Behavioral Factors Research Articles

The Association Between Health Literacy and Colorectal Cancer Screening: Findings Using a Three-Question Health Literacy Measure.

Health literacy (HL) can impact health behaviors including colorectal cancer (CRC) screening. Prior findings using extensive measures of HL suggested that low HL is associated with lower CRC screening rates. We hypothesized that low HL, when measured using a clinically applicable three-question measure, would also be associated with low CRC screening rates. Data collected from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) was utilized from 17 states that included a three-question HL measure. Participants ages 50-75 were included. The HL scores were categorized as adequate, marginal, or limited HL. The primary outcome was United States Preventative Services Task Force (USPSTF) recommendation-concordant CRC screening. The relationship between HL and CRC screening was examined using multivariable logistic regression. Among 38,044 participants who met inclusion criteria, 47.2% (n = 17,950), 49.9% (n = 18,989), and 2.9% (n = 1105) had adequate, marginal, and limited HL, respectively. Lower HL levels were associated with lower adherence to USPSTF CRC screening recommendations: 73.3% for adequate, 68.0% for marginal, and 48.9% for limited HL (p < 0.01). Respondents with limited HL were 45% less likely to undergo CRC screening (OR = 0.55; 95%CI: 0.48-0.63). A significant interaction (p < 0.01) between health literacy and sex was identified. CRC screening difference among HL levels was more pronounced for male (OR = 0.48; 95% CI: 0.40-0.79) than female respondents (OR = 0.63; 95% CI: 0.52-0.76). Limited health literacy is associated with significantly lower rates of appropriate CRC screening, particularly for males. This three-question HL measure provides a clinically applicable tool to identify people at risk for lack of CRC screening.

Research on association analysis between electricity consumption behaviors and weather factors based on mapreduce

The change of weather factors will lead to great changes in users’ electricity consumption behaviors. In order to discover the associations between users’ electricity consumption behavior and weather factors, and meet the needs of efficient mining of massive data, in this paper a parallel association rule mining method is presented based on MapReduce. Firstly, to convert electricity data into the form suitable for association rule mining, the density-based K-means method is implemented to discretize the electricity consumption data, in which the parallel calculation method of sample density is presented. Then the cluster results are combined with the weather data. Next, the parallel frequent itemset mining method and association rule mining method are designed and implemented based on Apriori‌. In the frequent itemset mining MapReduce job the Combiner function is added and implemented. The local support threshold is set in the Combiner implementation to filter out some candidate itemsets, thereby reducing the time to transmit data among slave nodes. Finally, experiments on a Hadoop cluster are conducted. The experimental results validate availability and scalability of the proposed method.

Gender differences in the association between Life's essential 8 and cardiovascular disease: a U.S.-based cross-sectional analysis

BackgroundThis research aims to elucidate the gender differences in the association between cardiovascular disease (CVD) prevalence and Life’s Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH).MethodsThis study included participants from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018.The scores of LE8, health behavior, health factor and each metric based on diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipid, blood glucose, and blood pressure were classified as low (0–49 points), moderate (50–79 points), and high (80–100 points). The scores of LE8, health behavior and health factor as continuous variables were also used for dose–response analysis. The main outcomes included the prevalence of CVD. The definition of CVD based on self-reported history of coronary heart disease or stroke.ResultsA total of 23,307 individuals were included in this analysis. Participants with CVD had significantly lower LE8 scores compared to those without CVD, and females demonstrated higher CVH levels compared to males including total LE8 scores and the scores of diet, nicotine exposure, blood lipid, blood glucose, and blood pressure (P < 0.05). Moreover, the LE8 score demonstrated a non-linear association with CVD in both males and females (all P-values for non-linearity were < 0.001). Furthermore, compared to the low LE8 level, a high LE8 level was associated with a 78% decreased risk of CVD in males (HR: 0.22, 95% CI: 0.16–0.31) and an 83% decreased risk in females (HR: 0.17, 95% CI: 0.11–0.26). Consistently, compared to low levels of health behaviors and health factors, higher levels were significantly associated with a decreased risk of CVD in both males and females (All P < 0.001). Additionally, the area under the curve (AUC) for the total LE8 score in CVD discrimination was significantly higher in females than in males (P < 0.001).ConclusionHigher CVH scores were associated with a lower risk of CVD, especially in females. These findings highlight the need for gender-specific preventive strategies in CVH promotion, with a particular focus on improving LE8 scores in high-risk populations.

