Public Health Policy Recommendations Research Articles

Measles resurgence in armenia: unmasking health system vulnerabilities and crafting comprehensive eradication strategies – a review

Measles is an acute febrile illness associated with rashes, fever and life-threatening complications. It is a vaccine-preventable disease with the Measles Mumps Rubella(MMR) vaccine but a recent global trend unveils a resurgence of measles in various parts of the world including Armenia. Measles was declared eliminated from Armenia in 2021 before reports of local outbreaks surfaced in 2023. The World Health Organization(WHO) identified discrepancies in the vaccination coverage during COVID-19. Measles also poses a great financial burden as a public health issue worldwide. Sociocultural factors impacting measles transmission are Maternal Education,Healthcare access, migration, vaccine hesitancy and socioeconomic status (Table 3). Efforts to control and eradicate measles from Armenia are run by a collaborative approach of national and international health bodies such as United Nations Children’s Fund(UNICEF), WHO,Global Vaccine Alliance (GAVI) and the Ministry of Health. Thus, the resurgence of measles can be managed through widespread patient education, innovative approaches, strengthening the healthcare system and addressing vaccine hesitancy, sociocultural barriers and humanitarian emergencies (Figure 2). This review investigates the complicated dynamics of measles inside Armenia’s health system in depth. A thorough examination of measles incidence and immunization patterns highlights the shift from few cases and high vaccination rates to a comeback caused by imported viruses. The causes of its recurrence have been thoroughly investigated, including reduced immunization programs and vaccine hesitancy. The research delves further into the “One Health” idea, assessing the possibility of interspecies transmission among nonhuman primates and examining the environmental factors that influence measles transmission. Among the challenges are weaknesses within Armenia’s health system as well as the possibility of interruptions from the COVID-19 outbreak. In measles vaccination status, the combination of maternal education, postnatal care, and socioeconomic variables exposes the larger drivers at work. The study concludes with a comprehensive set of public health policy recommendations covering vaccination promotion, surveillance, healthcare provider education, public awareness, international collaboration, data analysis, law enforcement, emergency preparedness, research, and coordination. The research sheds light on the tangled web of measles dynamics, health system resilience, and contextual subtleties via this multifaceted approach, inviting readers to investigate the multiple strategies required for eliminating measles in Armenia.

Sugar addiction and its role in obesity among adolescents residing in an urban field practice area of Bagalkot: A cross-sectional study

Obesity, a multi-factorial process is showing an increasing trend among children and adolescents leading to increased prevalence of insulin resistance, paving the way for cardio-metabolic risk factors. It has been proposed that certain food items as well as eating habits are addictive in a way that is similar to substances of abuse. Thus, this study was conducted among adolescents to determine the frequency of sugar addiction, the influencing factors and its association with obesity. A cross-sectional study was designed and 250 late adolescents (17–19 years old) chosen from colleges coming under urban field practice area of Bagalkot were enrolled in the study. A self-administered questionnaire which consisted of three sections - socio-demographic details, validated Modified Yale Food Addiction Scale (mYFAS) and Physical Activity Questionnaire for Adolescents (PAQ-A) was used to collect data regarding sugar addiction and physical activity in our study. Sugar addiction was found among 7.6%of adolescents and it was associated with overweight and obesity which was statistically significant (X=42.72, p<0.0001). Factors which significantly contributed to sugar addiction among adolescents were; adolescents staying in hostel (p<0.001), working mother’s (p<0.0001) and socio-economic status (p=0.02). Univariate analysis (unadjusted odds ratio) showed that risk factors such as sugar addiction (Odds ratio 9.6, 95% C.I. 2.18-42.8, p=0.003) and reduced physical activity (Odds ratio 3.8, 95% C.I. 2.02-7.26, p=0.0001) were associated with overweight and obesity.Incorporation of measures against hyper palatable sugary foods into public health policy recommendations and a further detailed evaluation regarding sugar addiction may provide a new insight and help in prevention and treatment of obesity.

The global impact of COVID-19 on tuberculosis: A thematic scoping review, 2020-2023.

