Physical inactivity continues to be a leading health crisis in the U.S. There are clear differences in physical inactivity prevalence across U.S. regions with unique distinctions and drivers. This study reports on improvements in self-reported physical activity in a school-based, K-8 health and wellness program in an underserved community in Chicago. In addition, the study also examines how the social vulnerability of the participants in the program compares with state and national standards. This study utilized a longitudinal cohort design. Seventy-two students participated in the Health and Wellness Academy, with a mean age of 10.43±2.18 years. Social vulnerability was higher in neighborhoods where students participating in the Health and Wellness Academy lived than Illinois overall and the national average. Among these participants, 58.3% were female, 54 of 72 (75%) were Hispanic, and the remaining 18 (25%) were Black. Each Health and Wellness Academy session had a portion of time dedicated to physical activity. Results indicated that physical activity levels increased along with time points. Mixed linear model regression results further revealed a significant increase for time effects on physical activity (p<0.001). Having a consistent and sustained intervention allows youth to be exposed to a variety of physical activity options. These findings indicate that the Health and Wellness Academy's tailored model allows for youth to find a physical activity that is meaningful and relevant, thus implementing it into their daily lives.

Fatherhood and men's participation across diverse antenatal care systems in rural Eastern Zimbabwe: A qualitative study.

European science for health research needs and priorities.

Unmet health care needs across Canada: A cross-sectional analysis of the intersecting roles of race and ethnicity, immigration, and sex.

Women with a history of gestational diabetes mellitus (GDM) have an elevated risk of type 2 diabetes in their later life, yet the underlying mechanisms of this remain unclear. We aimed to investigate the long-term impact of GDM on gut microbiota and related metabolites and to explore whether such alterations may contribute to type 2 diabetes risk. Among parous women from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we identified microbial species associated with a history of GDM (visit 2, 2014-2017, n=1525), and serum metabolites associated with both a history of GDM (visit 1, 2008-2011, n=2968) and GDM-related microbiota (visit 2, n=391). We further examined prospective associations of the GDM-related microbiome (visit 2, n=925) with incident type 2 diabetes over 6 years of follow-up, and of microbial-related metabolites (visit 1, n=2341) with incident type 2 diabetes over 12 years. Among 1525 US Hispanic/Latino parous women (median age: 58 years), seven species differed between women with and without a history of GDM, including higher abundances of four species (e.g. Parabacteroides merdae CAG:48, a proinflammatory taxon) and lower abundances of three species (e.g. Dialister sp. CAG:588, a short-chain fatty acid producer). Fifteen metabolites were associated with both a history of GDM and the GDM-related microbiome in a consistent direction, nine of which (e.g. saturated sphingomyelins and unsaturated fatty acids) were associated with glycaemic traits and incident type 2 diabetes. Using these microbial-related metabolites as proxy measures, proxy analysis suggested a positive relationship between the GDM-related microbiome and type 2 diabetes (r=0.55, p=0.036). A metabolite score derived from the nine microbial-related metabolites mediated an estimated 20% (95% CI 9%, 42%) of the association between a history of GDM and type 2 diabetes. A history of GDM is associated with an unfavourable gut microbiota and related metabolites in US Hispanic/Latino women, suggesting a potential role of the gut microbiota in GDM-related type 2 diabetes.

Trade-offs in mental health support: Preferred patient-centered communication attributes across AI chatbots, telemedicine, online health communities, and in-person clinicians.

