Prevention Programs Research Articles

Understanding Injuries in Young Female Soccer Players: A Narrative Review on Incidence, Mechanism, Location Risk Factors, and Preventive Strategies

There has been growing interest in understanding the injury profiles of young female soccer players due to their increasing participation in the sport and the unique risk factors they face. This narrative review examines the incidence, mechanisms, and location of injuries in this population, alongside the primary risk factors and effective preventive strategies. Injury incidence is higher during matches than in training sessions, with contact injuries dominating in games and non-contact injuries prevailing in practice. Knee and ankle injuries are the most prevalent, with anterior cruciate ligament (ACL) injuries being particularly concerning due to their frequency and long-term impact. The interplay of intrinsic factors, such as hormonal fluctuations, anatomical characteristics, and biomechanics, with extrinsic factors like training load, surface type, and footwear significantly influences injury risk. Prevention programs, particularly those combining neuromuscular, balance, and strength training, demonstrate high efficacy, provided that adherence is maintained. Moreover, fostering awareness among players, coaches, and stakeholders about psychosocial factors and menstrual health further enhances injury prevention. Tailored strategies addressing the specific needs of young female soccer players are crucial to ensuring their safety, optimizing performance, and supporting their long-term athletic development.

The crucial importance of preventive and cardiac rehabilitation programmes in patients with atrial fibrillation: AF-CARE units.

The crucial importance of preventive and cardiac rehabilitation programmes in patients with atrial fibrillation: AF-CARE units.

Disordered Eating in Emerging Adults: A Narrative Review and Recommendations for Prevention

Emerging adulthood is a critical developmental period during which individual, social, and professional changes occur. Among the psychopathological disorders that can appear during this period, disordered eating is a major risk. This narrative review provides an overview of the risk and protective factors of disordered eating. Recommendations intended to promote an appeased relationship with food and a positive body image within young adults are then proposed. The originality of this prevention approach is the promotion of protective factors, not only risk reduction. This paradigm shift allows young adults to learn positive skills, allowing for awareness of internal needs and external demands in a non-judgmental manner. Coupled with the implementation of self-care behaviors, this permits a balance between their internal system and the environment, gradually reaching flourishing. This is promising for the future implementation of prevention programs targeting the development of protective factors of disordered eating in young adults.

Injury Prevention Strategies in Female Football Players: Addressing Sex-Specific Risks

There has been rapid growth in women’s football worldwide; however, research on injury prevention strategies and physiological considerations specific to female athletes remains insufficient. Women’s football has experienced an increase in injury prevalence, despite being underrepresented in sports literature, with less than 25% of research focused on this demographic. The incidence of injuries, particularly among young elite female footballers, is notably high, impacting long-term health outcomes such as osteoarthritis and contributing to shorter playing careers. Certain injuries, such as anterior cruciate ligament (ACL) ruptures, occur at significantly higher rates in women compared to men, underscoring sex-specific risk factors that must be addressed in injury prevention programs (IPPs). This narrative review aims to evaluate the effectiveness of IPPs tailored for female football players and to address their heightened susceptibility to injuries compared to males. Research studies and review articles were identified using a literature search of the PubMed, SportDiscus, and Google Scholar databases from 1990 to December 2024. Biological factors, including hormonal influences—such as increased ACL laxity during the menstrual cycle—and musculoskeletal differences, such as muscle strength imbalances, reduced joint stability, and hip weakness, significantly contribute to this increased risk. Despite the existence of injury prevention protocols like FIFA 11+, their consistent application and adaptation to meet the unique needs of female footballers remain limited. In addition to physical injuries, mental health is a critical concern. Female football players exhibit higher rates of depression and anxiety compared to their male counterparts, influenced by factors such as injury-related stress and menstrual cycle variations. In conclusion, the growing participation of women in football highlights the urgent need for research and implementation of injury prevention strategies specifically tailored to female players.

