Public Health Workers Research Articles

Global alcohol policy implementation in Thailand: A narrative review

Alcohol consumption is growing in emerging economies. Thailand is an upper-middle-income emerging economy in Southeast Asia where the alcohol market has been under an oligopoly, which political groups are attempting to amend. The Thai Ministry of Public Health works in close partnership with the non-profit sector in alcohol control, and has recently adapted the World Health Organization’s (WHO) SAFER initiatives as part of the national alcohol agenda. In light of these ongoing changes, we conducted a narrative review with the following objectives: (1) to describe the development of alcohol control policy strategies in Thailand; and (2) to describe the current situation on alcohol policy implementation. We performed a search of the published and grey literature in both Thai and English languages using keywords related to topics of interest, and reviewed data on SAFER's effectiveness using a group of indicators (policy-attributable health outcomes). We found that Thailand has laws and regulations covering various domains of SAFER. However, gaps do exist with regard to regulation of alcohol outlet density, relatively low alcohol sales permit fees, control of online and surrogate marketing of alcoholic products, and enforcement of drinking-and-driving deterrence measures, among others. A review of the indicators showed that annual per capita alcohol consumption (APC) and prevalence of drinkers have remained constant since 2008, whereas the prevalence of binge-drinking has been on a decline since 2014. However, deaths attributable to alcohol have increased in both men and women. The findings of this narrative review may have implications for policymakers and stakeholders in behavioral health.

The nurse-led equitable learning framework for training programs: A framework to grow, bolster and diversify the nursing and public health workforce

BackgroundAddressing threats to the nursing and public health workforce, while also strengthening the skills of current and future workers, requires programmatic solutions. Training programs should be guided by frameworks, which leverage nursing expertise and leadership, partnerships, and integrate ongoing evaluation. Purpose statementThis article provides a replicable framework to grow, bolster, and diversify the nursing and public health workforces, known as the Nurse-led Equitable Learning (NEL) Framework for Training Programs. The framework has been applied by several multipronged, federally funded training programs led by investigators embedded in an academic nursing institution. MethodsThe NEL framework focuses on: (1) increasing equitable access to the knowledge, skills, and competencies needed to prepare a diverse workforce to deliver effective interventions; (2) fostering academic-practice linkages and community partnerships to facilitate the deployment of newly gained knowledge and skills to address ongoing and emerging challenges in care delivery; and (3) continuously evaluating and disseminating findings to inform expansion and replication of programs. ResultsTen programs using this framework have successfully leveraged $18.3 million in extramural funding to support over 1000 public health professionals and trainees. Longitudinal evaluation efforts indicate that public health workers, including nurses, are benefiting from the programs' workplace trainings, future clinicians are being rigorously trained to identify and address determinants of health to improve patient and community well-being, and educators are engaging in novel pedagogical opportunities to enhance their ability to deliver high quality public health education. ConclusionsTraining programs may apply the NEL framework to ensure that the nursing and public health workforces achieve equitable, sustainable growth and deliver high quality evidence-based care.

Views and opinions regarding e-cigarettes and vaping: a focus group study in South Australia

Background The use of e-cigarettes has become increasingly prevalent and of public health concern. In order to evaluate and plan public health policy, it is important to understand the issue as understood by the community. This study describes the perspectives and views of a small group of South Australian adults who do not use e-cigarettes. Methods A semi-structured focus group interview was conducted, using a question guide to stimulate discussion. Data were analysed using a descriptive qualitative approach. Results Five participants, aged 35-39 years, and one moderator were involved in the focus group. Six themes relating to participant perspectives were developed: Vaping for social reasons, vaping is superior to cigarettes, attraction of vaping, vaping is invasive and pervasive, addiction and impacts of vaping and prevention and cessation of vaping. Conclusion The views of this group add to those of other studies and help provide context for public health workers and policy makers regarding public health messaging, interventions, and legislation regarding vaping.