The prevalence and determinants of physical activity in secondary Vietnamese students: a hierarchical analysis

BackgroundPhysical activity (PA) levels among adolescents are low globally and in Vietnam. This study aims to assess the prevalence of PA and identify demographic, psychosocial, and behavioral factors related to PA among secondary school students in Ho Chi Minh City.MethodsA cross-sectional study was conducted from March to May 2023, involving 475 6th-grade students. Data were collected through self-reported questionnaires and anthropometric measurements. Psychosocial factors, including self-efficacy, enjoyment, family influence, and belief in PA were measured using validated scales, while teacher influence on PA was evaluated using a custom-designed questionnaire. Sedentary behavior was assessed using the Adolescent Sedentary Activity Questionnaire (ASAQ), and PA levels were determined using the Physical Activity Questionnaire for Older Children (PAQ-C). Gender differences were analyzed using chi-square tests and t-tests. Pearson's correlation coefficient and hierarchical multiple regression were applied to examine associations and factors influencing PA.ResultsOnly 36.8% of students met the recommended PA levels, with boys (40.7%) being more active than girls (32.9%). Boys had higher body mass index (BMI) and more screen time, while girls spent more time on cultural and social activities. Positive correlations were found between PA levels and psychosocial factors, especially in self-efficacy (r = 0.761, p < 0.001) and family influence (r = 0.717, p < 0.001). Sedentary behaviors, such as small screen recreation (r = -0.449, p < 0.001) and after-school education (r = -0.380, p < 0.001), negatively correlated with PA levels. Hierarchical analyses showed that BMI, self-efficacy, beliefs, family and teacher influence, and time spent on small screen recreation and after-school education significantly explained PA among adolescents.ConclusionVietnamese adolescents have low PA levels, with gender differences. Interventions should enhance support, reduce sedentary behavior, and address gender-specific barriers.

Exploring the mechanisms linking perceived school climate to negative emotions in adolescents: The mediating roles of social avoidance and distress, and psychological resilience, with physical exercise level as a moderator.

This study investigates the relationships between perceived school climate (PSC) and negative emotions (NEE) in adolescents, incorporating the mediating roles of social avoidance and distress (SAD) and psychological resilience (PSR) and examining the moderating influence of physical exercise level (PEL). Data were collected from 1,507 students in grades 5-9 across China using stratified random sampling. Demographic analysis revealed significant differences across gender, grade, and family location in PSC, SAD, PSR, NEE, and PEL. Structural equation modeling confirmed that PSC directly reduces NEE and exerts additional indirect effects through SAD and PSR, with a sequential chain mediation pathway accounting for the majority of the total effect. Multi-group analysis demonstrated structural invariance across genders. Moderation analysis indicated that PEL amplifies the protective effects of PSC on NEE, with higher levels of physical exercise strengthening this association. These findings provide comprehensive insights into the interplay of environmental, psychological, and behavioral factors, offering valuable implications for targeted educational and policy interventions.