Factors that influence the adoption of a school-based eHealth alcohol prevention program among Spanish personnel: a mixed methods study

BackgroundEvidence-based research has shown that using eHealth interventions effectively reduces risk behaviors such as alcohol consumption, a public health problem worldwide. However, despite its benefits, there has been a poor intention to adopt such innovations, and limited resources exist to understand factors influencing the uptake decision to use school-based eHealth alcohol prevention programs. This study aims to identify the factors that influence the adoption of a computer-tailored eHealth alcohol prevention program among school personnel in Spain.MethodsA cross-sectional study employing an exploratory sequential mixed methods research design was carried out. First, interviews were conducted with ten Spanish school counselors to assess factors influencing the adoption of the school-based eHealth program by exploring participants' awareness and salient beliefs concerning attitudes, social influences, and self-efficacy. Second, an online quantitative questionnaire was developed based on the qualitative research findings. Third, the new questionnaire was administered to Spanish school personnel (N = 100), including the school management team, school counselors, and teachers. Rogers' Diffusion of Innovations theory and the Integrated Change Model frameworks were used as theoretical bases for understanding the adoption process.ResultsSchool personnel with a strong intention to adopt the program (intenders) perceived significantly more advantages and positive innovation attributes, than those participants with a weaker intention to adopt (non-intenders). Intenders perceived a higher personal relevance and responsibility towards using the program, more self-efficacy (e.g., ability to understand, manage time and incorporate the program) and positive social influences from their colleagues, as well as greater willingness in preparing action plans, such as monitor students’ alcohol consumption and discussing the program with coworkers, than the non-intenders group. Advantages and social support were found to explain a significant portion of the variance in the adoption intention.ConclusionsThis study suggests that health intervention researchers should develop strategies to enhance educators' pro-innovation attitudes, personal relevance and responsibility, and perceived ease of use towards adopting an eHealth program. Furthermore, our results highlight that fostering school personnel's acceptance of the intervention and planning goal-oriented actions are crucial elements in optimizing adoption promotion of eHealth programs in school settings.

Sleep duration in adolescence buffers the impact of childhood trauma on anxiety and depressive symptoms.

Childhood trauma is a pervasive issue contributing to adverse mental health outcomes. Obtaining optimal sleep supports healthy development and protects against mood-related disorders. Whether sleep serves as a potential buffer between trauma and adverse mental health outcomes holds promise for informing targeted interventions and prevention for adolescents. Data were drawn from the baseline assessment of a randomised controlled trial of a mental health prevention program. A total sample of 752 adolescents completed an online, self-report survey in 2023. Participants were students (Mage=13.8 years), attending independent schools in Australia and comprised of 37% girls and 60% boys. Australian sleep guidelines were used to dichotomise nightly sleep duration into whether adolescents met, or did not meet, the sleep guidelines for their age. Mixed-effects linear regression was used to examine whether sleep moderated the association between trauma and symptoms of anxiety, depression, and mental wellbeing. The majority of participants (82%) reported exposure to at least one traumatic event. The mean number of traumatic events was 1.8. Trauma was independently associated with higher depressive and anxiety symptoms and lower mental wellbeing scores. Those reporting exposure to one or more traumatic events were more likely to report difficulties falling asleep and less likely to report meeting nightly sleep duration guidelines. We found a significant interaction between meeting nightly sleep duration guidelines and any trauma exposure on depressive and anxiety scores, such that depression and anxiety symptoms were lower in trauma-exposed adolescents who met sleep duration guidelines compared to those who did not meet sleep guidelines. Obtaining optimal amounts of sleep each night may help mitigate anxiety and depressive symptoms for non-clinical adolescents exposed to trauma, however, longitudinal research is needed to confirm the directionality of the relationships between trauma, sleep, and mental health symptoms. Future research should examine the effectiveness of public health interventions targeting sleep behaviours in adolescents to promote mental wellbeing.

Head, Hands, Knees and Ankles, Knees and Ankles: Injury Profiles of Women and Girls Playing Community Australian Football.

