Health Campaigns Research Articles

Combating drug abuse through pharmacist-led public health campaigns strategic initiatives for global prevention

The global drug abuse crisis continues to pose significant public health challenges, necessitating comprehensive prevention strategies. Pharmacists, as accessible and trusted healthcare professionals, are increasingly recognized for their pivotal role in drug abuse prevention. This paper explores pharmacist-led public health campaigns and interventions designed to mitigate drug abuse, particularly through education, outreach, and collaboration with other healthcare providers. It examines core components of effective campaigns, including targeting at-risk populations such as youth and high-risk communities. Additionally, the paper discusses global prevention strategies, addressing the cultural, economic, and legal barriers that pharmacists face while highlighting opportunities for their leadership in international drug prevention efforts. The conclusion emphasizes the need for policy recommendations to enhance the pharmacist’s role in drug abuse prevention, alongside future directions leveraging digital health technologies and international collaboration to achieve more effective global outcomes.

The influence of education on antenatal care and nutrition of newborns in Croatia

Abstract Background Previous studies indicate differences in the nutrition of newborns. Great efforts are invests in public health education of expectant mothers in order to improve the health of their offspring. Methods An analytical study of data on the influence of social factors and the level of education of mothers on the nutrition of newborns, habits of pregnant women and antenatal care in the City of Zagreb was conduct in 2022. The paper shows analytical results expressed in percentages of the prevalence and 95% confidence interval (CI). Results The survey covered 6,358 women giving birth in the City of Zagreb in 2022. Most mothers fed their newborns in the hospital with breast milk (48.6%) or a combination of breast milk and artificial nutrition (45.8%), and only 1.4% with artificial nutrition. The share of mothers who fed their newborns exclusively with breast milk is slightly higher among highly educated women (52.4%). The majority of women had their newborn’s first feeding within one hour (81.4%), also more often in highly educated women. The first breastfeeding is most often ten (10.1%) or 15 minutes after birth (8.2%). Only 1.1% of pregnant women smoked during pregnancy, of which the largest share was women with a high school diploma (62.1%). With the increase in education, the share of women with 5 or less antenatal checks decreases (completed college 3.3%, higher school 4.6%, secondary school 6.6%, primary school 12.7%). The largest share of pregnant women who had their first antenatal examination only after 10 weeks of pregnancy is among women with a high school diploma (11.3%). Conclusions The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement. Key messages • The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. • Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement.

Association between mental and physical health with poly-substance use among adults in 33 U.S. states

Abstract Leveraging national data from 33 states in the U.S. for adults 18 and over (N = 347,060), from the 2020-2022 Behavioral Risk Factor Surveillance System (BRFSS), we investigated the association between current self-reported physical and mental health outcomes and substance use, focusing on alcohol, nicotine, cannabis, and all combinations of poly-substance use. Specifically, we conducted multiple weighted linear regression analyses using self-reported outcomes for poor mental and physical health in the last 30 days to examine seven mutually exclusive combinations: alcohol (A) only, nicotine (N) only, cannabis (C) only, A+N, A+C, N+C, and A+N+C. We adjusted for race, sex, age group, education level, and marital status in our analyses. For poor mental health, mean number of days ranged from 3.49 (SD = 7.07) for A-only to 10.39 (SD = 11.54) for N+C and for poor physical health, means ranged from 2.38 (SD = 6.24) to 7.17 (10.61) for N+C. All adjusted β coefficients were significant for poor mental health days, notably with the three highest being 4.36 (95%CI: 3.72-5.00) for C-only, 5.68 (95%CI: 5.06-6.30) for N+C, and 5.27 (95%CI: 4.76-5.79) for A+N+C. For poor physical health, all adjusted β coefficients were significant except for A+N, with the two highest being 2.88 (95%CI: 2.31-3.45) for C-only, 3.16 (95%CI: 2.62-3.69) for N+C, and 1.83 (95%CI: 1.54-2.11) for N-only. Recent poly-substance use containing nicotine and cannabis was both associated with 5+ days of poorer mental health and 3+ days of poorer physical health. Overall, our findings hold implications for informing future policy discourse, shaping public health campaigns, and designing educational initiatives aimed at the link between mental health and substance use. Understanding the dynamics of poly-substance use involving the three most commonly utilized substances globally among adults is critical for crafting targeted interventions. Key messages • Recent poly-substance use (alcohol, nicotine, and cannabis) is related to poorer mental and physical health in the past 30-days. • Recent nicotine and cannabis co-use is associated with 5+ days of self-reported poorer mental health and 3+ days of physical health.

