Disease Prevention Programs Research Articles

Unlocking insights: Mahout’s perceptions and practices in managing Elephant Endotheliotropic Herpesvirus (EEHV) infection among captive Asian elephants in Surin province, Thailand

Surin, situated in the northeastern region of Thailand, has earned the reputation of being an "elephant village" due to its high captive elephant population and unique tradition of elephant rearing. However, the continuous occurrence of elephant endotheliotropic herpesvirus (EEHV) infection poses a significant threat to elephants, particularly the young ones. This study investigated various aspects of EEHV-related elephant care among ninety-two mahouts at the Surin Elephant Kingdom Project. This study used semi-structured interviews and observations to assess the mahouts’ knowledge, attitude, and practice (KAP scores) toward EEHV transmission, prevention, and management. The result revealed knowledge and practice scores below expectations, indicating an insufficient understanding the nature of disease and preventive measures. However, the mahouts exhibited awareness of the severity of the disease and factors contributing to transmission risk. Regarding the relationship among KAP scores, a positive correlation was observed at a low level (p < 0.05) between the knowledge and practice scores. Interestingly, approximately 55% of the survey respondents were confident that their elephants would not receive EEHV, leading to inadequate prevention measures. From the result, it is crucial to provide comprehensive knowledge about the nature of the disease and preventive measures to all mahouts. This education should emphasize the importance of early monitoring signs, appropriate weaning age, and preventing viral transmission practices. The KAP survey offers valuable insights that can identify areas requiring improvement and guide the development of effective and targeted disease prevention programs within the specific population. Therefore, it is recommended that the KAP survey should be employed in other parts of the country where the elephant management system differs.

Abstract 4125957: Feasibility and Acceptability of Behavioral Weight Loss Programs for Men in Trade and Labor Occupations

Objective: Men who work in trade and labor occupations experience high rates of obesity and related cardiovascular disease due to high rates of sedentary leisure time and poor diet. Despite this, they are underrepresented in weight control programs. This pilot randomized trial evaluated the feasibility and acceptability of a 6-month program tailored to this occupational group versus a non-tailored standard-of-care behavioral weight loss program. Methods: Men with overweight or obesity working in trade and labor occupations were randomly assigned to either a tailored program or the DPP Group Lifestyle Balance program delivered via 16 one-hour virtual group sessions. In-person assessments were conducted at baseline, 3, and 6 months. Semi-structured interviews and self-report were used to assess the acceptability of the interventions. Feasibility was assessed using recruitment metrics and proportion group sessions and study assessments completed. Results: Participants (N = 28; median 44.0 years, interquartile range (IQR): 38.5-54.5), median 31.8 BMI, IQR 31.1-39.6) were recruited into the study over 7 months, and 71% and 79% were retained for assessments at 3 and 6 months, respectively. Overall, participants attended a median of 7 of the 16 group sessions (IQR 2.5-11.5). The tailored group completed a median of 11 of 16 weekly online progress reports (IQR 5-15). All participants reported that they would recommend the programs to other men and felt confident that they would continue using the strategies learned in the programs. Though the trial focused on feasibility rather than efficacy, median weight losses at 6 months were -3.0% in the tailored group (95% CI -9.3, -0.6) and -1.9% in the standard group (95% CI -7.4, 2.0). Conclusions: Results suggest that both the tailored and standard weight loss interventions were well received by this group, but engagement was low. Future research should focus on understanding how to increase engagement rather than exclusively tailoring the program to this occupational group to enhance this group's involvement with cardiovascular disease prevention programs.