Women's participation in all football codes (including Australian Football [AF]) is increasing rapidly. To guide injury prevention strategies, the authors aimed to describe the current and lifetime prevalence of significant musculoskeletal injuries and concussions for women and girls playing community AF. Women will have high rates of injury associated with playing AF. Cross-sectional survey. Level 3. Participants were Victorian community AF players from 165 participating teams (<16 years, <18 years, senior women's). Demographics, injury prevalence, and health outcomes are reported descriptively. To explore relationships between sociodemographic factors and anterior cruciate ligament (ACL) injury history, the authors fitted univariate logistic regression models. Independent variables were age, body mass index, number of career AF games, sport experience, location (metropolitan/regional), and socio-economic index. A total of 2435 players (95% of players enrolled in the trial), aged 24 ± 7 years completed the survey. One-quarter (n = 619, 25%) reported a current injury, and half (n = 1238, 51%) reported a previous significant injury. The most common injury sites were knee (n = 160 26% current, n = 403 33% previous), ankle (n = 130 21% current, n = 427 35% previous), and hand/fingers (n = 100 16% current, n = 317 26% previous). Self-reported previous ACL injury (n = 139, 6%) and concussion (n = 1335, 55%) were also prevalent. Increasing age (odds ratio [OR], 1.07; 95% CI, 1.05-1.09) and more career games (OR, 2.22; 95% CI, 1.24-3.97) were associated with ACL injury history. Women and girls playing community AF reported high rates of significant injury. Injury prevention programs should target the most prevalent injury sites: head (concussion), ankle, knee, and hand/fingers. These findings highlight high injury rates for women playing AF and will be invaluable in shaping injury prevention strategies.

Sex differences in secondary prevention needs and recommendations among patients with spontaneous coronary artery dissection.

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of heart attacks, particularly for female patients; however, approximately 10% of cases occur in male patients. While male and female differences pertaining to clinical outcomes and treatment protocols have been addressed in the literature, research is limited on sex differences in secondary prevention programming, such as cardiac rehabilitation. Cardiac rehabilitation is recommended for patients with SCAD to promote physical and mental recovery. This letter highlights sex-specific gaps in existing programming and reports patients' suggestions for enhancing the recovery of this unique patient population.

Effectiveness of PEER Intervention on Older Adults’ Physical Activity Time Series Using Smoothing Spline ANOVA

Falls are a major cause of injury among older adults. The Physio-fEedback Exercise pRogram (PEER) combines physio-feedback, cognitive reframing, and guided exercises to reduce fall risk. However, its impact on physical activity (PA) over time is underexplored. Functional time-series analysis offers insight into behavior patterns and sustainability. This preliminary study assessed PEER’s effectiveness in improving PA levels immediately and over time. A total of 64 community-dwelling older adults were cluster-randomized into PEER (N=33) or control groups (N=31). Participants wore Fitbit trackers, generating time-series data on activity. The PEER group completed an 8-week program, while the control group received CDC fall prevention pamphlets. PA data were analyzed using smoothing spline analysis of variance (SSANOVA), chosen for its flexibility in modeling complex, non-linear relationships in time-series data and its ability to handle skewed distributions and repeated measures. Unlike traditional parametric models, SSANOVA decomposes temporal trends into interpretable components, capturing both smooth trends and abrupt changes, such as those occurring on group workout days. This capability ensures robust and nuanced analysis of intervention effects. Results showed PEER participants significantly increased evenly and had very active minutes and reduced sedentary behavior during the intervention. No significant effect was found for light active minutes. Specifically, during the intervention period, PEER participants engaged in an average of 6.7% fewer sedentary minutes per day, 13.8% additional fairly active minutes per day, and 2.8% additional very active minutes per day compared to the control group. While the reduction in sedentary minutes and increase in fairly active minutes were not statistically significant, the increase in very active minutes was significant. However, our functional time-series analysis revealed these improvements diminished over the 15-week follow-up, indicating challenges in maintaining PA. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. Public health policies should emphasize technology-driven fall risk assessments, community-based prevention programs, and initiatives that promote physical activity, home safety, and chronic condition management.

A comparison of video and live performance approaches in a school-based sexual abuse prevention program

ABSTRACT This study examines the impact of delivery modes (live vs. video) in a school-based child sexual abuse (CSA) prevention program for second to fifth grade children. The program uses musical theater to teach five primary safety lessons. Findings show no significant difference in comprehension between live and video groups, both exceeding benchmark scores. Theater-based CSA prevention enhances safety knoweldge. Video recorded prevention programs with adequate teacher preperation can provide a flexible and effective approach for school-based CSA prevention. In a post COVID-19 world, CSA prevention programs must adapt to the ever-changing educational landscape. Future research and limitations are also explored.

