Prevention Programs Research Articles

The prevalence of obesity and overweight among Iranian population: an umbrella systematic review and meta-analysis

BackgroundThe present umbrella systematic reviews and meta-analyses aim to determine the comprehensive prevalence of obesity and overweight across different age subgroups in Iran.MethodsWe conducted a comprehensive search across many databases, including Science Direct, Web of Science, Scopus, PubMed, and Google Scholar, to retrieve papers published until November 2023. The meta-analyses included in this study examined the prevalence of obesity and overweight in Iran. The current umbrella meta-analysis finally contained 24 meta-analyses. We evaluated the scientific reliability of the studies using the Assessment of Multiple Systematic Reviews (AMSTAR2).ResultsThe overall prevalence of overweight and obesity among the Iranian population was 18.38% (95% CI: 10.267, 26.496) and 10.91% (95% CI: 9.654, 12.177), respectively. The overall obesity prevalence in males was 9.93 (95%CI: 8.483, 11.388), and in females was 9.67% (95%CI: 8.317, 11.033). The prevalence of overweight and obesity among children and adolescents was 12.43% (95% CI: 10.184, 14.683) and 6.51% (95% CI: 5.866, 7.157), and in adults, it was 27.39% (95% CI: 14.878, 39.914) and 17.20% (95% CI: 13.483, 20.919), respectively. Male children and adolescents had a higher prevalence of overweight and obesity than females, but adult males had a lower prevalence than females.ConclusionThis study presents the trend of obesity and overweight among the Iranian population. Since the trend of increasing overweight and obesity is alarming, policymakers and healthcare providers at the national and regional levels should design and implement preventive programs and interventions.

A qualitative exploration of the coordinator’s role in an intersectoral childhood overweight prevention programme in the Netherlands: ‘a lot is expected from one person’

BackgroundIntersectoral collaboration and its coordination are vital for community health promotion. Given the diverse organisational contexts in which local coordinators build intersectoral collaboration, training and support needs of coordinators may vary widely. To date, there is limited insight into how coordinators tasked with building intersectoral collaboration apply their role given their specific organisational context. A more detailed understanding of this process will provide valuable guidance for training and supporting local coordinators. In the current study we focussed on coordinators involved in building intersectoral collaboration within the ‘Healthy Youth, Healthy Future’ (JOGG) approach in the Netherlands. The organisational contexts in which these local coordinators operate vary considerably. The aim of this study was to explore how local coordinators of the JOGG approach apply their role in building intersectoral collaboration and the competencies they require, taking into account their organisational context.MethodsWe conducted interviews with twelve local JOGG coordinators and two focus groups with eight community advisors from the national JOGG organisation. Data was analysed both inductively and deductively.ResultsJOGG coordinators appeared to take on seven different roles over time: implementer, project manager, networker, matchmaker, linchpin, politician and programme manager. These roles required different competencies and varied according to the organisational context, including: available resources, the position of the employing organisation in existing local stakeholder networks, the coordinators’ responsibilities in their employing organisation and professional background. In addition, the coordinators role depended on the implementation phase of the JOGG approach. During the first phase, roles at the operational level were more prominent, since they were important for engaging stakeholders and facilitating collaboration. In later phases, coordinators took on roles at a tactical and strategic level in order to mobilise their network.ConclusionsThis study highlights the diversity in how JOGG coordinators apply their role. Our findings highlight the importance of carefully selecting the organisation where coordinators are employed, as this influences their possibilities. In addition, our study provides directions for recruiting coordinators for an intersectoral health promotion approach and supporting them, taking into account the phase of the approach and organisational context.

Phone-Based Parental Support Program for Caries Prevention in Children: A Randomized Controlled Trial.

