Disease Prevention Programs Research Articles

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.

Water pollution with fluoride in the Republic of Moldova and its impact on oral health

Water quality, especially drinking water quality, is one of the most essential requirements for the survival of not only mankind but all terrestrial life on Earth. As a determining factor of health, the quality of drinking water must correspond to sanitary regulations, and the violation of the water protection regime results in pollution. Water pollution is one of the major threats to public health in the Republic of Moldova. According to data compiled by the Yale Center for Environmental Law and Policy, globally, the Republic of Moldova was placed 83rd out of 180 countries in terms of drinking water quality, the first place being occupied by the countries with the highest drinking water quality. The „age-standardized life-years lost per 100,000 people due to exposure to unsafe drinking water (Daily rate)” is a measure used to evaluate the quality of water. The Daly score for the Republic of Moldova in 2022 was 50.0. The Republic of Moldova is considered a biogeochemical zone with regard to some chemical elements in the environment, including the content of fluorine in groundwater, soil, and subsequently in food products. The analysis of water samples taken by the National Public Health Center of the Republic of Moldova demonstrated that in 90% of cases, water sources subjected to laboratory investigations for microbiological and chemical parameters (boron, fluorine, and nitrates) do not meet the requirements. The present study was a prospective, observational one, the main objective of which was to evaluate the epidemiological dental characteristics of children from the fluorosis-endemic area of the Republic of Moldova. The study targeted 520 12- and 15-year-old children from Fălești district, where the fluoride concentration in drinking water exceeds 16 times the permissible norm of 16.2 ppm/l. Thus, the prevalence of dental fluorosis in this locality (Dean index ≥1) was 98.7 for 12-year-old children and 100% for 15-year-old adolescents. The prevalence of dental caries was 51.2% with an intensity of 2.1 for 12-year-old children, and for 15-year-old children, the prevalence was 67.1% with an intensity of 3.5. Children’s age and severity of dental fluorosis were independent predictors of dental caries intensity. Thus, a positive correlation was established between the severity of dental fluorosis and the intensity of dental caries in both study groups and in all groups of teeth. The percentage of children with a COAD index (decayed, filled, or absent teeth) ≥1 was higher in those whose Dean index was ≥ 5 in the second molar compared to other groups of teeth. Conclusion. Dental fluorosis remains the most common dental disease in fluorosis-endemic areas, and the severity of fluorosis increases with increasing fluoride concentrations in drinking water. Contrary to the previously established opinion, tooth decay also develops in children from endemic areas of fluorosis, and its frequency and intensity are directly correlated with the concentration of fluoride in drinking water. The higher the concentration of fluoride, the higher the values of the prevalence indices and intensity of dental caries. Republic of Moldova performs suboptimally in the prevention of oral diseases in the pediatric population, and the implementation of dental disease prevention programs would have major implications for improving dental morbidity.

근골격계질환 분석용 소프트웨어를 이용한 제조업체 근로자들의 근골격계질환 위험도 분석

Purpose: To provide basic data for developing a musculoskeletal disease prevention program by measuring the body alignment status of manufacturing workers performing musculoskeletal-related work and identifying differences in body alignment status according to the area of musculoskeletal subjective symptoms and general characteristics. Method: The study was conducted from December 1, 2022 to January 26, 2023 among 162 workers at a parts manufacturer located in G City. As for the survey tool, body alignment was measured using posture measurement and analysis equipment (Exbody9100, Korea), and the survey was conducted using a self-administered questionnaire. Data analysis was performed using SPSS 27.0, including frequency analysis, independent t-test, and ANOVA. Results: The complaint rate of musculoskeletal symptoms was 98.8%, and the comprehensive musculoskeletal index indicating body alignment was 29.00±10.456, which could predict body misalignment. Pain severity (F=2.889, p<.024), duration of pain once pain occurs (F=3.245, p<.005), number of pain occurrences (F=3.093, p<.007), pain pattern depending on movement(F=2.542, p<.022) There was a significant difference with body alignment status. Conclusion: This study confirmed the relationship between physical imbalance and musculoskeletal pain and predicted the risk of developing musculoskeletal diseases through analysis of workers' body alignment status. Therefore, when establishing preventive measures for musculoskeletal diseases, preventive measures that can maintain body balance should be established.