Co-producing COVID-19 health education resources with ethnic minority communities in the UK

Abstract Background Effective communication of relevant health information is challenging in elderly minority ethnic groups due to language barriers and cultural differences. During the COVID-19 pandemic, much of the public health guidance around COVID-19 was in dominant languages, lacking cultural nuance. This study aimed to co-produce culturally, linguistically, and age-appropriate health education resources in COVID-19, tailored to the needs of older adults from ethnic minority backgrounds. Methods This study involved three stages: 1) Semi-structured interviews with Indian and Nepalese older adults (≥65 years), their families (≥18 years) and healthcare professionals (HCPs) (≥18 years) engaging with these communities; 2) Co-production of COVID-19 information resource, and c) Implementation of co-produced resources among the communities. Results 24 participants took part in the study. There was wide variation in participants’ knowledge of COVID-19; some were knowledgeable, while others had limited information. Participants highlighted the need for information in multiple formats and languages and discussed the importance of culturally avenues for information dissemination. Drawing on these findings and two co-production workshops held with the stakeholders, culturally sensitive information leaflets (electronic and paper) were co-prodcued in Hindi and Nepalese using age-appropriate images and infographics. The leaflets were distributed widely to the Nepalese and Indian communities, healthcare trusts and local authorities using the networks of community members, HCPs, and religious leaders. Conclusions The project highlights the significance of participatory methods in the development of culturally relevant public health interventions applicable to the cultural practices of ethnic minority groups. The co-production approach in this study could influence information provision for future public health campaigns for other marginalised groups. Key messages • Health information should be co-produced with a representative sample of the community members and relevant stakeholders. • There is a need on an ongoing basis to identify and fill the information gaps, address misinformation and develop targeted messages.

Understanding influences of cervical screening attendance among women of low socio-economic position

Abstract Women of lower socio-economic position (SEP) have a higher incidence of cervical cancer and lower uptake of cervical screening. The Integrated Screening Action Model (I-SAM) is a behaviour model aimed to guide intervention development that considers how individuals engage with screening through their environment, capability, opportunity, and motivation. The I-SAM can be used to understand behaviour of cervical screening. We aimed to understand perceptions and awareness of HPV screening among women aged 25-65 of low SEP living in an urban area in Ireland. Semi-structured interviews were conducted with women who self-reported regular or irregular screening attendance, no university-level education, low-income employment or not working, aged 25-65 and living in Dublin. Participants were recruited via community organisations. Data were analysed using I-SAM in a framework analysis to map barriers and enablers of attendance of regular and irregular attenders. Of the seventeen women interviewed, seven attended screening irregularly. Participants thought they had opportunity to attend when they were reminded and supported to attend by peers and healthcare professionals. Participants wanted to promote screening in the community and to normalise conversations on sexual health. Participants felt fear of cancer was a driver and deterrent to attend screening due to cancer running in the family, past health issues and abnormal cell treatments, and wanting to be there for their family. Few were aware of HPV or the switch to HPV screening. Irregular attenders were unsure how to book or find information on screening. Campaigns should involve communities that are less likely to attend to improve visibility of screening. Healthcare professionals could opportunistically promote HPV screening in primary care and community settings. Campaigns should be aimed at improving literacy of HPV screening, address concerns of cancer risk and support navigation through screening. Key messages • Understanding of HPV cervical screening is limited and campaigns are needed to improve awareness and literacy. • Public health campaigns should engage with communities to promote screening via community groups and healthcare professionals.

Digital interventions to prevent smoking habit among children. Is there evidence?