This thematic scoping review of publications sought to understand the global impact of COVID-19 on tuberculosis (TB), interpret the scope of resonating themes, and offer policy recommendations to stimulate TB recovery and future pandemic preparedness. Publications were captured from three search engines, PubMed, EBSCO, and Google Scholar, and applicable websites written in English from January 1, 2020, to April 30, 2023. Our scoping review was limited to publications detailing the impact of COVID-19 on TB. Original research, reviews, letters, and editorials describing the deleterious and harmful--yet sometimes positive--impact of COVID-19 (sole exposure) on TB (sole outcome) were included. The objective was to methodically categorize the impacts into themes through a comprehensive review of selected studies to provide significant health policy guidance. Two authors independently screened citations and full texts, while the third arbitrated when consensus was not met. All three performed data extraction. Of 1,755 screened publications, 176 (10%) covering 39 countries over 41 months met the inclusion criteria. By independently using a data extraction instrument, the three authors identified ten principal themes from each publication. These themes were later finalized through a consensus decision. The themes encompassed TB's care cascade, patient-centered care, psychosocial issues, and health services: 1) case-finding and notification (n = 45; 26%); 2) diagnosis and laboratory systems (n = 19; 10.7%) 3) prevention, treatment, and care (n = 22; 12.2%); 4) telemedicine/telehealth (n = 12; 6.8%); 5) social determinants of health (n = 14; 8%); 6) airborne infection prevention and control (n = 8; 4.6%); 7) health system strengthening (n = 22; 13%); 8) mental health (n = 13; 7.4%); 9) stigma (n = 11; 6.3%); and 10) health education (n = 10; 5.7%). Heterogeneity of publications within themes. We identified ten globally generalizable themes of COVID-19's impact on TB. The impact and lessons learned from the themed analysis propelled us to draft public health policy recommendations to direct evidence-informed guidance that strengthens comprehensive global responses, recovery for TB, and future airborne pandemic preparedness.

COVID-19 Post Vaccination Data in North America

This article explores the impact of COVID-19 vaccination on public health in Canada and the United States. Using OpenAI's GPT-3 language model, data was extracted from various online sources, including government health agencies, news articles, academic papers, and social media platforms. The data was analyzed using natural language processing techniques to identify common themes and sentiments. Despite the staggering death toll and impact on everyday life, the rollout of vaccines marks a critical milestone in the fight against the virus. However, challenges remain, including skepticism from some members of the public and the emergence of new virus variants. The early data is encouraging, showing a significant reduction in COVID-19 cases, hospitalizations, and deaths in vaccinated populations. The article emphasizes the critical role of vaccines in controlling the spread of the virus, alongside other public health measures, to overcome this devastating pandemic. The findings suggest that COVID-19 vaccination has had a significant positive impact on public health in both countries, with a decrease in COVID-19 cases, hospitalizations, and deaths. However, challenges remain, including vaccine hesitancy and the emergence of new variants. The article concludes with recommendations for public health policy, including increasing vaccine access and education, monitoring new variants, and continuing to follow public health guidelines.

The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia

BackgroundSARS-COV-2 (COVID-19) has severely impacted people's health worldwide. Vaccines are one of the health measures taken to reduce the impact of COVID-19, but recent reports have revealed that some people are reluctant to be vaccinated against COVID-19. Understanding the factors underlying an individual’s decision to take the COVID-19 vaccine is critical to designing an immunisation programme. This study examines factors that influence the intention to take a COVID-19 vaccine using the modified Health Belief Model (HBM) framework and analysing demographic factors. MethodA cross-sectional online survey was conducted from 10 January to 20 January 2021. Five hundred thirty-seven respondents above 17 years old and residing in Indonesia voluntarily completed an online survey. Survey questions addressed sociodemographic factors; perception of susceptibility, severity, benefits and barriers; cues to action; and intention to take the COVID-19 vaccine. A Structural Equation Modelling (SEM) approach with SmartPLS software was used to analyse the measurements and model construct. FindingsThe results showed that the perception of susceptibility, severity, benefits and barriers, as well as cues to action, predicted people’s intention to take a COVID-19 vaccine. Model structure explained a large proportion of variance in people’s intention to be vaccinated against COVID-19 (R2 = 66.8 %). Some demographic factors affected the key variables of the HBM. People with low and middle income negatively influence feeling severity, beneficial and barrier in intending to take vaccine. Other demographic factors such as sex, age, marriage and living areas did not affect the components of the HBM, except for females influencing severity and people living in urban areas associated with benefits variable. These findings imply that COVID-19 vaccination programmes should focus on providing accurate information about the severity of COVID-19 and the benefits of taking the vaccine. Building people’s confidence in their ability to eliminate barriers to taking the vaccine and involving family members and community and religious leaders will increase COVID-19 vaccine uptake. ConclusionDespite limitations to the study, such as respondent demographics that are unrepresentative of the wider Indonesian population, inadequate survey timing and an exclusive focus on vaccine intention as the outcome variable, the present study contributes to explaining individuals’ intentions to take a COVID-19 vaccine in a Eastern country context. This study is valuable to providing public health policy recommendations that focus on effectively designing immunisation programme interventions.

Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up.
 Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics.
 Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator.
 Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level.

Study protocol for First Dental Steps Intervention: feasibility study of a health visitor led infant oral health improvement programme

BackgroundDental caries in childhood is a burden on the daily lives of children and their families, and associated with poor oral health in adulthood. In England, dental caries is the most common reason for young children to be admitted to hospital. It is believed that most tooth extractions (due to decay) for children aged 10 years and under, could be avoided with improved prevention and early management. National public health policy recommendations in England include specific oral health initiatives to tackle tooth decay. One of these initiatives is delivered as part of the Healthy Child Programme and includes providing workforce training in oral health, integrating oral health advice into home visits, and the timely provision of fluoride toothpaste. This protocol seeks to assess the delivery of the First Dental Steps intervention and uncertainties related to the acceptability, recruitment, and retention of participants.MethodsThis study seeks to explore the feasibility and acceptability of the First Dental Steps intervention and research methods. First Dental Steps intervention will be delivered in local authority areas in South West England and includes oral health training for health visitors (or community nursery nurses) working with 0–5-year-olds and their families. Further, for vulnerable families, integrating oral health advice and the provision of an oral health pack (including a free flow cup, an age appropriate toothbrush, and 1450 ppm fluoride toothpaste) during a mandated check by a health visitor. In this study five local authority areas will receive the intervention. Interviews with parents receiving the intervention and health visitors delivering the intervention will be undertaken, along with a range of additional interviews with stakeholders from both intervention and comparison sites (four additional local authority areas).DiscussionThis protocol was written after the start of the COVID-19 pandemic, as a result, some of the original methods were adjusted specifically to account for disruptions caused by the pandemic. Results of this study will primarily provide evidence on the acceptability and feasibility of both the First Dental Steps intervention and the research methods from the perspective of both families and stakeholders.

Turbulent dispersion of breath by the wind

The pioneering work of Taylor on the turbulent dispersion of aerosols is one century old and provides an interesting way to introduce both diffusive processes and turbulence at an undergraduate level. Low mass particles transported by a turbulent flow exhibit a Brownian-like motion over time scales larger than the velocity correlation time. Aerosols and gases are, therefore, subjected to an effective turbulent diffusion at large length scales. However, the case of a source of pollutant much smaller than the integral scale is not completely understood. Here, we present experimental results obtained by undergraduate students in the context of the COVID-19 pandemic. The dispersion of a fog of oil droplets by a turbulent flow is studied in a wind tunnel designed for pedagogical purposes. It shows a ballistic-like regime at short distance, followed by Taylor's diffusive-like regime, suggesting that scale-free diffusion by the turbulent cascade process is bypassed. Measurements show that the dispersion of CO2 emitted when breathing in a natural, indoor air flow is not isotropic but rather along the flow axis. The transverse spread is ballistic-like, leading to the concentration decaying as the inverse-squared distance to the mouth. The experiment helps students understand the role of fluctuations in diffusive processes and in turbulence. A Langevin equation governing aerosol dispersion based on a single correlation time allows us to model the airborne transmission risk of pathogens, indoors and outdoors. The results obtained in this study have been used to provide public health policy recommendations to prevent transmission in shopping malls.

Validation of International Classification of Diseases criteria to identify severe influenza hospitalizations.

In this cohort study of hospitalized patients with linked medical record data, we developed International Classification of Diseases (ICD) criteria that accurately identified laboratory‐confirmed, severe influenza hospitalizations (positive predictive value [PPV] 80%, 95% confidence interval [CI] 71–87%), which we validated through medical record documentation. These criteria identify patients with clinically important influenza illness outcomes to inform evaluation of preventive and therapeutic interventions and public health policy recommendations.