Community Paramedicine Program in Social Housing and Health Service Utilization

Community Paramedicine at Clinic (CP@clinic) is a chronic disease prevention program that decreases 911 calls for emergency medical services, but its wider system effects are unknown. To evaluate the effects of CP@clinic vs usual care on individual-level health service utilization outcomes. This open-label, pragmatic cluster randomized clinical trial evaluated all residents 55 years or older in 30 social housing buildings in Ontario, Canada, that had (1) a unique postal code, (2) at least 50 apartments, (3) 60% or more residents 55 years or older, and (4) a similar building for pairing (15 intervention and 15 control buildings, pair-matched randomization). The 12-month intervention had a staggered start date from January 1, 2015, to December 1, 2015, and ended between December 31, 2015, and November 30, 2016. Administrative health data analysis was conducted in May 2022. CP@clinic was a health promotion and disease prevention program led by specially trained community paramedics who held weekly drop-in sessions in social housing buildings. These paramedics conducted 1-on-1 risk assessments, provided health education and referrals to relevant community resources, and, with consent, sent assessments to family physicians. Control buildings received usual care (universal health care, including free primary and specialty medical care). Individual-level health service utilization was measured from administrative health data, with ED visits via ambulance as the primary outcome; secondary outcomes included ED visits for any reason, primary care visits, hospitalizations, length of hospital stay, laboratory tests, receipt of home care, transfer to long-term care, and medication initiation. Generalized estimating equations were used to estimate intervention effects on individual-level health service utilization, accounting for trial design and individual-level baselines. The 30 social housing buildings had 3695 residents (1846 control and 1849 intervention participants; mean [SD] age, 72.8 [9.1] years; 2400 [65.0%] female). Intention-to-treat analysis found no significant difference in ED visits by ambulance (445 of 1849 [24.1%] vs 463 of 1846 [25.1%]; adjusted odds ratio [AOR], 0.97; 95% CI, 0.89-1.05) but found higher antihypertensive medication initiation (74 of 500 [14.8%] vs 47 of 552 [8.5%]; AOR, 1.74; 95% CI, 1.19-2.53) and lower anticoagulant initiation (48 of 1481 [3.2%] vs 69 of 1442 [4.8%]; AOR, 0.68; 95% CI, 0.53-0.86) in the intervention arm vs the control arm. CP@clinic attendance was associated with higher incidence of primary care visits (adjusted incidence rate ratio, 1.10; 95% CI, 1.03-1.17), higher odds of receiving home care (AOR, 1.07; 95% CI, 1.01-1.13), and lower odds of long-term care transfers (AOR, 0.32; 95% CI, 0.13-0.81). In this cluster randomized clinical trial of CP@clinic, the intervention did not affect the rate of ED visits by ambulance; however, there were increased primary care visits and connections to home care services, which may have increased antihypertensive medication initiation and reduced long-term care transfers from social housing. Health policymakers should consider CP@clinic's impact as an upstream approach to improve care for older adults with low income. ClinicalTrials.gov Identifier: NCT02152891.

Building Resilience: Strengthening European public health workforce through ECDC Fellowship Programs

Abstract The European Centre for Disease Prevention and Control (ECDC) Fellowship programmes offer a two-year training in field epidemiology (EPIET) and in public health microbiology (EUPHEM) aiming to create and maintain a network of highly trained field epidemiologists and public health microbiologists and strengthen the public health epidemiology workforce in the European Union (EU) and beyond. The Mediterranean and Black Sea Programme for Intervention Epidemiology Training (MediPIET) also aims to strengthen the public health workforce in countries neighboring the EU. During the training, fellows who are based in different public health institutes in the EU and neighboring countries, set-up, implement and evaluate surveillance of communicable diseases, investigate outbreaks and conduct operational research directly linked to public health actions. The programmes facilitate knowledge exchange and collaboration across borders, building a foundation for participants and their institutions and promoting long-term collaboration through the alumni network. Participants from diverse disciplinary and cultural backgrounds enable interdisciplinary and multi-sectoral knowledge transfer, enhancing the effectiveness of public health responses. By facilitating collaboration and networking, exchanging experiences, disseminating best practices and assimilating lessons learned, these programmes contribute to addressing contemporary health challenges, including emerging vector-borne diseases and strengthening public health systems in Europe and neighboring regions. In the face of global challenges such as climate change and globalization, the fellowships exemplify how collaboration can strengthen Europe’s defenses against emerging health threats.

