BMJ Global Health最新文献

{"title":"Green space exposure and active transportation during the COVID-19 pandemic: a global analysis using Apple mobility data.","authors":"Ruoyu Wang, Selin Akaraci, Esteban Moro, Pedro C Hallal, Rodrigo Reis, Ruth Hunter","doi":"10.1136/bmjgh-2024-017108","DOIUrl":"10.1136/bmjgh-2024-017108","url":null,"abstract":"<p><strong>Introduction: </strong>There is little evidence investigating the association between green space (exposure and inequality) and active transportation during the COVID-19 pandemic. This study focused on the spatial heterogeneity in trajectories of different transportation modes during the COVID-19 pandemic worldwide, as well as the association between green space exposure and inequality and active transportation during the COVID-19 pandemic from a global perspective.</p><p><strong>Methods: </strong>This study was based on an ecological study design and used three different Apple Mobility indices (driving, walking and public transit) to evaluate the trajectories of different transportation modes during the COVID-19 pandemic in 299 cities across 46 countries. Green space exposure was calculated based on fine-resolution population and green space mappings. Green space inequality was calculated by incorporating the Gini index into the green space exposure (green space Gini index). The hot/cold spot analysis was used to explore spatial heterogeneity in trajectories of different transportation modes during the COVID-19 pandemic worldwide, while Gaussian spatial mixed models were used to model the association between green space exposure and inequality and active transportation.</p><p><strong>Results: </strong>The hot/cold spot analysis shows that there were spatial inequalities in the trajectories of different transportation modes worldwide during the COVID-19 pandemic. Results from Gaussian spatial mixed models showed that green space exposure was positively associated with the walking index (Coef.=46.82; SE=18.20), while green space inequality was positively associated with the walking index (Coef.=58.88; SE=26.87) and public transit index (Coef.=162.07; SE=80.16). Also, the effect of green space varied across city development levels, the stringency of policy and COVID-19 severity.</p><p><strong>Conclusions: </strong>Our findings demonstrate the importance of sufficient city-scale green spaces to support active transportation, with important implications to help cities better prepare for future pandemics and support active transportation during non-pandemic times.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075950","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":"Design, coverage and utilisation of maternity conditional cash programmes in low- and middle-income countries: a scoping review.","authors":"Sanghita Bhattacharyya, Chetana Chaudhuri, Sruti Mohanty, Urvashi Kaushik","doi":"10.1136/bmjgh-2023-012890","DOIUrl":"10.1136/bmjgh-2023-012890","url":null,"abstract":"<p><strong>Introduction: </strong>Over the years, conditional cash transfers (CCTs) have become a popular tool to enhance demand for, and access to, essential healthcare services. While the immediate goal of CCTs is to improve the affordability of healthcare services, these are also being used to improve all health-seeking behaviour outcomes across countries. We examined how the design, operationalisation and facilitation of maternity benefits programmes have evolved, and the advantages and challenges that accompany in low- and middle-income country settings.</p><p><strong>Methods: </strong>A scoping review was conducted across three major electronic databases: PubMed, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane library database. We also reviewed grey literature and used the snowball search approach to review the websites of numerous public health organisations and repositories. Based on set inclusion criteria and protocols, two reviewers independently screened titles and abstracts. This was followed by detailed full-text screening. Disagreements, if any, were resolved by a third researcher.</p><p><strong>Results: </strong>Of 235 articles identified, 65 met the inclusion criteria. These articles shed light on a wide variety of CCT design features, including benefit sizes, monitoring and compliance mechanisms, and periodicity of transfers, insights on eligibility criteria, conditionalities to be fulfilled to avail the benefits such as mandatory antenatal and postnatal checks, institutional delivery, immunisation etc. Challenges highlighted include poor awareness and low community participation and lack of agency among women in decisions about use of cash among demand-side constraints. Supply-side issues range from lack of role clarity and ownership among service providers, inefficient fund flow, and inadequate staff and infrastructure provision to tackle increased service utilisation.