Children referred for comprehensive dental care under general anesthesia, due to severe early childhood caries, have a high risk of continued caries progression in posttreatment years. To assess the effect of a phone-delivered, motivational interviewing-based parental support program on caries recurrence and oral health habits in preschool children treated under general anesthesia for severe early childhood caries. The prospective design of this 2-arm randomized clinical trial (allocation ratio 1:1; blinded outcome assessment) comprised 151 patients from pediatric dental departments in the Stockholm region of Sweden. Inclusion criteria were healthy children aged <6 y with early childhood caries who were scheduled for treatment under general anesthesia. Control group parents received standard advice on toothbrushing and sugar reduction. Intervention group parents received planned phone counseling with an oral health coach every other week for 1 y, based on motivational interviewing principles, offered in Arabic, English, Polish, Turkish, and Swedish. The primary outcome was caries progression 1 and 2 y postsurgery, assessed using the International Caries Detection and Assessment System. Secondary outcomes were parent-reported daily toothbrushing and dietary habits. Sixty-five percent of the control group and 77% of the intervention group experienced caries relapse on at least 1 new surface after 1 y (nonsignificant). At the 2-y follow-up, relapse rates were 53% (control group) and 71% (intervention group; P < 0.05) compared with baseline. The intervention group was significantly less likely to engage in adverse oral health behaviors such as snacking on sweets (intervention group, 10%; control group 33%) and sweet drinks (intervention group 9%; control group, 29%) after 1 y. No group differences in daily fluoride toothpaste brushing occurred. The motivational interviewing-based parental support program improved dietary habits but showed no effect on caries recurrence in children treated under general anesthesia for early childhood caries.ClinicalTrials.gov NCT02487043. The findings of this study can assist clinicians, public health leaders, and researchers in tailoring preventative behavior-focused programs for early childhood caries. These results may improve the understanding of how behavioral interventions that involve parents of young children affect caries prevention, highlighting approaches that are less likely to be effective and guiding future efforts toward more promising strategies for high-risk populations.

Aortic pulse wave velocity predicts cardiovascular mortality among middle-aged metabolic syndrome subjects without overt cardiovascular disease

BackgroundThe objective of this cohort study was to assess the predictive value of main arterial markers for cardiovascular death in middle-aged subjects with metabolic syndrome (MetS).MethodsThis prospective longitudinal study analyzed data from 5829 metabolic syndrome subjects without overt cardiovascular disease aged between 40 and 64 years and enrolled in the Lithuanian High Cardiovascular Risk primary prevention program. Initial assessment comprised the evaluation of aortic pulse wave velocity (aPWV), carotid intima-media thickness (cIMT), carotid stiffness index, cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), aortic augmentation index adjusted for a heart rate of 75 bpm (AIXHR75), and endothelium-dependent flow-mediated dilatation (FMD).ResultsDuring the mean follow-up period of 6.35 ± 2.99 years, 170 subjects (2.9%) had died, with 41 out of these deaths (24.1%) related to cardiovascular causes. Cox proportional hazard regression analysis revealed associations between cardiovascular deaths and increases in aPWV (HR 1.34, 95% CI 1.14–1.58, p < 0.001), CAVI (HR 1.28, 95% CI 1.09–1.50, p = 0.002), and cIMT (HR 1.004, 95% CI 1.001–1.006, p = 0.003), as well as a decrease in ABI (HR 0.020, 95% CI 0.001–0.359, p = 0.008). However, after adjustment for age and gender, only aPWV remained a statistically significant predictor. Common survival tree analysis foregrounded the predictive significance of C-reactive protein (CRP), as the primary variable associated with an increased risk of cardiovascular death, followed by aPWV and smoking as secondary and tertiary variables. The analysis also demonstrated sex-related differences: in women, the primary predictive variable was aPWV, whereas in men, CRP was identified as the primary variable, followed by CAVI and cIMT.ConclusionsThe findings of this study suggest that, among the markers of subclinical arterial damage, an increase in both aPWV and CAVI has a statistically significant predictive value for cardiovascular mortality in the middle-aged subjects with MetS. However, only aPWV demonstrated predictive value that was independent of age and gender.