Evaluating trends and insights in cardiovascular risk among the polish population

Abstract Introduction Cardiovascular diseases (CVD) are the leading cause of death in Poland and worldwide. Lifestyle changes and early diagnosis can reverse this unfavorable trend. In the face of escalating global health challenges, the identification of CVD risk factors becomes paramount, especially within national contexts where demographic shifts and lifestyle changes can significantly impact the health profile of the population. Aim of the study. Determining the prevalence of CVD risk factors in the Polish population and analyzing their changes over time. Material and Methods Data of 705,420 Poles aged 35-55 years who were enrolled in CVD disease prevention programme between 2012 and 2021 were analysed. The prevalence of the following CVD risk factors was determined: nicotinism, hypertension, elevated total cholesterol, elevated LDL, reduced HDL, elevated triglycerides, elevated glucose (indicating pre-diabetes), low physical activity, overweight, obesity, SCORE ≥5%. In addition, we assessed how the mean SCORE, BMI, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL cholesterol, LDL cholesterol, triglycerides, glucose levels and waist circumference changed over time. Results Nicotinism affected 17.98%-24% of women (W) and 27.29%-36% of men (M). Hypertension was in 7.04%-8.58% of W and 17.45%-19.62% of M. Elevated total cholesterol were in 55.69%-63.64% of W and 65.91%-72.68% of M. Elevated LDL were in 44.77%-54.2% of W and 58.26%-65.48% of M. Reduced HDL were in 9.84%-11.52% of W and 14.48%-16.57% of M. Elevated triglyceride were in 13.44%-15.37% of W and in 33.81%-36.29% of M. Elevated glucose indicating a pre-diabetic status were in 10.70%-13.16% of W and in 18.91%-22.76% of M. Low physical activity was in 75.96%-82.2% of W and 73.32%-81.67% of M. Overweight conditions were in 30.37%-31.67% of W and 48.61%-49.45% of M. Obesity affected 14.04%-17.12% of W and 20.67%-24.69% of M. SCORE ≥ 5% was in 0.23%-0.38% of W and in 13.08%-18.72% of M. There was a decrease in the mean SCORE value (-0.08; 95%CI: -0.09 - -0.06) from 2012. An increase over time was noted in mean BMI (-0.01; 95%CI: -0.05 - 0.04). There was a slight decrease followed by a notable increase over time in mean systolic (-0.35; 95%CI: -0.47 - -0.24) and diastolic blood pressure (-0.25; 95%CI: -0.32 - -0.18). There was a decrease in mean total cholesterol (-3.29; 95%CI: -4.27 - -2.31) and mean LDL cholesterol (-3.11 95%CI: -4.22 - -2.01). A notable increase was observed in mean glucose values (0.01; 95%CI: 0-0.01). Over time, there was an increase in mean waist circumference value (-0.19; 95%CI: -0.54-0.16). Conclusions The escalation of CVD risk among the Polish population is illustrated, with a marked increase in obesity, sedentary lifestyles and indicators of metabolic syndrome. These trends highlight the urgent need for targeted public health initiatives and for the implementation of comprehensive strategies to mitigate these risks

Advancing Pharmaceutical Care in Community Pharmacies in Poland: A Blueprint for Enhanced Patient Care Quality

Background: This article reviews the current state of pharmaceutical care in community pharmacies in Poland and proposes a collaborative framework for its advancement. While pharmaceutical care has evolved significantly worldwide, with Europe leading the way, Poland has lagged in its development. Although Polish pharmacists are well-qualified and community pharmacies are numerous, pharmaceutical care remains underdeveloped. Methods: We conducted a literature review and analyzed case studies from European countries with advanced pharmaceutical services. Based on these findings, we collaborated with policy makers, commissioners, and academics to develop a framework for enhancing pharmaceutical care in Poland. The plan emphasizes integrating seven key services into Polish community pharmacies. Results: Our proposed framework outlines seven essential pharmaceutical services: medicine use reviews, new medicine services, minor ailment services, repeat prescription services, integrated prevention programs, cardiovascular disease prevention programs, and vaccination programs. Evidence from other European countries suggests that implementing these services could significantly improve health outcomes and patient quality of life. This is particularly important in light of Poland’s ageing population, the rising prevalence of chronic diseases, and the healthcare system’s increasing burden due to polypharmacy. Conclusions: The proposed framework presents a practical and collaborative approach to advancing pharmaceutical care in Poland. By adopting these key services, community pharmacies could play a more integral role in improving patient care quality and alleviating pressure on the broader healthcare system.

Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women

BackgroundStrong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.MethodsThis process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.ResultsAverage reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders’ perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being “more than satisfied” with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.ConclusionsSHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.Clinical trials Registrationwww.clinicaltrials.gov #NCT03059472.