Drivers of Youth Consumer Adoption of Sharing Commerce: Examining the Effect of Social and Technical Enablers on Generation Z in Sri Lanka

Aim: This study aims to investigate the factors influencing the adoption of sharing commerce among youth in Sri Lanka, addressing an empirical gap in the existing literature. Background: Sharing commerce, a subset of the sharing economy, focuses on peer-to-peer sharing of goods and services, leveraging underutilized assets and resources. Understanding the factors that drive young consumers, often referred to as 'digital natives,' to adopt sharing commerce is crucial for fostering innovation and sustainable economic growth. Methods: The research employs a quantitative approach, integrating established theories; the Technology Acceptance Model (TAM), the Theory of Planned Behavior (TPB), and Sociotechnical theory. Social influence, Trust, Perceived usefulness and Technology infrastructure are included as determinants. Data were collected through a survey questionnaire administered to the respondents in the Colombo District, Sri Lanka. The study used multiple regression analysis to identify the key factors influencing the intention to adopt sharing commerce. The data was collected for a period of three months from March 2024 to June 2024. Out of the 400 distributed questionnaires, 383 responses were received from all the groups. Findings: The multiple regression analysis reveals that technology infrastructure and perceived usefulness positively influence the intention to adopt sharing commerce. In contrast, social influence and trust have a negative impact. These findings highlight the complex interplay of technological, social, and personal factors in shaping young consumers' adoption-sharing behaviour. Originality: The study expands the Theory of Planned Behavior (TPB) by providing empirical evidence that negative social influence can deter young consumers from adopting sharing commerce. This finding adds a new dimension to TPB by exploring the negative aspects of social pressure, which have been less emphasized in previous research. The study contributes to Sociotechnical theory by emphasizing the importance of a reliable and user-friendly technological framework in facilitating the adoption of sharing commerce. Implications: The findings provide valuable insights for policymakers, businesses, and educational institutions to foster innovation and sustainable economic growth through sharing commerce.

Smoking History Intensity and Permanent Tooth Removal: Findings from a National United States Sample

The role of smoking in the development of periodontal disease has been well explored. However, this study aims to explore the relationship between intensity of smoking history and permanent tooth removal. We utilized the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative sample of 107,859 US adults, to explore this association. Smoking history intensity was a BRFSS-derived measure of pack-year smoking history. Permanent tooth removal was binarized as the presence or absence of a history of permanent tooth removal. A binary logistic regression was conducted to analyze this association after adjusting for a variety of sociodemographic, health, and substance-use covariates. There was a dose-dependent relationship in which increasing smoking history intensity was associated with increased odds for removal of one or more permanent teeth. For example, those who reported a pack-year history of 30 or more years had a 6.4 times significantly higher odds of reporting a history of permanent tooth removal when compared to those with a 0 pack-year history (adjusted odds ratio = 6.37, 95% CI = 3.80–10.69, p &lt; 0.001). These findings can be used to promote smoking reduction or cessation as a means of decreasing risk of permanent tooth removal due to tooth decay or gum disease.

Galectin-3 in Cardiovascular Health: A Narrative Review Based on Life’s Essential 8 and Life’s Simple 7 Frameworks

Gal-3, also known as galectin-3, a lectin that binds β-galactosides, has gained attention as a novel biomarker and pathophysiological mediator in cardiovascular disease, where it contributes to inflammation, fibrosis, metabolic dysregulation and cardiac remodeling. This narrative review, developed following SANRA (Scale for the Assessment of Narrative Review Articles) guidelines, aims to integrate current clinical and experimental findings on gal-3 into the American Heart Association Life’s Simple 7 (LS7) and Life’s Essential 8 (LE8). By thematically organizing our review across modifiable domains of cardiovascular health, including glucose regulation, lipid metabolism, physical activity, blood pressure, diet, sleep, tobacco use, and body weight (BMI, body mass index), we highlight the role of gal-3 in linking environmental, behavioral and molecular risk factors to cardiometabolic outcomes. Particular attention is given to the oxidative stress, inflammatory–fibrotic axis, and immune activation as mechanistic pathways underlying gal-3-associated cardiovascular damage. We also discuss its relevance to public health and prevention, considering gal-3’s potential for early risk stratification, monitoring lifestyle interventions and personalized prevention strategies. This review bridges molecular mechanisms with clinical and public health relevance, particularly in the context of environmental and lifestyle-related cardiovascular risk.

