Journal of public health (Oxford, England)最新文献

{"title":"Conceptualizing the effects of COVID-19 on eating and physical activity in people with type 2 diabetes and hypertension in Ecuador using the social ecological model.","authors":"I Benazizi-Dahbi, A L Torres-Castillo, C Caicedo-Montaño, M Puig-García, A Peralta-Chiriboga, M Hernández-Enríquez, M F Rivadeneira Guerrero, M Márquez-Figueroa, L A Parker, E Chilet-Rosell","doi":"10.1093/pubmed/fdaf025","DOIUrl":"10.1093/pubmed/fdaf025","url":null,"abstract":"<p><strong>Background: </strong>Our aim was to explore patients' perceptions of changes in diet and physical activity in people with type 2 diabetes mellitus and/or arterial hypertension in two low-income districts of Ecuador.</p><p><strong>Methods: </strong>We carried out a qualitative study of 19 telephone interviews in August-September 2020 with people with type 2 diabetes mellitus and/or arterial hypertension. Interviews were recorded, anonymized and transcribed verbatim for analysis using the social ecological model.</p><p><strong>Results: </strong>Within the context of poor access to the health services, participants identified a lack of social policies to address food insecurity and income stability. Food insecurity was related to mobility restrictions and loss of income, particularly among vulnerable populations, such as migrants and women. Changing work environments influenced physical activity patterns and food availability. Family support was crucial to overcome economic shortfalls allowing for better eating habits. Despite recognizing overeating as detrimental to disease management, participants reported increased desire to binge eat due to emotional distress and anxiety.</p><p><strong>Conclusions: </strong>The lack of social policies dealing with poverty and food insecurity during the pandemic made non-communicable disease self-care with physical activity and diet challenging for vulnerable populations.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":"160-168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Helicobacter pylori infection associated with animal contact? A systematic review and meta-analysis.","authors":"Xin Wang, Kun Xu, Tao Zhang, Jihui Zeng, Peng Feng, He Liu, Jingfei Zhang, Juan Gao, Xian Gao, Longfei Shi, Xinyao Sun","doi":"10.1093/pubmed/fdaf060","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf060","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori infection has been reported in both humans and animals. This meta-analysis aimed to analyze the correlation between H. pylori infection in humans and animal rearing/contact.</p><p><strong>Methods: </strong>This study was conducted by searching five databases from their creation to 25 November 2024. The data was analyzed using Review Manager software. Heterogeneity was estimated with I2 statistics. A random-effect model was used when heterogeneity was significant; otherwise, a fixed-effect model was used.</p><p><strong>Results: </strong>A total of 21 studies and 10 662 subjects were finally included. Animal rearing/contact was significantly associated with higher odds of H. pylori infection (OR = 1.80, 95% CI: 1.42-2.28, P < .001). The OR value of H. pylori infection in individuals rearing/contact with domestic animals was 1.71 times that of those without rearing/contact (OR = 1.71, 95% CI: 1.33-2.21, P < .001). H. pylori infection was correlated with dog rearing/contact (OR = 2.25, 95% CI: 1.24-4.08, P = .008), but not with pet (OR = 1.61, 95% CI: 0.94-2.78, P = .09) and cat (OR: 1.26, 95% CI: 0.96-1.67, P = .10) rearing/contact. Rearing/contact with animals (OR: 2.04 and 1.62), domestic animals (OR: 1.90 and 1.40), and dogs (OR: 4.11 and 1.50) were risk factors for H. pylori infection in adults and children.</p><p><strong>Conclusions: </strong>This meta-analysis confirmed that H. pylori infection in humans was correlated with animal rearing/contact, particularly in adults.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decision-making model for public health authorities in circumstances of potentially high public risk.","authors":"Fatima N Dalal, Simon E Kolstoe, Yimmy Y Chow, Dipti Dashore, Marc Lipman, Patrick Lillie, Simon Padfield, Roger Gajraj, Carmel McGrath, Tom Fowler, Susan L Ibbotson","doi":"10.1093/pubmed/fdaf052","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf052","url":null,"abstract":"<p><strong>Background: </strong>An expert multidisciplinary panel was commissioned by a UK Health Security Agency led incident management team (IMT) to support decision making in the case of an individual with extensively drug-resistant tuberculosis. The behaviour and stated intentions of the individual were potentially a significant risk to public health, and the regional IMT felt unable to adequately balance the rights of the individual, versus the public health risk, within current processes and legal powers.</p><p><strong>Method: </strong>We describe the composition, organization, implementation, and conclusions of a national, expert, multidisciplinary panel.