Learning by Doing: The Potential for Experiential Education in Health Promotion

Background: Rural populations face significant health disparities (e.g., high rates of chronic diseases) and unique accessibility barriers (e.g., limited healthcare facilities). Training higher education students to serve as facilitators for chronic disease prevention programs may address rural health promotion needs. Purpose: The purpose of this pilot, exploratory study was to create an experiential learning opportunity for students and examine their experiences. Methodology/Approach: Project leaders completed a Diabetes Prevention Program Lifestyle Coach training and, based on their experiences, created training program goals, content, and schedule. Undergraduate students in health-related programs or courses were recruited to participate. Four students completed a 4-week experiential training program and, at the end of the program, participated in an individual qualitative interview for researchers to understand their experiences. Findings/Conclusions: Data were analyzed through a qualitative-descriptive approach. The main theme, experiential learning, branched into two subthemes: (a) professional development and (b) program implementation and future program directions. Students’ experiential learning influenced their personal and programmatic views of prevention training. Implications: The benefits of experiential learning in prevention will enhance students’ education and future employment experiences. Future studies should improve upon training delivery and examine the acceptability of this method of delivery in the rural population.

Learning health systems to implement chronic disease prevention programs: A novel framework and perspectives from an Australian health service.

Chronic diseases are a considerable burden to health systems, communities, and patients. Much of this burden, however, could be prevented if interventions effective in reducing chronic disease risks were routinely implemented. The aim of this paper is to discuss the role of public health agencies in preventing chronic disease through the application of learning health system (LHS) approaches to improve the implementation of evidence-based interventions. We draw on the literature and our experience operating a local LHS in Australia that has achieved rapid improvements in the implementation of chronic disease prevention interventions. The proposed LHS framework has been adapted to be both implementation and chronic disease prevention focused. The framework describes both broad improvement processes, and the infrastructure and other support (pillars) recommended to support its core functions. The framework serves as a basis for further exploration of the potentially transformative role LHS's may have in addressing the chronic disease health crisis.

An investigative study on Yersinia enterocolitica in animals, humans and dried milk in New Valley Governorate, Egypt

BackgroundYersiniosis is one of the most significant intestinal disorders caused by Yersinia enterocolitica and affects both humans and animals. This study aimed to investigate the prevalence of Y. enterocolitica in New Valley Governorate, Egypt in animals, humans, fresh milk and dried milk. Additionally, this study analyzed the presence of virulence genes, including ail and Yst in tested isolates and conducted a phylogenetic analysis to determine the genetic similarity between human, and animal Y. enterocolitica isolates. Finally, the antimicrobial resistance patterns of the isolates were examined.ResultsAmong the 982 samples examined, the prevalence of Y. enterocolitica based on ISO10273-2017 was 11.7% in animal samples including 12.8% of animal faeces, and 10.4% in milk samples. Moreover, the prevalence of Y. enterocolitica was 13.2% in human stool, and 9.5% in dried milk samples. The molecular characterization of the six randomly selected isolates showed that the 16S rRNA, ail and Yst genes were found in 50, 33.3 and 100% of the examined Y. enterocolitica isolates, respectively. Phylogenetic analysis of animal and human isolates based on the 16S rRNA gene revealed a high degree of similarity between the isolates. All the tested animal and human Y. enterocolitica isolates (100%) were resistant to ampicillin and cefotaxime, but highly sensitive to norfloxacin.ConclusionsThe high prevalence of Y. enterocolitica in animal and human samples with high degrees of genetic similarity poses a threat to public and animal health. Animal faeces, milk and milk powder represent the main sources of Y. enterocolitica infection in humans. Additionally, high levels of antibiotic resistance of Y. enterocolitica can cause public health hazards by leading to the failure of disease prevention and treatment programs in humans and animals.