Loneliness in College Students

Introduction: Loneliness among college students is quite prevalent. Students in their early years experience a transition period when entering university. Conditions with a new living environment, a new social environment, adjustments to peer relations, and a new academic atmosphere, support the occurrence of loneliness conditions in students. This study aims to understand loneliness in college student Methods: Literature ReviewResults: College students have a greater risk of experiencing loneliness. The impact of loneliness on students is also quite significant, both physically and psychologically. Loneliness can affect mental conditions of depression, anxiety, suicide, and low self-esteem which will ultimately lead to a decrease in quality of life. The physical effects of loneliness can also result in prolonged feelings of fatigue, limited physical activity, cardiovascular disorders, and unhealthy lifestyles which ultimately also have an impact on decreasing quality of life. Intervention and prevention to overcome loneliness are urgently needed, such as improving social skills, overcoming and adapting maladaptive social cognition, increasing social support, mindfulness interventions, and improving friendships. Conclusions: Prevention programs for loneliness are very important to implement. Such an intervention could help reduce the burden of the disease in students’ future professional lives. Keywords: Loneliness, Well-Being, College Students

Совершенствование организационных и лечебно-профилактических мероприятий, направленных на профилактику избыточной массой тела и ожирения.

Relevance. Obesity is a serious public health problem due to its high prevalence, increasing treatment costs and adverse effects. In this regard, the development of preventive measures aimed at preventing the formation and progression of obesity based on modern information and digital technologies seems to be an urgent and extremely important task. Research objective: development of a system for early diagnosis of overweight and obesity with the identification of predictors of their formation to prevent the progression of the pathological process and effective prevention of its occurrence. Materials and methods. To assess the prevalence of overweight and obesity, an analysis of the data of the reporting forms of federal statistical observation № 30 «Information about the medical organization» and № 12 «Information on the number of diseases registered in patients living in the service area of the medical organization» for the period 2012–2023 was carried out. To assess the economic component, we used the data from reports on the summary of expenses at the expense of budget funds, funds received from the provision of paid services. The study used the following methods: analytical, statistical, comparative analysis and content analysis. Statistical processing of materials was carried out using calculation tables in Excel format. Results. The article presents data on the relevance and prevalence of overweight and obesity in the adult group, including the workingage population. The risks of human health impairment with possible disability and mortality due to overweight and obesity are analyzed. Socioeconomic factors leading to obesity are considered. The economic consequences of this problem, as well as unresolved problems of obesity prevention are noted. Priority areas of comprehensive prevention programs are identified and prognostic models for the development of overweight and obesity are developed, taking into account the identified individual medical and social risk factors. The results of the study will allow personalizing preventive measures aimed at preventing obesity and its complications.

Exploring risk and protective factors of intimate partner violence in Korean young adults

Intimate partner violence (IPV) is most prevalent in young adults, yet scarce evidence is available regarding South Korean young adults’ experience of IPV and culturally tailored IPV prevention programs. To address this gap, this study aimed to holistically assess IPV victimization and perpetration rates and the related risk and protective factors among Korean young adults. Using online survey data from 600 Korean young adults using simple random sampling, this study found that the lifetime prevalence of both IPV victimization and perpetration was about 30%. Both IPV victimization and perpetration had affected over 20% in the past 12 months. Independent variables in multiple logistic regression models explained 18% and 23% of variances in lifetime IPV victimization and perpetration, respectively. Korean young adults who reported more depressive symptoms were more likely to report IPV victimization. Those who reported more alcohol consumption, traditional attitudes about gender roles, being more tolerant of IPV, and poorer physical health status were also more likely to commit IPV. However, those who had experienced family neglect were less likely to report IPV perpetration. The findings of this study highlighted that childhood adverse experiences minimally explained IPV and that alcohol consumption, mental health, and attitudinal variables should be targets of IPV prevention among Korean young adults.