Oral Health in the State of Kuwait: An Appraisal

BackgroundOral health issues have received significant attention from most global health agencies, which have integrated these issues into their noncommunicable disease, sustainable development, and universal health coverage objectives. MethodsThis paper provides an update on the progress made in the last 2 decades and aims to highlight some of the challenges faced by the oral health care system in Kuwait. ResultsDespite the nation's rising expenditure on oral health care, the prevalence of oral diseases remains high in Kuwait. The lack of reliable data on periodontitis and edentulism limits the ability of researchers to comment on the trends of these conditions. This emphasises the critical need for a nationwide household-level oral health survey in both pediatric and adult populations that would provide valuable information on the oral health status of these populations. ConclusionIn the future, Kuwait must invest more in oral disease prevention programs, especially among children and the high-risk communities of the population.

Sustainability Planning for a Community Network to Increase Participation in Evidence-Based Lifestyle Change Programs: A Mixed-Methods Approach.

Community-based chronic disease prevention programs can have long-term, broad public health benefits. Yet, only 40 to 60% of evidence-based health programs are sustained. Using established frameworks and evidence-based tools to characterize sustainability allows programs to develop structures and processes to leverage resources effectively to sustain effective program activities and systems. This study used a mixed-methods, partner-engaged approach to identify barriers and facilitators to sustaining a community network (the Alliance program) aimed to increase participation in evidence-based lifestyle change programs delivered in the community. Surveys and qualitative interviews were conducted with the Alliance partners based on the Program Sustainability Assessment Tool and Consolidated Framework for Implementation Research. Overall, partners felt Alliance had a high capacity for sustainability. Strategic planning, communication, and partnerships were areas partners prioritized to improve the potential for sustaining the program. Results informed the co-development of a sustainability action plan. This paper furthers our understanding of factors critical for the sustainability of community-based programs for chronic disease prevention and health equity and presents a process for developing action plans to build sustainability capacity.

Adaptation and qualitative evaluation of the BETTER intervention for chronic disease prevention and screening by public health nurses in low income neighbourhoods: views of community residents

BackgroundThe BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews.MethodsWe first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method.ResultsThirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals.ConclusionsResidents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention.Trial registration#NCT03052959, 10/02/2017.

Chronic disease prevention and screening outcomes for patients with and without financial difficulty: a secondary analysis of the BETTER WISE cluster randomised controlled trial

ObjectiveBuilding on Existing Tools To improvE chronic disease pRevention and screening in primary care Wellness of cancer survIvorS and patiEnts (BETTER WISE) was designed to assess the effectiveness of a...

Employer Engagement Strategies to Promote and Add Evidence-Based Chronic Disease Prevention and Management Programs as a Covered Benefit

Employer Engagement Strategies to Promote and Add Evidence-Based Chronic Disease Prevention and Management Programs as a Covered Benefit

A rapid review to inform the policy and practice for the implementation of chronic disease prevention and management programs for Aboriginal and Torres Strait Islander people in primary care

BackgroundMore than 35% of Aboriginal and Torres Strait Islander adults live with cardiovascular disease, diabetes, or chronic kidney disease. There is a pressing need for chronic disease prevention and management among Aboriginal and Torres Strait Islander people in Australia. Therefore, this review aimed to synthesise a decade of contemporary evidence to understand the barriers and enablers of chronic disease prevention and management for Aboriginal and Torres Strait Islander People with a view to developing policy and practice recommendations.MethodsWe systematically searched for peer-reviewed published articles between January 2014 to March 2023 where the search was performed using subject headings and keywords related to “Aboriginal and Torres Strait Islander peoples,” “Chronic Disease,” and “Primary Health Care”. Quality assessment for all included studies was conducted using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. The data were extracted and summarised using a conventional content analysis approach and applying strength-based approaches.ResultsDatabase searches identified 1653 articles where 26 met inclusion criteria. Studies varied in quality, primarily reporting on 14 criteria of the Aboriginal and Torres Strait Islander Quality Appraisal Tool. We identified six key domains of enablers and barriers of chronic disease prevention and management programs and implied a range of policy and practice options for improvement. These include culturally acceptable and safe services, patient-provider partnerships, chronic disease workforce, primary health care service attributes, clinical care pathways, and accessibility to primary health care services. This review also identified the need to address social and cultural determinants of health, develop the Aboriginal and Torres Strait Islander and non-Indigenous chronic disease workforce, support multidisciplinary teams through strengthening clinical care pathways, and engage Aboriginal and Torres Strait Islander communities in chronic disease prevention and management program design and delivery.ConclusionEnabling place-based partnerships to develop contextual evidence-guided strategies that align with community priorities and aspirations, with the provision of funding mechanisms and models of care through policy and practice reforms will strengthen the chronic disease prevention and management program for Aboriginal and Torres Strait Islander people.