Diarrheal diseases remain a leading cause of morbidity and mortality among children under five in Africa, despite the availability of cost-effective preventive and therapeutic interventions. This review examines the role of policy development and government-led interventions in diarrhea control, highlighting successes, persistent gaps, and emerging opportunities. Key strategies, including oral rehydration therapy, zinc supplementation, rotavirus vaccination, and water, sanitation, and hygiene (WASH) initiatives, have proven effective but are often undermined by inequitable access, weak health systems, and inconsistent implementation. The review emphasizes the evolving role of public health authorities in coordinating multisectoral strategies, strengthening surveillance, ensuring sustainable financing, integrating digital health innovations, and promoting equity-focused interventions. Research and monitoring priorities, including pathogen surveillance, sustainable WASH financing, and evaluation of digital IMCI and community health worker models, are essential to inform evidence-based policymaking. The study underscores that well-coordinated, adequately resourced, and context-specific government interventions are critical to reducing diarrheal morbidity and mortality and achieving child health equity in Africa. Keywords: Diarrheal diseases; Public health policy; Government interventions; Africa; Child health.

Mental health disorders are a major problem globally, particularly among vulnerable groups such as youth. In resource-limited settings, community health volunteers (CHVs), including youth volunteers, play a crucial role in mental health promotion, stigma reduction, early identification of distress and referral to formal services. However, evidence on training components and delivery strategies of mental health training programmes for youth CHVs remains limited. This systematic review following PRISMA guidelines aims to identify the key components, delivery strategies and reported outcomes of mental health training programmes for youth CHVs, in order to inform future module development to enhance volunteers' motivation, self-efficacy, knowledge and communication skills. English articles published between 2010 and 2024 were searched through PubMed, Scopus and Web of Science databases. Eligibility criteria included mental health training interventions for non-professional community volunteers, including youth volunteers with measurable outcomes. Data were extracted and quality assessment performed using the Mixed Methods Appraisal Tool (MMAT). Seven studies were included in this review. Training content focusing on mental health literacy, building communication and counselling skills, stigma reduction and mental health promotion demonstrated the most significant improvement in CHV's knowledge, skills, and self-efficacy. Programs adapting interactive strategies of role-playing, case studies and group discussion, combined with classroom teaching methods were significantly effective as well. Participants expressed greater confidence in handling mental health disorders within their communities. In conclusion, training programmes that prioritise mental health literacy, stigma reduction, supportive communication, self-care and help-seeking behaviour skill, implemented through interactive delivery methods are the most effective. The findings are essential for the future development of training module for youth CHVs to empower and enhance their capability to deliver effective mental health care within their community. CRD42024562221 (PROSPERO).

This scoping review aimed to map the characteristics of outcomes arising from Community Health Development and Capacity Building in Community Health (CHD/CCH) conducted by public health-related nursing professionals and to identify the types of evidence that inform public health research and practice. Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched PubMed, CINAHL, Web of Science Core Collection, and the Cochrane Library. Eligibility was based on the Population-Concept-Context framework: (a) community-dwelling individuals and communities, (b) CHD/CCH activities involving collaborative engagement with residents and stakeholders, and (c) nursing professionals engaged in public health practice. Quantitative, qualitative, mixed-methods studies, and gray literature were included without restrictions on language or publication year. Outcomes were synthesized according to follow-up period (short, mid, long term) and ecological level (micro, meso, macro). Thirty studies published between 1990 and 2024 were included. Of them, 14 used qualitative designs, 13 mixed methods, and 3 quantitative methodologies. Short-term evaluations primarily reported individual and organizational changes, whereas mid- and long-term studies demonstrated more complex, multilevel outcomes such as policy development, strengthened community networks, and enhancements to health and social service systems. Across ecological levels, 14 domains of community capacity were identified. Public health-related nursing practice contributes to multilayered community capacity building through CHD/CCH. However, gaps remain in quantitative evaluation and standardized outcome measures, underscoring the need for methodological advancement to reinforce the evidence base for community development in public health nursing.

A logic model for alternative response programs to guide public health research and practice.

