Health Programs Research Articles

Understanding health literacy in men: a cross-sectional survey

BackgroundMales have a shorter life expectancy than females. Men are less likely to seek the advice of a health professional or utilise preventive health services and programs. This study seeks to explore health literacy and the characteristics affecting this among Australian men.MethodsFour hundred and thirty-one adult males engaged with the New South Wales Rural Fire Service, completed an online cross-sectional survey, undertaken from September – November 2022. The survey tool captured demographic data, health status and lifestyle risk characteristics. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ). Descriptive statistics, frequencies, percentages, means and standard deviations, were used to describe the sample. Interferential statistics, including the Mann-Whitney U Test and the Kruskal-Wallis Test, were used to explore differences between demographics and HLQ scales.ResultsFor the first 5 scales (4-point Likert scale), the lowest score was seen for ‘Appraisal of health information’ (Mean 2.81; SD 0.52) and the highest score was seen for ‘Feeling understood and supported by healthcare providers ’ (Mean 3.08; SD 0.64). For the other 4 scales (5-point Likert scale), the lowest score was seen for ‘Navigating the healthcare system’ (Mean 3.74; SD 0.69). The highest score was seen for ‘Understand health information well enough to know what to do’ (Mean 4.10; SD 0.53). Age, income level and living in an urban/rural location were significantly related to health literacy scales.ConclusionsThis study provides new insight into men’s health literacy and the factors impacting it. This knowledge can inform future strategies to promote men’s engagement with health services and preventive care.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

Confronting Alzheimer's Disease Risk in Women: A Feasibility Study of Memory Screening as Part of the Annual Gynecological Well-Woman Visit.

Objective: Routine health care visits offer the opportunity to screen older adults for symptoms of Alzheimer's disease (AD). Many women see their gynecologist as their primary health care provider. Given this unique relationship, the Women's Preventive Services Initiative and the American College of Obstetrics and Gynecology advocate for integrated care of women at all ages. It is well-established that women are at increased risk for AD, and memory screening of older women should be paramount in this effort. Research is needed to determine the feasibility and value of memory screening among older women at the well-woman visit. Materials and Methods: Women aged 60 and above completed a 5-item subjective memory screener at their well-woman visit at the Columbia University Integrated Women's Health Program. Women who endorsed any item were considered to have a positive screen and were given the option to pursue clinical evaluation. Rates of positive screens, item endorsement, and referral preferences were examined. Results: Of the 530 women approached, 521 agreed to complete the screener. Of those, 17.5% (n = 91) were classified as positive. The most frequently endorsed item was difficulty with memory or thinking compared with others the same age. Among women with positive screens, 57.5% were interested in pursuing clinical referrals to a memory specialist. Conclusion: Results support the feasibility and potential value of including subjective memory screening as part of a comprehensive well-woman program. Early identification of memory loss will enable investigation into the cause of memory symptoms and longitudinal monitoring of cognitive change.

The Role of the Dentist in Home Care for the Older People: A Narrative Review of the Literature

Objective; This study aimed to discuss the role of dentists in providing home care to older people. Methodology; Studies on the role of the dentist in the oral health of older people living at home were reviewed. The search terms used included: home care, domiciliary care, older people, and oral health. Inclusion criteria comprised articles published in Scielo and Google Scholar databases. The article was categorized to provide a clear exposition of the information. Results; Home Care (HC) in Brazil evolved from an informal practice initiated by sanitary agents in the early 20th century to a structured service with the creation of the Unified Health System (UHS) in 1988. The UHS established programs such as the Family Health Program, which integrated home visits by doctors and nurses, and later incorporated HC in three levels (HC1, HC2, HC3) to address different care complexities. The role of dentists in HC includes promoting oral health, treating urgenties, guiding caregivers, and performing clinical procedures, which are essential for the quality of life of the older people. This approach requires specific handling techniques and professional adaptation, focusing on prevention and less invasive treatments, considering the biopsychosocial health of patients. Conclusion: Home Care Services are crucial, with dentists providing care that includes the prevention and promotion of oral health. HC promotes humanized and comprehensive care, positively impacting the well-being of the older people. Long-term effectiveness depends on prevention, caregiver education, and professional adaptations.

