Health Prevention Programs Research Articles

Age-threshold for increased risk of developing back disorders: prospective cohort with 74 000 individuals from the UK Biobank.

To investigate the prospective associations between age and the risk of low back disorders (LBD), dorsal disorders (DD), and cervical disorders (CD), and to identify a potential age-threshold for increased risk of back disorders. Prospective cohort from the UK Biobank comprising adults with no history of back disorders. We examined different ages and their association with the risk of back disorders derived from diagnoses of hospital registers. Associations were investigated using restricted cubic splines adjusted for sex, racial and ethnic background, tobacco use, Townsend Deprivation Index, alcohol consumption, educational attainment, employment status, self-reported health, diet quality, body mass index, medication use, physical activity, and handgrip strength. The analytic sample comprised 74,191 participants (mean [SD] age, 55.2 [7.8] years; 57%women) who were followed-up for 7.9 years (IQR = 7.3-8.4). Overall, 3297 (4.3%) cases of incident LBD, 1224 (1.6%) cases of DD, and 792 (1.0%) of CD were documented. The association between age and LBD showed a curvilinear shape with significant higher risk within the range of 61 (hazard ratio [HR] = 1.39 [95%CI,1.02-1.49]) and 70 (HR = 1.71 [95%CI,1.38-2.12]) years (reference:40 years). Similarly, the association of age with DD exhibited a significant curvilinear association within the range of 60 (HR = 1.31 [95%CI,1.01-1.92]) and 70 (HR = 2.74 [95%CI,1.94-3.86]) years. The association between age and CD was not significant. The risk of LBD and DD, but not CD, increases beyond 60 years of age. Targeting people at this critical age-threshold to prevent risk for LBD and DD may be warranted for future interventions and preventive health programmes.

Corrected Myopia and Its Association with Mental Health Problems Among Rural Primary School Students in Northwest China

ABSTRACT Purpose The aim of this study was to evaluate the myopia correction and its association with mental health problems among rural primary school students in China. Methods Using survey data from 17,950 students in 251 rural primary schools, this study examines the association between corrected myopia and mental health problems, as well as academic performance among rural students in China. Vision exams were offered to sample students, and student mental health status was measured using the Mental Health Test (MHT). Results The results show that 21.98% of sample students failed the vision screening for myopia. Over 65% of sample students showed some form of anxiety, with 56.86% experiencing learning anxiety and 18.71% experiencing body anxiety. The MHT score of myopic students was higher than that of students with normal vision, indicating that myopic students had worse mental health overall. Correcting myopia with eyeglasses was associated with better mental health, indicated by a lower MHT score (by 0.62 points) when controlling for covariates. Myopic students with high baseline academic performance who wore eyeglasses benefited especially from myopia correction, as they had a lower total MHT score (by 1.77 points) and lower body anxiety score (by 0.49 points, p < 0.05) than their high-performing peers with uncorrected myopia. Conclusions These findings suggest that future mental health prevention programs in rural China should focus on reducing the prevalence of myopia and providing eyeglasses to myopic students as potential interventions.

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.

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

Rabies-preventive health program for mothers in maternal and child health centers: quasi experimental study

BackgroundRabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Rabies remains a major public health problem in Egypt, with an estimated 60 people dying annually from the disease.AimThe aim of this study was to assess the effect of preventive program on mothers' awareness for prevention of rabies.Study designQuasi-experimental research design was utilized in this study.SettingThis study was conducted at three major Maternal and child centers (Botors, Embaby and Segar) in Tanta City.SampleA total sample of 150 mothers who attended the child clinic with children aged 6–12 years.ToolsResearchers developed three tools for data collection. The tools underwent content validity assessment, and their internal consistency was evaluated using Cronbach's alpha coefficient. Structured interviewing questionnaire for assessment of mothers’ knowledge, attitudes and practices regarding rabies Tool I, Mothers' knowledge regarding rabies questionnaire. This tool consisted of two parts: demographic characteristics of the studied mothers and mothers’ knowledge about rabies. Tool II, Rabies attitudinal Likert scale. Tool III, Mothers reported practice Questionnaire.ResultsFrom the obtained results, it was found that, a statistically significant correlation was found between mothers' total knowledge scores, attitude and total practice scores, both before and after the implementation of the rabies prevention program.ConclusionIt was concluded that the rabies- preventive health program had a positive impact on mother’s knowledge, attitude and practices regarding rabies. The mean knowledge score improved from 14.08 before preventive program to 20.90 one month posttest. Negative attitude of the studied mothers was 48% before program but it reduced to 1.3% one month after preventive program. Only 13.35% of the participants had satisfactory level of practice before program and increased to 83.30% one month posttest.RecommendationsDissemination of the program through mass media campaigns and community outreach activities to enhance public knowledge, improve attitudes, and promote better practices regarding rabies prevention and control measures.