</p><p><strong>Conclusion: </strong>CCTs have the potential to improve access to maternal and child health services, but need effective design and operational processes, which should be closely monitored. CCTs could also benefit from addressing inequities by including more women from vulnerable and lower socio-economic groups.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075948","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":"<i>Correction:</i> Alcohol restrictions and suicide rates in South Africa during the COVID-19 pandemic: results of a natural experiment.","authors":"","doi":"10.1136/bmjgh-2024-017171corr1","DOIUrl":"10.1136/bmjgh-2024-017171corr1","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971130","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":"Health disparities among Deaf communities from Colombia: assessing communication, technology and healthcare access.","authors":"Jyoti Dalal, Laura Catalina Izquierdo Martínez, Angela Martínez-R, Jess Cuculick, Nora Groce, Minerva Rivas Velarde","doi":"10.1136/bmjgh-2024-018377","DOIUrl":"10.1136/bmjgh-2024-018377","url":null,"abstract":"<p><strong>Introduction: </strong>Despite efforts to improve health equity, there is still limited knowledge about the number and characteristics of people with disabilities, particularly the Deaf community. Our aim is to use linguistically and culturally adapted research instruments to measure key health indicators and priorities within the Deaf community from a low- and middle-income country-Colombia, contributing to a better understanding of health inequities.</p><p><strong>Methods: </strong>We used data from the Health Survey for Deaf (HSD) and National Quality of Life Survey (NQLS) from Colombia. We included various communication and technology-related indicators-usage of smartphone, modes of interacting with healthcare personnel, along with health indicators-self-perception of health, healthcare quality, hospitalisation and functional difficulties in various domains. ORs were computed to depict the differences in two groups, adjusted for both age and gender, using logistic regressions.</p><p><strong>Results: </strong>We included 204 and 877 Deaf participants from HSD and NQLS, respectively. Owning a phone was significantly associated with a better self-perception of health (ORs=2.27, 95% CI 1.63 to 3.17 for NQLS-Deafs; 1.49, 1.43 to 1.54 for NQLS-general population) but also with more functional difficulties corresponding to most domains (all ORs >1). However, for HSD datasets, we found that phone ownership was associated with having significantly less functional difficulties in moving hands (0.34, 0.14 to 0.81) and cognition (0.36, 0.15 to 0.89). Access to professional interpreting services was correlated with increased communication-related functional difficulties (2.02, 1.00 to 4.08), for HSD participants. Better self-perception of health was linked to fewer functional difficulties (all ORs <1), while recent hospitalisation was associated with more functional difficulties (all ORs >1).</p><p><strong>Conclusions: </strong>We found that Deaf individuals generally experience poorer health outcomes compared with hearing individuals. To address these disparities, we recommend (1) improving data quality that could lead to targeted responses and monitoring of it and (2) implementing personalised health surveys that account for the Deaf population's fluency in Spanish and Colombian Sign Language and their specific understanding of health issues.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976132","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":"Malaria morbidity, mortality and associated costs in Indonesia: analysis of the National Health Insurance claim dataset.","authors":"Ery Setiawan, Angela Devine, Helen Dewi Prameswary, J Kevin Baird, Ric Price, Kamala Thriemer","doi":"10.1136/bmjgh-2024-018255","DOIUrl":"10.1136/bmjgh-2024-018255","url":null,"abstract":"<p><strong>Introduction: </strong>Data on morbidity, mortality and cost for malaria-related hospitalisation are important for prioritising resources for malaria control strategies, but these data are often limited. The aim of this study was to understand the current malaria service delivery in Indonesia, including referral rates to hospitals, mortality outcomes and malaria-related costs at hospitals, using data from National Health Insurance claims.</p><p><strong>Methods: </strong>Data were gathered from the recent Indonesian National Health Insurance dataset for claims made between 2015 and 2020. Cases were selected for any diagnosis with the international classification of diseases-10th revision codes for malaria-related diseases. Patients' sociodemographic status, repeated presentations to healthcare facilities, referral patterns and costs of treatment for the hospital settings were assessed by malaria species. Costs were reported in 2020 US$.