Relational Approach Towards Decolonizing Curriculum Development within the Colonial Postsecondary Institution

The Canadian academy is dominated by Western epistemologies that devalue Indigenous ways of knowing and marginalize Indigenous communities, cultures, and histories (Louie et al., 2017). This paper draws on a cross-disciplinary, interprofessional collaboration between a School of Public Health Sciences and School of Social Work to develop an online graduate course that sought to advance knowledge and practice in Indigenous wellbeing and health through a social justice lens. We explore key considerations, strategies, and challenges undertaken by an interdisciplinary group of non-Indigenous professors to create a learning experience for students that challenges colonial ways of seeing, being, knowing, and doing in the professional practice fields of public health and social work and that serves to elevate and sustain Indigenous voices, knowledges, sciences, and practices within the academy. In doing so, we centre the process of course development, including working with an Indigenous Advisory Circle and Indigenous contributors of content, guest lecture videos, and artwork. The paper describes the creation of a relational teaching and learning community, while raising concerns about the institutionalization of this approach to Indigenous-focused course development in the absence of the structural changes needed to enhance the presence of Indigenous faculty and Elders in academic institutions.

The Role of Chief Medical officers in making Public Health Overview Documents in Norwegian Municipalities. A qualitative Study

AimsTo investigate how Chief Medical Officers experience their role in the municipalities´ work with making the public health overview documents, demanded by the Norwegian Public Health Act from 2012.MethodsA qualitative study with semi-structured focus group interviews with 21 Chief Medical Officers from 20 different municipalities in Norway. The interviews were conducted in 2017. The data were analyzed thematically.ResultsThe Chief Medical Officers were mainly positive to participating in making public health overview documents. They took on roles as leaders of the work, medical advisors, data collectors towards local GPs and listening post to other sectors. Organizational factors like too small positions and a lack of tradition to involve the CMO in public health work were experienced as barriers to their involvement. The collaboration with the public health coordinators was said to be rewarding, and the intersectoral process involved employees from other sectors in a new way in public health. Although there were some positive experiences, several CMOs considered the use and impact of the public health overview document as limited.ConclusionThere was a large variation in the amount and the type of involvement the Chief Medical Officers had in making the public health overview documents in Norwegian municipalities. More research is needed to understand if this has any consequences for the quality of public health work in the municipalities and whether it is a sign of a changing role of the Chief Medical Officers.

Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era

BackgroundMedical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact.MethodsTo analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students’ experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews.ResultsWe demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work.ConclusionsThis educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact.Trial registrationN/A.

The impact of antiretroviral treatment and child-focused unconditional cash transfers on child mortality

Although there is sufficient evidence in the epidemiological literature that antiretroviral treatment (ART) reduces child mortality, there is limited evidence of its effect in the socio-economic determinants of child mortality literature. Furthermore, evidence on the effect of child focused unconditional cash transfers (UCTs) on child mortality is limited, especially in the African context. Using South Africa's provincial level data over the period 2001 to 2019, we evaluate the effect of ART and child focused UCTs on child mortality. We use the two-stage instrumental variable mean group estimator. We find that ART reduces child mortality. Moreover, we find an inverted U-shaped non-linear relationship between UCTs and child mortality that is contingent to the level of cash transfer coverage. Our analyses also reveal that UCTs improve the effect of ART on child mortality by enhancing access and adherence to treatment. While the focus of our analyses was on the child mortality effects of ART and UCTs, our findings reaffirm the well-documented impacts of factors such as public health expenditure, HIV/AIDS, female education, and health worker density on child mortality. Collectively, the combination of high ART and UCTs coverage, increased public health expenditure, enhanced female education, and improved health worker density, represents value for money for policymakers and funders. These areas should be prioritised to improve child well-being.

Preventing Zoonotic Diseases: An Investigation into Veterinary Medicine's Role in Public Health

Animal infectious diseases are an important public health issue that threatens human health, and veterinarians play an important role in preventing and controlling animal infectious diseases. This study aims to explore the role of veterinarians in preventing animal infectious diseases and public health. Through interviews and questionnaire surveys with veterinary workers, this study collected their practical experience in animal disease monitoring, diagnosis, prevention, and control, as well as their participation and challenges in public health. The research findings reveal the crucial role of veterinarians in the prevention of animal infectious diseases, particularly in improving animal health, maintaining public health safety, and promoting harmonious coexistence between humans and nature. In addition, the study also identified challenges faced by veterinarians in public health work, such as resource constraints, demand for professional knowledge, and insufficient public awareness. Based on the research results, suggestions were proposed to improve the role of veterinarians in public health, in order to provide reference for the future development of veterinarians in the field of public health.