The Role of the Dentist in Home Care for the Older People: A Narrative Review of the Literature

Objective; This study aimed to discuss the role of dentists in providing home care to older people. Methodology; Studies on the role of the dentist in the oral health of older people living at home were reviewed. The search terms used included: home care, domiciliary care, older people, and oral health. Inclusion criteria comprised articles published in Scielo and Google Scholar databases. The article was categorized to provide a clear exposition of the information. Results; Home Care (HC) in Brazil evolved from an informal practice initiated by sanitary agents in the early 20th century to a structured service with the creation of the Unified Health System (UHS) in 1988. The UHS established programs such as the Family Health Program, which integrated home visits by doctors and nurses, and later incorporated HC in three levels (HC1, HC2, HC3) to address different care complexities. The role of dentists in HC includes promoting oral health, treating urgenties, guiding caregivers, and performing clinical procedures, which are essential for the quality of life of the older people. This approach requires specific handling techniques and professional adaptation, focusing on prevention and less invasive treatments, considering the biopsychosocial health of patients. Conclusion: Home Care Services are crucial, with dentists providing care that includes the prevention and promotion of oral health. HC promotes humanized and comprehensive care, positively impacting the well-being of the older people. Long-term effectiveness depends on prevention, caregiver education, and professional adaptations.

Socioeconomic determinants and reasons for non-acceptance to vaccination recommendations during the 3rd - 5th waves of the COVID-19 pandemic in Hungary

BackgroundIn Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary’s lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3rd - 5th pandemic waves of COVID-19.MethodsThe study’s empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories.ResultsBetween the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk.ConclusionAlthough compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people’s opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.

Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex.

This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.

Effects of genetic disclosure based on gene polymorphisms in TAS1R2 (rs12033832) and UCP-2 (rs659366) on sugar restriction

High sugar intake is one of the factors that may contribute to rising obesity and type 2 diabetes, hence changing one’s lifestyle is necessary. It is known that single nucleotide polymorphism in TAS1R2 (rs12033832) associates with one’s sugar intake, whereas rs659366 in UCP-2 associates with diabetes risk. The purpose of this study was to evaluate the effects of genetic disclosure based on rs12033832 and rs659366 in health programs to the sugar restriction. Participants (n = 41) were Indonesians who underwent a 14-day health transformation program in which they were divided into two groups, control (without genetic disclosure) and genetic disclosure (GD) group. It was observed that both groups significantly reduced their sugar intake (g/day), in the control group (49.75±19.18 vs 32.04±20.14; p-value = 0.009) and the GD group (49.1±18.48 vs 33.92±13.93; p-value = 0.002). Moreover, participants who possessed a high risk of type 2 diabetes mellitus (T2DM) were shown to significantly reduce their sugar intake (48±21.39 vs 31.06±12.12; p-value = 0.003), whereas the decrease in the low-risk group was not significant. The proportion of participants who exceed daily dose recommendation (>50 g/day) decreased as well from 50% to 38% (p = 0.047) in the control group, whilst the GD group decreased from 38% to 9.5% (p = 0.030). These findings demonstrated that there were positive impacts from the program regarding the sugar restriction regardless of genetic disclosure. Nevertheless, health programs with genetic disclosure could be more valuable than general health programs.

Understanding Employee Wellness for Improved Performance and Achieving Sustainable Development Goal 3

The study examines the need, importance, and advantages of wellness that organisations should consider for their employees' general well-being. It is imperative to note that employee wellness is also linked to sustainable development goal 3 that deals with healthy living and wellness and expects organisations to abide to the goals and targets within their organisational context. The study is grounded in qualitative desktop research. The data is gathered through iterature and document reviews. The data was analysed through document and conceptual analysis. The findings explore the implementation gaps in employee wellness programmes, that also affect the effective realisation of SDG 3. In South Africa, societal issues such as health care, health sector financing, disease control and prevention pose a significant challenge to organisations and their ability to operate at peak performance. This is due to the main contributing factor, which is employee performance. The study suggests that this is imperative in every sector to sustain the physical, emotional, psychological, and health wellness of individual professionals, at every level, that has a positive impact on sustaining performance of the organisations. Effective wellness programmes may decrease stress levels and assist professionals to perform better.

