Prevention Programs Research Articles

The economic burden of breast cancer in western Iran: a cross-sectional cost-of-illness study

BackgroundBreast cancer is a significant global health challenge, affecting millions annually and imposing a considerable burden on healthcare systems and economies worldwide. This cross-sectional study aims to determine the economic impact of breast cancer in Lorestan Province, western Iran.MethodsA retrospective cost-of-illness analysis utilizing a cross-sectional design was performed from November 2023 to July 2024. Data were collected using patient medical records and telephonic interviews. Costs were categorized into direct medical costs, direct non-medical costs, and indirect costs. A bottom-up approach was employed for cost calculation from a societal viewpoint, with a prevalence-based analysis.ResultsThe study analyzed 525 patients with an average age of 42.74 ± 11.75 years. The total economic burden of breast cancer was estimated at $5,394,409.13, with a mean of $10,275.07 per patient. Direct medical costs comprised 70.2% of the total expenses, primarily attributed to hospitalization, chemotherapy, and laboratory tests. Direct non-medical costs, including accommodation and transportation for patients and their companions, accounted for 12.5%. Indirect costs, largely stemming from productivity losses due to morbidity and mortality, represented 17.3% of the total burden.ConclusionBreast cancer imposes a substantial economic burden on patients and their families in Lorestan Province. Enhancing health insurance coverage, providing government subsidies for treatment, and improving healthcare infrastructure to offer advanced diagnostic and treatment options locally are critical steps to alleviate this burden. Early detection and prevention programs can facilitate earlier diagnosis and reduce treatment costs. Comprehensive policies addressing both medical and non-medical expenses are necessary to improve patients’ quality of life and lessen the financial challenges associated with breast cancer in Iran.

Insights into youth nutritional status in Serbia: assessing prevalence and trend in the context of social determinants

BackgroundThe study aimed to assess the prevalence and distribution of different levels of nutritional status among young people, to examine its association with social determinants of health, and to analyse its trend over time.MethodThe research was a secondary analysis of the data from four national health surveys of the Serbian population. The research sample included 11,243 respondents, aged 15 to 29, both genders. A multivariate logistic regression model was applied to examine the association between socio-demographic characteristics, lifestyle, health status, and the level of respondents’ nutritional status. The trend analysis of the levels of nutritional status by the research years was done using multiple linear regression in adjusted models.ResultsA total of 63.3% of respondents had body mass index (BMI) in the normal weight range, 11.7% were underweight, 18.5% were pre-obese, and 6.2% were obese. The average BMI of the study participants was 23.01 ± 6.01. The female respondents were more frequently underweight, and the male respondents were pre-obese and obese. Different factors were associated with different nutritional status levels - for underweight: female gender (OR: 5.29), age 15–19 (OR: 0.06), being married/ in a relationship (OR: 0.69), living in Belgrade region (OR: 1.35), presence of chronic diseases (OR: 0.56), consumption of psychoactive substances (OR:0.56) and non-smoking (OR: 0.70); for pre-obesity: female gender (OR: 0.38), ages 15–19 (OR:0.36) and 20–24 (OR:0.65), being married/ in a relationship (OR: 1.39), having high wealth index (OR:1.30) and non-smoking status (OR:1.32); for obesity: female gender (OR: 0.36), ages 15–19 (OR:0.35) and 20–24 (OR:0.51), being married/ in a relationship (OR:2.31) and primary education level (OR:2.17). The trend analysis of nutritional status level in the research period showed an increase in the average value of the BMI of the respondents in the entire sample, as well as the prevalence of obesity, while the prevalence of underweight and pre-obesity decreased.ConclusionThe research provided insight into the specific factors associated with and trends of levels of nutritional status of the young, leading to the conclusion that preventive and interventional public health programs and strategies must be fully adapted to their specific needs.