Burden and predictors of chronic obstructive pulmonary disease occurrence and severity among an occupational cohort of United States Department of Energy former workers.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that reduces lung function and primarily affects older adults. Evidence suggests that occupational exposures like diesel exhaust, cadmium, welding fumes, and silica increase the risk of COPD. Some United States Department of Energy (DOE) workers may be exposed to these noxious substances as they execute their job responsibilities. Assessment of the burden of COPD among these workers and identification of the potential associations between the condition and the above occupational exposures is important for guiding screening, prevention, and control programs. Therefore, the objectives of this study are to: (a) estimate the burden of COPD among former workers of the DOE in the United States and (b) investigate the association between occupational exposures and COPD occurrence and severity among these workers while controlling for environmental, behavioral, and socio-demographic factors. Retrospective data containing health screening records of former DOE workers, covering the time period 2006-2019, were obtained from the National Supplemental Screening Program. Multivariate imputation by chained equation was used to impute missing values. Binary and multinomial logistic regression models were used to investigate predictors of COPD occurrence and severity, respectively. Of the 17,376 participants included in the study, 20.8% had COPD. History of asthma, age at exam, body mass index, and smoking were significant predictors of both COPD occurrence and severity. Individuals exposed to silica had higher odds of COPD compared to those that were not exposed to silica. Similarly, diesel exhaust exposure was significantly associated with risk of more severe COPD. The findings of this study demonstrate the importance of considering occupational experience in the assessment of both COPD occurrence and severity. This information may be important for occupational screening programs as well as aiding in identifying modifiable risk factors to guide prevention and control efforts.

The burden of migraine and predictions in the Asia–Pacific region, 1990–2021: a comparative analysis of China, South Korea, Japan, and Australia

BackgroundMigraine is a leading cause of disability worldwide, significantly impacting quality of life and healthcare systems. Despite its high prevalence and burden, migraine remains underprioritized in global health policies. This study examines the epidemiological trends of migraine in Australia, China, Japan, and South Korea from 1990 to 2021, highlighting regional disparities and forecasting future burdens.MethodsThis study utilized data from the Global Burden of Disease (GBD) 2021 to analyze incidence, prevalence, and years lived with disability (YLDs) of migraine. Age-standardized rates (ASRs) were calculated to enable fair cross-country comparisons. Joinpoint regression analysis was applied to assess temporal trends, while Bayesian age-period-cohort (BAPC) modeling was used to project future trends until 2050. Additionally, decomposition analysis was conducted to differentiate the effects of population aging, growth, and epidemiological changes.ResultsIn 2021, China had the highest migraine burden, with 13.05 million new cases and 184.75 million prevalent cases, followed by Australia, Japan, and South Korea. Incidence rates peaked in adolescence (10–14 years), while prevalence and disability were highest in middle-aged women (40–44 years). From 1990 to 2021, Australia exhibited stable trends, China experienced increasing burden, Japan saw a decline due to aging, and Korea exhibited mixed patterns influenced by opposing demographic and epidemiological forces. Future projections suggest a stable trend in Australia, declining incidence in China and Japan, and continued burden in Korea.ConclusionMigraine remains a significant public health challenge across all four countries, with age, gender, and demographic changes playing key roles in burden variations. The study highlights the need for region-specific healthcare strategies and age- and gender-sensitive interventions. Future research should explore socioeconomic, behavioral, and healthcare access factors to refine migraine management strategies.

Capitalising on Tax Variation to Estimate the Effect ofAlcohol Consumption on Edentulism.