Police mental health in small and rural areas of Pennsylvania

PurposeThe nature of policework is uniquely challenging to officers’ mental health, producing detrimental outcomes such as higher rates of suicide, substance abuse and divorce compared to other occupations. This is especially true in small and rural police departments, where officers often have broader responsibilities and cover a larger geographic area than their counterparts who work in large urban departments. Given the limited resources available to small and rural police, the purpose of this study is to explore the mental health services available to officers in small and rural police departments.Design/methodology/approachWe used a mixed methods approach. First, we surveyed 349 small and rural Pennsylvania police chiefs about the mental health services in their department. Of these chiefs, 53 participated in subsequent in-depth qualitative interviews about officer awareness of the mental health services available to them, what resources they thought would be helpful to officers and what barriers exist to prevent officers from seeking help.FindingsQuantitative results indicated that 22% of small and rural police departments had no mental health programs available to officers; Critical Incident Stress Management and Employee Assistance Programs were most commonly available. Budget size and the presence of a union influenced whether a department had mental health programs available to officers. Qualitative interviews found that although most departments provided some mental health services, officers were unlikely to use them. Chiefs expressed a need for improved services that officers might be more likely to use.Practical implicationsGiven the lack of resources available in small and rural police departments and the lack of adoption of some resources, we recommend peer assistance, general wellness programs and telehealth as feasible options for officer mental health.Originality/valueSmall and rural police comprise the bulk of policing in the USA, yet remain understudied. This study focuses on small and rural police.

A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: statistical analysis plan for a pragmatic cluster randomised controlled trial

BackgroundGlobally, violence against children poses substantial health and economic challenges, with estimated costs nearing USD 7 trillion. This prompts the urgent call for effective evidence-based interventions in preventing and mitigating violence against children. ParentApp is a mobile, open-source application designed to offer a remote version of the Parenting for Lifelong Health (PLH) programme. ParentApp is the first digital parenting intervention for caregivers of adolescents aged 10–17 years to be tested in low- and middle-income settings.MethodsThis study is a pragmatic, two-arm, cluster-randomised trial in Mwanza, Tanzania’s urban and peri-urban areas. Assessments are set for baseline, 1 month post-intervention, and 12 months post-intervention. We randomised 80 clusters, each with about 30 caregiver-adolescent dyads, with a 1:1 ratio stratified by urban or peri-urban location. Both arms receive an entry-level smartphone preloaded with Kiswahili apps—ParentApp for intervention and WashApp control.The primary method of analysis will be generalised linear mixed-effects models with adjustment for person-level characteristics and multiple imputation. In three-level models, measurement waves are nested within a person, nested within a sub-ward. Regressions will constrain groups to be equal at baseline and include covariates for stratification, percentage of male caregivers, and individual-level characteristics.DiscussionsPreparations for the trial began in December 2022, including community mobilisation and sensitisation. Rolling recruitment, baseline data collection, and implementation onboarding took place between April and September 2023. One-month post-test data collection began in August 2023 and thus far achieved 97% and 94% retention rates for caregivers and adolescents respectively. Final post-test data collection will begin in September 2024, anticipated to run until April 2025. This SAP was submitted to the journal before the interim analysis to preserve scientific integrity under a superiority hypothesis testing framework.Trial registrationThe trial was registered on the Open Science Framework on 14 March 2023: https://doi.org/10.17605/OSF.IO/T9FXZ.The trial protocol was published in Trials 25, 119 (2024): Baerecke, L., Ornellas, A., Wamoyi, J. et al. A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial. Trials 25, 119 (2024). https://doi.org/10.1186/s13063-023-07893-x.

Determinants of pneumococcal vaccination dropout among children aged 12-23 months in Ethiopia: a secondary analysis from the 2019 mini demographic and health survey.

Vaccination is a cost-effective public health program that helps reduce significant morbidity and mortality in children under the age of five. Worldwide, the number of vaccine-preventable causes of child death has significantly decreased since the Expanded Program of Immunization (EPI) was introduced. However, for a variety of reasons, 23 million children did not have adequate access to vaccines in 2020. Therefore, this study aimed to evaluate the determinants of pneumonia conjugate vaccine (PCV) dropout among children aged 12-23 months in Ethiopia. The study analyzed cross-sectional data obtained from the 2019 mini Ethiopian demographic and health survey. Multilevel binary logistic regression analysis was utilized, and the best fit model was chosen using the Akaike Information Criteria. The study comprised a weighted sample of 989 children aged 12 to 23 months. The study presented the Adjusted Odds Ratio (AOR) along with a 95% Confidence Interval (CI) to identify the significant factors influencing PCV dropout. The PCV dropout rate was reported at 20.2% in this study. In the multilevel analysis, possession of a health card (AOR = 0.076, 95% CI: 0.019, 0.04), vaccination for PCV 2 (AOR =0.002, 95% CI: 0.023, 0.263), and region 7 (AOR = 6.98, 95% CI: 10.1, 48.31) were significantly associated with children's PCV dropout. Having a health card, having received the PCV 2 vaccinations, and region were significant predictors of PCV dropout. Consequently, health education on immunization for all mothers and region-specific, customized public health interventions are needed to reduce the vaccination dropout rate.