Prostate cancer screening knowledge and attitude among men over 50 at a referral Hospital in Oshana region, Namibia

Background: Prostate cancer is the third most common cancer in men and fourth in causing cancer-related deaths in both men and women in Africa.Aim: The aim of this study was to assess knowledge and attitudes about prostate cancer screening among men over 50 years.Setting: The study setting is Intermediate Hospital Oshakati.Methods: A quantitative cross-sectional design was adopted. Census sampling was employed, and the data were collected through the use of a structured, self-administered questionnaire. Data were analysed with the aid of the Statistical Package for the Social Sciences (SPSS) version 26.0 using frequencies and percentages, and Chi-square test of association.Results: Majority of the respondents were knowledgeable about prostate cancer except in questionnaire items 3, 12 and 13 in which they (71.8%, 82.4% and 94.7%, respectively) were not knowledgeable. In all the items of the questionnaire, majority of the respondents had positive attitudes towards prostate cancer screening. The percentages of the positive attitude range from 80% to 95% across all the items. There is no significant association between the respondents’ prostate cancer screening knowledge and all the respondents’ characteristics (age, level of education, marital status and religion), p 0.05, respectively. There is no significant association between respondents’ prostate cancer screening attitude and all the respondents’ characteristics, p 0.05, respectively.Conclusion: The survey respondents were knowledgeable about prostate cancer screening, except when it comes to the different methods of diagnosing prostate cancer, what happens to the prostate gland in prostate cancer and who should be screened for prostate cancer.Contribution: The results from this study can be used by the Ministry of Health and Social Services and its stakeholders to create a baseline data which help to develop appropriate preventative measures and awareness programmes. Furthermore, this study can be used to identify possible reasons for the late reporting of men for PCa screening and aid to inform the public on the need for early-seeking behaviour through screening.

Perspectives on usability and adoption of a new ACL injury prevention programme for female handball players: a mixed methods approach

Effective injury prevention programmes (IPPs) hold promise for mitigating ACL injuries in female handball players, yet adherence remains a challenge. This mixed methods study explores the relationship between programme usability...

Teachers’ perceptions of rejection sensitivity in inclusive primary schools: qualitative case study

Rejection sensitivity (RS) among primary school students is a serious problem that often has multiple negative consequences including poor academic performance and mental health problems. The current study used a qualitative methodology to determine the role of teachers’ psychological awareness in preventing RS allergy in the school environment through stakeholder intervention and RS allergy prevention programs. When teachers notice students with disabilities being rejected, they can take steps to reduce it. The researcher conducted semi-structured interviews with 18 teachers working in public primary inclusive schools in Al-Ahsa, Saudi Arabia, with deaf, hard of hearing (DHH), and learning disabilities programs. The findings provide an initial step in identifying the forms and types of RS in the school context, helping administrators, teachers, parents, and students reduce the phenomenon of RS and develop long-term plans to address it. Taking teachers’ perceptions into account may enable the development and implementation of new programs to address RS directed toward individuals with disabilities in primary schools. The discussion highlights future research directions and limitations of current research.

Use of alternative payment models for substance use disorder prevention in the United States: development of a conceptual framework

BackgroundAlternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.MethodsIn November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.ResultsThe conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.ConclusionGiven that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.

Variation in risk and protective factors among boy and girl gang involved youth: a direct comparison

PurposeThis study aims to directly compare risk and protective factors of male and female gang-involved youth.Design/methodology/approachThis study uses the 2022 Arizona Youth Survey data. Gang-involved boys and girls are compared through multivariate logistic regression analyses to examine the relationship between risk and protective factors and youth gang membership.FindingsMultivariate analyses reveal significant differences in risk and protective factors between gang-involved boys and girls in connection with family conflict.Practical implicationsThere is a need for semi-specialized prevention and intervention programming for male and female gang youth. Gang programs should emphasize addressing issues with family and home life more for girls than for boys. School-based gang programs need to similarly emphasize educational commitment and positive peer influence for both gang-involved boys and girls. Improving positive neighborhood attachment through community programming will be beneficial for reducing the likelihood of gang involvement for both girls and boys.Originality/valueThere is a need to improve comprehension of the similarities and differences among male and female gang youth. Few studies directly compare the two groups, and by focusing on risk/protective factors, the results can help to provide direct applications to existing intervention and prevention programming.