Environmental assessment of interventions to restrain the impact of industrial pollution using a quasi-experimental design: limitations of the interventions and recommendations for public health policy

BackgroundIn an industrial area, the asymmetry between the weights of the economic interests compared to the public-health needs can determine which interests are represented in decision-making processes. This might lead to partial interventions, whose impacts are not always evaluated. This study focuses on two interventions implemented in Taranto, Italy, a city hosting one of the largest steel plants in Europe. The first intervention deals with measures industrial plants must implement by law to reduce emissions during so called “wind days” in order to reduce PM10 and benzo [a] pyrene concentrations. The second one is a warning to the population with recommendations to aerate indoor spaces from 12 pm to 6 pm, when pollutant concentrations are believed to be lower.MethodsTo analyse the impact of the first intervention, we analysed monthly PM10 data in the period 2009–2016 from two monitoring stations and conducted an interrupted-time-series analysis. Coefficients of time-based covariates are estimated in the regression model. To minimise potential confounding, monthly concentrations of PM10 in a neighbourhood 13 km away from the steel plant were used as a control series. To evaluate the second intervention, hourly concentrations of PM10, SO2 and polycyclic-aromatic-hydrocarbons (PAHs) were analysed.ResultsPM10 concentrations in the intervention neighbourhood showed a peak just a few months before the introduction of the law. When compared to the control series, PM10 concentrations were constantly higher throughout the entire study period. After the intervention, there was a reduction in the difference between the two time-series (− 25.6%). During “wind days” results suggested no reduction in concentrations of air pollutants from 12 pm to 18 pm.ConclusionResults of our study suggest revising the warning to the population. Furthermore, they evidence that in complex highly industrialised areas, air quality interventions cannot focus on only a single pollutant, but rather should consider the complex relationships between the different contaminants. Environmental interventions should be reviewed periodically, particularly when they have implications for social constraints. While the results of our study can be related only to the specific situation reported in the article, the methodology applied might be useful for the environmental management in industrial areas with similar features.

The association between sugar intake during pregnancy and allergies in offspring: a systematic review and a meta-analysis of cohort studies.

It has been hypothesized that a mother's diet during pregnancy may modulate her offspring's immune system development and lead to development of allergic diseases among offspring. However, the evidence for this is unclear and inconclusive. This systematic review was undertaken to examine the weight of evidence for causality from cohort studies on the association between maternal free sugar intake during pregnancy and development of allergies in offspring. Using a systematic search strategy, PubMed, SCOPUS, and Web of Science databases were searched from inception to May 2020. For the reporting of this systematic review, the PRISMA guideline was followed. Studies examining maternal sugar consumption during pregnancy (using self-reported data) and the development of allergic diseases among offspring (infancy to 5 years) were included. The Newcastle-Ottawa Scale quality assessment tool was used to assess the study quality. Meta-analysis was conducted using a random-effects model to synthesize the findings. Of 159 publications identified from the search, 5 articles with 4 unique cohort studies were included in this systematic review. The limited meta-analysis showed that a mother's increased free sugar intake during pregnancy was associated with an increased risk of developing asthma in offspring (odds ratio 1.07 [95% CI, 1.00 to 1.14; I2 = 0%]). High free sugar intake by the mother during pregnancy was also associated with increased odds of offspring (to age 7.7 years) developing other common allergies, including allergic rhinitis, atopy and eczema, wheeze, and food allergies . From the limited evidence, this review suggests that high free sugar consumption during pregnancy may be associated with the development of allergies in offspring. Clinical guidelines and public health policy recommendations for maternal diet in pregnancy should include advice about reducing free sugar intake due to a possible association with allergies in offspring. However, recommendations should be made with caution considering other maternal and fetal risk factors.

The Backward Art of Slowing the Spread? Congregation Efficiencies during COVID-19

Were workers more likely to be infected by COVID-19 in their workplace, or outside it? While both economic models of the pandemic and public health policy recommendations often presume that the workplace is less safe, this paper seeks an answer both in micro data and economic theory. The available data from schools, hospitals, nursing homes, food processing plants, hair stylists, and airlines show employers adopting mitigation protocols in the spring of 2020. Coincident with the adoption, infection rates in workplaces typically dropped from well above household rates to well below. When this occurs, the sign of the disease externality from participating in large organizations changes from negative to positive, even while individuals continue to have an incentive to avoid large organizations due to the prevention costs they impose on members. Rational cooperative prevention sometimes results in infectious-disease patterns that are opposite of predictions from classical epidemiology.