The global prevalence of Chlamydia trachomatis genital infection in pregnant women: a meta-analysis.

Chlamydia trachomatis genital infection is one of the most common sexually transmitted bacterial infections with severe detrimental effects on pregnant women and fetuses. CTGI increases the risk of ectopic pregnancy, exogenous fetal infection, and respiratory complications such as bronchitis and pneumonia. According to the different published reports, this systematic review and meta-analysis study aimed to evaluate the global prevalence of CTGI in pregnant women. Initial searching was applied using valid databases of PubMed, ScienceDirect, Embase, WoS, Scopus, and Google Scholar using MeSH keywords (by October 2023). Following duplicate detection and data exclusion, the Title and Abstract of other remaining papers were evaluated (primary screening). Full-texts of selected papers were assessed (secondary screening) and eligible studies were included for data extraction (total No of investigated pregnant women and the number of positive cases). The PRISMA approach was used for paper selection, and the quality assessment was determined according to the STROBE checklist. Data meta-analysis, heterogeneity, publication bias, and the factors affecting heterogeneity index were analyzed using CMA software. The findings were presented in the Forest Plot diagram and Static tables. Besides, heterogeneity was analyzed using I2 test and diffusion bias was demonstrated in Funnel Plot. Among 1061 selected articles, 44 eligible investigations were enrolled for meta-analysis. The global prevalence of chlamydia trachomatis genital infection (CTGI) was found 8.4% (95% CI 5.8 - 12.1). Meta-regression analysis showed that following the increase in sample size and year of paper publication, the prevalence of Chlamydia trachomatis genital infection in pregnant women decreased significantly (p < 0.05). The global prevalence of Chlamydia trachomatis genital infection in pregnant women is considerably influenced by some interfering factors including Age, Socioeconomic status, Geographic region, and Individual behaviors. Thus, the implementation of more comprehensive health programs for prevention, screening, and treatment seems necessary, especially for high-risk pregnant cases.

Chronic disease risk factors among hospital employees: A cross-sectional study in Türkiye.

Chronic diseases have become a significant public health problem with the prolongation of human life. There are four main behavioral risk factors for mortality. This study evaluated the significant risk factors for chronic diseases in university hospital employees. The cross-sectional study population consisted of hospital employees working at Gazi University Hospital for at least one year. The sample size was calculated to be 285, with a 100% response rate. The study's independent variables were age, gender, educational status, working department, and presence of chronic diseases. Dependent variables were smoking, alcohol use, physical inactivity, and body mass index (BMI) categories. Data on participants' characteristics, habits, and behaviors were obtained from the hospital system or with open-ended questions. Their body weight and height were measured. The International Physical Activity Questionnaire (IPAQ) was used to assess physical inactivity. The smoking prevalence of hospital employees was 41.8%. Regular alcohol use was 19.3%. Based on the BMI values obtained, 37.9% of the participants were pre-obese, and 18.2% were obese. According to the results of the IPAQ, 13.7% were inactive. The prevalence of smoking was 50.4%, alcohol consume 11.6%, physical inactivity 50.4%, and overweight 65.3% among those who graduated from high school or lower. In contrast, the prevalences were 35.4%, 25.0%, 69.5%, and 49.4%, respectively, among those who graduated from university or higher. A one-unit increase in age of participants without chronic disease increased BMI by 1.06 times (p<0.05). When individuals with a high school education or lower are taken as the reference group, it was found that physical inactivity is 1.78 times higher among those with a university degree or higher (p<0.05). The effect of education level on health habits and behaviors should be considered in terms of the target group and content of preventive health programs and awareness-raising studies.