Prevalence estimates and nature of online child sexual exploitation and abuse: a systematic review and meta-analysis.

Online child sexual exploitation and abuse (OCSEA) is a global health issue. The aim of this global systematic review and meta-analysis was to better understand the prevalence and nature of OCSEA on a global scale. Comprehensive literature searches were done in six UN languages (Arabic, Chinese, English, French, Russian, and Spanish) and multiple databases, for records published between Jan 1, 2010, and Sept 30, 2023. Studies were evaluated independently by two different authors for inclusion according to eligibility criteria. Eligible studies included children younger than 18 years or adults retrospectively reporting OCSEA. Studies used general population samples and were representative at the national and sub-national level. Risk of bias in prevalence studies was assessed and a synthesis of the findings produced. A random-effects model was conducted for meta-analysis of studies to calculate prevalence estimates with 95% CIs for past year recall and lifetime recall of four OCSEA subtypes and overall OCSEA (from studies that measured at least three different sub-types within the same sample). This study was pre-registered with Open Science Framework (osf.io/6vux2). Of the 47 097 records derived from literature searches, 86 records reporting on 123 studies were included in this systematic review and meta-analysis. Pooled mean prevalence for past year recall of OCSEA subtypes was estimated: online solicitation (12·5% [95% CI 10·5-14·7]); non-consensual taking, sharing, and exposure to sexual images and videos (12·6% [9·7-16·2]); online sexual exploitation (4·7% [2·9-7·3]); and sexual extortion (3·5% [1·9-6·4]). The mean prevalence of past-year recall for overall OCSEA was 8·1% (4·9-13·0). Heterogeneity of individual estimates was high, influenced by research design factors including the method of data collection and variability in definitions used. Heterogeneity in prevalence estimates identified across studies and regions indicates that more research is required to draw stronger conclusions about the scale of OCSEA. However, the findings of this study are of great relevance to policy makers, practitioners, and researchers to make informed decisions about allocating resources and designing effective prevention and response programmes to protect children worldwide. The Human Dignity Foundation.

Incremental Cost-Effectiveness Ratios (ICERs) and Revised Metformin Cost-Effectiveness Conclusions in the Diabetes Prevention Program/ Diabetes Prevention Program Outcomes Study.

Introduction: Based on previously published US Diabetes Prevention Program (DPP) cost-effectiveness analyses (CEAs), metformin continues to be promoted as "cost-effective." We reviewed a 10-year CEA to assess this. Treatment alternatives included placebo, branded metformin and individual lifestyle modification. Following the original CEA, we added group lifestyle as a modeled alternative. Methods: Original published data were taken as given and re-analyzed according to accepted principles for calculating incremental cost-effectiveness ratios (ICERs). With more than 2 treatments, these require attention to the rankings of interventions according to cost or effect prior to stipulating appropriate ICERs to calculate. Results: With appropriate ICER calculations, metformin was not cost-effective. Net Loss calculations indicated substantial costs/health losses to using metformin instead of the optimal lifestyle alternative in response to metformin having been confusingly labeled "cost-saving" in the original CEA. Conclusions: The original DPP CEA, subsequent analyses and citations of such analyses continue to conclude that both metformin and lifestyle modification are cost-effective in diabetes prevention. However, using metformin implies substantial costs and health losses compared to the cost-effective lifestyle modification. It may be that metformin has a role in cost-effective diabetes prevention, but this has yet to be shown based on DPP data.

Temporal trends and patterns in mortality from falls across 59high-income and upper-middle-income countries, 1990-2021, with projections up to 2040: a global time-series analysis and modelling study.