</p><p><strong>Results: </strong>The national panel convened over three structured virtual meetings to consider the balance between the rights of the individual to an unrestricted life, and the duty to protect the public's health. Evidence included briefs from the regional IMT and input from a public consultation group. Following the first two meetings the need for a literature review examining the success of surgical interventions was identified and conducted.</p><p><strong>Conclusions: </strong>Evidence and conclusions were mapped onto a custom-designed risk assessment template. The panel provided authoritative advice regarding the case, and developed a review methodology that is transferable to similar complex public health scenarios both in the UK and internationally.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and reproductive health knowledge and behaviors and prevalence of sexually transmitted infections among adolescents and young adults from Angola.","authors":"Sandra Aixut, Esperanza Esteban, Joan Martínez-Campreciós, Paula Regina Oliveira, Freddy Gómez-Martínez, Diana Martín-García, Domingos Luwawa, Edilson Canõma, Eugenia Neves, Nataniel Chinjengue, Fernando Quilezi, Osvaldo Lueto, Naquarta Gomes, Raquel Iglesias, Pedro Bala, Vicente Descalzo, Inés Oliveira, Olatz Larrea, Eva López Guerrero, Israel Molina, Maria Luisa Aznar","doi":"10.1093/pubmed/fdaf054","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf054","url":null,"abstract":"<p><strong>Background and objective: </strong>There is little information on sexual and reproductive health knowledge (SRHK) and practices in Angola and no data on the prevalence of sexually transmitted infections. The objective of this study was to assess the SRHK and behaviors, and estimate the prevalence of four sexually transmitted infections (STIs) among adolescents and young adults from 4 municipalities in Benguela province, Angola prior to an educational intervention.</p><p><strong>Material and methods: </strong>We performed a cross-sectional study to assess SRHK and sexual behavior using a structured questionnaire among adolescents and young adults aged 15 to 25 years old from two urban and two rural municipalities of Benguela province. We also evaluated the prevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis using rapid tests.</p><p><strong>Results: </strong>A total of 1400 youths were included in the study. Overall, 818 (58.4%) participants had adequate SRHK. Urban origin [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.35-2.04], older age (OR 1.14, 95% CI 1.09-1.20), being female (OR 2.06, 95% CI 1.57-2.71) and having journals and internet as the main sources of information (OR 1.37, 95% CI 1.00-1.86 and OR 2.33, 95% CI 1.69-3.21, respectively) were significantly associated to a good SRHK in the multivariate analysis. Four hundred and fifty-three [45.9% of those who have had sexual intercourse (n = 986)] reported risky sexual behavior. We observed that risky sexual behavior was associated with male gender (OR 2.89 95% CI 2.13-3.92, P< .001). Prevalence of STI was: 5 (0.35%) for HIV, 190 (13.6%) for HBV, 4 (0.3%) for HCV, and 20 (1.4%) for syphilis.</p><p><strong>Conclusion: </strong>SRHK was higher than expected although in-depth knowledge was uncommon, especially in men from rural areas with lack of access to journals or the internet. Unsafe sexual behavior was widespread among our sample. Prevalence of HBV was higher than expected. Sexual education campaigns using both digital and non-digital approaches should be focused on reaching the young population dispersed in rural areas where internet connection is difficult and should be accompanied by HBV vaccination promotion.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmeasured confounding in meta-analyses of observational studies evaluating maternal periodontitis and adverse birth outcomes.","authors":"May Salama, Abdullah Al-Taiar, Denise McKinney, Saad Al Otaibi, Sultan Al-Sallum, Eric Mishio Bawa, Anwar T Merchant","doi":"10.1093/pubmed/fdaf056","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf056","url":null,"abstract":"<p><strong>Background: </strong>Maternal periodontitis has been consistently linked to adverse birth outcomes (ABOs). However, a causal relationship is not established due to potential unmeasured confounding factors in observational studies and inconclusive results from randomized controlled trials. This study aimed to assess the impact of unmeasured confounding factors in meta-analyses examining associations between maternal periodontitis and preterm birth (PTB) or low birth weight (LBW).</p><p><strong>Methods: </strong>PubMed and MEDLINE, Cochrane, Embase, and Google Scholar were searched for systematic reviews with meta-analyses of observational studies between 2002 and 2023. Systematic reviews with meta-analyses of observational studies were included if either PTB or LBW were the outcome and were published in English. The E-value analogue method was used to evaluate possible unmeasured confounding effects in random effects meta-analyses.