Promoting oral cancer screening by general practitioners in Australia: Strengthening primary healthcare.

Oral cancer remains a significant public health issue. General practitioners (GPs) can play an important role in raising awareness of oral cancer. This paper explores why providing advice relating to modifiable risk behaviours associated with oral cancer and undertaking routine oral cancer screening are important for GPs in clinical practice. To support GPs, an e-learning module on oral cancer screening, prevention and early detection was established as part of the Oral Cancer Screening and Prevention Program (funded by the Victorian Department of Health). The development of the e-learning module was led by Dental Health Services Victoria in partnership with The Royal Australian College of General Practitioners (RACGP), and the content was developed in consultation with experts from the University of Melbourne, Cancer Council Victoria and the Victorian Comprehensive Cancer Centre. The Oral Cancer: Prevention, early detection and referral e-learning module was launched on the RACGP training website in November 2023.

Identifying Key Moments in Type 2 Diabetes Management: A Qualitative Study of the Experiences of People With Type 2 Diabetes and Diabetes Health Coaches.

For people with type 2 diabetes who are overweight, weight loss increases the likelihood of achieving diabetes remission. The aim here was to draw on the experiences of people living with type 2 diabetes and coaches who deliver type 2 diabetes prevention and remission programmes. This was done to develop a service that increases the proportion of people who achieve remission by identifying an effective weight management service. A qualitative researcher and co-researcher with type 2 diabetes conducted 37 narrative interviews with adults with type 2 diabetes (October 2022-June 2023) and 16 semi-structured interviews with health coaches delivering type 2 diabetes programmes in England. Data were analysed using Reflexive Thematic Analysis. Participants were diverse in ethnicity, socioeconomic status, age, gender and years since diabetes diagnosis. Four themes were generated relating to moments in a person's diabetes care: (1) coming to terms with diagnosis, (2) lightbulb moments, (3) sustaining change as normal and (4) becoming expert/building confidence. These four themes were united under a high-level interpretivist theme: 'Same journey, different experience', capturing the mismatch between a linear rigid care pathway described by coaches and the diversity of experience of people living with type 2 diabetes. Coaches and people with type 2 diabetes are aligned on their reports of key moments in adapting to diabetes. Participants' desire for flexibility in their care contrasted with coach reports of rigid service provision. These insights may enable more people with type 2 diabetes to engage and adhere to weight management services aimed at diabetes remission.

Risk of musculoskeletal disorders in female farmers and its socioeconomic determinants in Kashmir Valley.

Background/ AimsThis study investigates the prevalence of musculoskeletal disorders (MSDs) among female farmers, both perennial and non-perennial, in the Kashmir Valley, India. Given the manual labourintensive nature of agriculture in India, MSDs are a significant concern, often stemming from repetitive and constrained postures adopted during farming activities. MethodsUtilizing a cross-sectional design, data was collected through a questionnaire comprising two parts: the Nordic Musculoskeletal Questionnaire (NMQ) for self-reporting MSDs and the second part dealing with socio-economic parameters. Participants were recruited randomly using a three-stage sampling technique from the working age group of 18 years to up to 60 years, resulting in 293 respondents (comprising 66.14% perennial and 33.86% non-perennial farmers). ResultsThe overall prevalence of MSDs was found to be 74.74%, with a notable majority of perennial cultivators (95.3%) reporting MSDs. Activities performed by female farmers were frequently characterized by repetitive and constrained postures, with the lower back being the most commonly affected site (68.78%), followed by the neck/shoulders (62.94%) and elbows/hands (13.54%). Multinomial logistic regression analysis revealed age and marital status as significant risk factors for lower back disorders, neck/shoulders, and elbows/hands (p < 0.05), with workplace environment emerging as an additional risk factor for elbows/hands. ConclusionThe high prevalence of MSDs amongst the respondents establishes the urgent need for preventive strategies and educational programs aimed at promoting ergonomics awareness among female farmers