Beta-Thalassemia Haplotypes in Southwest of Iran

Background: Thalassemia is a widespread disease affecting people across various ethnicities and regions. In comparison to previous studies conducted in different regions of Iran, such as those in Lorestan and Sistan-Baluchestan, this study highlights unique mutation patterns prevalent in the southwestern population, emphasizing the genetic heterogeneity in this region. The identification of common mutations of beta-thalassemia in various ethnic groups within the nation is regarded as a practical solution for thalassemia prevention and prenatal diagnosis. Materials and Methods: In this retrospective observational study, the medical records of 545 patients with various types of beta-thalassemia (silent, minor, intermediate, and major), referred to the center at Baqaei 2 hospital over a 14-year period (2008–2022), were examined. The age range of patients spanned from a 2-month-old fetus to a 34-year-old individual. Their mutations and thalassemia types were determined and confirmed using molecular methods, including PCR-ARMS (polymerase chain reaction-amplification refractory mutation system) and sequencing. The results were analyzed using SPSS software. Results: The study examined 545 patients and identified 81 types of mutations. The most frequent mutations observed were CD36-37(-T)/N, IVSII-1/N, and IVS1-110(G>A). The study also noted population heterogeneity, reflected in the wide range of mutations found in the region. Among the patients, 6 had the silent form of beta-thalassemia, 488 had the minor form (464 patients and 24 fetuses), 9 had the intermediate form (8 patients and 1 fetus), and 42 had the major form (26 fetuses and 16 adults). Conclusion: The identification of prevalent beta-thalassemia mutations facilitates disease control and prevention programs and is crucial for the identification of various beta-thalassemia gene mutations. This should be re-evaluated periodically. Observing a wide range of beta-thalassemia genotypes in the southwestern region of Iran suggests gene flow; thus, identifying these genotypes is instrumental in preventing and controlling the disease.

Efforts to Introduce an Indigenous Identifier in a Canadian Provincial Health Authority

Across Canada, Indigenous identity data is not routinely collected in healthcare settings. This paper focuses on [province] and whether the largest and only province-wide healthcare services organization in Canada, [healthcare organization name] should implement an Indigenous identifier in their new electronic medical record system. Due to the current absence of an Indigenous identifier, it is difficult to identify Indigenous peoples in administrative healthcare data to guide healthcare decision-making specifically for Indigenous peoples and to assist with population-specific disease surveillance and prevention programs. Moreover, it is often challenging for Indigenous nations, communities, and organizations to access this data. The data that does exist in [province] frequently excludes large segments of the Indigenous population. Indigenous researchers globally have called for improved health data in alignment with Indigenous research principles, data governance and sovereignty. This paper reports on an exploratory study of potential avenues to enhance availability of Indigenous specific health data in [province]. Of interest are possible supports, concerns, and potential barriers for the introduction of a policy to collect self-disclosed Indigenous identity data in the [org] new electronic medical record system. This research included interviews and focus group sessions with diverse subject matter experts including academics, Indigenous health practitioners and healthcare administrators. The project was embedded in the [removed] which is an [province] based research network for improving primary health with and for Indigenous peoples

Analysis of Impact and Sustainability in Chronic Diseases Prevention Program in XXX Highschool Balikpapan (Systematic Review)

A healthy lifestyle requires discipline. It's not easy, particularly adolescent who feel free and are looking for their existence. Its implementaiton needs to be applied to adolescent due to many cases of chronic diseases developing among them, following their lifestyle. Sedentary/lazy to move, smoking, alcohol, lack of rest and not being able to manage mental health. Generally, adolesecent at the educational level of Junior and Senior High School. The objective of this study is to analyze aspects of the impact and sustainability of chronic disease prevention programs for adolescents. This study is a systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews & Meta Analyses) method combined with open-source search engine. The database used for searching data and information is PubMed. The keywords used during the search process are "Prevention of Chronic Disease" AND "Chronic Disease" OR "Non-communicable Disease" OR "Infectious Disease" AND “Impact of Chronic Diseases” AND “Teenagers” OR “Adolescents” AND “School”. The most variable aspects of disease prevention are more information related to chronic diseases, knowledge, attitudes and stakeholder support. The CERDIK program provides knowledge, education and information among adolescents. These factors must be taken into consideration to improve lifestyle, maintain health so that you are not vulnerable to health problems during the teenage period

Analisis Kebijakan Kesehatan Mendorong Partisipasi Masyarakat dalam Program Pencegahan Penyakit

This article analyzes health policies aimed at promoting community participation in disease prevention programs. The study aims to investigate the effectiveness of current policies in fostering active involvement of communities in disease prevention efforts. Methodologically, a comprehensive review of existing health policies and their implementation strategies is conducted, focusing on case studies and empirical data from various regions. The results highlight the critical role of community engagement strategies in enhancing the effectiveness and sustainability of disease prevention initiatives. The analysis underscores the importance of tailored policy interventions that empower communities through education, resources, and participatory decision-making processes, thereby strengthening public health outcomes and promoting a culture of proactive health management.