Abstract Smoking remains one of the foremost preventable causes of death and disease on a global scale, with its roots often traced back to early childhood. The habit typically begins at a young age, setting a pattern that becomes increasingly difficult to break over time. This enduring issue highlights the critical need for effective preventive measures. Traditional approaches to curbing smoking among the youth-such as public health campaigns, school-based education, and legislative measures like age restrictions on tobacco purchases-have had limited success. In this context, digital interventions (DIs) have begun to emerge as a promising new frontier for tobacco prevention. Leveraging the pervasive influence of technology in young people’s lives, these interventions include gamified educational programs, which transform learning about the dangers of smoking into interactive and engaging activities; social media campaigns, which can spread powerful anti-smoking messages quickly and broadly; and virtual reality experiences, which immerse users in scenarios that vividly illustrate the impact of smoking on health. These digital strategies not only offer fresh avenues for conveying important health information but also engage young audiences in a medium they find relatable and compelling. In this context, the presentation will discuss results of a systematic review aims to assess the efficacy of DI in preventing smoking, and improving knowledge and awareness about smoking damages, among children. This review is part of the PRIN project, titled: “Leo&Giulia standing for public health”, whose goal is to evaluate the effectiveness of a DI aimed at school-aged children, intended to increase knowledge about the negative effects of smoking and prevent its use. Grasping the impact of DI in smoking prevention can greatly benefit public health by offering practical alternatives.

The Role of Gender in Managing Finances among Newly Married Couples in Klang Valley, Malaysia

This study explores the couple's role in managing finances and marital satisfaction from the perspective of newly married couples. By delving into individual demographic and behavioral segments, we reveal how couples manage and plan finances to achieve financial well-being and marital satisfaction, further identifying the role of gender in household financial management. Through a phenomenological method, we conducted semi-structured interviews with seven middle-income newly married couples residing in Klang Valley. Interviews with informants took 6 months between February 2022 and July 2022. The duration of the interview is between sixty and ninety minutes. The interpretation of qualitative data was analyzed thematically using N-Vivo 13 software. The results of the study shed light on the couple's financial management practices to achieve financial well-being and marital satisfaction. The husband is the main pillar in the household's financial affairs. This study offers value in the enrichment of data that reveals couples' understanding of managing finances and plans for their future. By focusing on newly married Malay couples, we gained a deeper insight into simple strategies implemented by household financial managers, division of financial responsibilities, and course of action. Findings that reveal the understanding and behavior of middle-income newlyweds in the Klang Valley towards financial well-being can be used by policymakers, governments, and non-governmental organizations to formulate financial health policies, programs, and campaigns to educate the public about early planning towards financial well-being and enjoying marital satisfaction.

Harnessing SSB tax for health and economic prosperity: A Path to sustainable growth

This study explores the implementation of sugar-sweetened beverages (SSB) excise taxes as a policy tool to address public health challenges related to excessive sugar consumption in Indonesia. With rising rates of diabetes and obesity, SSB taxes have been widely adopted globally, yielding positive outcomes such as reduced consumption and increased government revenue. This research synthesizes global evidence through a scoping review and examines how an SSB excise tax could be structured to fit Indonesia’s unique socio-economic context. The findings suggest that a tiered tax based on sugar content would be most effective in curbing consumption while encouraging the beverage industry to innovate healthier alternatives. Revenue generated from the tax, estimated to reach IDR 9.68 trillion annually, could be directed toward public health initiatives, particularly for preventing and managing non-communicable diseases. The study also recommends complementary public health campaigns to raise awareness of the risks associated with sugar consumption. Effective collaboration between the Directorate General of Taxes and the Ministry of Health is crucial for successfully implementing and monitoring the policy. The introduction of SSB excise taxes in Indonesia represents a strategic opportunity to enhance public health, generate substantial government revenue, and support long-term sustainable development.

Peadiatric amputation from traditional bone setters’ gangrene in Ibadan: a malady

Background: Pediatric amputations resulting from gangrene pose a significant medical challenge, especially in resource-limited settings. In Nigeria, traditional bone setters (TBS) often serve as the first point of contact for musculoskeletal injuries, but their practices can lead to severe complications, including gangrene. Our hospital manages many of such cases. This study aims to explore the epidemiology, clinical presentation, and outcomes of pediatric patients who developed gangrene requiring amputation following TBS treatment, with the goal of informing public health strategies and improving pediatric care quality. Methods: The study is a retrospective study which seek to extract the data from the hospital record all the patient who underwent amputation due to gangrene after initial TBS treatment. All the case notes were retrieved and data was extracted and analyzed using descriptive statistics. The study adhered to ethical standards and anonymized data to protect patient confidentiality, ensuring the study's integrity. Results: The study involved 33 pediatric patients aged 8.3 years, with a significant gender disparity. Most patients were from the Yoruba ethnic group and practiced Islam. 87.9% of parents had no formal education. Gangrene was most common in the left hand, and falls were the leading cause of initial injury. The average surgery time was 81.2 minutes, with a 13-day hospital stay. Post-operative complications occurred in 43.5% of patients, with surgical site infections (SSI) being the most common. Only 8.7% received occupational therapy. Conclusions: The study highlights post-operative care challenges in pediatric amputations, including high complications and limited access to services. It suggests targeted interventions, infection control, and public health campaigns to improve outcomes. Future research should include long-term follow-up studies.

