demonstrated protective effects against MCI with gender-specific patterns, showing a significant protective effect of exercise for high DEM consumption (HR = 0.780).</p><p><strong>Conclusions: </strong>The study reveals a complex, gender-specific relationship between DEM consumption and MCI risk. Exercise emerges as a significant moderator, particularly for males, highlighting the importance of integrated dietary and physical activity approaches to cognitive health. The findings underscore the need for gender-sensitive interventions targeting nutrition and physical activity among older adults.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2088"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Bullying in adolescents across three years in the context of the COVID-19 pandemic: a repeated cross-sectional and prospective analysis.","authors":"Bruno Nunes de Oliveira, Marcus Vinicius Veber Lopes, Bruno Gonçalves Galdino da Costa, Gabrielli Thais de Mello, Gabriel Pereira Maciel, Kelly Samara Silva","doi":"10.1186/s12889-025-23289-9","DOIUrl":"10.1186/s12889-025-23289-9","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2083"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effects of chronic pain and diabetes on cardiovascular disease risk: findings from a nationwide cohort study.","authors":"Tian-Qi Teng, Jing Liu, Meng-Meng Wang, Hai-Chu Yu","doi":"10.1186/s12889-025-23376-x","DOIUrl":"10.1186/s12889-025-23376-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a significant risk factor for cardiovascular diseases (CVD). However, the impact of dynamic changes in pain site count and the interaction between pain and diabetes on CVD risk remain unclear.</p><p><strong>Methods: </strong>The study was a prospective cohort analysis based on data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020). Participants aged ≥ 45 years with follow-up data on pain, diabetes, and cardiovascular disease (CVD) were included, excluding those with CVD at baseline. Pain sites and counts were categorized, and changes in pain site count across waves 1 to 3 were assessed, dividing participants into four groups: Cluster 1 (n = 6477) with persistently low counts; Cluster 2 (n = 964) with a significant increase; Cluster 3 (n = 272) with consistently high counts; and Cluster 4 (n = 680) with a significant decrease. CVD was defined as self-reported physician-diagnosed heart disease (including myocardial infarction, angina, coronary heart disease, heart failure, or other heart problems) and stroke. Cox regression was used to assess the relationship between pain and CVD, and an additive interaction analysis evaluated the interaction between pain and diabetes.</p><p><strong>Results: </strong>13,492 participants were enrolled. With a median follow-up of 9 years, 3,146 participants (23.32%) developed incident CVD. Cox regression showed that pain was associated with a 28% higher risk of CVD (HR 1.28, 95% CI 1.18-1.41). When pain affected more than six sites, CVD risk increased by 64% (HR 1.64, 95% CI 1.44-1.87). Participants with consistently high pain site count had the highest CVD risk compared to those with consistently low count (HR 1.94, 95% CI 1.53-2.46), while those with a decreasing trend in pain site count had a lower risk (HR 1.49, 95% CI 1.26-1.78). Interaction analysis revealed a significant interaction between pain and diabetes in predicting CVD, contributing an additional 35% risk (RERI 0.35, AP 0.2, S 1.9).</p><p><strong>Conclusions: </strong>The number of pain sites and its dynamic changes are closely associated with CVD risk, and the synergistic effect of pain and diabetes requires more attention.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2085"},"PeriodicalIF":3.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224192","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}