Evaluation of the Knowledge, Attitude, and Practices toward Scabies among Hopsotial Outpatients in Jalalabad City, Afghanistan

Background: Scabies is widespread skin disease in tropical and subtropical areas and is particularly prevalent in developing regions with low socioeconomic conditions. Scabies can be effectively prevented with proper education. Therefore, this study aimed to determine the level of knowledge, attitude, and practices toward scabies among hospital outpatients in Jalalabad City, Afghanistan. Materials and Methods: A cross-sectional study was conducted on 442 individuals who visited the adult outpatient departments (OPD) at public and private health facilities for various health services from August 1 to November 15, 2023. A non-probability convenience sampling technique was used to select study participants, and data was collected through structured questionnaires. The data was then analyzed using the statistical package for social sciences (SPSS) version 27. Findings: In this study, a total of 442 participants were enrolled; 67.6% of them were male and 32.4% were female. Regarding knowledge, half of the participants had heard about scabies, and more than 70% were aware of its signs and symptoms. The majority of respondents (52%) had a moderate level of knowledge about scabies, while 24% had poor knowledge and 24% had good knowledge. The respondents’ attitudes were generally good and their practices were moderate. The study showed a statistically significant relationship between the knowledge score and demographic variables, such as gender, educational level, and family income. Conclusion: The study concluded that, overall, participants reported moderate knowledge of scabies. Additionally, the respondent’s knowledge about scabies is somewhat influenced by their demographic factors. Thus, there is a need for enhanced health education, awareness initiatives, and preventive programs to improve community knowledge and support the implementation of effective prevention measures.

Frailty, social deprivation, and mortality among Medicare fee-for-service beneficiaries.

The geographic distribution of frailty and social deprivation, and their association with mortality in the United States, have not been well studied. We estimated claims-based frailty index (CFI) (range: 0-1) and area-level social deprivation index (SDI) (range: 0-100) in a 5% random sample of 1,207,323 Medicare fee-for-service beneficiaries 65 years and older. We examined the prevalence of frailty (defined as CFI ≥ 0.25) and the mean SDI and estimated their correlation by state and county. The association of frailty and social deprivation with one-year mortality was estimated using logistic regression, adjusting for age, sex, and dual eligibility status. The study population had the following characteristics: mean age of 76 years, 56% female, 10.3% with frailty, and 24.0% with high social deprivation (SDI ≥ 67). The correlation between frailty and social deprivation was weak (ρ = 0.39 by state and 0.28 by county). The risk of death for the total study population was 4.5%. The age, sex, dual eligibility, and SDI-adjusted risk of death for robust, pre-frail, and frail individuals was 1.8%, 4.4%, and 13.3%, respectively. The age, sex, dual eligibility-adjusted risk of death for low, medium, and high SDI regardless of frailty was 4.4%, 4.7%, and 4.6%, respectively. In robust beneficiaries, the adjusted risk of death for low, medium, and high social deprivation was 1.6%, 1.9% (odds ratio [OR]: 1.21 [95% confidence interval, CI: 1.15, 1.27]), and 2.0% (1.31 [1.24, 1.38]), respectively, whereas in beneficiaries with frailty, the corresponding risk by social deprivation was 13.4%, 13.7% (1.03 [0.99, 1.07]), and 12.9% (0.96 [0.92, 1.00]). This study identifies regions of the United States that may be most vulnerable from frailty and social deprivation. These findings emphasize the significance of frailty and social deprivation on mortality and the need for community-based preventative health programs such as frailty screening to improve health outcomes for Medicare beneficiaries living with frailty.

Barriers and facilitators to the use of mental health prevention programs among preschool- and elementary school-aged children