</p><p><strong>Results: </strong>62 original studies from nine meta-analyses met the inclusion criteria. In relation to the exposure and outcome, the random-effects meta-analysis showed that even with an unmeasured confounder having a relative risk (RR) of 3.00, 80% of cohort studies evaluating PTB and 90% evaluating LBW would have an RR > 2.00.</p><p><strong>Conclusions: </strong>Associations between maternal periodontitis and ABOs in observational studies appear robust to unmeasured confounding factors, supporting the hypothesis that maternal periodontitis is causally related to ABOs.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the discourse: a closer look at high-risk behaviors among Iranian adolescents.","authors":"Saeid Mirzaei, Mohammad Hossein Mehrolhassani, Vahid Yazdi-Feyzabadi, AliAkbar Haghdoost, Nadia Oroomiei","doi":"10.1093/pubmed/fdaf058","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf058","url":null,"abstract":"<p><strong>Background: </strong>This study explores the dominant discourses surrounding policies related to high-risk sexual behaviors, drug use, and alcohol abuse among Iranian adolescents, as well as the prevailing discourse among the adolescents themselves who engage in these behaviors.</p><p><strong>Methods: </strong>Using a qualitative approach, we conducted interviews with 36 Iranian adolescents exhibiting high-risk behaviors and analyzed high-level documents on adolescent health from 1979 to 2023.</p><p><strong>Results: </strong>The dominant discourse in policy documents is rooted in religious principles, emphasizing that social structures should align with the ultimate goal of human life, which is nearness to God. In contrast, the dominant discourse among adolescents' centers on material desires and personal pleasure, valuing social structures that promote joy and individualism.</p><p><strong>Discussion: </strong>This study reveals a significant discourse gap between policymakers and adolescents, which could undermine the effectiveness of current policies and interventions. Policymakers in Iran and other ideologically driven countries should recognize this gap and take steps to bridge it. By incorporating the perspectives of adolescents and tailoring policies to align more closely with their values, there is a greater likelihood of enhancing the effectiveness of these initiatives.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hazardous alcohol use: a cross-sectional study of cardiology patients in Sweden.","authors":"Paul Welfordsson, Anna-Karin Danielsson, Caroline Björck, Bartosz Grzymala-Lubanski, Kristina Hambraeus, Ida Haugen Löfman, Frieder Braunschweig, Matthias Lidin, Sara Wallhed Finn","doi":"10.1093/pubmed/fdaf057","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf057","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use is understudied in cardiology settings. We investigated the prevalence of hazardous alcohol use and probable dependence among cardiology patients.</p><p><strong>Methods: </strong>Cross-sectional study in three regions of Sweden. Alcohol use was assessed using the AUDIT-10 questionnaire. We defined hazardous alcohol use as: AUDIT-10 ≥ 6 for women or ≥ 8 for men (primary definition) and probable dependence as AUDIT-10 ≥ 13 for women or ≥ 15 for men. We examined associations using logistic regression.</p><p><strong>Results: </strong>We included 1107 participants (median age = 73 years; range = 18-102; 66% men). The prevalence of hazardous alcohol use was 7.8% (95%CI = 6.2-9.3, primary definition) and 0.9% (95%CI = 0.3-1.5) had probable alcohol dependence. We found increased odds of hazardous alcohol use in: age groups 18-39 years (OR = 4.90, 95%CI = 1.41-17.08) and 40-64 years (OR = 4.02, 95%CI = 1.69-9.67) compared to ≥80 years; a city compared to a small town (OR = 2.44, 95%CI = 1.02-5.84); participants with unhealthy diets (OR = 2.37, 95%CI = 1.36-4.13), and overweight participants (OR = 2.25, 95%CI = 1.23-4.12).</p><p><strong>Conclusions: </strong>Hazardous alcohol use affected about one in 12 cardiology patients. However, less than 1 in 100 had probable alcohol dependence. Findings suggest that many cardiology patients with hazardous alcohol use are appropriate for brief interventions, and may not require more intensive alcohol dependence treatments.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 pandemic's impact on sexually transmitted infections and the modifying role of public health funding: an interrupted time series study.","authors":"Naomi Schwartz, Stephen Hunter, Samantha M Forbes, Dionne Gesink, Erin Hobin, Laura N Anderson, Steven Rebellato, Roman Pabayo, Brendan T Smith","doi":"10.1093/pubmed/fdaf053","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf053","url":null,"abstract":"<p><strong>Background: </strong>This study investigated whether the COVID-19 pandemic was associated with changes in sexually transmitted infection (STI) incidence and trajectories in Ontario, Canada and the modifying role of public health funding for infectious and communicable diseases (ICD).