Chronic disease management professionals‘ COPD Knowledge: A survey in China's rural health centres

BackgroundHealth professionals in rural primary care settings who engaged in non-communicable disease (NCD) management play a critical role in prevention and treatment of chronic obstructive pulmonary disease (COPD). Understanding their COPD relevant knowledge can provide evidence for informing COPD prevention and management enhancement strategies in primary care. ObjectiveTo understand the knowledge of COPD among health professionals who engaged in NCD management in rural health centres. MethodsIn June 2021, 20 township hospitals in Zigong, Sichuan Province were randomly selected. A self-developed survey questionnaire was administrated to all health professionals who engaged in NCD management, including general practitioners(GPs), public health professionals, and rural doctors. The participants were asked to choose correct answers on a number of questions regarding knowledge of NCD management. ResultsAll participants (n=474) completed the survey questionnaires. The respondents consisted of 68 GPs (14.4 %), 177 public health professionals (37.3 %), and 229 rural doctors (48.3 %). Regarding comprehensive COPD knowledge, GPs had a statistically significant higher percentage of correctness than rural doctors (35.3% vs 7.4 %, P < 0.017), and public health workers also outperformed rural doctors (31.6% vs 7.4 % , P < 0.017). In identifying risk factors for COPD, GPs achieved a significantly higher percentage of correctness than rural doctors(73.5% vs 46.3 % , P < 0.017), as did public health workers (66.7% vs 46.3 %, P < 0.017). In the assessment of diagnosis and evaluation of COPD, GPs' percentage of correctness was significantly higher (38.2 %) compared to public health workers (20.3 %) and rural doctors (3.9 %, P < 0.017), with public health workers also exceeding rural doctors (P < 0.017). In terms of treatment strategies for COPD, both GPs (30.9 %) and public health workers (19.2 %) showed significantly higher percentage of correctness than rural doctors (6.6 %, P < 0.017). Regarding follow-up management for COPD, public health workers exhibited a significantly higher percentage of correctness than both GPs (46.9% vs 29.4 % ) and rural doctors (46.9% vs 14.4 %, P < 0.017), with GPs higher than rural doctors(P < 0.017). ConclusionThe health professionals who engaged in NCD management in primary care settings in rural areas of Zigong city in Sichuan Province demonstrate inadequate knowledge of COPD, especially in terms of diagnosis, evaluation, treatment strategies, and follow-up management. Levels of COPD understanding varies between different types of health professionals who engaged in NCD management, with rural doctors displaying lower awareness. Based on the findings, the authors suggest improving the knowledge of rural health professionals on prevention and management of COPD.

Relationship of various COVID-19 antibody titer with individual characteristics and prediction of future epidemic trend in Xiamen City, China.

Reinfection of coronavirus disease 2019 (COVID-19) has raised concerns about how reliable immunity from infection and vaccination is. With mass testing for the virus halted, understanding the current prevalence of COVID-19 is crucial. This study investigated 1,191 public health workers at the Xiamen Center for Disease Control, focusing on changes in antibody titers and their relationship with individual characteristics. The study began by describing the epidemiological characteristics of the study participants. Multilinear regression (MLR) models were employed to explore the associations between individual attributes and antibody titers. Additionally, group-based trajectory models (GBTMs) were utilized to identify trajectories in antibody titer changes. To predict and simulate future epidemic trends and examine the correlation of antibody decay with epidemics, a high-dimensional transmission dynamics model was constructed. Analysis of epidemiological characteristics revealed significant differences in vaccination status between infected and non-infected groups (χ2=376.706, P<0.05). However, the distribution of antibody titers among the infected and vaccinated populations was not significantly different. The MLR model identified age as a common factor affecting titers of immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibody (NAb), while other factors showed varying impacts. History of pulmonary disease and hospitalization influenced IgG titer, and factors such as gender, smoking, family history of pulmonary diseases, and hospitalization impacted NAb titers. Age was the sole determinant of IgM titers in this study. GBTM analysis indicated a "gradual decline type" trajectory for IgG (95.65%), while IgM and NAb titers remained stable over the study period. The high-dimensional transmission dynamics model predicted and simulated peak epidemic periods in Xiamen City, which correlated with IgG decay. Age-group-specific simulations revealed a higher incidence and infection rate among individuals aged 30-39 years during both the second and third peaks, followed by those aged 40-49, 50-59, 18-29, and 70-79 years. Our study shows that antibody titer could be influenced by age, previous pulmonary diseases as well as smoking. Furthermore, the decline in IgG titers is consistent with epidemic trends. These findings emphasize the need for further exploration of these factors and the development of optimized self-protection countermeasures against reinfection.