Deaths related to falls are a substantial public health problem worldwide, and insight into trends and differences in global fall-related deaths can be valuable for identifying prevention strategies and developing effective policies. Thus, we aimed to estimate global fall-related mortality rate trends and forecast future fall-related deaths. In this global time-series analysis and modelling study, we investigated temporal trends in fall-related mortality rates from 1990to 2021using the WHO Mortality Database, following the GATHER guidelines, and forecasted trends until 2040across 59 high-income and upper-middle-income countries. We focused on identifying specific patterns of variation in mortality rates across different age groups, sexes, and income levels based on World Bank country classification. We analysed temporal trends and patterns using a locally weighted scatter plot smoother curve presented by age-standardised mortality rates (ASMRs), and future projections were calculated based on Bayesian age-period-cohort analysis. We performed a decomposition analysis to identify variations in fall-related deaths by examining factors such as population growth, ageing, and epidemiological changes. Fall-related mortality rates per 100 000people declined from 23·21 (95% CI 21·30to 25·12) in 1990to 11·01(9·94to 12·08) in 2009, increasing to 12·50 (10·36to 14·64) by 2021. Throughout the period from 1990to 2021, fall-related mortality rates were consistently higher among men, individuals in high-income countries, and older adults. The results represent a clear pattern in fall-related mortality rates according to sex, income level, and age group. ASMRs exhibited varying patterns, with an initial decrease of 43·83% (from 11·54 [95% CI 9·33to 13·76] in 1990to 6·48 [95% CI 5·28to 7·68] in 2005) in upper-middle-income countries with a subsequent rise of 49·69% to 9·70 (9·33to 13·76) in 2021, with a 17·81% increase among women (from 9·04in 2009to 10·65in 2021), and with a 1434·8% increase in individuals aged 85years and older (from 5·00 [-4·94to 14·94] in 1992to 76·74 [62·10to 91·39] in 2021). Furthermore, ASMRs showed a positive correlation with Socio-demographic Index (β=42·29 [10·26to 74·32]; p<0·011), the Environmental Performance Index (β=0·19 [0·05to 0·33]; p=0·0090), and the reverse Gini coefficient (β=22·58 [0·45to 44·72]; p=0·046). Projections indicate that the fall-related mortality rate is expected to rise from 14·80 (95% credible intervals, 14·04to 15·59) per 100 000people in 2021to 19·48 (7·02to 98·84) by 2040. The increase in fall-related deaths from 1990to 2040can be attributed to the growth in population, because the absolute number of fall-related deaths has risen despite a declining rate. Temporal trend in fall-related deaths declined from 1990to 2009, followed by an increase in 2021. Fall-related deaths among women and individuals aged 85years and older will continue to increase until 2040, particularly in upper-middle-income countries. Urgent and proactive implementation of targeted interventions and prevention programmes is necessary to reduce fall-related mortality effectively. National Research Foundation of Korea.

FOSTERING VALUES THROUGH EDUCATION: PSYCHOLOGICAL RESOURCES AND STRATEGIES FOR A NONAGGRESSIVE UNIVERSITY ENVIRONMENT

Approaches to strengthening educational values, such as human dignity, equality, and respect for human rights, are increasingly common in modern pedagogy and are reflected in the United Nations Sustainable Development Goals for ensuring inclusive and equitable education for all. In this regard, we aimed to examine the psychological and value-based dimensions of education and behaviours manifested in interpersonal relationships, focusing on the issue of (non)aggression. We administered a questionnaire to 427 students to identify intervention models in education. The questionnaire assessed emotional and attitudinal characteristics related to experiences within the educational system, including students’ approaches to vulnerable situations and their suggestions for implementing best practices in education. To examine more deeply the psychological resources of students – such as hope, self-efficacy, resilience, and optimism, which are essential for understanding their responses and attitudes towards nonaggression – we used the Psychological Capital Questionnaire (PCQ). The majority of participants consider aggression in educational institutions to be a significant issue that negatively affects both the victims and the community as a whole. The analysis of the questionnaire results confirmed the significative contribution of the psychological capital to the formation of a constructive educational environment, important in the development of educational values. Proposed suggestions from the participants mentioned the need for monitoring and reporting incidents, implementing an educational program for aggression prevention and an active involvement of school counsellors, parents, teachers, and authorities in preventing and combating school aggression.