A telehealth approach to central line-associated bloodstream infection prevention activities in nursing homes: the SAFER lines program.

To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in nursing home residents with peripherally inserted central catheters (PICCs). Pre-post prospective cohort study with baseline (September 2015-December 2016), phase-in (January 2017-April 2017), and intervention (May 2017-December 2018). Generalized linear mixed models compared intervention with baseline frequency of localized inflammation/infection, dressing peeling, and infection-related hospitalizations. Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection. Six nursing homes in Orange County, California. Adult nursing home residents with PICCs. CLABSI prevention program consisting of an actionable scoring system for identifying insertion site infection/inflammation coupled with a mobile-app enabling photo-assessments and automated physician alerting for remote response. We completed 8,131 assessments of 817 PICCs in 719 residents (baseline: 4,865 assessments, 422 PICCs, 385 residents; intervention: 4,264 assessments, 395 PICCs, 334 residents). The intervention was associated with 57% lower odds of peeling dressings (OR 0.43, 95% CI 0.28-0.64, P < .001), 73% lower local inflammation/infection (OR = 0.27, 95% CI: 0.13-0.56, P < .001), and 41% lower risk of infection-related hospitalizations (OR = 0.59, 95% CI: 0.42-0.83, P = .002). Physician mobile-app alerting and response enabled 62% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.38, CI: 0.24-0.62, P < .001) and 95% faster removal of infected lines from mean (SD) 19 (20) to 1 (2) days. A mobile-app-based CLABSI prevention program decreased the frequency of inflamed/infected central line insertion sites, improved dressing integrity, increased speed of removal when inflammation/infection were found, and reduced infection-related hospitalization risk.

Metabolic control and its associated factors in type 1 diabetic people: longitudinal trajectory modeling

BackgroundDiabetes is a chronic disease, and hyperglycemia can increase the risk of diabetic complications and the need for more inpatient services. Therefore, the prevention and control of diabetes are important. This study aimed to identify the trajectories of metabolic control and its correlates in people with type 1 diabetes.MethodThis is a longitudinal study with 2020 type 1 diabetic individuals aged 18 to 59 years. The participants’ glycosylated hemoglobin (HbA1c) was measured three times with a six-month interval between each measurement. The data were analyzed using group-based trajectory modeling. Multinomial logistic regression was used to determine the factors related to these groups.ResultsThe results showed four trajectories of safe controlled (46.2%), moderate stable risk (28.7%), moderate increasing risk (12.5%), and high decreasing risk trajectory (12.6%) (entropy = 0.70). The results of multinomial logistic regression showed dyslipidemia could increase the odds of being in the three risk trajectories. Education, physical inactivity, and poor psychological status could also increase the odds of being in the moderate stable and high decreasing trajectories. Moreover, sex, job, and BMI could increase the odds of being in the high decreasing risk group (p < 0.05).ConclusionSince there are different trajectories of metabolic control of diabetes, it is necessary for healthcare providers and health experts to plan behavioral interventions based on the location of individuals in different trajectories and the related significant risk factors. In this way, appropriate prevention, care, and treatment programs can be provided for the people in each group.

Physical training in a comprehensive program of prevention and treatment of sarcopenia in geriatric patients

Muscles play an important role in daily activities. In a healthy person, skeletal muscles make up about 40% of the total body weight and contain 50-75% of all body proteins. During aging and/or in the presence of concomitant risk factors, there is a loss of strength, mass and function of skeletal muscles. Sarcopenia is widespread among older people and is associated with an increased risk of adverse outcomes, including falls, decreased functionality, frailty and mortality. Lack of physical activity in old age is an important risk factor for sarcopenia. Therefore, physical activity is the main method of preventing and slowing the progression of age-related sarcopenia. Although physical activity cannot completely suppress the process of sarcopenia and age-related deterioration of muscle function, physical training can delay the onset of sarcopenia and reduce its severity. This literature review provides up-to-date information on the physiological, biochemical, and hormonal effects of exercise. The main types of physical activity that can be used for the prevention and treatment of sarcopenia in geriatric patients, the advantages and disadvantages of various types of physical exercise are considered.