'Solitude is not thrust upon any lovable person': loneliness, shame, and the problem (of) personality.

The relationship between loneliness and shame is frequently asserted, usually under-theorised, and very rarely subject to historical attention and care. Researchers in and across a number of disciplines are comfortable in the truism that shame and stigma are attached to loneliness through a series of psychosocial processes and dialogues, with negative social, medical, cultural and political valuations of loneliness dovetailing into neoliberal (and older) logics of individual responsibility for relationships and health. Far less clear is where these languages come from; how shame has accrued (or been assembled) around loneliness as an emotion or experience; and how this has changed over time. Drawing on the author’s practice as a historian of medicine, this article follows the problem of ‘personality’ through primary sources in print journalism, loneliness activism, public health work, and the psy and social sciences. It traces shaming narratives on loneliness through interwar and postwar conversations on selfishness, self-pity and the typology of lonely personalities, and considers how discourses on hostility and intolerance shaped a growing theorisation of chronic and intractable loneliness.

Dedication of Professional Midwives in Providing Healthcare Services in Selected Rural Communities in the Philippines: a Descriptive Qualitative Study

The majority of professional midwives in the Philippines work in public health, particularly in rural areas. In this paper, we sought to investigate and gain insights into midwives' motivations, experiences, and aspirations while working and providing client-centered care in rural areas of the Cordillera Administrative Region, one of the administrative regions in the Philippines. This study utilized a qualitative descriptive study design through in-depth interviews using a semi-structured topic guide to collect data from September–October 2021. Participants were selected based on their at least three-year work experience, current roles as midwives in public rural health settings, and willingness to participate. Phone calls were used for interviews due to travel restrictions during the COVID-19 pandemic. Data were recorded, transcribed, and analyzed through content analysis. Developed themes were confirmed and validated by the study participants. A total of seven rural professional midwives participated in this study. Three main themes emerged from the data analysis – including the process of embracing the midwifery profession, rewarding yet challenging work experiences, and aspiration for competence and better work status. This study is the first of its kind done in the country and, as such, has provided new insights and findings regarding the midwifery profession in the Philippines. Despite facing challenges in providing healthcare in the rural setting, rural midwives find their profession to be a fulfilling and gratifying work experience. They strive for greater competence and improved work status and are dedicated to serving rural areas to the best of their abilities. Enabling midwives in rural communities with support and avenues for professional growth will enhance the provision of healthcare services in geographically challenged regions.

Development of a University-Government Partnership for Public Health Response and Workforce Development in the State of Oregon.

The COVID-19 pandemic exposed and exacerbated a public health workforce shortage and national strategies have called for the development of clear occupational pathways for students to enter the public health workforce and meaningful public health careers. In response to the immediate need for public health workers during the pandemic, several universities and academic hospitals rapidly mobilized students and employees and partnered with local or state health departments. However, many of those partnerships were based on short-term volunteer effort to support critical COVID-19 public health efforts. In this article, we document the development of Oregon's Public Health Practice Team, a student, staff, and faculty workforce developed at the Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health in close collaboration with the Oregon Health Authority (OHA). This project contributed significant effort to several phases of Oregon's statewide public health response to COVID-19, and over time developed into a lasting, multi-purpose, inter-agency collaborative public health practice program. Health equity has been centered at every stage of this work. We describe the phases of the partnership development, the current team structure and operations, and highlight key challenges and lessons learned. This provides a case-study of how an innovative and flexible university-government partnership can contribute to immediate pandemic response needs, and also support ongoing public health responses to emerging needs, while contributing to the development of a skilled and diverse public health workforce.