To estimate alcohol consumption's effect on edentulism using state alcohol taxes as an instrumental variable (IV). Analysis of 514,357 U.S. Behavioural Risk Factor Surveillance System participants (2003-2006, 2008, 2010, 2012) linked to state alcohol taxes. We used IV regression modelling to assess the relationship between alcohol consumption and edentulism, plus potential mediators (body mass index, dental visits) and a positive control (coronary heart disease). Robustness to imperfect exogeneity was evaluated through sensitivity analyses and falsification testing using IV analysis on individuals under the age of 16 years. A 1.1-drink increment per day was associated with a 12% higher risk of edentulism (95% confidence interval: 9%-16%). Alcohol consumption was positively associated with body mass index, dental visits and coronary heart disease. No significant effect on edentulism was observed in the negative control population (individuals aged < 16 years). The findings of this quasi-experimental study suggest that alcohol consumption increases the risk of edentulism.

Adverse childhood experiences and chronic health outcomes: evidence from 33 US states in the Behavioral Risk Factor Surveillance System, 2019-2023

BackgroundRecent evidence suggests a significant association between adverse childhood experience (ACE) and chronic health outcomes among U.S. adults. However, there remains a critical need to explore these associations specifically with respect to racial disparities. Early adversity and preexisting health vulnerabilities may interact, compounding the risk of chronic diseases in historically marginalized populations. This study further explored the relationship between ACE and chronic disease, recognizing that ACEs may exert a more pronounced effect in racial and ethnic groups already at elevated risk. To investigate this relationship, subgroup analysis was conducted to explore variations by race and ethnicity.MethodsWe analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) collected from 33 states between 2019 and 2023. ACE scores were categorized as none, low (1-2), or high (3+). Log-binomial regression assessed the relationship between ACE scores and 17 health outcomes. Subgroup analyses examined variation by race/ethnicity, and geographic patterns were summarized by state. All analyses accounted for age, sex, race/ethnicity, income, and education.ResultsOf 359,507 participants, 24.4% reported high ACE exposure. Emotional abuse, parental separation, and household substance abuse were the most reported ACEs. Individuals with high ACE exposure had higher risks of depression, smoking, coronary heart disease, and other conditions. Racial disparities were evident in the subgroup analysis. While white respondents with high ACE were significantly associated with many health outcomes, other races/ethnicities often demonstrated higher risk ratios when significant. Particularly, AIAN respondents showed the highest national-level risk for conditions such as heart attack, coronary heart disease, and stroke. Geographically, ACE prevalence and health-related outcomes varied by state, with Oregon and Nevada exhibiting the highest mean ACE scores.DiscussionHigh ACE scores are associated with chronic disease and mental health issues. These findings highlight significant racial and geographic disparities in ACE exposure and its health impacts. Addressing ACEs holistically by considering state-related factors and predisposed health risks among racial/ethnic groups is an emerging need. State-level policies focused on trauma prevention, particularly for vulnerable racial groups and high-risk geographic areas, may help implement interventions tailored to address the unique associations between ACEs and health outcomes in diverse populations.

Firm carbon orientation and green innovation: Does green intellectual capital matter?

PurposeIn the context of carbon peaking and carbon neutrality goals, effectively promoting sustainability has become essential. Considering the need to reduce carbon emissions in the climate-sustainability era, this study investigates the impact of firms’ carbon orientation (FCO) on green innovation (GI). Drawing on the legitimacy theory, this study shows that FCO is a critical driver of GI, as it enables firms to enhance their environmental legitimacy and strategically leverage their innovation capabilities to translate sustainable commitments into GI outcomes. Moreover, by integrating legitimacy and resource-based view (RBV), this study has also argued that the effect of FCO on GI depends on their green intellectual capital (GIC) because by improving resource efficiency and decreasing carbon emissions, it assists businesses in turning their sustainable pledges into boosts.Design/methodology/approachThe textual analysis was employed to construct FCO and GIC. The data was employed from 2016 to 2022 due to the Paris Agreement. The fixed-effect regression model was used for baseline regression analysis after utilizing the Hausman test to evaluate how well the fixed-effects and random-effects models agreed. Further analyses were performed to check the robustness of the result and endogeneity issue.FindingsThe results showed that FCO significantly affects GI. GIC and its dimensions enhance the impact of FCO on GI. Additionally, the series of analyses reveal that the effects of FCO and GIC on GI are robust and exhibit exogenous.Originality/valueThis study pioneered the development of measures for FCO and GIC in Chinese manufacturing firms through textual analysis. It highlights the critical role of FCO as a behavioral factor in promoting GI and reveals the importance of GIC in enhancing the impact of FCO on GI.