</p><p><strong>Methods: </strong>A repeated cross-sectional study was conducted using population-level age and sex standardized incidence of chlamydia, gonorrhea, and infectious syphilis by public health unit (PHU) in Ontario from January 2015-October 2022. A negative binomial regression interrupted time series analysis estimated trends in STI incidence rates pre- and post-pandemic-onset and whether associations differed by public health ICD funding per capita.</p><p><strong>Results: </strong>There was an immediate reduction post- compared to pre-pandemic onset in chlamydia (Rate Ratio (RR) = 0.27, 95% confidence interval (CI): 0.21-0.35), gonorrhea (RR = 0.15, 95% CI: 0.02-0.94), and syphilis (RR = 0.16, 95% CI: 0.02-1.18). Post-pandemic onset, a dollar increase in PHU's ICD funding per capita was associated with greater incidence of chlamydia (RR = 1.10, 95% CI: 1.08-1.12), gonorrhea (RR = 1.14, 95% CI: 0.99-1.32) and syphilis (RR = 1.11, 95% CI: 0.97-1.28). Following this initial drop, trends in STI incidence did not differ importantly by ICD funding.</p><p><strong>Conclusions: </strong>Findings are consistent with a role of public health funding in mitigating observed decreases in STIs. Results suggest that public health funding plays a role in maintaining STI detection services during a public health emergency.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an authorized nurse immunizer led opportunistic patient influenza and COVID-19 vaccination program under the RE-AIM framework.","authors":"Sarah Davies, Kathryn Taylor, Donna Moore","doi":"10.1093/pubmed/fdaf049","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf049","url":null,"abstract":"<p><strong>Background: </strong>Influenza and COVID-19 are significant vaccine-preventable causes of morbidity, mortality, and healthcare costs. Hospital-based, nurse-led models can increase vaccine uptake, yet few target adults. This study evaluates the implementation of an opportunistic patient influenza and COVID-19 vaccination program in the Central Coast Local Health District (CCLHD), led by Authorized Nurse Immunizers (ANIs).</p><p><strong>Methods: </strong>Evaluation of the ANI-led program was conducted using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. The 10-week program involved screening patients for vaccine eligibility, offering vaccinations and collecting quantitative data and qualitative feedback across the five RE-AIM domains.</p><p><strong>Results: </strong>Of 849 patients screened alongside service encounters, 398 were vaccinated with 76% of eligible patients consenting to flu and 59% to COVID-19 vaccination. Inpatients had lower vaccination rates on admission compared to the general population and higher rates after program contact. The program was well received by patients and staff and adopted across various CCLHD settings, effectively addressing community access barriers.</p><p><strong>Conclusions: </strong>Opportunistic vaccination using an ANI-led model is an effective strategy to improve vaccination coverage among higher-risk patients. This evaluation demonstrates the benefits of a dedicated nurse immunizer workforce and suggests potential for broader adoption in similar healthcare settings to improve public health outcomes.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication about COVID-19 with urban American Indian and Alaska Native peoples: the role of health literacy, trust, and information source.","authors":"Amanda D Boyd, Austin Henderson, Azhar Uddin, Solmaz Amiri, Richard F MacLehose, Spero M Manson, Dedra Buchwald","doi":"10.1093/pubmed/fdaf050","DOIUrl":"https://doi.org/10.1093/pubmed/fdaf050","url":null,"abstract":"<p><strong>Background: </strong>Developing optimal health communication strategies about COVID-19 and vaccines requires an understanding of the health literacy level of populations, trusted sources of information, and perceptions of COVID-19 messaging. We examined how health literacy is related to knowledge about COVID-19 among American Indian and Alaska Native (AI/AN) peoples.</p><p><strong>Methods: </strong>We surveyed 788 AI/AN peoples at five Tribal health organizations between January and May 2021. We assessed health literacy using a 4-item health literacy index, and knowledge of COVID-19 in three domains: protection against contracting COVID-19; contracting COVID-19, and clinical manifestations of contraction. Questions also included rating trust of COVID-19 information sources and perceptions of messaging.</p><p><strong>Results: </strong>Participants had a high level of knowledge about COVID-19; however, health literacy was not significantly associated with any domain of COVID-19 knowledge. Participants perceived the most trusted source of COVID-19-related health information to be health professionals, followed by health clinics. Social media was the least trusted source of information. Tribal sources of information were rated on average higher quality than non-tribal sources.</p><p><strong>Conclusions: </strong>AI/AN peoples had high levels of accurate knowledge about COVID-19 regardless of assessed health literacy. Information sources should include Tribal-led organizations and health professionals to increase uptake of COVID-19 messaging.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}