</p><p><strong>Results: </strong>Data were available for 12 970 episodes of malaria, which occurred in 8833 patients. <i>Plasmodium falciparum</i> accounted for 6019 (46.4%) episodes, and <i>P. vivax</i> for 4307 (33.2%) episodes. The incidence rates were 0.38 (95% CI 0.29 to 0.47) per person-years for <i>P. falciparum</i> and 0.33 (95% CI 0.19 to 0.52) for <i>P. vivax</i>. 46% of malaria cases initially presented at the hospital. Among these patients, the mean cost was US$16.2 (SD 4.4) for an outpatient consultation and US$228.7 (SD 122.6) for inpatient care. In total, 4.8% (623) of patients re-presented to the hospital within 30 days of a malaria episode, of whom 1.7% (219) required admission for inpatient care, which was estimated to cost US$230.0 (SD 105.5). The risk of mortality for inpatients with <i>P. falciparum</i> malaria was 2.1% (36/1718) compared with 1.2% (16/1359) for patients with <i>P. vivax</i> malaria; p=0.069.</p><p><strong>Conclusions: </strong>The National Health Insurance claim data provide detailed costing estimates. Integrating data from the existing malaria information system with the data from the National Health Insurance claims can provide important insights into the healthcare costs associated with the management of malaria that could help optimise national antimalarial policy.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958667","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":"Vaccination and its social and behavioural drivers in children with disability in Fiji.","authors":"Israt Jahan, Unise Vakaloloma, Sureni Perera, Ilisapeci Tuibeqa, Rachel Devi, Litiana Volavola, William May, Donald Wilson, Lanieta Tuimabu, Rosalie Power, Susan Woolfenden, Margie Danchin, Sarah McIntyre, Hayley Smithers-Sheedy, Nadia Badawi, Kristine Macartney, Gulam Khandaker, Meru Sheel","doi":"10.1136/bmjgh-2024-017510","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-017510","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the vaccination of children with disabilities are limited across Pacific Island countries like Fiji. This study aimed to examine the vaccination status and measure the social and behavioural drivers influencing vaccination of children with disability in Fiji.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in Suva-Nausori area, Rewa, Fiji among children with disabilities (eg, motor, vision, hearing, speech, intellectual, epilepsy) aged 2-19 years and their caregivers. Caregivers were interviewed using a questionnaire to collect data on sociodemographic, functional characteristics (UNICEF's child-functioning tool), child's vaccination status according to Fiji's National Immunisation Programme (NIP), and drivers of vaccination using the WHO-UNICEF Behavioural and Social Drivers Tool. Descriptive and regression analyses were undertaken.</p><p><strong>Results: </strong>In April-May 2023, 198 children and their caregivers were recruited from the study area. The mean age of participating children was 7.6 years, 67.7% were male. Of the 198 children, 55% were fully vaccinated against all vaccines provided under the NIP. Percentage vaccination was highest for dose 1 of each NIP vaccine antigen and declined for subsequent doses. Vaccination against all NIP vaccines was significantly lower among children aged 15-19 years, those with hearing difficulties, and whose caregivers had low confidence in vaccine safety, whereas vaccination was higher among children with mobility difficulties.</p><p><strong>Conclusion: </strong>Study findings highlight the need for equitable access to vaccines for children with disability who are vulnerable to infection from vaccine-preventable diseases. Policies and response plans should emphasise inclusiveness and assist children with disabilities to overcome access barriers within existing vaccination programmes.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954126","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":"Characterising the effects of displacement on gender-based violence among women living with HIV in Ukraine: a cross-sectional study.","authors":"Althea Wolfe, Mary Anne Roach, Gnilane Turpin, Omar Syarif, Pim Looze, Katarzyna Lalak, Jean de Dieu Anoubissi, Yi-Chi Chiu, Alexandra Volgina, Sophie Brion, Keren Dunaway, Olena Stryzhak, Daria Ocheret, Laurel Sprague, Carlos Garcia de Leon Moreno, Stefan David Baral, Carrie Lyons, Katherine B Rucinski","doi":"10.1136/bmjgh-2024-016478","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-016478","url":null,"abstract":"<p><strong>Introduction: </strong>Women living with HIV (WLHIV) in conflict zones are at high risk of sexual and physical violence due to instability, stigma and proximity to military personnel. Given sustained ongoing conflict, this study evaluated the relationship between displacement and gender-based violence (GBV), including experiences of sexual violence, abuse by healthcare workers and reproductive coercion among WLHIV in Ukraine. These forms of violence are conceptualised as severe forms of enacted stigma that are downstream outcomes of social, cultural and political norms, as well as social and structural stigmas related to misogyny and HIV.