Working young adults' engagement with public and workplace health promotion efforts in Singapore: A qualitative study.

Young adults entering the workforce are at increased risk of becoming overweight or obese. Yet, internationally, young adults are rarely targeted in health campaigns, and little is known on how to improve their interest and participation in health promotion efforts. Through 33 semi-structured interviews with young adults working in Singapore, we explored their engagement with existing public and workplace health promotion efforts that encouraged healthy eating and increased physical activity, and their subjective health in the context of their daily lives. Interviews were coded and thematically analysed, taking an inductive and deductive approach. Despite some interest in health messaging, participating working young adults rarely adopted health-promoting activities such as meeting daily recommended servings of fruits and vegetables and exercising regularly. Participants reported that the health promotion campaigns they were aware of, suggested actions that they couldn't incorporate in their lives as they did not address the barriers that they are facing from socio-environmental contributors such as long working hours, personal and social commitments, and the food environment. Furthermore, some considered their health to be good enough and therefore had little reason to change existing practices. Affordable and accessible health screenings were an objective way for young adults to re-evaluate their perceptions of their own health which motivated some to favourably change their behaviours. Our findings suggest that future health promotion campaigns would benefit from more fully addressing some of the existing barriers that young working adults face, in tandem with policy changes to directly tackle the socio-environmental conditions for young workers.

Dietary Habits of Young Poles and Their Selected Determinants: A Review and Implications for Public Health.

This study investigates the dietary patterns, health behaviors, and related determinants among young people in Poland, amid increasing lifestyle-related health concerns like obesity and poor nutrition. Understanding the factors influencing these behaviors is crucial for crafting effective public health strategies. The objective was to analyze young Poles' eating habits, their perceptions of health, and the role of various determinants in shaping these behaviors. A survey was conducted among a representative sample of young Poles, gathering data on eating habits, health perceptions, and lifestyle choices. The survey focused on the respondents' understanding of healthy eating, sources of nutrition knowledge, and the influence of family, social media, and public health campaigns. Data were analyzed using descriptive statistics, and correlations between health behaviors and socio-demographic factors were examined. The study revealed that 88% of young respondents prioritize health, with 73% acknowledging a link between nutrition and health. While most participants accurately described healthy eating and reported adherence to dietary guidelines, 43% engaged in emotional eating, which often led to compulsive behaviors associated with obesity. Social media, internet articles, and family were primary sources of nutrition knowledge. Despite their knowledge, fruit and vegetable consumption was below recommended levels, and physical activity levels were insufficient in nearly half of the respondents. Only 36% regularly read food labels, with many choosing products containing additives. Appearance-related stress was prevalent among 52% of respondents, while sleep deficits and lack of sufficient physical activity were common. The findings suggest that while young Poles possess a high level of awareness regarding healthy eating, gaps remain in the application of this knowledge, particularly concerning emotional eating and inadequate fruit and vegetable consumption. Public health campaigns should be more effectively targeted to address these gaps and promote sustainable health behaviors from early childhood. Addressing emotional eating, enhancing physical activity, and improving nutrition education through effective channels like social media are key to improving public health outcomes.

Public responses and parasocial relationships following senator John Fetterman's depression disclosure.

Research has found that when a public figure discloses an illness, it can motivate members of the public to reconsider their own health behaviors, particularly when they have a parasocial relationship with the public figure. When the public figure is a politician, it is possible that partisan differences may also influence emotional, attentional, and behavioral responses to health news. We empirically examined public responses to Democrat John Fetterman's disclosure of his treatment for depression shortly after he was inducted into the United States Senate as the junior senator from Pennsylvania in 2023. Using a survey of adult Pennsylvania residents who identified as eligible voters in April 2023, we found that 204 respondents were aware of the news of Fetterman's diagnosis of and treatment for depression. Our data revealed that differences in demographics and parasocial relationships-both positive and negative-with Fetterman predicted different patterns of emotional responses to the news. In addition, age, anger, a negative parasocial relationship, and a positive parasocial relationship were associated with additional outcomes, including attention to news about the disclosure and depression-related information seeking. Mental health advocates could use politicians' depression disclosures to provide information at a time when people are paying more attention to the condition; however, they may need to find other public figures to counteract negative responses to partisan officials. Policymakers could also consider funding mental health campaigns, which could be launched alongside public figure disclosures.