Motivational Variables as Moderating Effects of a Web-Based Mental Health Program for University Students: Secondary Analysis of a Randomized Controlled Trial.

Self-guided web-based interventions have the potential of addressing help-seeking barriers and symptoms common among university students, such as depression and anxiety. Unfortunately, self-guided interventions are also associated with less adherence, implicating motivation as a potential moderator for adherence and improvement for such interventions. Previous studies examining motivation as a moderator or predictor of improvement on web-based interventions have defined and measured motivation variably, producing conflicting results. This secondary analysis of data from a randomized controlled trial aimed to examine constructs of motivation as moderators of improvement for a self-guided 8-week web-based intervention in university students (N=1607). Tested moderators included internal motivation, external motivation, and confidence in treatment derived from the Treatment Motivation Questionnaire. The primary outcome was an improvement in depression and anxiety measured by the Depression Anxiety Stress Scale-21. Piecewise linear mixed effects models showed that internal motivation significantly moderated symptom change for the intervention group (t1504=-2.94; P=.003) at average and high (+1 SD) motivation levels (t1507=-2.28; P=.02 and t1507=-4.05; P<.001, respectively). Significant results remained even after controlling for baseline severity. The results showed that confidence in treatment did not significantly moderate symptom change for the intervention group (t1504=1.44; P=.15). In this sample, only internal motivation was positively correlated with service initiation, intervention adherence, and intervention satisfaction. The combination of a web-based intervention and high or moderate internal motivation resulted in greater improvement in the total Depression Anxiety Stress Scale-21 score. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. The results suggest that the combination of a web-based intervention and high or moderate internal motivation results in greater improvement. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. To better understand the moderating role of internal motivation, future research is encouraged to replicate these findings in diverse samples as well as to examine related constructs such as baseline severity and adherence. Understanding these characteristics informs treatment strategies to maximize adherence and improvement when developing web-based interventions as well as allows services to be targeted to individuals likely to benefit from such interventions. ClinicalTrials.gov NCT04361045; https://clinicaltrials.gov/study/NCT04361045.

Scoping review of qualitative studies on family planning in Uganda.

Family planning (FP) is an essential component of public health programs and significantly impacts maternal and child health outcomes. In Uganda, there is a need for a comprehensive review of the existing literature on FP to inform future research and programmatic efforts. This scoping review aims to identify factors shaping the use of FP in Uganda. We conducted a systematic search of eight scholarly databases, for qualitative studies on FP in Uganda. We screened the titles and abstracts of identified articles published between 2002-2023 and assessed their eligibility based on predefined criteria. We extracted data from the 71 eligible studies and synthesized the findings using thematic analysis and the Ecological Systems Theory (EST) individual, interpersonal, community, institutional, and policy-level determinants. Findings reveal the interplay of factors at different socio-ecological levels influencing family planning decisions. At the individual level, the most common determinants related to the EST were knowledge and attitudes of FP. Interpersonal dynamics, including partner communication and social support networks, played pivotal roles. Community-level factors, such as cultural norms and accessibility of services, significantly influenced family planning practices. Institutional and policy-level factors, particularly a healthcare system's quality and policies, also shaped use. Other themes included the intersection of HIV/AIDS on FP practice and Ugandan views of comprehensive abortion care. This scoping review underscores the intricate socio-ecological fabric shaping FP in Uganda. The findings highlight the need for targeted interventions to increase knowledge and awareness of FP, improve access to services, and address social and cultural norms that discourage contraceptive use. Policymakers and program implementers should also consider gender dynamics and power imbalances in FP programs to ensure they are equitable and effective.

Complex Governance Network Analysis Between Brazilian Public Policies

Objective: The objective of this article is to create a Complex Governance Network Analysis Framework between two public policies. To prove the predictions of this study, the Theoretical Framework proposed here was applied between the National School Feeding Program (PNAE) and the School Health Program (PSE) in two locations. Theoretical Framework: To discuss the objective of this article, the approaches of Complex Governance Network (Morçöl, 2023) and Individual and Social Learning (Habermas, 1984, 1987; Lankester, 2013; Maarleveld and Dangbenonpag, 1999) were used. Method: This research is of a qualitative-descriptive nature and abductive logic, using as a strategy a study of multiple embedded cases and collection of primary and secondary data. Results and Discussion: By proposing a complex governance network analysis framework between two public policies, this study made a theoretical contribution by adding more dimensions to this theoretical lens. The study of learning contributes to understanding the cognitive evolution of the population, including adult learning, a responsible individual active in public policies. Research Implications: As practical contributions, this research helps in monitoring and structuring strategies in public management. Because, by understanding the learning level of each public servant, it is possible to observe the creativity of each actor involved in solving problems. Originality/Value: The study of learning contributes to understanding the cognitive evolution of the population, including adult learning, a responsible individual active in public policies.