Update on the pathophysiology, prediction and prevention of inflammatory bowel diseases

The pathophysiology of inflammatory bowel diseases is not fully understood. In astaged model by the European Crohn's and Colitis Organization (ECCO) regarding disease development, it is assumed that there is apopulation at risk for manifestation of disease following subtle changes over time. This work aims to summarize the current state of knowledge regarding the pathophysiology, prediction and prevention of chronic inflammatory bowel diseases. Selective literature research via PubMed. Several genetic, biochemical, and microbiome scores have the potential to identify individuals at increased risk of developing inflammatory bowel disease, possibly up to adecade before onset. The growing knowledge regarding the pathogenesis of inflammatory bowel diseases makes prediction before disease onset apossible future diagnostic goal. Hypothetically, early changes before the disease manifests could be reversible and may be amenable to prevention programs.

Sustained alcohol service refusal rates to underage patrons in nightlife setting: 25-year follow-up of a Swedish alcohol prevention program

In 1996, a multicomponent alcohol prevention intervention was launched and later institutionalized in Stockholm. This study examines the long-term effects of the program on compliance with the legal minimum age limit for alcohol service at licensed premises. The intervention comprised community mobilization and collaboration, training, and enforcement aimed at preventing alcohol service to underage (<18years) or obviously intoxicated patrons. Six cross-sectional studies were conducted between 1996 and 2022 in Stockholm using pseudo-underage mystery shoppers attempting to enter licensed premises and order alcoholic beverages. The primary outcome was refusal of entry to the premises or refusal of alcohol service. Throughout the study period, regular collaboration meetings were held, the number of annual inspections and trained staff increased, and the number of sanctions varied. The refusal rate of alcohol service to pseudo-underage mystery shoppers rose from 54.8% in 1996 (baseline) to 59.1% in 1998, 67.6% in 2001, 88.3% in 2007, 91.3% in 2013, and 79.6% in 2022. Compared to the reference year 1996, all rates from 2001 to 2022 showed significant increases in the odds of refusal. The multicomponent alcohol prevention program has been successfully sustained through collaboration and community mobilization, training, and enforcement. This success is evidenced by consistently high refusal rates for alcohol sales to underage customers over an extended period.

Decreasing Hospital-acquired Pressure Injuries During the COVID-19 Pandemic: A 5-step Quality Improvement Approach.

Hospital-acquired pressure injuries (HAPIs) are common adverse events with large burdens on patients and health systems. In 2020, during the initial waves of the COVID-19 pandemic, the incidence of admitted patients with HAPIs of stage II and above in our health system rose from 2.92% to 3.80%. In response to rising HAPI rates across our own hospital system, we established a quality aim to reduce HAPIs stage II and above by 50% over 3 years from the onset of the COVID-19 pandemic. We designed a multidisciplinary quality improvement HAPI prevention program. Our initiative had 5 key aspects: fostering governance and accountability, providing education and training, changing clinical practice, monitoring data and evaluation, and modernizing environments and equipment. HAPI rate (outcome measure) declined from 3.8% at the onset of the COVID-19 pandemic to 1.6% (58% reduction, P<0.00001) postintervention. Braden Risk Assessment Tool use (process measure) improved from 88.2% to 92.2%. (P=0.00024). Rate of patient falls with injuries (balancing measure) decreased from 1.5 per 1000 patient days to 1.0 per 1000 patient days (P=0.0009). Despite working during the COVID-19 pandemic where organizational resources were constrained and infection control practices were heightened, a multidisciplinary QI HAPI prevention program, informed by evidence-based practices and supported by access to real-time data, led to an ∼58% reduction in the HAPI rate.

Preliminary effectiveness of social prescription and virtual patient information in increasing tertiary prevention among cancer patients (ESPRIT): protocol for a single-centre, randomised controlled pilot trial

IntroductionTertiary prevention through physical activity and psychosocial support can positively impact patient outcomes, such as physical function and quality of life (QoL). However, more research is required on the effectiveness...

Promising Predictors of Adolescent Sexual Behavior Outcomes: ASystematic Review of Longitudinal Research.