Lacked of Breast Cancer Awareness of Indonesian Rural Women: A Descriptive Study to Adult Women in District Pangandaran, Indonesia

Breast cancer remains a significant global health challenge, particularly in low and middle-income countries like Indonesia. Patients with advanced metastatic breast cancer have a dismal prognosis. A cancer promotion program’s failure can be attributed to low awareness of breast cancer. This descriptive study aimed to evaluate breast cancer awareness among adult women in District Pangandaran, Indonesia. Data was gathered in July 2018 from 189 individuals using a verified Breast Cancer Awareness Measure instrument developed by Cancer Research UK. Results revealed a concerning lack of awareness among participants regarding various breast cancer risk factors, symptoms, and screening practices. Additionally, reluctance to seek medical help due to fear of diagnosis was observed, particularly among housewives without health insurance. These findings highlight the urgent need for comprehensive health programs to enhance breast cancer awareness and promote early detection strategies tailored to the Indonesian population, especially in rural areas. Healthcare providers and public health workers play a vital role in this effort, along with implementing innovative health promotion policies by the government to improve cancer prevention programs.

Experience in managing the process of continuing medical education of medical workers in public health and health care

Introduction. The problem of continuous professional development of medical specialists with higher and secondary medical education is especially relevant at the present stage, when medical knowledge, technologies, and drugs are being improved every day. &#x0D; Purpose. Analysis of the forms of conducting cycles of continuous medical education in the field of health care management and public health at the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation for the development of the most popular and perfect form of its implementation.&#x0D; Materials and methods. An analysis of the main directions of the mnagement of the process of continuous medical education of medical workers in general and in public health and health care in the Federal State Autonomous Educational Institution of Higher Education of the Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation. &#x0D; Results. Since 1977 a continuous medical education was started in the USSR. A course for advanced training of doctors in social hygiene was opened at the Department of Social Hygiene and Health Organization of the 2nd Medical Institute. Within the framework of the specialty “Organization of Health Care and Public Health”, the department conducted cycles of professional retraining (PP-504 hours), advanced training: 144 hours (PC-144), 72 hours and 36 hours. Continuing medical education is aimed at obtaining the competencies necessary to perform a new type of professional activity. The plans for further improvement of continuing medical education by the department provide for the renewal of work programs, the creation of distance and new relevant cycles.&#x0D; Limitations of the study. An analysis of professional retraining cycles of students of various durations for the acquisition of new qualifications, qualitative expansion of the field of knowledge, skills and abilities in the period 2017–2022 was carried out. &#x0D; Conclusion. The presented data indicate the expediency of managing advanced training within the framework of the specialty “Organization of Health Care and Public Health” using short cycles of advanced training of full-time and distant forms of training of students.

Too Many Deaths, Too Many Left Behind: A People's External Review of the U.S. Centers for Disease Control and Prevention's COVID-19 Pandemic Response

The US population has suffered worse health consequences due to COVID-19 than comparable wealthy nations. COVID-19 had caused over 1.1 million deaths in the United States as of May 2023 and contributed to a 3-year decline in life expectancy. A coalition of public health workers and community activists launched an external review of the CDC's pandemic management from January 2021 to May 2023. We used a modified Delphi process to identify core pandemic management areas, which formed the basis for a survey and literature review. Our analysis yields three overarching shortcomings of the CDC's pandemic management: 1) CDC leadership downplays the serious impacts and aerosol transmission risks of COVID-19; 2) CDC leadership has aligned public guidance with commercial and political interests over scientific evidence; 3) CDC guidance focuses on individual choice rather than emphasizing prevention and equity. Instead, the agency must partner with communities most impacted by the pandemic and encourage people to protect each other using layered protections to decrease COVID-19 transmission. As emerging variants can already evade existing vaccines and treatments, and long COVID can be disabling and lacks definitive treatment, multifaceted, sustainable approaches to the COVID-19 pandemic are essential to protect people, the economy, and future generations.

Hubungan Beban Kerja dengan Stres Kerja Tenaga Kesehatan Masyarakat di Puskesmas Kota Pekalongan

Work stres is a state of physical imbalance that causes physical and psychological tension that affects the way of thinking, emotions and working conditions. Work stres among health workers is quite high, as are the public health workers who work in puskesmas. Work stres affects the workload which is too high. The influencing factor is the workload. The purpose of this research is to find out whether there is a relationship between workload and work stres in public health workers at the Pekalongan City Health Center. This study used a quantitative method with a sample of 26 public health workers in 14 Community Health Centers in Pekalongan City. Based on the results of the analysis of the Pearson Correlation Test, a significant value (p) was obtained between workload and work stres which was 0.019 or p-value &lt;0.05. If you look at the interpretation above, the test results show that the test results stated that there was a significant relationship or that there was a relationship between workload and work stres in public health workers at the Pekalongan City Health Center.