</p><p><strong>Methods: </strong>Data were collected in Ukraine in 2020 as part of the People Living with HIV Stigma Index 2.0, led by 100% Life, the largest organisation for people living with HIV in Eastern Europe/Central Asia. WLHIV were recruited throughout Ukraine through limited chain referral and venue-based sampling. All participants completed a sociobehavioural questionnaire. Self-reported outcomes included sexual violence, violence in healthcare settings and reproductive coercion related to pregnancy, sterilisation and contraception. Displaced participants comprised WLHIV who were asylum seekers/refugees or internally displaced. Log binomial regression models estimated adjusted prevalence ratios (aPR) and 95% CIs for associations between displacement and GBV outcomes.</p><p><strong>Results: </strong>A total of 1062 cisgender WLHIV completed the questionnaire, among whom 144 (13.6%) were displaced. Displaced WLHIV had higher proportions of lifetime experience using drugs (66.7% vs 22.0%, p=<0.01), selling sex (28.5% vs 12.2%, p=<0.01) and facing HIV-related stigma/discrimination (47.9% vs 34.4%, p=<0.01). Displaced WLHIV were significantly more likely to have experienced sexual violence (aPR: 2.74, 95% CI: 1.67 to 4.51), violence in healthcare (aPR: 2.57, 95% CI: 1.49 to 4.43), pregnancy coercion (aPR: 2.60, 95% CI: 1.41 to 4.78), sterilisation coercion (aPR: 4.26, 95% CI: 1.17 to 15.43) and contraception coercion (aPR: 2.48, 95% CI: 1.00 to 6.15) compared with non-displaced WLHIV.</p><p><strong>Conclusion: </strong>As the war in Ukraine continues, humanitarian and health systems can use these findings to guide integration of GBV referrals and scale-up of trauma-informed care and antiexploitation training into Ukrainian programming. Moreover, additional surveillance methods, including community-led monitoring, can support routine documentation of experiences of coercion and abuse in healthcare settings. Broadly, transformative approaches are needed to tackle structural causes of gender inequality, HIV and violence.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980314","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":"Quantifying the loss of healthy life expectancy due to population ageing: health benefit estimation from a global perspective.","authors":"Jun-Yan Xi, Jian-Guang Zhao, Xue-Qi Li, Bo Yan, Jian-Jun Bai, Yi-Ning Xiang, Wei Hu, Jie Hu, Yu Liao, Jing Gu, Xiao Lin, Yuan-Tao Hao","doi":"10.1136/bmjgh-2024-018194","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018194","url":null,"abstract":"<p><strong>Study objective: </strong>Investing in health to improve healthy life expectancy (HLE) is fundamental to create a demographic dividend. However, how dramatic population ageing affects HLE remains unknown. This study aims to quantify and project the major diseases and injuries attributed to changes in population size and age structure that contributed to substantial losses in HLE.</p><p><strong>Methods: </strong>Using data from 188 countries in the Global Burden of Disease Study 2021 and World Population Prospects 2024, we assessed the correlation between HLE and total dependency ratios. Furthermore, we decomposed the mortality and disability burden attributable to changes in population size as well as age structure for 22 disease and injury categories and then quantified the loss of HLE due to the attributable burden. Additionally, we projected the loss of HLE due to priority diseases in 2030, while considering the impact of population ageing.</p><p><strong>Results: </strong>From 2010 to 2019, globally, the mortality and disability burden attributable to age structure caused 0.40 years and 0.71 years of HLE loss, while for population size, these two estimates were 1.18 years and 1.00 years. By 2030, the mortality and disability burden attributable to age structure may lead to 0.76 years and 0.89 years of HLE loss, while for population size, these two predictions will be 1.21 years and 1.17 years.</p><p><strong>Discussion: </strong>Population size growth is a consistent and crucial contributor to HLE losses. Reaping the second demographic dividend requires eliminating the double burden of premature death caused by infectious and chronic diseases, whereas gaining the sustainable third demographic dividend requires investments in healthy and successful ageing.