Primary Care Uptake Interventions in Taxi, App-Based, and Other For-Hire Vehicle Drivers: The HAILL Cluster Randomized Controlled Trial.

Taxi, app-based, and other for-hire vehicle drivers have major health risks and poor healthcare access. Compare workplace interventions to improve driver healthcare access. Taxi Health Access Intervention for Linkages and Lifestyle (HAILL) was a three-arm cluster randomized controlled trial (2015-2022; analyses 2024) with outcomes assessed at 12months. Randomization was at the cluster (taxi garage) level. We approached 97 taxi garages in New York City (garages with ≥ 100 drivers and app-based driver hubs), 32 were excluded, and 65 enrolled. Drivers attending workplace Health Fairs at the garages were consecutively screened for participation; 735 enrolled. All sites received the Health Fair intervention (health history, screenings [blood pressure, etc.], clinician consult, and 3months of primary care access facilitation follow-up). Arm 1 received the Health Fair only. Arm 2 received the Health Fair and Navigator case management for up to 12months. Arm 3 received the Health Fair and up to 12months of appointment reminder text messages and peer support. Medical Expenditure Panel Survey items measured primary care uptake (primary outcome). A Behavioral Risk Factor Surveillance Survey item measured insurance enrollment (secondary outcome). Two independent-sample t tests compared arm 1 versus 2 and arm 1 versus 3 primary care uptake proportions. Sixty-one garages participated (arm 1, n = 20; arm 2, n = 22; arm 3, n = 19). In the cluster intention-to-treat analyses, primary care uptake was 44% in arm 1 versus 57% in arm 2 (P = .264) and versus 43% in arm 3 (P = .994); health insurance enrollment was 63% in arm 1 versus 58% in arm 2 (P = .627) and versus 50% in arm 3 (P = .197). All interventions increased healthcare access, with a positive trend in primary care uptake between arms 1 and 2. Health Fairs and Navigator case management should be considered by policy makers. ClinicalTrials.gov NCT02508363 ( https://clinicaltrials.gov/study/NCT02508363 ).

The health-related quality of life among survivors with post-COVID conditions in the United States.

Even after a mild initial SARS-CoV-2 infection, a considerable proportion of patients experience long-lasting symptoms. However, there is scarce data on how post-COVID conditions (PCCs) are associated with health-related quality of life (HRQL) among COVID survivors. We aimed to study this association among adult COVID survivors in the United States. The Behavioral Risk Factor Surveillance System 2022 data was utilized. The study population consisted of participants with a history of SARS-CoV-2 infection, categorized based on whether they had any PCCs. We evaluated the respondents' HRQL in the two groups according to 1) self-reported general health (SRGH), 2) self-reported mental health, 3) self-reported physical health, and 4) efficiency in daily activities. A total of 108,237 COVID survivors were included (35% were 18-34 years old and 46.5% were male), among whom 22.7% had PCCs. Unfavorable SRGH was more common among COVID survivors with PCCs than those without PCCs (25.7% vs. 15.5%, p < 0.001). Also, rates of having unfavorable mental and physical health and compromised daily efficiency for more than 13 days a month were significantly higher among PCC-positive respondents (p < 0.001). In the regression analysis adjusted for sociodemographics, comorbidities, and behavioral determinants of health, the presence of PCCs appeared as independent associates of unfavorable SRGH (aOR: 1.39, CI95%: [1.28-1.52], p < 0.001). Among PCC-positive respondents, dizziness on standing, mood changes, and musculoskeletal pain accompanied the highest odds of unfavorable HRQL. Based on a multivariate logistic regression analysis, early middle age, obesity, physical inactivity, diabetes, cardiovascular and pulmonary diseases, cancer, depression, smoking, being single and less educated, and having low annual income were independent factors associated with increased odds of unfavorable SRGH among survivors with PCCs. Our study corroborates that survivors with PCCs may experience significant adverse impacts on their health and daily life activities. Our results highlight the importance of further studies on PCCs' diagnosis, follow-up, and treatment.