Innovative qualitative methods are important in nursing research for understanding perspectives that are often under-heard, including those of adolescents. This methodological article draws on a focused ethnographic study of 11 urban adolescents aged 12-18 years to examine the use of photo elicitation in nursing research on greenspace, health and place. Using disposable cameras, participant-led photo tasks, semi-structured interviews and integrated visual-verbal analysis, the study explored how photo elicitation supported adolescent engagement while generating insight into how young people perceived and used urban greenspaces. This article discusses the methodological and ethical issues that arose in the study, including camera training, timely return of cameras, assent and parental consent, privacy and image ownership, and the interpretation of photographs alongside interview and fieldnote data. It also reflects on the integration of emic and etic perspectives and on the role of reflexivity in analysing adolescent-generated visual data. Trustworthiness was supported through verbatim transcription, audit trails, NVivo analysis and team triangulation, with analysis informed by the approach of Braun and Clarke (2006) . Photo elicitation supported reflection, participant-led discussion and richer contextual understanding of adolescents' experiences. This article offers practical guidance for nursing researchers using visual methods with adolescents, with an emphasis on study design, ethical planning, and integrated analysis of visual and verbal data. These methodological lessons are relevant to adolescent health, community health and nursing research using participatory qualitative approaches.

Mitigation of COVID-19 through onsite testing and education among formerly incarcerated individuals (the MOSAIC study): an open-label, single-centre, randomised controlled trial.

Cutaneous T-cell lymphoma (CTCL) is an infrequent non-Hodgkin lymphoma of the skin, with mycosis fungoides (MF) as the most common subtype. MF in palms and soles is an exceptionally rare presentation, particularly in pediatric patients. We report a case of a 17-year-old boy presenting with progressive enlargement of his hands and feet with thickening of palms and soles, initially suspected to have acromegaly. Laboratory and imaging workup ruled out endocrine and genetic causes of acromegaly. A skin biopsy confirmed a diagnosis of MF. This case illustrates the diagnostic challenges of pediatric MF, due to both its extreme rarity and potential for overlapping clinical presentation with other systemic conditions. The patient's socioeconomic background and immigration status limited initial access to specialized care, further complicating the evaluation and underscoring the health care barriers for immigrant populations. Community health centers play a crucial role in early diagnosis and care coordination, yet limited access to dermatology services in rural areas remains a significant challenge. Beyond expanding our current understanding of pediatric MF and broadening the differential diagnosis of acral enlargement in adolescents, this case emphasizes the importance of equitable health care access for immigrant patients. The findings highlight the need for increased dermatologic services in community health settings and among underserved populations.

Culturally and linguistically diverse (CALD) communities have unique strengths, needs, and health seeking behaviours reflecting their cultural background. Therefore, top-down population-level health promotion initiatives with externally imposed performance indicators are frequently ineffective in CALD contexts. Accordingly, the Healthy New Communities (HNC) program implements an equity-based bottom-up commissioning model aimed at addressing socio-cultural factors impacting health seeking behaviours with people from refugee and migrant backgrounds. In the first phase of a comprehensive evaluation of the HNC program commissioning model, stakeholders involved in the implementation of commissioned activities and programs shared their experiences with this innovative funding model pioneered by the Queensland Health Metro South Hospital and Health Services, Health Equity and Access Team. Their perspectives were gathered in focus groups and interviews and analysed using an inductive approach to thematic analysis. The findings demonstrate the effectiveness of the HNC program commissioning model in engaging CALD communities in health promotion initiatives. Flexibility, responsiveness, trust, relationships, shared commitments, and cultural representation facilitated community members' participation in the commissioned activities. The impacts of the HNC program commissioning approach extend beyond the adoption of healthy lifestyles and include positive social, emotional, cultural, and physical impacts across a range of life domains and the creation of employment, training, and career pathways. The HNC program demonstrates how socio-cultural determinants of health can be influenced by commissioning models that prioritise community engagement, relationships, co-design, and the culturally shaped health-seeking behaviours of CALD individuals, families, and communities in the funding, design, and implementation of health promotion initiatives. SO WHAT?: Phase one results are promising and lay the foundation for an in-depth investigation of the potential of equity-based commissioning models for improving health and wellbeing outcomes for CALD communities across Queensland and beyond.