Emotional and behavioural problems occur frequently in childhood and are usually associated with burdens on children, families, and society. Preventive interventions could reduce these burdens, but are rarely used despite their availability and effectiveness. The aim was to identify general, individual, structural, and family-related barriers/facilitators to potential and actual participation in prevention programs. As part of a prospective implementation study, n = 3,231 project folders were handed out to parents in 28 paediatric practices in Dresden and surrounding area during routine health check-ups (U9-U11) for children aged 5 to 10 years. In addition to screening for mental health problems, a questionnaire was used to identify potential barriers/facilitators to participation in prevention programs. Of n = 2,844 families agreeing to participate in the study n = 2,122 (74.6 %) completed the questionnaire at least partially. Regression analyses were used to test associations between potential barriers/facilitators and actual participation in (a) a pre-intervention interview (PII; in order to check indications with the program provider) or (b) the prevention program among children with a prevention recommendation. Of the participating families, 1.8 % reported that they had already participated in a prevention program to improve mental health or had received a recommendation for it before. 59.5 % of the families expressed their general interest in such programs, and 95.7 % would participate if their paediatrician recommended it. At the structural level, a lack of knowledge about mental health prevention programs was identified as a barrier to potential participation; as only 9.2 % of the families were aware of such programs before participating in the study. 65.8 % of all the families considered full reimbursement of the participation fees after paying in advance a prerequisite for their potential program participation, and 56.7 % wanted to receive a voucher from their health insurance fund entitling them to participate without prepayment. At the individual level, the parents' attitude towards the usefulness of prevention programs predicted the actual utilisation of the PII after the paediatrician's recommendation. At the structural level, the acceptance of longer travel times (up to 60 minutes) as well as the assumption/reimbursement of the entire course fees were relevant predictors. Furthermore, male sex (of the children) and higher screening scores were also important predictors at the family-related level. After the PII, the only factor associated with actual participation in prevention programs was efficient public transport accessibility. In order to increase participation in prevention programs, funding to cover participation fees should be secured through health insurance funds. In addition, advertising and educational measures in the public as well as by paediatricians in the context of screening could raise the awareness of and improve attitudes towards useful programs. Implementing the programs in children's environments could reduce structural barriers and create equal opportunities for participation.

Prevalence of depression and anxiety among university students in Jeddah, Saudi Arabia: exploring sociodemographic and associated factors.

Previous studies have shown that mental health issues such as depression and anxiety are on the rise globally, particularly among university students. The aim of this study is to assess the prevalence of depressive and anxiety symptoms among university students, and the associated potential risk factors, in Jeddah, Saudi Arabia. A cross-sectional questionnaire study was conducted in a sample of 728 students who anonymously completed three sets of questionnaires: a sociodemographic and lifestyle information questionnaire, the Patient Health Questionnaire-9 (PHQ-9) to screen for depressive symptoms and the Generalized Anxiety Disorder-7 (GAD-7) scale to screen for anxiety symptoms. In a survey of 728 students, 81.5% reported depression and 63.6% anxiety, with no difference between medical and non-medical majors. Regular exercise, a history of psychological disorders, a diagnosis of chronic illness, and the use of antidepressant medications were significant indicators of depression. Significant anxiety markers included female gender, a diagnosis of chronic illness, a history of psychological disorders, the use of antidepressant medications, and smoking. Surprisingly, we did not observe any significant differences between the prevalence of depression or anxiety symptoms and common risk predictors, such as poor academic performance, low family income, and year of study. Depression and anxiety had a high prevalence among undergraduates, regardless of their field of study; therefore, we recommend the implementation and expansion of community-based mental health prevention programs and mentorship programs. Universities with counseling programs should identify and eliminate factors that contribute to depression and anxiety.

Pesticide Exposure and Cancer Risk: A Cross-Sectional Study on Farmers in Nakhon Sawan, Thailand

Introduction Cancer is a leading cause of disease burden worldwide. Although much of the existing literature, primarily from Western countries, suggests an association between pesticide exposure and cancer risk, these findings may not be directly applicable to the Thai population. This is due to differences in social, economic, and public health contexts, as well as variations in health status, pesticide use patterns, and self-protection behaviors. This study aimed to investigate the relationship between pesticide exposure and cancer risk among Thai farmers. The findings are expected to contribute valuable insights for public health prevention and control programs, as well as enhance the existing body of literature. Methods In this cross-sectional study, data were collected from 10,646 farmers aged 20 years and older through in-person interviews using a structured questionnaire. The association between pesticide exposure and cancer was analyzed using logistic regression, adjusting for potential confounding factors. Results The study identified a significant association between the historical use of pesticides, including insecticides, herbicides, and fungicides, and cancer risk. Among 39 individual pesticides examined, sixteen were found to have a significant odds ratio. The study’s results aligned with existing literature regarding the potential effects of glyphosate, paraquat, 2,4-D, folidol, chlorpyrifos, EPN, mevinphos, dichlorvos, endosulfan, dieldrin, mancozeb, maneb, and copper sulfate. Additionally, this study newly identified a significant association with propineb (OR = 2.41, 95% CI: 1.39–4.17), carbendazim (OR = 1.77, 95% CI: 1.11–2.81), and benomyl (OR = 4.04, 95% CI: 1.69–9.63). Conclusion The study found cancer prevalence among farmers in Nakhon Sawan, Thailand, to be associated with historical pesticide use. These findings aligned with existing literature, underscoring the potential effects of long-term pesticide exposure on cancer risk. This issue warrants increased public attention and stricter regulation of pesticide use. An effective exposure prevention program should be urgently implemented, particularly for Thai farmers.