Improving Health and Reducing Chronic Disease Disparities with Latinx Communities: Evaluating the Role of Documented Community-Based Intervention Participation.

Limited evidence exists on the impact of participation in community-based chronic disease self-management and prevention programs on health disparities. The purpose of this research was to determine the effects of participation in the Healthy Here Wellness Referral System on existing disparities in glycated hemoglobin (HbA1c), systolic blood pressure (BP), and diastolic BP among Hispanic/Latinx adults compared with non-Hispanic White adults. We merged administrative clinical and referral data from 2018 through 2022 for adult patients in six focus ZIP codes in New Mexico resulting in a sample of 1331 patients and used regression models to examine predictors of intervention participation as well as propensity-adjusted impacts of participation on HbA1c and BP outcomes. Non-Hispanic White patients who were referred to community-based programming but did not participate saw statistically significant increases in HbA1c. Hispanic/Latinx patients saw statistically significant decreases in HbA1c with referral alone, with no added benefit from program participation. The impact of participation differed statistically significantly (t(683) = 3.55, p < .001) between these two groups for HbA1c levels, as well as for systolic (t(958) = 2.11, p = .04) and diastolic BP outcomes (t(958) = 2.96, p = .003). Results of this study support the promise of using centralized referral systems to co-produce health improvement in community settings. Mixed findings highlight the need for further uptake of theory-informed measurement in evaluations seeking to understand heterogeneous program impacts by race and ethnicity.

On certain issues of modern health care system development

Nowadays, the reforming of health care system in the Russian Federation is the most actual since country survives difficult economic conditions and is in need of development of new enhanced scientific and methodological approaches to various aspects of public health and health care, targeting increase of all types of efficiency in this system (medical, social, economic ones). For proper functioning of health care system, not only physicians, but also such specialists as physicists, engineers, mathematicians, biologists, chemists, lawyers, economists, psychologists, teachers and others are to be involved in process of developing new approaches. The multidisciplinary approach and effective interdisciplinary interaction can input into improvement of health care system based on needs of patients. To achieve the highest benefit for patient, development of comfortable conditions for all participants of diagnostic and treatment process, appropriate quality of medical care and maximal level of satisfaction of subjects in given system, it is necessary to consider segmentation of medical services market i.e. characteristics of consumers and providers. The systematic approach is to be applied to achieve this target, involving organizations of private and public sector of practical health care and scientific and educational organizations. it is needed to develop methods of early diagnostic, disease prevention programs and training of personnel in health care system, taking into account approaches of integrative and preventive medicine.

The Status of Nationwide Implementation of Integrative Medicine Programs by Japanese Local Government from a “Social Model” Viewpoint

Background: The world's demographics are transitioning, prompting governments globally to adopt diverse health promotion and disease prevention programs to enhance people's quality of life. While several integrative medicine (IM) programs, including traditional or alternative medicine, may be in place, the level of implementation nationwide is unknown. This research represents the first nationwide study in Japan, conducted in 2018 before local government health programs were cancelled due to the COVID-19 pandemic. The study examines the use of IM by local government in Japan and its safety and effectiveness as a “social model.”Methods: IM programs for disease prevention and health promotion of all 1,944 Japanese local governments in 2018, were retrieved the using the Web Archive Project of the National Diet Library, which is a maintained website repository for all Japanese local government including IM and health programs.Results: A total of 1,739 IM programs were implemented in 537 local governments (27.6% among all Japanese local governments). These included programs for Yoga (1,242; 71.4% of the projects), Qigong (211; 12.1%), and Aromatherapy (145; 8.3%). Among the providers of the programs, only 16 (0.9%) were national medical-related license holders. The purpose of disease prevention or health promotion was not described with scientific basis (safety and effectiveness).Conclusion: Japanese local government conduct health-promoting IM programs, but untrained providers administer many of them. There needs to be more evidence to support the alleged health promotion objectives. Local governments require better support and evidence-based planning to rectify this situation.