Abstract P447: Heart Disease Health Disparities Among Native Hawaiian and Pacific Islander Communities in the United States: A Systematic Review

Background: Heart disease is a leading cause of death among Native Hawaiian and Pacific Islander (NH/PI) communities. However, the nature of disease development and risk factors is not well characterized due to poor availability of disaggregated data, hampering efforts towards the design and implementation of culturally-relevant interventions. The purpose of our review is examine known gaps in heart disease prevention measures and programs for NH/PI populations to identify opportunities to mitigate health disparities through structural- and provider-level factors. Methods: We conducted a systematic search of PubMed, Embase, and CINAHL databases to identify peer-reviewed articles focused on heart disease (coronary artery disease, heart attack, heart failure) in NH/PI populations. Eligible studies were assessed for their relevance to NH/PI populations living in the US, US territories and Freely Associated States and their coverage of topics such as prevalence, risk factors, cultural determinants, prevention, and management. Results: Of the 1,440 articles initially identified (3 duplicates removed), 1,437 article titles and abstracts were screened, 585 full-text articles were screened for eligibility and 68 articles were included for analysis. The main reasons for exclusion were the absence of NH/PI individuals, lack of focus on heart disease, grouping NH/PI people with Asian American and other racial groups, and studies conducted outside the US (e.g., Australia, New Zealand). Many of the included articles examined prevalence, risk factors, health behaviors, knowledge, and healthcare utilization, from sources such as the Multiethnic Cohort Study, Behavioral Risk Factor Surveillance Systems, National and Hawaii Vital Statistics and claims data. Culturally-grounded interventions, community-based programs, and initiatives (e.g., Native Hawaiian Health Research Project, Ohana Heart Project, Pacific Islander Health Care Project, Wahine Heart Wellness Program), which incorporate traditional practices, were identified as showing promise in reducing risk and improving heart health among NH/PI adults. Conclusion: The review unveiled a disproportionate burden of heart disease and high prevalence of obesity, diabetes, and hypertension among NH/PI communities, often attributable to lifestyle behaviors, socioeconomic factors, and limited access to healthcare. These disparities are compounded by the underrepresentation of NH/PI populations in national health surveys and the scarcity of comprehensive epidemiological studies featuring robust NH/PI samples. It is evident that further research and policy initiatives are crucial to increase research investments and promote data equity and disaggregation for this population.

Disability-adjusted Life Years of Hepatitis B in Iran during 2009–2019: An Analysis Based on the Global Burden of Disease Study 2019

Background and Purpose Hepatitis B virus infection is currently among the ten leading causes of death from infectious diseases in the world. The aim of the current study is spatial analysis related to life years adjusted by hepatitis B disability in Iran from 2009 to 2019. Materials and Methods The study is ecological. Using data from the Global Burden of Diseases (GBD), cause-specific mortality served as the basis for estimating disability-adjusted life years (DALYs). Time trend analysis of DALYs attributed to hepatitis B from 2009 to 2019 and spatial pattern analysis and identification of high-risk and low-risk clusters of DALYs attributed to hepatitis B in Iranian provinces were performed. Time trend changes were evaluated using joinpoint regression analysis. Results The most likely high-risk cluster with LLR=238.59 in the West of Iran includes the western provinces of the country (Lorestan, Kermanshah, Hamedan, Markazi, Khuzestan, and Ilam) (relative risk of occurrence 2.31). The three provinces of Lorestan (RR=2.22), Sistan and Baluchistan (RR=1.73), Golestan (RR=1.46) have the highest relative Khazar, and the three provinces of Gilan (RR=0.41), Mazandaran (CIR=0.48) and Kurdistan (CIR=0.51) had the lowest relative risk. During the years 2009 to 2019, the total DALYs decreased by 1.5% annually (p<0.05). Conclusion According to the results of the disease control and prevention programs, it can be effective in reducing the disease burden in the country by giving priority to the provinces that are among the high-risk disease clusters.