Perioperative inpatient falls for anterior cervical discectomy and fusion patients are on the rise: Risk factors associated with this “never event”

Background ContextPatients undergoing anterior cervical discectomy and fusion (ACDF) often have brief inpatient stays and may be at risk for inpatient falls (IPFs). Such IPFs should be preventable and have been termed a “never event” by the National Quality Forum, an affiliate of The Joint Commission. Despite increasing attention to IPF prevention, no studies have investigated the incidence, trends, and factors associated with IPFs among ACDF patients. PurposeTo characterize the trends in the incidence of ACDF-related IPFs and their risk factors. Study Design/SettingRetrospective cohort study. Patient SampleAdult patients who underwent inpatient ACDF between 2010 – Q3 2022 were abstracted from a large, national, multi-insurance administrative claims database. Outcome MeasuresIncidence, trends, and factors associated with IPFs. MethodsAdult patients who had undergone single or multi-level inpatient ACDF were identified by administrative coding. Exclusion criteria included: patients < 18 years of age, those who underwent outpatient ACDF, concurrent posterior cervical procedures, thoracic or lumbar fusion, and those with trauma, neoplasm, or infection diagnosed within 90-days prior to surgery. The subset of patients who suffered an IPF were subsequently identified. The annual incidence of IPFs was analyzed over the study years and various risk factors were assessed for their correlation with IPFs by multivariable logistic regression. To determine the association between IPF and length of stay (LOS), patients with relative to without IPF were matched 1:4 based on age, sex, and Elixhauser Comorbidity Index (ECI) and compared by multivariable logistic regression. ResultsOf the 294,165 inpatient ACDF patients meeting inclusion criteria, IPFs were identified for 5,548 (1.9%). Between 2010 and Q3 2022, the annual incidence of IPFs increased from 309 (1.1%) to 515 (4.8%) for patients undergoing ACDF (p<0.001). Independent predictors of an IPF were: hospital acquired delirium (odds ratio [OR] 4.50), history of prior falls (OR 3.38), hospital acquired psychosis (OR 3.17), alcohol use disorder (OR 2.68), cervical myelopathy (relative to radiculopathy) (OR 2.66), socioeconomically disadvantaged patients (OR 1.85), history of dementia (OR 1.77), underweight body mass index (BMI <18.5) (OR 1.67), multi-level ACDF (OR 1.43), history of prior cervical surgery (OR 1.41), male sex (OR 1.37), Medicaid insurance (OR 1.34), older age (OR 1.33), patients in the northeast United States (OR 1.15), and obese BMI >30 (OR 1.15) (p<0.001 for all). Relative to patients without IPF, patients who suffered an IPF following ACDF demonstrated incrementally increasing odds of extended LOS (4-5 days [OR 2.63], 6-7 days [OR 3.85], 7+ days [OR 6.78]) (p<0.001 for all). ConclusionIn this robust national sample of patients undergoing inpatient ACDF, IPFs were identified for 1.9%, with an increasing annual incidence over the years. Among these patients, various factors were associated with their occurrence, many of which may be potentially modifiable. These findings have major clinical implications on care pathway optimization regarding early identification of high-risk patients undergoing ACDF and lays a foundation for the refinement of multidisciplinary fall prevention programs.

Son-to-mother violence in the aftermath of domestic violence: Experiences of sons attending group violence prevention programs