Steatotic liver disease is a marker of multimorbidity, not underlying cirrhosis, in older adults

Steatotic liver disease (SLD) prevalence in adults is estimated at 30%, but older populations are understudied. Here, SLD prevalence and associated risk factors were assessed 1,021 Whitehall II study participants (mean age 72.5) using transient elastography (FibroScan). SLD was present in 33.3% (CAP ≥ 275 dB/m), with most classified as metabolic dysfunction-associated SLD. Only 2.4% had significant fibrosis ( ≥ 7.9 kPa). Adjusted for age and sex, SLD was associated with low physical activity (OR 1.60, 95% CI 1.13-2.27), poorer motor function (SF-36 PCS OR 1.21, 95% CI 1.05-1.40), difficulties in activities of daily living (OR 3.19, 95% CI 1.17-8.64), and multimorbidity (OR 1.45, 95% CI 1.22-1.73). These associations persisted after adjustment for socioeconomic, behavioural, and cardiometabolic risk factors. Frailty was associated with SLD at higher CAP thresholds ( ≥ 290 dB/m). In this older adult sample, SLD is common and appears more as a marker of multimorbidity and low physical activity than significant fibrosis.

Chronic Conditions and Racially Biased Healthcare Experiences Impact Breast Cancer and Colorectal Cancer Screening Across Racial/Ethnic Groups.

Mammogram uptake and colorectal cancer (CRC) screening are influenced by racially biased healthcare experiences and presence of chronic conditions; moreover, there is racially/ethnically disparate uptake of each. The current study aimed to expand on extant literature by examining the association between racially biased healthcare experiences and chronic conditions across three racial/ethnic groups. We conducted weighted multivariable logistic regressions to examine the interaction between chronic conditions (none, cancer, other chronic conditions) and racially biased healthcare experiences (none, better, worse, other) on mammogram and CRC screening adherence across three racial/ethnic groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic/non-Hispanic Other [NHO]) using 2022 Behavioral Risk Factor Surveillance System data. Among 42,053 and 86,033 eligible respondents for mammogram and CRC screening, most respondents had an up-to-date mammogram (77.4%) or CRC test (67.0%). In adjusted analysis, Hispanic/NHO respondents with conditions other than cancer and felt they were treated worse than other races while seeking healthcare had a decreased odds of having an up-to-date mammogram (OR 0.21, 95% CI 0.09-0.46). NHW respondents with cancer who felt they were treated better than other races while seeking healthcare had increased odds of having an up-to-date mammogram (OR 1.70, 95% CI 1.11-2.60). All significant associations (i.e., p < 0.05) between chronic conditions and CRC screening were positive, regardless of treatment while seeking healthcare across racial/ethnic groups. Culturally sensitive interventions aimed at improving patient-centered communication may improve mammogram and CRC screening adherence, particularly for racially/ethnically minoritized groups.