Factors Influencing School‐Based Mental Health Program Selection: Insights From Educational Stakeholders

ABSTRACTSchool mental health programs are an important component of the national response to the current student mental health crisis. However, evidence‐based programs often face numerous barriers to their selection, scale‐up, and sustainability in real‐world settings. In this study, we interviewed 15 educational stakeholders to examine what influences their selection of school‐based mental health programs. Interviews focused on factors influencing the selection and sustainability of mental health programs in schools. We coded transcribed interview data using a hybrid, iterative process, and generated themes from these codes. We identified five categories of themes related to key decision‐making criteria: program fit with student and school needs, evidence of program effectiveness, stakeholder buy‐in, logistical considerations for staff delivering programs, and cost and resource requirements. Findings have implications for researchers who wish to improve dissemination strategies for school‐based mental health prevention programs and for policymakers who wish to shape funding priorities to support greater diversity in program availability. Findings are also useful to practitioners who may use these insights to reflect on their own program selection practices or may see their own experiences reflected and normalized through the lens of the key themes presented here.

The use of a benign fast-growing cyanobacterial species to control microcystin synthesis from Microcystis aeruginosa.

Microcystis aeruginosa (M. aeruginosa), one of the most prevalent blue-green algae in aquatic environments, produces microcystin by causing harmful algal blooms (HAB). This study investigated the combined effects of nutrients and cyanobacterial subpopulation competition on synthesizing microcystin-LR. In varied nitrogen and phosphorus concentrations, cyanobacterial coculture, and algicidal DCMU presence, the growth was monitored by optical density analysis or microscopic counting, and the microcystin production was analyzed using high-performance liquid chromatography-UV. Furthermore, growth and toxin production were predicted using MATLAB. First, coculturing with a fast-growing cyanobacterium Synechococcus elongatus UTEX 2973 (S. elongatus) reduced M. aeruginosa biomass and microcystin production at 30oC. Under high nitrogen and low phosphorus conditions, S. elongatus is mostly effective, with up to 94.7% and 92.4% limitation of M. aeruginosa growth and toxin synthesis, respectively. Second, this biological strategy became less effective at 23oC, where S. elongatus grew slower. Third, photosynthesis inhibitor DCMU (3-(3,4-dichlorophenyl)-1,1-dimethylurea) hindered M. aeruginosa growth (at 0.1 mg/L) and microcystin production (at 0.02 mg/L). DCMU was also effective for controlling microcystin production in S. elongatus-M. aeruginosa cocultures. Based on experimental results, a multi-substrate, multi-species kinetic model was built to describe coculture growth and population interactions. Future research should examine more complex models to further develop and refine to facilitate the derivation of more effective recommendations for health prevention programs, particularly for mothers and girls.

Work ability and psychosocial work stress - predictors of retirement intention among older teachers.