There is growing acknowledgment that son-to-mother violence can occur as part of domestic and family violence (DFV) dynamics. DFV can significantly impact mother–child relationships. This situation is complex because mother–child relationships have different power dynamics and responsibilities than intimate adult partnerships. Recognition of and responses to adolescent-to-parent violence (APV) are inconsistent in service and justice systems, often leaving families under-serviced. There is a dearth of evidence on the effectiveness of programs specific to APV. This article analyses participants’ experiences in two APV reduction group programs. Both of the programs focused on encouraging accountability, addressing trauma, rebuilding attachment between sons and mothers, challenging harmful gendered attitudes, and increasing mothers’ parenting confidence. We report on a thematic analysis of interviews with 15 sons aged 12–17 whose mothers had experienced DFV from adult male partners. The participants were taken from the two different group programs. Our findings highlight sons’: 1) complex needs and trauma; 2) feelings of injustice and shame; 3) uncertainty regarding program aims; 4) connection with other young people; and 5) increased empathy for their mothers. Our findings can inform more responsive policy and practice interventions that engage this vulnerable cohort, address trauma, and prevent future violence.

A mixed-methods study among adolescents and teachers in Bogotá, Colombia: adapting the OurFutures Alcohol Program.

Early onset of alcohol consumption among Colombian adolescents highlights the need for effective and accessible preventive interventions. This project aimed to conduct formative work to inform the adaptation of an effective eHealth alcohol use prevention program originally developed in Australia, the OurFutures Alcohol Module, to the Bogotá context. Twenty-six adolescents and 10 teachers in Bogotá participated in the study. We used a mixed-methods approach comprising interviews, surveys and semi-structured discussions to evaluate the acceptability of OurFutures. Study materials were translated into Spanish before conducting three 1.5-hour focus groups with adolescents (aged 11-15; n = 26), and 1-hour interviews or online surveys with teachers to assess attitudes towards alcohol use and the acceptability of one lesson from the OurFutures Alcohol Module in the Bogotá context. Qualitative data were analysed thematically, and descriptive analyses of quantitative data reported percentage agreement for survey questions. Overall, 96% of students and 89% of teachers expressed strong satisfaction with the OurFutures Alcohol Module lesson. Most students (96%) liked its storyline and character portrayal, and most teachers (80%) said they would use OurFutures with their students. Participants provided feedback for improving program relatability, including adapting scenarios, character names, clothing and language to align with the Bogotá context and resonate with Colombian adolescents. This study marks the first step in informing the adaptation of the OurFutures Alcohol Module to the Bogotá context and highlights key considerations for cultural adaptations of other substance use prevention interventions. This research underscores the importance of place-based end-user involvement in co-designing adolescent prevention interventions.

Correlation between fall experience and life functions among community-dwelling older adults in Japan

PurposeThis study investigated the correlation between the risk of falls and life functions, including motor function, cognitive function, and urinary disorders, among older adults residing in small cities in the metropolitan areas of Japan and evaluated the contents of fall prevention instructions. MethodsSixty-nine older adults residing at home participated in this case-control study conducted between September and October 2019. The survey items included questions pertaining to the history of falls; grip strength; the 30-s Chair Stand Test (CS-30), Functional Reach Test (FRT), and Timed Up and Go Test (TUG) scores; mental and cognitive functions [Test Your Memory-Japanese version test (TYM-J)]; living conditions; and urination status [Core Lower Urinary Tract Symptom Score (CLSS)]. ResultsParticipants with a history of falls had significantly lower CS-30 and FRT scores, and significantly higher TUG scores and CLSS than those with no history of falls. Grip strength bore significant correlations with the CS-30 and TUG scores. The CS-30 scores were correlated with the FRT and TUG scores. The FRT scores were correlated with the TUG and French State Activity Index (FAI) scores. The TUG scores were correlated with the TYM-J and FAI scores. The CLSS showed no significant correlations with the remaining items. The FRT scores and CLSS exerted a significant effect on the risk of experiencing falls. ConclusionBoth balancing ability and micturition status affect fall risk and should be considered in treatment strategies for urinary disorders in fall prevention programs for older adults.

True and false positive HIV point of care test results in a prospective multinational study of at-risk African women: implications for large-scale repeat HIV testing in HIV prevention programs.