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965047","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":"Mosquito and global dengue cases in a warming world.","authors":"Jie Hu, Benjamin P Horton, Tsin Wen Yeo, Joseph J Y Sung, Yim Hung Lam Steve","doi":"10.1136/bmjgh-2023-014688","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-014688","url":null,"abstract":"<p><p>Dengue presents a significant global health challenge, affecting 50-100 symptomatic infections every year and placing immense strain on healthcare systems in tropical and subtropical regions. However, future projections of dengue infections in a warming world remain unclear. We used the support vector machine (SVM) and artificial neural network (ANN) models with <i>Aedes</i> mosquitoes and dengue records from 1960 to 2019 to comprehensively assess the effects of climate change and socioeconomic conditions on the distribution of mosquitoes and the global dengue incidence rate. The SVM and ANN models were applied to project the global future incidence rate and infections during 2021-2040, 2041-2060 and 2061-2080 under various climate change and socioeconomic conditions in a 5 km spatial resolution. We found a geographical distribution expansion of <i>Aedes</i> mosquitoes and dengue in future years, especially in higher latitudes such as North America and Europe. It was estimated that 77 (confidence interval: 40 to 198) million yearly global infections will occur during 2041-2060 under the Shared Socio-economic Pathway SSP2-4.5, a 57% increase of 49 (26-127) million compared with 2000-2019. The rise in annual infections is primarily attributed to the growing incidence rates driven by rising temperatures and the enhanced suitability of <i>Aedes aegypti</i>, and an expanding human population. Our high-resolution projection provides support to local control measures to minimise health impacts from dengue. Specifically, the <i>Aedes</i> mosquito control programmes such as eliminating the <i>Ae. aegypti</i> breeding sites are recommended in Africa and South Asia, where dengue is particularly severe in all climate change and socioeconomic conditions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969248","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":"Applying the Information-Motivation-Behavioral Skills model to a video-assisted HPV intervention to promote self-screening uptake: a qualitative study in Western Kenya.","authors":"Hanul Choi, Haley Dion, Michelle Huang, Laya Sathyan, Emily Herfel, Breandan Makhulo, Jeniffer Ambaka, Megan J Huchko","doi":"10.1136/bmjgh-2024-017616","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-017616","url":null,"abstract":"<p><strong>Introduction: </strong>Human papillomavirus (HPV) is the leading source of cervical cancer in Kenya. HPV, like other sexually transmitted infections, is stigmatised, which hinders efforts to address the disease. Education and empowerment are crucial in combating HPV stigma and increasing screening uptake. We conducted qualitative analyses of a video-assisted HPV educational intervention in Kisumu, Kenya to determine its impact on women's knowledge, motivation and behaviour for HPV and cervical cancer prevention. The stigma-responsive video featured a group discussion with an individual describing her experience with HPV, self-testing and preventive treatment.</p><p><strong>Methods: </strong>Three focus group discussions (FGDs) were conducted with 10 women, respectively, ages 30-64, from three intervention clinics, to explore their experience with the video-assisted education, perspectives on HPV and self-sampling, and the feasibility of peer-led education to increase screening and follow-up. The initial codebook was developed prior to the FGDs using an Information-Motivation-Behavioral (IMB) Skills model framework, followed by a rapid analysis to identify missing themes. We conducted qualitative coding using NVivo V.12. The IMB Skills model was used to analyse the codes and findings from the FGDs to assess the impact of the education.</p><p><strong>Result: </strong>Women in FGDs identified the lack of community-level knowledge on HPV and the stigma and fear of physical pain from pelvic examination as barriers to HPV screening. Many participants mentioned that the knowledge gained through the video reduced their stigma and fear, and it motivated them to screen. Participants demonstrated behavioural change through self-sampling uptake, community empowerment and referral to watch the video.</p><p><strong>Conclusion: </strong>From the FGDs, we found the direct mechanism linking information, motivation and screening behaviour in our video-assisted HPV educational intervention. The intervention improved women's self-reported HPV-related knowledge and increased their motivation for self-sampling and engagement in preventive behaviours. We recommend scaling up the intervention by bringing the video-assisted education to more clinics in Kisumu.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966707","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}