An Interactive Modeling Tool for Projecting the Health and Direct Medical Cost Impact of Changes in the Sexually Transmitted Diseases Prevention Program Budgets.

Estimating the return on investment for public health services, tailored to the state level, is critical for demonstrating their value and making resource allocation decisions. However, many health departments have limited staff capacity and expertise to conduct economic analyses in-house. We developed a user-friendly, interactive Excel-based spreadsheet model that health departments can use to estimate the impact of increases or decreases in sexually transmitted infection (STI) prevention funding on the incidence and direct medical costs of chlamydia, gonorrhea, syphilis, and STI-attributable HIV infections. Users tailor results to their jurisdictions by entering the size of their population served; the number of annual STI diagnoses; their prior annual funding amount; and their anticipated new funding amount. The interface was developed using human-centered design principles, including focus groups with 15 model users to collect feedback on an earlier model version and a usability study on the prototype with 6 model users to finalize the interface. The STI Prevention Allocation Consequences Estimator ("SPACE Monkey 2.0") model will be publicly available as a free downloadable tool. In the usability testing of the prototype, participants provided overall positive feedback. They appreciated the clear interpretations, outcomes expressed as direct medical costs, functionalities to interact with the output and copy charts into external applications, visualization designs, and accessible information about the model's assumptions and limitations. Participants provided positive responses to a 10-item usability evaluation survey regarding their experiences with the prototype. Modeling tools that synthesize literature-based estimates and are developed with human-centered design principles have the potential to make evidence-based estimates of budget changes widely accessible to health departments.

Validation of the Kidney Failure Risk Equation in the Colombian Population.

Chronic kidney disease prevention programs must identify patients at risk of early progression to provide better treatment and prolong kidney replacement therapy-free survival. Risk equations have been developed and validated in cohorts outside of Colombia, so this study aims to evaluate the discrimination and calibration of the four-variable kidney failure risk equation in a Colombian population where it has yet to be validated. External validation study of a kidney failure risk equation using a historical cohort of patients with CKD stages 3, 4, and 5, adults without a history of dialysis or kidney transplantation with a two-year follow-up, belonging to the Baxter Renal Care Services Colombia network. The discriminatory capacity of the model was evaluated by the concordance index using Harrell's C statistic, and the time-dependent area under the receiver operating characteristic (ROC) curve was estimated using the nearest neighbor method, as well as the optimal cut-off point for sensitivity and specificity. Calibration was determined by the degree of agreement between the observed outcome and the probabilities predicted by the model using the Hosmer-Lemeshow statistic. A total of 5,477 patients were included, with a mean age of 72 years, 36.4% diabetic, and a mean baseline eGFR of 36 ml/min/1.73 m2. The rate of dialysis initiation was three events per 100 patient-years, 95% CI (2.9-3.6). The optimal cutoff for sensitivity was 0.94, for specificity, 0.76, and the area under the ROC curve was 0.92. Harrell's C-statistic was 0.88 for the total population, 0.88 for diabetic patients, and 0.93 for those 65 years or older. The validation of the model showed good calibration. In this Colombian cohort, the four-variable KFRE with a two-year prediction horizon has excellent calibration and discrimination, and its use in the care of CKD Colombian patients is recommended.

Endline assessment of knowledge about sickle cell disease among the tribal community of Chhotaudepur district of Gujarat.

Sickle cell disease (SCD) is a significant public health concern in India, with one of the highest disability burdens worldwide. For the success of the disease prevention and control program that aims to reduce prevalence through health promotion and screening, the public's prior knowledge of the disease is important. Hence, this study was conducted to assess baseline knowledge of the disease and effects of health education and community mobilization program in the SCD endemic tribal community of Gujarat. This quasi-experimental study was conducted in three phases at Chhotaudepur district of Gujarat, India. Knowledge of the community was assessed through the administration of pretested quantitative questionnaire in 1646 and 1631 individuals respectively during formative and evaluation phases. Differences between the proportions of two phases were statistically assessed by chi-square tests. Despite 75.3% of respondents having heard of SCD before, only 20% could perceive the correct cause. It was improved by 42% post-intervention. During the evaluation, 83% respondents recognized the most common symptom of extreme pain, whereas 86.8% identified the correct diagnostic method. Seventy-seven percent respondents reported modern medicine as a treatment for SCD at endline. Knowledge and awareness about SCD were found inadequate in the community. However, health education intervention strategies effectively improved knowledge related to the disease and its causes, diagnosis, and treatment. Hence, urgent action is required to incorporate community mobilization and awareness generation strategies to mitigate the disease burden.