Accurate HIV point of care testing is the cornerstone of prevention and treatment efforts globally, though false (both negative and positive) results are expected to occur. We assessed the spectrum of true and false positive HIV results in a large prospective study of HIV incidence in African women using three contraceptive methods tested longitudinally in Eswatini, Kenya, South Africa, and Zambia. HIV serologic testing was conducted quarterly using two parallel rapid HIV tests. When one or both tests were positive, additional confirmatory testing was conducted, including HIV enzyme immunoassay (EIA) and ribonucleic acid (RNA). 7730 women contributed 48,234 visits: true positive results occurred at 412 visits (0.9%) and false positives at 96 visits (0.2%). Of 412 women with HIV seroconversion, 10 had discordant (i.e., one negative and one positive) rapid tests and 13 had undetectable HIV RNA levels. Of 62 women with false positive rapid HIV results, most had discordant rapid testing but six (9.7%) had dually-positive rapid results and four (6.5%) had false positive or indeterminate EIA results. The positive predictive value of dual positive rapid results was 98.3%. Although the majority of rapid test results were accurate, false positive results were expected and occurred in this population of initially HIV seronegative individuals tested repeatedly and prospectively. When HIV infection occurred, not all cases had textbook laboratory results. Our findings highlight the importance of confirmatory testing, particularly for individuals undergoing repeat testing and in settings where the point prevalence is expected to be low.

"We're Going to Start Healing": Perceptions of Sexual Violence on a Rural Indian Reservation in the Northern Great Plains.

Indigenous people experience disproportionally higher rates of sexual violence, but we know little about how to prevent sexual violence among this population. The purpose of this study was to understand the perspectives (e.g., causes, prevention) of sexual violence among an Indigenous community residing on a large rural Indian Reservation in the Northern Great Plains. The study conducted seven focus groups with adults, high school students, and middle school students, and a thematic analysis approach was used to assess the gestalt of the data. Three primary themes emerged from the data: (a) causes of sexual violence, (b) characteristics and contexts of sexual violence, and (c) prevention of sexual violence. Specifically, Indigenous relatives desired sexual violence education; however, there was agreement that there is a lack of programming or education from schools and community organizations. Notably, adults focused on how colonization affected the attitudes and behaviors related to sexual violence and the importance of empowering youth. Adolescent boys believed that the general acceptance of physical violence and bullying in their community led to a culture of ambivalence and distrust of sexual assault disclosures. Adolescent girls referenced how gender and social norms that subjugate women/girls have led to rape myth acceptance and victim-blaming. Findings highlight the need for empowerment-based, culturally grounded, gender transformative prevention programs to address the social biases and gender norms that contribute to sexual violence while promoting cultural strengths and community among youth. This research has important implications for informing sexual violence prevention programming across Indian country.

Advancing Rheumatic Heart Disease Management in Indonesia: Strengthening Early Detection, Targeted Screening, and Prevention Strategies

Background: Indonesia ranks fourth globally in rheumatic heart disease (RHD) prevalence, with a mortality rate of 4.8 per 100,000—higher than malaria. Despite global progress in RHD management, Indonesia lacks a comprehensive national prevention program. Secondary prevention strategies could significantly improve outcomes in high-risk populations by targeting disease progression. Method: This systematic review and meta-analysis examined the impact of secondary prevention on echocardiographic outcomes in Indonesian RHD patients. The review included randomized controlled trials, observational studies, quasi-experimental designs, and case-control studies, emphasizing the role of secondary prevention in mitigating disease progression. Results: Six studies meeting inclusion criteria underwent full-text analysis, with four eligible for meta-analysis. These studies revealed that secondary prevention improved echocardiographic markers, demonstrating its potential to alter disease trajectories in resource-limited settings. Conclusion: Indonesia faces challenges in RHD management due to geographical and healthcare constraints. Echocardiographic screening, a sensitive and specific diagnostic tool, is vital for early detection and monitoring. With technological advancements, cost-effective screening is increasingly feasible, even in remote areas. Strengthening early detection, targeted screening, and secondary prevention strategies is critical for reducing the RHD burden in Indonesia.