The Violence of Fat Hatred in the “Obesity Epidemic” Discourse

The concern globally over the “obesity epidemic” has become one of the most widely discussed social problems over the last twenty or so years. There is an intense focus from the media, popular culture, government agencies, and medical community about the harms of “obesity,” which includes strategies for eradicating the “obesity epidemic.” Public discussions of “excess weight” typically imply that fat persons are responsible for their body size, and public health policy recommendations follow from that assumption. Through the voices of 74 women of size, I demonstrate the ways in which the “obesity epidemic” discourse is a form of symbolic violence. Interviewees discussed countless acts of public humiliation, blocked opportunities, and fears about attending appointments with health care practitioners because of the stigma, discrimination, and mistreatment they receive. Moreover, the anti-fat rhetoric made interviewees feel responsible for the oppression. The violence manifested through the “obesity epidemic” rhetoric creates and perpetuates the phenomenon of hyper(in)visibilty, a phenomenon where marginalized bodies are simultaneously paid tremendous attention and dismissed. I conclude by urging sociologists to include body size in their intersectional research, teaching, and activism.

Public health policy-making for hearing loss: stakeholders\u2019 evaluation of a novel eHealth tool

BackgroundHearing loss (HL) affects 466 million people of all ages worldwide, with a rapidly increasing prevalence, and therefore requires appropriate public health policies. Multi-disciplinary approaches that make use of eHealth services can build the evidence to influence public policy. The European Union-funded project EVOTION developed a platform that is fed with real-time data from hearing aids, a smartphone, and additional clinical data and makes public health policy recommendations based on hypothetical public health policy-making models, a big data engine and decision support system. The present study aimed to evaluate this platform as a new tool to support policy-making for HL.MethodsA total of 23 key stakeholders in the United Kingdom, Croatia, Bulgaria and Poland evaluated the platform according to the Strengths, Weaknesses, Opportunities and Threats methodology.ResultsThere was consensus that the platform, with its advanced technology as well as the amount and variety of data that it can collect, has huge potential to inform commissioning decisions, public health regulations and affect healthcare as a whole. To achieve this, several limitations and external risks need to be addressed and mitigated. Differences between countries highlighted that the EVOTION tool should be used and managed according to local constraints to maximise success.ConclusionOverall, the EVOTION platform can equip HL policy-makers with a novel data-driven tool that can support public health policy-making for HL in the future.

Vaccine Hesitancy and Demand for Immunization in Eastern Europe and Central Asia: Implications for the Region and Beyond

Immunization is a global success story. It has saved millions of lives and prevented disease worldwide and millions more have been spared the permanent disabilities caused by diseases such as polio and the long-term morbidity caused by other diseases such as measles. Despite the compelling evidence of the public health and economic value of vaccines, vaccine hesitancy has become a growing concern globally. By calling into question the safety and efficacy of vaccines, vaccine hesitancy threatens the progress made in combating morbidity and mortality including efforts to introduce COVID-19 vaccines. This paper a) examines key factors that drive limited demand for vaccines and vaccine hesitancy, (b) highlights the role of demand promotion for immunization and of risk communication and community engagement to address those challenges, (c) discusses vaccine demand and hesitancy in Eastern Europe and Central Asia, and (d) makes recommendations for public health policy and programming for the introduction of the COVID-19 vaccine and beyond. Recommendations include strengthen social listening and digital engagement to address the concerns of caregivers and healthcare professionals, improve the availability and use of social data for evidence-based programming, reinforce public trust in health institutions and service providers, mainstream demand for immunization, strengthen the communication competencies of health service providers, test and apply solutions based on behavioral insights to reinforce demand, engage regularly with local governments and local actors, and strengthen resilience and response capacities for diseases outbreaks and public health emergencies.

A first insight about spatial dimension of COVID-19: analysis at municipality level.

BackgroundThis paper is about spatial patterns of by corona virus disease-2019 (COVID-19).MethodsUsing data for the first 21 weeks from municipalities in Catalonia, we analyse whether reported positive cases appear randomly or following some kind of spatial dependence. Global and local measures of spatial autocorrelation are used.ResultsThere are some clusters alongside Catalan municipalities that change over time.ConclusionsUse of spatial analysis techniques is suggested to identify spatial disease patterns and to provide spatially disaggregated public health policy recommendations.