Multilayered politicized constructions of COVID-19 vaccines: A global south view of Pfizer and Sinovac

Despite their overwhelming public health benefits for pandemic response, Covid-19 vaccines have been subject to political controversy around the world. Multidisciplinary scholarship in the health and social sciences points to a wide range of factors that influence the public’s divided views of vaccines. But these factors have largely been considered in relative isolation from each other as independent influences on vaccine beliefs. In this paper, we propose a multilayered politico-psychological model of collective constructions of the Covid-19 vaccines. Borrowing from Montiel and Christie’s (2007) theoretical framework, we examine how the Covid-19 vaccines are holistically constructed in relation to interdependent social meanings across micro-level, meso-level, and macro-level socio-ecological layers. Harnessing a mixed methods research design, we apply this framework to analyze a large corpus of Filipino tweets (N = 229,236) about the Pfizer and Sinovac vaccines. Micro-level discourses feature competing individual emotions which construct Pfizer as an object of desire and Sinovac as an object of fear. Meso-level constructions invoke collective contexts of information and resource scarcity within which Pfizer is a serendipitous prize while Sinovac is a mandated responsibility. Finally, macro-level constructions embed the Covid-19 vaccines within national and international structures, framing Pfizer as a symbol of political integrity and Sinovac as an instrument of political corruption for government leaders. In conclusion, these multilayered discourses around the Covid-19 vaccines illuminate complex negotiations of agency among a Global South public during the pandemic. We discuss multilevel interventions and politico-psychological implications for public health campaigns more broadly.

Minority ethnic older adults’ perception and behaviour towards COVID-19 public health campaigns in the UK

In the UK, minority ethnic groups were reported to face the greatest risk from COVID-19. Yet, little is known about their perception and behaviour towards COVID-19 campaigns. This study used 35 semi-structured, in-depth interviews with minority ethnic adults aged 60 or over in England and Wales to explore their motivations for complying with or disregarding official guidance and their evaluations of various campaign content and channels used early in the pandemic. Using Template Analysis, key themes in the interviewees’ discourse were identified, which were subsequently analysed using the Theory of Planned Behaviour (TPB). This study found that the predominant motivations for non-compliant behaviour included fatigue from information overload, government- and socially-induced distrust, as well as self-reported personality traits. In contrast, compliant individuals emphasised community-based obligations and their trust in official communications. Although participants recognised the pandemic as a challenging time, they were generally unsatisfied with the credibility, consistency, and accessibility of public health messaging. This investigation contributes to health communications studies by adopting a qualitative approach and providing insights into an under-researched demographic.

Knowledge, attitude, and practice towards breast self-examination among women: a web based community study.

The most common form of cancer among women is breast cancer in the Kingdom of Saudi Arabia. Thus, the purpose of this study was to evaluate women in Saudi Arabia's Asir Region, on their knowledge, attitudes, and practices (KAP) regarding breast self-examination (BSE). The research was carried out cross-sectional and conducted from October 2023 to June 2024 in Saudi Arabia's Asir province. Out of 397 study participants, 89 (22.4%) had good knowledge, and 308 (77.6%) had poor knowledge; 185 (46.6%) had a positive attitude, and 212 (53.4%) had a negative attitude 24 (6%) had good practice 373 (94%) had poor practice about breast BSE. According to study participants, social media, 204 (51.4%), radio, television, and newspapers were the best places to learn about BSE. In this study, 316 (79.6%) had heard of BSE. 230 (57.9%) stated that breast cancer patient's likelihood of survival increases with early detection. Only 231 (58.2%) and 247 (62.2%) agreed that breast cancer is indicated by changes in the color and shape of the breast and retraction/discharge of the breasts, respectively. Out of 147, 24 (16.3%) self-examined just one week after each menstruation. Single (OR = 6.259; 95% CI = 1.790-21.887, p = 0.004) and married (OR = 4.923; 95% CI = 1.509-16.056, p = 0.008), Single (OR = 2.736; 95% CI = 1.248-6.000, p = 0.012) and married (OR = 3.176; 95% CI = 1.734-5.817, p = 0.00) were significantly associated with good knowledge and attitude of BSE, respectively. Illiterates (OR = 0.233; 95% CI = 0.060-0.895, p = 0.034), pre-university (OR = 0.222; 95% CI = 0.092-0.538, p = 0.001), Illiterates (OR = 0.293; 95% CI = 0.114-0.755, p = 0.011), pre-university (OR = 0.462; 95% CI = 0.271-0.788, p = 0.005) are less likely to have good knowledge and attitude compared to college and university educated. The study revealed that few women have good knowledge, attitudes, and practices among BSE. In this study, attitude level is high in comparison to knowledge and practice. However, 94% never practiced at all. It is strongly advised that a focus be placed on improving women's KAP regarding BSE, as well as BSE educational programs in universities and more community service activities such as health campaigns in public places.