Objectives. To examine (1) the strategies regional public behavioral health boards employ to align county-based public social service agencies with private substance use treatment organizations, (2) regional variations in strategies, and (3) factors that affect community-board relationships. Methods. We conducted a multiple case study of 17 Ohio county-based systems implementing a cross-sector model to support parental substance use disorder (Ohio START). We applied template analyses to 48 small group interviews conducted in 2020-2021 with 104 staff from child welfare and behavioral health organizations and community boards. Results. Participants described direct and indirect ways that boards supported system alignment, funding, brokering of information and relationships, and planning. Reasons for boards not being involved included perceived needlessness and a lack of connection between the board and the community. Rural and Appalachian communities reported various forms of close integration of boards and communities. Conclusions. Behavioral health boards can support cross-system integration by reducing barriers to collaboration and enhancing community capacity to address complex public health issues, especially in resource-limited regions. Public Health Implications. Incorporating a centralized organization could mitigate implementation barriers and promote effectiveness in community collaborations, especially under resource constraints. (Am J Public Health. 2026;116(S3): S202-S209. https://doi.org/10.2105/AJPH.2026.308579).

In the United States and globally, the negative effects of climate change, such as extremes of heat, wildfire smoke, and air pollution, are associated with early pregnancy loss, preterm birth, preeclampsia, hypertensive disorders of pregnancy, and stillbirth. Climate change amplifies existing gender-based disparities, which include elevated risks of infectious diseases, malnutrition, sexual violence, mental health disorders, lack of reproductive control, negative obstetric outcomes, and death, when compared with men. These adverse effects disproportionately affect marginalized groups. With the ongoing and increasing threats of climate change and environmental pollutants on human health, it is imperative that obstetrician-gynecologists (ob-gyns) educate not only themselves but students, other health care professionals, their patients, and communities about the adverse effects these threats have on gynecologic and obstetric health. Institutions should encourage the inclusion of climate change education in medical curricula. Ob-gyns should incorporate environmental health education into all prepregnancy counseling visits, with a focus on identifying any potential harmful exposures and determining what mitigation efforts can be initiated before pregnancy.

This study aimed to develop and validate the Community Development Competency Scale (ComDe-Scale) for public health nurses (PHNs) working in Community General Support Centers (CGSCs) in Japan. A nationwide cross-sectional survey was conducted with all 5495 CGSCs, yielding 1562 valid responses (28.4%). Item analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were performed to examine the factor structure, internal consistency, and construct validity. Hypothesis testing included correlations with the Network Establishment Practices Scale (NEPS) and subgroup comparisons by CGSC experience and managerial status. Convergent and discriminant validity were assessed using average variance extracted (AVE), composite reliability (CR), and the Fornell-Larcker criterion. Measurement invariance across management types (direct vs. outsourced) was evaluated through multigroup CFA. The ComDe-Scale demonstrated a three-factor, 20-item structure: (1) Strategic Management for Driving Community Health, (2) Empowerment for Interprofessional and Organizational Collaboration, and (3) Community-Rooted Outreach for Building Networks. Model fit indices indicated a good fit (CFI = 0.955, RMSEA = 0.060). Internal consistency was high (Cronbach's α = 0.845-0.946). All hypotheses for construct validity were supported (p < .001). Convergent validity (AVE = 0.569-0.589, CR = 0.842-0.941) and discriminant validity (√AVE > inter-factor correlations) were confirmed. Partial measurement invariance was observed across management types. The ComDe-Scale demonstrated satisfactory reliability and validity and can serve as a practical tool for evaluating and strengthening the competencies of PHNs engaged in community development at CGSCs.

Interventions to assess social needs for children with medical complexity and their families: A scoping review.

Let's Talk Birth Control: Study protocol for a cluster randomized trial of a clinic-based contraceptive intervention for adolescents and young adults.

Protocol for the sequential multiple assignment randomized trial to reduce food insecurity and improve adherence in patients with hypertension (SMART-FI).