Therapeutic prevention of child sexual abuse: the Stand Strong, Walk Tall framework and overview

Approaches to addressing child sexual abuse as a widespread and damaging societal concern are increasingly broadening from a traditional focus on reducing reoffending to pursuing perpetration prevention at an earlier stage. The current paper introduces Stand Strong, Walk Tall (SSWT), a therapeutic secondary prevention programme designed for adults who experience sexual attraction towards children, with an explicit dual focus on enhancing client wellbeing alongside prevention. Here we describe SSWT’s intervention framework, comprising theoretical underpinnings, research-informed targeted needs and intervention philosophy. We further provide an overview of the programme design including protocols for referral and assessment, service parameters such as duration and frequency of client contact, and programme process and content. Therapeutic secondary prevention approaches such as SSWT offer an important addition to comprehensive strategies for addressing child sexual abuse and should be considered by jurisdictions worldwide.

Moving Beyond the Checklist—An Enhanced Approach to Context-Driven Overuse Injury Prevention in Overhead Youth Athletes

The increasing discussions regarding the research-to-practice gap in sport injury prevention have led to a growing focus on the significance of context in injury prevention programs. A context-driven injury prevention program is advantageous to address and enhance injury prevention efforts in specific populations. Considering the prevalent concern for overuse injuries among overhead youth athletes, and the developmental and contextual factors unique to this population, this review introduces the OverHead Youth Athlete (OH-YA) overuse injury prevention process. Tailored to address the challenges of working with overhead youth athletes, the context-specific four-step framework includes the following: (1) development of a context-specific instrument with strong sample representation, (2) determination of the context-specific injury burden magnitude and associated factors, (3) development of a context-specific intervention with end-users, and (4) evaluation of the context-specific intervention. This framework would likely help maximize the use of typically limited resources in youth sports. Using shoulder overuse injuries among overhead youth athletes as a case study, the OH-YA overuse injury prevention process provides an enhanced approach to context-driven overuse injury prevention while illustrating the importance and integration of context to minimize the “research-to-practice” gap.

One-month outcomes of a culturally tailored alcohol-exposed pregnancy prevention mobile app among urban Native young women: A randomized controlled trial of Native WYSE CHOICES.

The majority of alcohol-exposed pregnancy (AEP) prevention programs for Native women have focused on at-risk adult women residing in rural tribal communities; however, over 70% of the Native population resides in urban areas. Moreover, Native young women universally-regardless of risk status-may benefit from culturally tailored resources. We hypothesized that urban Native young women who engaged with Native WYSE CHOICES (NWC), a culturally tailored AEP prevention intervention delivered by mobile phone app, would report reduced risk of AEP at the 1-month follow-up compared to those who engaged with a comparison condition. From August 2021 to January 2023, we recruited 439 urban Native young women (ages 16-20) nationally to a randomized controlled trial administered fully virtually including most recruitment, data collection and intervention engagement. Participants were randomly assigned to the NWC app or an alternative app. We used linear and logistic regression analyses to predict scores on 1-month outcome variables by study arm assignment. Results of regression analyses predicting scores on 1-month outcomes by study arm showed trending intervention effects on measures of AEP knowledge (p = 0.06), alcohol use with sexual activity (p = 0.10), and an AEP risk index (p = 0.12). At 1-month follow-up, intervention group participants reported greater AEP knowledge, lower likelihood of alcohol-involved sexual activity in the past month, and lower scores on an AEP risk index compared to the comparison group. The NWC app produced trending changes in key areas of knowledge and behavior that may result in reduced AEP risk among urban Native young women. These findings suggest that the NWC app holds promise for addressing AEP in Native populations. Small changes in these areas may result in lifelong changes in the current generation that impact the health and wellbeing of generations to come.