The transgenerational transmission of physical attractiveness perceptions: Role of parents' physical activity and nutrition habits in modelling body-focused health attitudes and body shape perception in five-year-old offspring

Introduction: Observing parents’ body-focused behaviours during middle childhood is one of the initial ways in which children model their perceptions of pro-health attitudes and their connection to physical attractiveness. This study aimed to investigate the relationship between parents' health behaviours, their appearance, and the perceptions of adult body types (skinny, medium, obese) by their five-year-old children. Moreover, the role of gender in the above relationship for both children and parents was also examined. Materials and methods: This study participants were 680 families with five-year-old children (330 girls). Participation was limited to the moth-er-father-child triad. The Beauty and Health Scale, Healthy Behaviour Inventory, Inventory of Physical Activity Objectives, and a body composition analyser were used to measure body fat percentage. Results: Assessment of pictures of male silhouettes by five-year-old girls revealed the perception that men who exercise do not lose weight but maintain a healthy, attractive appearance. However, they believed that women should actively lose weight to achieve an attractive figure. Interestingly, women were more likely to be perceived as overweight, despite engaging in physical activity. Conclusions: This study underscores the importance of integrating health education and physical activity interventions into family-oriented disease prevention programmes aimed at cultivating positive health behaviours in children as well as parents.

The Effects of Health and Unmet Dental Care Needs on the Health-Related Quality of Life in Korea Older Adults: A Nationwide Study

Background: The purpose of this cross-sectional study was to assess the relationship between oral health, unmet dental needs and health-related quality of life in South Korea older adults. Methods: The present study used raw data from the 2019~2020 Korea National Health and Nutrition Examination Survey, and analyzed 4956 participants aged over 65 yr. Hierarchical multiple regression analysis was used for associations between oral health, unmet dental needs, and HRQoL. Results: The EQ-5D index differed according to tooth pain, chewing difficulty, speaking problem, subjective oral health status, oral examination, and unmet dental care needs (P&lt;0.001). In the model 2, male, under 75 yr of age, high school graduate or higher, employed, living with a spouse, no stress, good subjective health status, no speaking problem, and no unmet dental care needs were associated with higher EQ-5D index (Adj R2 = 27.6%, P&lt;0.001). Conclusion: To improve the HRQoL of older adults in South Korea, oral health problems need to be minimized through oral disease prevention and oral health education programs.

Strengthening Linkages Between Health Care and Public Health: A Novel Framework for Public Health Action in Health Care Settings to Improve Cardiovascular Disease Risk.

The Chronic Disease Prevention and Control Program (CDPCP) at the Nebraska Department of Health and Human Services developed a novel public health framework and tools to translate public health knowledge, grant work, and terminology to a health care audience in order to inform clinical practice changes in the management of hyperlipidemia and hypertension. The CDPCP piloted the tools with 2 accountable care organizations that included 19 clinics and then funded 9 independent clinics. The project sought to empower clinics to design and implement interventions for reducing high blood pressure and high blood cholesterol focused on populations disproportionately at risk for those conditions utilizing electronic health records. A team comprising the CDPCP and evaluation specialists created a framework called CAAPIE (Capture, Assess, Action Plan, Implement, Evaluate) to provide a clinic-friendly approach to the public health-focused work. For the capture phase, baseline data were collected from clinics. To guide the assess, action plan, and evaluate phases, the team created a Scan & Plan Tool for clinics to assess practices and policies and then use results to develop an action plan. The assessment was repeated upon completion of the project to evaluate change. Interviews were conducted to assess the utility of these tools and capture information related to the implementation of the project. Clinicians reported the framework and tools provided a useful approach, aiding clinics in understanding public health terminology and intended outcomes of the project. Work resulted in the creation of new or enhanced clinical policies and procedures that led to modest improvements in the management of high blood pressure and high cholesterol. The CAAPIE framework is a novel approach for state health departments to utilize in translating public health grant work to health care professionals, promoting a working relationship between the spheres to achieve positive impacts on individual and population-based health care.