Factors Associated with the Incidence of COVID-19 Infectious Disease in Muang Pattani District, Thailand

Objective: This study aimed to investigate the COVID-19 incidence in Muang Pattani district; from April 2021 and September 2022, Specifically, the main objective was to study the varying distribution by demographic, area and period of COVID-19.Material and Methods: COVID-19 data, with 15,807 reported cases was obtained from the Muang Pattani District Health Office. A descriptive analysis was used to describe the characteristics of the COVID-19 cases. A negative binomial model was used to investigate COVID-19 incidence.Results: The overall incidence of COVID-19 was around 1,188.9 cases per 100,000 of the population. Females had a higher incidence rate of COVID-19 infection than males. People aged from 20 to 39 years old had significantly higher incidence rates than the average, with the highest rate being found in the Barohom sub-district. In 2021, the highest rates were in the month of October, followed by July and August; while March was reported as the highest rate in 2022.Conclusion: The findings of this study can be used by the public health organizations and others involved in COVID-19 for direct prevention and control in those high-incidence areas. This study has also proven that its findings can be applied to cases related to the prevention programs of other infectious diseases in Thailand.

Health Care Engagement in Disease Prevention and Management: Factors Influencing Chronic Disease Program Referral Adherence Among Non-Hispanic Black and Hispanic Men With Chronic Conditions.

This study aimed to identify factors associated with being referred to an evidence-based disease prevention and management program by a health care provider and adherence to such referrals by non-Hispanic Black and Hispanic men. Utilizing a cross-sectional design, data were collected via an internet-based questionnaire from a national sample of 1,679 non-Hispanic Black and Hispanic men ages 40 years and older with one or more chronic diseases. A 105-item survey assessed program referral and attendance, chronic conditions and medications, disease symptoms, support, communication during physician visit, health care frustrations, disease self-management efficacy, barriers to self-care, helpfulness of learning from others for self-care, and sociodemographics. Binary logistic regression models were fitted to assess factors associated with referrals to a disease prevention and management program and attendance. Results indicated that approximately 23% of participants were referred to a program, and 19.2% reported attendance. Factors associated with being referred to and attending a program included being younger, having more chronic conditions, taking more medications daily, having higher pain scores, reporting more health care frustrations, and reporting better communication with physicians during visits. Men referred to attend a chronic disease program by a health care provider were 16.86 times more likely to attend a chronic disease program (p < .001). These findings suggest the importance of health care engagement for non-clinical disease prevention and management programs, particularly among non-Hispanic Black and Hispanic men with complex disease profiles.

A 15-year longitudinal study of search-and-rescue dogs identifies the musculoskeletal, integumentary, and gastrointestinal systems as commonly affected.

A longitudinal study followed search-and-rescue (SAR) dogs for 15 years to determine the incidence of health events and whether factors of deployment during 9/11, breed, or sex altered the risk of specific events. 150 SAR dogs: 95 dogs deployed to the September 11 terrorist attack sites and 55 SAR dogs not deployed. Each year, a survey was sent to the handler to collect health information until the dog died or the handler withdrew from the study. The reported health events were then categorized according to the body system affected and etiology. Incidence risk rates, with 95% CIs, were calculated for the most common types of health events. Incidence rate ratios were calculated stratified by deployment status, sex, and breed and significance assessed. 1 or more health event was recorded in 96 of the 150 enrolled dogs. The most affected systems were the musculoskeletal (31%; CI, 24 to 39), integumentary (22%; CI, 15 to 29), and gastrointestinal (20%; CI, 14 to 26). The health events were most commonly reported as inflammatory (45%; CI, 37 to 53) and degenerative (28%; CI, 21 to 35) in nature. There were no significant differences in incidence of health events based on deployment status to the September 11, 2001, terrorist attacks. Additionally, there was no significant effect of breed or sex on incidence of health events. To improve the health and longevity of SAR dogs, disease prevention and management programs should focus on reducing the health problems involving the musculoskeletal system as well as the integumentary and gastrointestinal systems.