7-Year Impacts of a Selective Personality-Targeted Alcohol Use Prevention Program on Alcohol and Mental Health Outcomes

7-Year Impacts of a Selective Personality-Targeted Alcohol Use Prevention Program on Alcohol and Mental Health Outcomes

Rapid Identification of β-Thalassemia, Hb E, and High Hb F Determinants Using a High-Resolution Melting Analysis: Application in Prenatal Diagnosis in Southern Thailand

β-thalassemia (thal), hemoglobin (Hb) E, and high Hb F determinants, which are caused by mutations in the β-globin gene cluster, are common genetic disorders in Thailand and Southeast Asia. Prenatal diagnosis is essential for couples at risk to identify severe forms, including homozygous β-thal and Hb E/β-thal. Conventional methods, including reverse dot-blot hybridization and gap-polymerase chain reaction (PCR) for genotyping of point and large deletion mutations, require post-PCR steps, which are time-consuming and costly. This study aimed to develop a rapid and efficient method using monoplex high-resolution melting (HRM) analysis for genotyping of Hb E and 11 β-thal mutations; multiplex HRM analysis for identifying six deletional mutations, including two β0-thal mutations (3.5 and 45 kb deletion); and a novel method for detecting four high Hb F determinants, namely, δβ0-thal (12.5 kb deletion), HPFH6, Indian inv-del (Aγδβ)0-thal, and Thai del-inv-ins (Aγδβ)0-thal. The developed assays were validated using 182 blinded fetal DNA samples with 41 β-thal genotypes. Different HRM patterns were observed among wild-type, heterozygote, homozygote, and compound heterozygote genotypes. Six deletional mutations showed specific melt curves. This technique demonstrated 100% concordance with conventional methods. The assay showed 100% sensitivity, specificity, and positive and negative predictive values within the limit of detection at DNA concentrations of 8.0 ng/reaction. Finally, this developed assay was efficient in identifying both point mutations and large deletion, convenient, rapid, and cost-effective and did not require post-PCR steps. Thus, this technique has potential for application in prenatal diagnosis of thal and can inform prevention and control programs.

Discussion of HIV and Other Sexually Transmitted Infections With Sex Partners of Nigerian Men Who Have Sex With Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices.

Discussion of HIV and other sexually transmitted infections among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partner's HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria. From 2013 to 2018, we enrolled SGM aged 18+ years in Lagos or 16+ years in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included "have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner. Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%) SGM. Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education [aRR 1.40 (95% CI: 1.24 to 1.58)], who were divorced/separated/widowed [aRR 1.19 (95% CI: 1.06 to 1.33)], who discussed their HIV status with CSP [aRR 1.18 (95% CI: 1.10 to 1.25)], discussed CSP's HIV status [aRR 1.20 (95% CI: 1.13 to 1.27)], and used a condom at last sex with CSP [aRR 1.16 (95% CI: 1.08 to 1.25)]. HIV/STI-related communication with CSP was more common among participants with higher than secondary education [aRR 1.36 (95% CI: 1.12 to 1.66)], who were divorced/separated/widowed [aRR 1.38 (95% CI: 1.13 to 1.69)], who discussed their HIV status with MSP [aRR 1.47 (95% CI: 1.27 to 1.69)], who discussed CSP's HIV status [aRR 1.22 (95% CI: 1.06 to 1.40)], and used a condom at last sex with CSP [aRR 1.22 (95% CI: 1.08 to 1.38)]. HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.

Prevalence and factors related to psychological distress among Ebola survivors and healthcare workers in the Eastern DR Congo.

This article examines for the first-time prevalence and factors associated with psychological distress among Ebola survivors and healthcare workers (HCWs). A representative sample of 563 participants completed the survey (309 survivors; 202 HCWs; 52 survivors/HCWs). Prevalence of psychological distress was higher among survivors (85.25 %) compared to HCWs (51.24 %), and combined group (73.08 %), χ2=69.32, p<.001. Logistic regression models showed that COVID-19 (OR=1.02, 95 %CI: [1.01-1.03], p=.005) and Ebola stigmatization (OR=1.06, 95 %CI: [1.04-1.07], p<.001) were the most important predictors of psychological distress. Significant main effects of social support (B=-.05, p=.001) was observed. This study shows the need of implementing culturally adapted trauma-informed prevention and intervention programs among survivors and HCWs.