Women Leaders and Policy Compliance during a Public Health Crisis

AbstractHow does the gender of a political leader affect policy compliance of the public during a public health crisis? State and national leaders have taken a variety of policy measures to combat the COVID-19 pandemic, with varying levels of success. While many female leaders have been credited with containing the spread of COVID-19, often through implementing strict policy measures, there is little understanding of how individuals respond to public health policy recommendations made by female and male leaders. This article investigates whether citizens are more willing to comply with strict policy recommendations about a public health issue when those recommendations are made by a female leader rather than a male leader. Using a survey experiment with American citizens, we compare individuals’ willingness to comply with policy along three dimensions: social distancing, face covering, and contact tracing. Our findings show that a leader's gender has little impact on policy compliance in general during the pandemic. These findings carry important implications for successful crisis management as well as understanding how a crisis in a nonmasculine issue context influences the effectiveness of a leader's ability to implement measures to mitigate the crisis.

Shedding light on maternal sunlight exposure during pregnancy and considerations for public health policy

Sunlight exposure during pregnancy could be implicated in the physiological development and growth of the fetus, as well as long-term health after birth. Although several studies suggest the involvement of ultraviolet radiation-mediated vitamin D synthesis, current knowledge regarding the effects of sunlight exposure during pregnancy remains limited. We aimed to (i) summarize the existing body of research studying the influence of sunlight exposure on fetal growth-related birth outcomes and long-term health outcomes and (ii) determine its implications for therapeutics and public health policy. Of the studies identified on birth outcomes, the majority (5/8) demonstrated an association between sunlight exposure and reduced adverse birth outcomes (e.g., low birth weight, preterm births, small for gestational age, etc.), 2/8 studies showed no association, and 1/8 suggested a negative association between sunlight exposure and reduction of these adverse birth outcomes. Of the studies examining long-term health outcomes, sunlight exposure during pregnancy was shown to promote skeletal growth and development (2/6), and reduce the incidence of multiple sclerosis (2/6), asthma (2/6) and pneumonia (1/6). However, several of these studies used different methodologies and populations making it difficult to compare and integrate findings. Based on these results, we examined: the importance of exposure at different stages of pregnancy, proposed mechanisms by which sunlight exposure could lead to optimal outcomes, epidemiological differences influencing the findings, and necessary practical considerations prior to the implementation of public health policy recommendations. While these findings are promising, more rigorous research is warranted to support these recommendations.

Measurement of public health benefits of physical activity: validity and reliability study of the international physical activity questionnaire in Hungary

BackgroundTo ensure accurate measurement of the health benefits of habitual physical activity in large sample epidemiological studies, physical activity questionnaires (PAQs) are the most feasible methods. Therefore, the purpose of this study was the validation and cultural adaptation to the Hungarian population of the International Physical Activity Questionnaire (IPAQ-HL).MethodsA cross-sectional study among Hungarian healthy adults (age 21.375 ± 1.940 years, n = 120) was performed comparing measures of last 7 days IPAQ-HL self- administered questionnaire and obtained accelerometer (Actigraph GT3X) data for concurrent validity, reassessed by a random subsample (n = 33) to measure reliability.ResultsOur results indicate acceptable criterion validity for total physical activity, moderate to vigorous physical activity (R = 0.387, p < 0.001; R = 0.331 p < 0.001 respectively) and moderate physical activity (R = 0.193, p = 0.034). The ICC scores revealed moderate to good correlations (ICC = 0.744–0.942, p < 0.001). Moderate Kaiser–Meyer–Olkin measure (0.531, p < 0.001) and good reproducibility for vigorous, moderate to vigorous and moderate activities was found for IPAQ-HL in the studied population. Nevertheless, like analogous self-reports in other languages, it overestimates the time spent on physical activity.ConclusionsIPAQ-HL proved to be a reasonably valid measure for population prevalence epidemiological studies and is suggested for use to develop public health policy recommendations or to optimize public health interventions. However, the results on vigorous activity should be interpreted with caution, the questionnaire showed moderate validity for this particular intensity.

COVID-19 Prevention and Control Public Health Strategies in Shanghai, China.

COVID-19 was characterized as a pandemic by the World Health Organization on March 11, 2020. This research aims to analyze the public health strategies to prevent and control COVID-19 in Shanghai, China, and provide recommendations for public health policy and interventions in the United States. Based on the Social-Ecological Model, this research collected information for public health strategies from the Shanghai Municipal Health Commission and various Chinese websites. The daily confirmed new cases of COVID-19 decreased from 27 to 0 in 53 days since the first case of COVID-19 was confirmed in Shanghai on January 20, 2020. The pattern of daily confirmed new cases suggests the effectiveness of public health strategies. This research also provides recommendations on the development and improvements of public health strategies in the U.S. by acknowledging the differences in political and social systems between the two countries.