Sexually Transmitted Infection Partner Services Outcomes Before and During the SARS-CoV-2 Pandemic in King County, WA.

SARS-CoV-2 pandemic mitigation efforts resulted in reallocation of public health personnel, likely impacting provision of timely sexually transmitted infection partner services (PS). We describe PS outcomes before and during the pandemic in King County, WA. We examined PS outcomes for syphilis and gonorrhea cases diagnosed in 2019 and 3 periods in 2020 (pre-lockdown: January 1, 2020-March 23, 2020; lockdown: March 24, 2020-June 5, 2020; post-lockdown: June 6, 2020-December 31, 2020). We described changes over time in 3 PS outcomes: cases initiated, interviewed, and with named sex partners. We calculated adjusted prevalence ratios (aPRs) with Poisson regression comparing these outcomes in the 2020 periods with 2019. Reported gonorrhea (4611 vs. 4179) and syphilis (665 vs. 586) cases declined from 2019 to 2020. In 2019, 60.7% of cases were initiated, compared with 42.1% before lockdown (aPR, 0.74; 95% confidence interval [CI], 0.70%-0.78%), 41.7% during lockdown (aPR, 0.79; 95% CI, 0.73-0.85), and 41.7% after lockdown (aPR, 0.81; 95% CI, 0.77-0.85). Among initiated cases, the proportion interviewed also seemed to drop in the 3 lockdown periods (52.4%, 41.0%, 44.1%) compared with 2019 (55.7%). However, in adjusted analyses, the prevalence of interview among case patients was only lower pre-lockdown (aPR, 0.91; 95% CI, 0.85-0.99), and higher during (aPR, 1.10; 95% CI, 1.01-1.20) and after (aPR, 1.12; 95% CI, 1.06-1.19). Interviewed patients named partners more often during (21.4%; aPR, 1.35; 95% CI, 1.05-1.74) and less often after lockdown (16.0%; aPR, 0.63; 95% CI, 0.51-0.79), compared with 2019 (26.6%). These results underscore the need for a trained public health worker reserve, and plans for deployment of existing workers and prioritization of cases to continue essential sexually transmitted infection public health activities during public health crises.

The association of sexual minority status and bullying victimization is modified by sex and grade: findings from a nationally representative sample

BackgroundSexual minority status is associated with face-to-face bullying and cyberbullying victimization. However, limited studies have investigated whether such a relationship differs by sex or grade in a nationally representative sample.MethodsWe concatenated the national high school data from the Youth Risk Behavior Surveillance System (YRBSS) chronologically from 2015 to 2019, resulting in a sample of 32,542 high school students. We constructed models with the interaction term between sexual minority status and biological sex assigned at birth to test the effect modification by sex on both the multiplicative and additive scales. A similar method was used to test the effect modification by grade.ResultsAmong heterosexual students, females had a higher odds of being bullied than males, while among sexual minority students, males had a higher odds of being bullied. The effect modification by sex was significant on both the multiplicative and additive scales. We also found a decreasing trend of bullying victimization as the grade increased among both heterosexual and sexual minority students. The effect modification by the grade was significant on both the multiplicative and the additive scale.ConclusionsTeachers and public health workers should consider the difference in sex and grade when designing prevention programs to help sexual minority students.

Health Literacy of the Inhabitants of easter Slovakia regarding Disease of Civilization – survey Results

Introduction: Diseases of civilization represent a group of diseases that have common risk factors as a result of long-term exposure to an unhealthy lifestyle, an unhealthy diet, smoking, a lack of physical activity and stress. Aim of the research: To find out whether random respondents who took part in the “Days of Health” event at the Bardejov Spa have basic knowledge about diseases of civilization. Based on the findings, draw recommendations for practice. Research sample group: 398 respondents: 305 women and 93 men. The average age of the respondents was 56.4 years (+-12.8 years). Methodology: On a voluntary and anonymous basis, the patients filled out a questionnaire focused on their knowledge about diseases of civilization. The questionnaire contained both closed and open questions. Results: The authors of the article analyzed respondents’ answers. The results were statistically processed. Conclusion: Our results show that there is a need for repeated interventions by health care workers (doctors, nurses) and public health workers to spread awareness about diseases of civilization and the possibility of their prevention. Increasing the level of health literacy is a good prerequisite for a healthier population.