Prevalence and risk of occurrence of visible birth defects in mining areas in South Kivu: A hospital-based cross-sectional study.

Possible contamination related to mining activities might contribute with other risk factors in increasing the burden of birth defects (BDs) in many developing countries including the Democratic Republic of Congo. The subsequent prevalence is frequently underestimated. Implementation of focused public health interventions is hindered by the paucity of comprehensive data. We assessed the potential impact of mining on the prevalence and occurrence of visible BDs in neonates in South Kivu (SK). A hospital-based cross-sectional study was conducted among 65,474 newborns registered in 7 hospitals in SK from 2016-2021. Hospitals were categorized based on mining activities in their respective catchment areas. Living in a mining zone was the exposure, whereas the outcome was visible BDs. Prevalence was estimated per 100,000 live births, and risk of occurrence with odds ratio (OR) and their 95% confidence interval. 261 neonates with visible BDs were recorded accounting for a prevalence of 399 cases per 100,000 live births. The prevalence ranges between 217 and 1365 cases per 100,000 live births. An increased risk was found in mining zones(OR=2.07; 95%CI=1.59-2.68), Mubumbano(OR=1.72, 95%CI=1.22-2.43), and Mwenga(OR=3.89, 95%CI=2.73-5.54), whereas a reduced risk was reported in non-mining zones(OR=0.48, 95%CI=0.37-0.62) in Katana (OR=0.49, 95%CI=0.33-0.73). Musculoskeletal(28.74%) and central nervous systems(19.92%) were the most common BDs. A significant difference in prevalence for BDs involving the face, GI system and abdominal wall, musculoskeletal, central nervous and genitourinary systems between mining and non-mining zones was found(p<0.001). There is an excessive risk for visible BDs in areas with hazardous mining activities in SK region.​​ More complex studies are needed to define the possible causal relationship. Moreover, findings generated herein should be corroborated by other research design, periodically monitored by public health authorities, and used to inform initiatives promoting enhanced environmental health, access to pediatric surgical care, and public health campaigns aimed at decreasing risk of BDs.

The differential effects of parent-targeted alcohol harm-reduction campaigns with varying executional styles.

Parental provision of alcohol to children is associated with a range of negative outcomes. Public health campaigns discouraging this practice are required as part of a comprehensive approach to reduce alcohol-related harm among minors, however, limited research has examined the relative effectiveness of different messaging approaches. This study compared the effects of two campaigns with different executional styles on parents' intentions to provide alcohol to minors-one campaign used a fear-based approach and the other adopted a first-person narrative approach. The study used a repeated cross-sectional design. An independent samples t-test was used to compare the effects of two campaigns with alternative executional styles on parents' alcohol provision intentions. Two ordinal logistic generalised linear models were used to assess whether intentions effects differed according to parents' demographic and behavioural characteristics. Both campaigns were effective at motivating parents to abstain from providing alcohol to minors. This outcome was particularly notable among female respondents and those who had never provided alcohol to their children. Older respondents and those who used less alcohol were more likely to intend to change their behaviours as a result of exposure to the fear-based campaign, while the campaign using a narrative approach was more effective with heavier drinkers. Overall strong performance of both campaigns combined with varying effectiveness by parent attributes highlights the utility of parent-focused campaigns targeting alcohol provision to minors. To best protect minors, continued investments are needed to develop suites of evidence-based campaigns that resonate with different parent subgroups.