Many teachers worldwide retire early for health or personal reasons. Predictors could help to identify teachers at risk in order to counteract this development. The study therefore investigates whether the intention to retire can be predicted by work ability, psychosocial work stress and work behaviour. The data came from a representative cross-sectional study of German secondary school teachers (N = 18 971). The analyses included 1496 full-time teachers aged ≥50 years (58% female). Teachers were assigned to 1 of 2 groups based on their intention to take early or regular retirement. A binomial regression model was used to analyze the predictive power of the intention to retire for the following factors: work ability index (WAI) - factor 1, effort-reward ratio (ER ratio), overcommitment (OC), age and gender. In addition, a qualitative analysis of the teachers' suggestions was carried out regarding which measures would make the regular retirement age attainable. Half (49%) of the teachers intended to retire early, with the proportion of women being around twice as high (67%) as men (33%) (d = 0.37). The analyzed predictors explained a total of 22% of the variance. The WAI factor 1 proved to be the most important predictor (variance explanation: 14%). Effort-reward ratio and OC each contributed around 10% to the variance explanation of the retirement intention. The probability of taking early retirement increased with decreasing work ability, increasing ER ratio and a high tendency to overcommit; age and gender were of secondary importance. Teachers suggested a reduction in compulsory hours (46%), relief from extracurricular tasks (45%) and smaller classes (29%) as decisive measures for achieving regular retirement. Work ability index factor 1, ER ratio and OC could be used as part of occupational health prevention programmes to identify and advise older teachers at risk who need support. Int J Occup Med Environ Health. 2024;37(5).

Engaging and Recruiting Latino‐led Community Organizations to Build Workforce Capacity in AD/Brain Health Prevention Research

AbstractBackgroundAD prevention and early detection are crucial to reduce prevalence projections in Latinos. Despite these projections, our community partners in Los Angeles County continue to disclose barriers in accessing culturally and linguistically congruent bilingual programs activating behavioral modifications for AD prevention and early identification of cognitive changes. In this study, we partnered with community organizations to co‐design and pilot a brain health prevention program tailored to the needs of their constituents.MethodWe used a mixed‐methods design using quantitative data from surveys, and qualitative data from informal short interviews in Spanish and English with Latino community organizations and their constituents. We implemented Community‐Based Participatory Research (CBPR) and Human Centered Design (HCD) principles, anchoring the program in the cognitive reserve theory, tailored to cultural values, traditions, and needs of Latinos in Los Angeles County. Spanish and English‐speaking Latino members requested brain health and early detections materials easy to comprehend. Four Spanish and English brochures were designed. We also design a communication training toolkit to improve delivery of the program from our research team, employing oral storytelling techniques with cultural metaphors explaining brain structure/functions and cognitive functioning/decline.ResultsBetween June and December 2023, our team received invitations to participate in 11 community engagement and outreach events across Los Angeles County. A team of 3 bilingual trained research assistants engaged with approximately 475 Spanish and English‐speaking community members with an average of 43 individuals per event. Average distance traveled averaged 37 miles roundtrip total per event. Total printing cost per event was approximately $292, with an additional $30 for giveaways. In the 6 months of implementation, a total of thirty community‐based organizations requested formal presentations and trainings for their staff. Overarching qualitative themes included the community‐centeredness of the program, it’s cultural, linguistically and health literacy appropriateness, and the culturally competent communication skills showcased by bilingual research staff.ConclusionFollowing CBPR, and HCD principles, we showed respect for community needs, while empowering the members to be an integral part of the design and pilot. Our approach engaged and recruited 30 Latino‐led community organizations interested in building their own workforce capacity in brain health prevention and early detection.

Participation in Tobacco Cessation Programs Among Medicaid Managed Care Enrollees in Florida.

Background/Objectives: Tobacco use remains a significant public health issue, particularly among individuals with low incomes, including Medicaid recipients who often face multiple barriers to quitting. This study aimed to identify barriers, from the perspective of Medicaid managed care organizations (MCOs), influencing Medicaid recipient participation in tobacco cessation programs. Methods: Focus group interviews were conducted with Florida Medicaid MCOs to elicit processes for case identification, outreach, referral, program participation, and incentives. Answers were synthesized into themes. Results: Medicaid recipients were primarily identified through nicotine dependency claim codes or Health Risk Assessments (HRAs). Individuals were referred to state and local community tobacco cessation programs through text messaging and outreach by MCO case managers. The MCOs identified the following as barriers: primary care physicians (PCPs) with limited knowledge about cessation programs and pharmacologic treatments for nicotine dependence, low availability of health coaches, long wait times for entry into cessation programs, weak coordination between MCOs and cessation programs, and insufficient incentives for individuals for program participation. Suggested strategies to overcome barriers were continuing medical education (CME) for PCPs about tobacco cessation programs and prescription therapies, increasing the training of health coaches, more investment in quitlines, increasing data sharing between MCOs and cessation programs, and increasing incentives for individuals. Conclusions: These findings highlight the importance of engaging MCOs in discussions about policy and program improvements, as their insights can drive meaningful changes in how tobacco cessation and other preventive health programs are structured and implemented. Targeted interventions are needed to enhance tobacco cessation program participation among Medicaid recipients.