Do farmers overuse pesticides? A critical review from their perspective

Excessive pesticide use by farmers is a critical issue influenced by psychological, behavioural, socioeconomic and regulatory factors. This study employs a bibliometric analysis and systematic review to assess key factors driving excessive pesticide use, focusing on research trends and behavioural influences. A total of 43 peer-reviewed articles from the Scopus database (2000-2024) were selected using PRISMA methodology, based on relevance to psychological and behavioural factors influencing pesticide use. Findings indicate that peer influence, farmers’ risk perceptions, financial constraints and limited awareness of sustainable alternatives like Integrated Pest Management (IPM) contribute significantly to pesticide overuse. Moreover, reliance on chemical pesticides, psychological stress from market uncertainties and risk-averse decision-making further contribute to overuse, highlighting the need for targeted interventions. Bibliometric analysis highlights a fragmented research landscape with limited interdisciplinary collaboration. China emerges as a leading contributor, demonstrating a strong national research focus with a significant number of studies conducted by Chinese researchers and institutions, while other countries show varying levels of cooperative engagement. This study underscores the importance of enhancing farmers’ awareness of non-chemical pest control methods, strengthening regulatory frameworks and fostering community-led initiatives. Future research should prioritise the exploration of education, economic conditions and social norms to better understand their impact on pesticide use behaviours. These insights aim to inform policy and interventions that promote sustainable pest management while balancing agricultural productivity with environmental and public health priorities.

Identifying the influence of demography and familiarity on public attitude toward low-income housing

AimThe study aims to explore the relationship between “familiarity” and “demography” and the public attitude toward low-income housing and its residents; due to controlling the stigma and having more stable mixed residential neighborhoods.MethodTo extract the attitude characteristics, a systematic review was conducted and the survey was performed using an online questionnaire for non-residents. Exploratory factor analysis revealed 11 factors within three dimensions of attitude. Correlation and confirmatory factor analysis were then used to examine the relationship between attitude, familiarity, and demographics.ResultsFamiliarity was directly associated with some cognitive and behavioral factors. Among the demographic factors, no significant relationship was found between gender and attitude. Direct and indirect relationships were found between age, education, income, duration of residence, place of residence, and tenure type with cognitive, affective, and behavioral factors. The results showed that lower socio-economic characteristics of outsiders lead to more positive attitudes, and the higher the familiarity and experience of people regarding low-income housing and its residents, the better their attitude.ConclusionTo create social mix projects that promote pleasant feelings and desirable behavior, it is necessary to accurately determine the demographic characteristics of socio-economic groups.

Risk factors for infection in older adults with home care: a mixed methods systematic review with meta-analysis

Worldwide, home care in the form of home healthcare and home help, has become increasingly more available. This systematic review aims to provide a deeper understanding of factors that are of particular importance for infection control in the home care setting for older adults. Five databases were searched (MEDLINE, Embase, ProQuest, Web of Science, CINAHL) for eligible studies using any research design reporting on individual, medical, behavioral and environmental factors. Retrieved studies were screened and assessed for quality. The Joanna Briggs Institute manual guided the research process and the work of generating a synthesis. Qualitative findings were compiled using meta-aggregation. For quantitative evidence, meta-analyses were conducted when possible. Of 19,484 unique records, 27 studies (7 cohort studies, 9 cross-sectional and 11 qualitative) were included in the review. Risk factors for infection reported in the quantitative studies referred to individual, medical, social, behavioral, environmental, and organisational aspects. Meta-analyses showed associations between urinary catheter use (OR 3.97, 95%CI 2.56–6.15) and limited mobility (OR 1.49, 95%CI 1.31–1.68), respectively, and risk of infection. Pooled ORs of urinary incontinence and risk of infection were not statistically significant. Findings from the qualitative studies covered perceived and observed risk factors to infection control and prevention. The evidence resulted in five synthesised findings covering attitudes, behaviors, home environment, personal interactions, lack of equipment, unsafe disposal of material, pets, unsafe practices and procedures, and lack of training. The combined quantitative and qualitative evidence sheds light on separate yet interconnected elements of risks for infection that may reinforce each other, potentially exposing vulnerable older adults to amplified risks.