Barriers and facilitators for adherence to follow-up by HR-HPV-positive women with premalignant cervical lesions: a mixed-design study in Mexico

BackgroundMexico reports low follow-up completion rates among women with abnormal cervical cancer screenings. This study aimed to identify barriers and facilitators to follow-up adherence among women with human papillomavirus (HPV) infection and premalignant cervical lesions in Mexico.MethodsA mixed-methods study was conducted from February to April 2019. Participants included women undergoing follow-up care for high-risk human papillomavirus (HR-HPV) and premalignant lesions, along with health personnel from the Women’s Healthcare Center (CAPASAM) in Mexico. Quantitative data were obtained from the Women’s Cancer Information System and through a questionnaire about factors affecting follow-up adherence. Additionally, the health personnel involved completed a compliance checklist regarding care regulations. Descriptive statistics were used for analysis. Qualitative data were collected via semi-structured interviews with both groups, followed by a content analysis based on identified categories. The Hazard Analysis and Critical Control Point System confirmed care process risks. Proposals to enhance the Early Detection Program for Prevention and Control of Cervical Cancer were collected from a CAPASAM health personnel nominal group.ResultsIdentified barriers to follow-up included low income among CAPASAM users, family provider roles limiting time for appointments, long waits for testing and results delivery, distant facilities, insufficient service hour communication, inadequate health personnel training, and a lack of systematic counseling. Hesitation toward follow-up was also linked to shame, apprehension, uncertainty, test aversion, fear of positive results, and limited cervical cancer and screening knowledge. Patriarchal attitudes of partners and limited access to the now-discontinued PROSPERA government program further discouraged follow-up. Facilitators comprised respectful treatment by CAPASAM staff, no-cost services, health campaigns, and positive user attitudes.ConclusionsThe study found more barriers than facilitators to follow-up adherence, highlighting the need for strategies to bolster the Early Detection Program. Future strategies must address the comprehensive array of factors and incorporate stakeholder perspectives.

Age at menarche by birth cohort: A pooled analysis of half a million women in Asia

ObjectivesTo evaluate changes in the age at menarche in Asian populations. Study designRetrospective cohort study. MethodsWe included 548,830 women from six countries in Asia. The data were sourced from 20 cohorts participating in the Asia Cohort Consortium (ACC) and two additional cohort studies: Japan Multi-institutional Collaborative Cohorts (J-MICC), and Japan Nurse Health Study (JNHS) with data on age at menarche. Joinpoint regression was used to evaluate changes in age at menarche by birth year and by country. ResultsThe study includes data from cohorts in six Asian countries namely, China, Iran, Japan, Korea, Malaysia and Singapore. Birth cohorts ranged from 1873 to 1995. The mean age of menarche was 14.0 years with a standard deviation (SD) of 1.4 years, ranged from 12.6 to 15.5 years. Over 100 years age at menarche showed an overall decrease in all six countries. China showed a mixed pattern of decrease, increase, and subsequent decrease from 1926 to 1960. Iran and Malaysia experienced a sharp decline between about 1985 and 1990, with APC values of −4.48 and −1.24, respectively, while Japan, South Korea, and Singapore exhibited a nearly linear decline since the 1980s, notably with an APC of −3.41 in Singapore from 1993 to 1995. ConclusionsOverall, we observed a declining age at menarche, while the pace of the change differed by country. Additional long-term observation is needed to examine the contributing factors of differences in trend across Asian countries. The study could serve as a tool to strengthen global health campaigns.

The challenging concept of eradication: A core concept guiding and frustrating public health.

The celebrated 1980 announcement that smallpox had been eradicated was made using the following definition of eradication: "Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts: intervention measures are no longer needed." Public health around the world works with this definition of "eradication," setting it as a goal for other infectious disease control programs. The definition is simple. Its application, however, has produced long-running and complex public health campaigns that threaten the commitment of funders, health care providers, and governments. In this paper, the authors demonstrate the disease-specific challenges of eradication through the example of the Global Polio Eradication Initiative (GPEI). While many deem eradication worth its high costs because it is the end of morbidity and mortality from a disease, it does not mean the end of disease control efforts. Public health must be prepared for the possibility of disease reoccurrence in the form of undetected natural reservoirs of disease, lab leaks from stored samples, bioterror attacks using stolen samples, and the synthetic recreation of microbes. This paper clarifies the role of reoccurrence prevention in eradication, calling for its addition in the definition of eradication.