Emotional Risk Factors, Rumination, and Self-Criticism in Relation to Suicidal Ideation Among Chinese Depressive Outpatients.

Previous studies indicated that individuals with major depressive disorder (MDD) are at high risk of suicide, making the identification of risk factors in suicidal depressive outpatients essential for developing effective prevention and treatment strategies. This study aims to (1) identify emotional risk factors and (2) examine the relationship between cognitive markers-including rumination and self-criticism-and suicidal ideation among depressive outpatients. A total of 165 Chinese clinical outpatients with depression were recruited from local hospitals in Hong Kong. In our sample, 68% of patients with moderate depression and 87.5% of patients with severe depression reported experiencing suicidal thoughts. The results from the logistic regression revealed a significant interaction between rumination and self-critical thoughts in relation to suicidal ideation. Specifically, the ruminative patients with self-critical thoughts were more likely to have suicidal thoughts than those without self-critical thoughts. These findings align with the cognitive model of suicide, suggesting that maladaptive information processing and negative cognitive content are associated with an increased risk of suicide. The current findings have clinical implications for the future development of more specific and accurate mental health assessment, preventive programs, and psychotherapies for depressive outpatients.

Investigation of prevalence of substance use disorders using direct and indirect methods and factors affecting initiation of substance use

ABSTRACT Background Substance Use Disorders (SUDs) are among some of the major health problems in different societies, especially in Iran, resulting in devastating outcomes. This study was conducted to investigate the prevalence of SUDs using both direct and indirect (network scale-up (NUS) and cross-wise model (CM) methods and to identify the factors affecting initiation of substance use. Methods The study was conducted among people aged 15–69 years in Kermanshah, Iran, with a total of 6127 people selected utilizing a stratified sampling method. Results The prevalence of SUDs was estimated at 3.85% by direct CM, 11.05% by indirect CM and 10.07% by NUS. The results of multivariate logistic regression revealed that the most important factors in increasing the chance of substance use were history of substance use in the family, mental diseases, poor economic status, and age group of 31–45 years. Conclusion Regarding the almost three-fold prevalence of indirect methods for estimating the prevalence of SUDs compared to direct methods on the one hand and the high prevalence of substance use in the province on the other, special prevention health programs are required by considering the groups at risk.

Impact of the COVID-19 Pandemic on Oral Health Behaviors Among Children in Iran.

Parents are responsible for their children's oral health. This study evaluated parents' knowledge, attitudes, and performance on their children's oral health before and after an educational intervention and the impact of COVID-19 on these variables. This quasi-experimental study included 227 children aged 6-8 years who were referred to 11 Shiraz medical centers from July to December 2021. Data were collected from questionnaires and interviews. After completing the questionnaire, oral health education was provided immediately and then monthly thereafter using dental models and pamphlets. After 3 months, a questionnaire assessed the education's effectiveness. Data were analyzed using independent t-tests, one-way analysis of variance (ANOVA), paired t-tests, and Pearson's correlation. A total of 163 participants (71.80%) completed all phases, including the second questionnaire. Participants showed moderate knowledge (77.30%), attitude (89.00%), and performance (80.40%). Neither knowledge nor attitude before the intervention had a significant association with demographic characteristics. Parents' education, number of children, and maternal employment were significantly associated with performance (p = 0.002, p = 0.040, p < 0.001, respectively). The intervention significantly enhanced these variables (p < 0.001). In terms of COVID-19, 72.40% of participants expressed good knowledge about transmission, 52.80% showed moderate concern, and 54% had poor performance. Parental knowledge, attitude, and performance changed significantly following the intervention (p = 0.030, p < 0.001, p < 0.001, respectively). Educational intervention significantly improved parents' knowledge, attitudes, and performance toward children's oral health. Because of the poor performance of parents during the COVID-19 pandemic, we recommend the implementation of continuing education and preventive oral health programs.