The Impact of Violent Pornography on Sexual Coercive Behaviors Among College Men: A Prospective Examination.

Sexual coercion is a widespread public health concern, especially among college students, and is associated with a multitude of negative consequences for survivors. Prior studies document an association between exposure to violent pornography and engagement in sexual coercion among men, although longitudinal examination of this association is largely absent. Using a prospective design, the current study examined how exposure to violent pornography relates to increased engagement in sexually coercive behaviors among college men over time. It was hypothesized that increased exposure to violent pornography would be associated with higher levels of gender inequitable attitudes, higher rape myth acceptance, greater problems with alcohol use, lower recognition of rape scenarios as rape, greater ascription of responsibility to the woman in instances of rape, and lower ascription of responsibility toward the man in instances of rape, all of which in turn would predict greater engagement in sexually coercive behavior over time. Data was collected from 247 college men who completed self-report surveys at baseline, 4-month, and 7-month intervals. Higher gender inequitable attitudes, greater problems with alcohol use, and lower levels of responsibility assigned to men for rape mediated the relation between exposure to violent pornography at baseline and endorsement of sexually coercive behavior at the 7-month. Findings highlight the need to address pornography literacy in sexual assault prevention programs for college men.

Developing a data-driven predictive model for substance abuse prevention among youth using behavioral analytics

Substance abuse among youth presents a critical public health challenge, necessitating innovative approaches for early intervention and prevention. This study proposes the development of a data-driven predictive model that leverages behavioral analytics to identify youth at risk of substance abuse. The model utilizes data from multiple sources, including social media activity, school performance records, and mental health screenings, to analyze behavioral patterns that may indicate a predisposition toward substance misuse. The core methodology integrates machine learning algorithms to process and analyze large datasets, uncovering correlations between specific behaviors and the likelihood of substance abuse. Predictive features such as changes in social engagement, academic performance fluctuations, and indicators of emotional distress are identified and incorporated into the model to enhance its accuracy. By applying supervised learning techniques, the model is trained to recognize patterns in historical data, allowing it to make predictions about future substance use risks. Furthermore, the model's design emphasizes real-time monitoring and adaptability, enabling health professionals and educators to receive timely alerts and intervene early when behavioral warning signs are detected. The application of behavioral analytics in this context offers a more proactive, personalized approach to prevention, targeting at-risk individuals before they develop harmful substance use habits. In addition to its predictive capabilities, the model also provides actionable insights into effective intervention strategies. By identifying the most influential behavioral factors, it informs tailored prevention programs that address specific risk behaviors among youth. These findings can support policymakers and healthcare providers in developing data-driven, evidence-based prevention initiatives that better allocate resources to high-risk populations.

Mothers’ and fathers’ definitions of bullying and the strategies they would recommend to their children in response to bullying

ABSTRACT Despite the critical role that both mothers and fathers play in guiding their children, relatively few studies have actively sought the perceptions of how fathers define bullying and what strategies they suggest when assisting their children with the challenges of bullying victimization. For the present study an anonymous online, questionnaire was administered in New Zealand and used to gain insight into 104 parents’ (73 mothers; 31 fathers) definitions of bullying as well as the strategies they would recommend to their children when dealing with four different types of bullying incidents (verbal, relational, physical and cyberbullying). Approximately half of the participants included just one of the three traditional criteria associated with bullying in their definition, with the majority of respondents mentioning ‘an intent to harm’. The most commonly cited strategy was to tell a teacher or school staff member followed by talk to the bully about their behaviour, while retaliation was the least likely strategy to be suggested. Significant gender differences were identified in the verbal bullying scenario, which is typically the most common type of bullying. Mothers were significantly more likely than fathers to suggest that their child ignore the bully and use retaliation. Implications for bullying prevention programmes are discussed.