Long-Term Prevalence Trends in Children in Relation to Environmental Issues in the Astrakhan Region

Introduction: One of the tasks of preventive medicine and hygiene is to study the relationship between environmental factors and human health. The purpose of the study was to compare pediatric prevalence rates in the Astrakhan Region and in the city of Astrakhan in 2007–2020 with those for the Russian Federation in relation to per capita emissions of environmental pollutants. Materials and methods: We used official statistics on the size of population, prevalence rates in children, and emissions of air pollutants in the Astrakhan Region for the years under study. Methods of mathematical and statistical analysis, construction of trend lines and calculation of linear regression equations using built-in Microsoft Excel software were applied. An online Spearman’s Rho Calculator was used to compute correlation coefficients. Results: The prevalence in children showed a statistical downward trend both in Astrakhan and in the Astrakhan Region as a whole with its rates being, on average, 7.8 % and 15.6 % lower than the national ones, respectively. The Spearman’s Rho (rs) showed the presence of a high and direct statistically significant correlation between per capita emissions of air pollutants and disease prevalence in the child population in the Astrakhan Region (rs = 0.73; p = 0.003) with a moderate direct, yet insignificant, correlation for the Russian Federation as a whole (rs = 0.32; p = 0.41) and null correlation for the data computed for the of Astrakhan (rs = 0.26; p = 0.32). Conclusion: Along with the predicted decreasing trend in prevalence in the pediatric population, we established a statistical relationship between local environmental problems and children’s health, which should be taken into account in the development of disease prevention programs.

Neutrosophic Evaluation of Health Promotion Programs for Resource Allocation

The efficient allocation of resources to health promotion and disease prevention programs in the field of healthcare is a multidimensional and highly sensitive challenge that requires the simultaneous consideration of multiple criteria and objectives. In this context, neutrosophic logic emerges as a promising tool capable of addressing the inherent uncertainty and imprecision in health decision-making. This article explores the application of neutrosophic logic in decision-making regarding the allocation of resources to health promotion and disease prevention programs, taking into account a wide range of criteria. The main objective of this research is to validate the importance of using neutrosophic logic in resource allocation for these programs, emphasizing its ability to handle ambiguity and uncertainty effectively and equitably. The results obtained have demonstrated that neutrosophic logic is an effective tool in decision-making in the field of public health.

An evaluation of knee osteoarthritis pain in the general community-Asir region, Saudi Arabia.

Knee osteoarthritis (KOA) is one of the most common conditions resulting in disability, particularly in the elderly population. Osteoarthritis (OA) is the most common articular disease and the leading cause of chronic disability in the developed world. This study was carried out to evaluate knee pain in the Asir region of Saudi Arabia. An analytical cross-sectional survey design was adopted in the Asir region from April 2023 to August 2023 to assess the knee pain of the adult population using an anonymous online questionnaire. Of 1234, 332 were men (26.90) and 902 were women (73.09). WOMAC index score category 55.34% (n = 683) of the subjects had a low risk (score <60), 28.68% (n = 354) had a moderate risk (score 60-80), and 15.96% (n = 197) had a high risk (score ≥81) for KOA. According to clinical criteria, 79.33% (n = 979) of the study subjects had OA. Age group, gender 2.17 (1. 67-2.82) [OR 2.17; 95% CI 1.67-2.82), family history of OA [OR 0.47; 95% CI 0.37-0.62], diabetes [OR 2.78; 95% CI 2.17-3.56], hypertension [OR 0.35; 95% CI 0.26-0.45] were significantly associated with the percentage of the WOMAC index score using the Chi-square test analysis (P<0.05). Therefore, the WOMAC index showed higher diagnostic precision with a statistically significant association [OR 9.31 CI 6.90-12.81] with a P< 0.0001. KOA is more common in older, obese people who have reached the age of 50 in the Asir region, and it is more prevalent in women. Alarms the need for appropriate awareness programs for better disease prevention and health outcomes for the benefit of the community through general public health programs.