This review examined research to identify longitudinal predictors of adolescent sexual behavior outcomes. These predictors hold promise as potential outcomes for teen pregnancy prevention program evaluations when measuring sexual behavior outcomes is infeasible or theoretically, methodologically, or developmentally inappropriate. We conducted a systematic review using a prespecified search strategy and processes consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We examined 32 research studies published between 2008 and 2024. Four categories of predictors of sexual behavior during adolescence emerged across the reviewed studies. Variables within the caregiver control, self-regulation, sexting, and substance use categories each predict future sexual behavior outcomes, with findings consistent across 3 or more studies for each category. This systematic review documents the current evidence base for precursors of sexual behavior outcomes among adolescents and specifies which predictors have promising, potentially promising, mixed, and limited evidence. This review is the first step in gathering information that will eventually inform an avenue for teen pregnancy prevention program developers and researchers to highlight the promise of programs when evaluating impacts on sexual behavior outcomes is infeasible or inappropriate.

Improving health outcomes by strengthening public sector capacity in social and behaviour change programming in Nigeria: a qualitative study

ObjectiveThis paper examines the outcomes of the public sector capacity strengthening (PSCS) approach and how they contribute to the promotion of maternal, newborn, and child health, and nutrition (MNCH+N), family...

Cyberbullying Victimization and Mental Health Symptoms Among Children and Adolescents: A Meta-Analysis of Longitudinal Studies.

Cyberbullying victimization and mental health symptoms are major concerns for children and adolescents worldwide. Despite the increasing number of longitudinal studies of cyberbullying and mental health among this demographic, the robustness of the causal associations between cyberbullying victimization and the magnitude of mental health symptoms remains unclear. This meta-analysis investigated the longitudinal impact of cyberbullying victimization on mental health symptoms among children and adolescents. A systematic search identified primary studies published in English between January 2010 and June 2021, yielding a sample of 27 studies encompassing 13,497 children and adolescents aged 8 to 19 years old. The longitudinal association between cyberbullying victimization and mental health symptoms among children and adolescents was found to be weakly positive and consistent across time and age. Three significant moderators were identified: the effect of cyberbullying victimization on mental health was larger among older children, groups with a higher proportion of males, and in more recent publications. No evidence of publication bias was detected. This study adds to the existing body of research by providing a new perspective on the long-term effects of cyberbullying victimization on the mental health of children and adolescents' mental health. Furthermore, it underscores the necessity of developing effective cyberbullying prevention programs, interventions, and legal regulations to comprehensively address this issue.

Youth Mental Health Prevention and Promotion Programs in Chinese Societies: A Systematic Review and Meta-Analysis

Youth Mental Health Prevention and Promotion Programs in Chinese Societies: A Systematic Review and Meta-Analysis

A Comparative Study of the Effectiveness of Text-Based Crisis Intervention and Phone-Based Crisis Intervention in Reducing Emotional Distress Among Texters and Callers.

Today, dying by suicide is one of the most important mental health challenges in the world, and proper planning and using various preventive methods play an important role in this field. The present research aimed to study comparatively the effectiveness of text-based intervention in reducing emotional distress of people involved in psychosocial crises, comparing it with phone-based intervention. In this study, the Distress Thermometer, assessing emotional distress, was used at the start and end of both text and phone-based interventions to explore their effectiveness in crisis de-escalation and management. This study comprises two samples within an overarching study, with 700 clients receiving text-based intervention and 737 clients receiving phone-based intervention. The research findings indicate the effectiveness of both methods in reducing emotional distress among individuals in crisis. The mean emotional distress significantly differed between pre-and post-tests. Importantly, prior to controlling for baseline distress levels, text-based intervention demonstrated particularly strong efficacy in reducing emotional distress, showing a statistically significant difference. Recognizing the effectiveness of both intervention methods and particularly the favorable response of young people with immediate suicide risk to text-based intervention, prioritizing the implementation of text-based systems is recommended in the national suicide prevention programs of developing countries.