TRAUMA, ADDICTION, AND THE PATH TO RECOVERY AFTER THE KAHRAMANMARAŞ EARTHQUAKES

The 2023 Kahramanmaraş earthquakes in Turkey, characterized by their suddenness and severity, have highlighted the acute need to understand and address the psychological aftermath of such natural disasters. This article examines the intersection of trauma and addiction that frequently follows such catastrophic events. It delves into the widespread psychological distress and the documented rise in post-traumatic stress disorder, anxiety, depression, and addictive behaviors among the affected populations. The review synthesizes findings from global earthquake studies, including those from Japan, Nepal, Italy, Iran, Pakistan, Haiti and China, to draw parallels and learn from previous experiences in managing post-disaster mental health challenges. The article proposes a multi-pronged approach to intervention that includes immediate responses such as Psychological First Aid and longer-term strategies like sustained psychological counseling and community-based support. It acknowledges the complexity of integrating cultural nuances into these interventions and highlights the importance of ethical considerations, political coordination, and the need for training mental health professionals in trauma-informed care. Challenges such as resource limitations, infrastructural damage, cultural barriers, and the need for long-term sustainability of mental health programs are discussed. Furthermore, the article stresses the importance of supporting the mental health of professionals and volunteers working in disaster zones, who are at risk of burnout and secondary trauma. Innovative and adaptable interventions, supported by rapid and responsive research, are advocated to improve mental health outcomes. This comprehensive review contributes to the discourse on disaster response, emphasizing that addressing both trauma and addiction is essential for the holistic recovery of affected individuals and communities.

School-Based Behavioral Health Programming for Newcomer Youth: A Scoping Review

ObjectiveNewcomer youth experience health disparities in accessing behavioral health services. School-based mental health programming is proposed a potential solution to address these disparities. The present study uses a scoping review methodology to examine the state-of-the-art of the evidence base for school-based mental health programming for newcomer youth. Studies were categorized into a tiered typology using the framework established by the National Center for School Mental Health. MethodsSeveral databases were examined as well as the results of one scoping and two systemic recent reviews. ResultsA total of 37 studies were included in the present analysis, over half from the last decade. Most studies were conducted in the United States and Europe, and most programs were focused on mental health promotion and wellness (Tier 1) or were multi-tiered. Programming for younger children, especially those in early childhood settings, were underrepresented. ConclusionsWhile the literature is promising regarding programming for newcomer youth, particularly the advent of complex multi-tiered programming, many gaps still remain. For example, most programs do not provide information on how programming was adapted for different groups of newcomers with different cultural and contextual needs. Tier 1 programs lack theoretical foundations or theories of change in the design of programming. Further, more research is needed for a group with rising numbers across high- and middle-income countries, particularly for programming targeting early and middle childhood.

Academic accountability to local communities and society through Programme Science: a case study from the HPV self-sampling programme HOPE in Peru.

Health challenges in the 21st century underscore the need for adaptable and innovative approaches in public health. Academic institutions can and should contribute much more effectively to generate and translate scientific knowledge that will result in better programmes to improve societal health. Academic accountability to local communities and society requires universities to actively engage with local communities, understanding the context, their needs, and leveraging their knowledge and local experience. The Programme Science initiative provides a framework to optimize the scale, quality and impact of public health programmes, by integrating diverse approaches during the iterative cycle of research and practice within the strategic planning, programme implementation and programme management and evaluation. We illustrate how the Programme Science framework could be a useful tool for academic institutions to accomplish accountability to local communities and society through the experience of Project HOPE in Peru. Project HOPE applied the Programme Science framework to introduce HPV self-sampling into a women's health programme in Peru. Collaboration with local authorities and community members was pivotal in all phases of the project, ensuring interventions aligned with community needs and addressing social determinants of health. The HOPE Ladies-community women trained and empowered to promote and provide the HPV kits-crafted the messages used through the study and developed strategies to reach individuals and provided support to women's journey through health centres. By engaging communities in co-creating knowledge and addressing health inequities, academic institutions can generate contextually relevant and socially just scientific knowledge. The active participation of community women in Project HOPE was instrumental in improving service utilization and addressing barriers to self-sampling. The Programme Science approach offers a pathway for academic institutions to enhance their accountability to communities and society at large. By embedding researchers within public health programmes and prioritizing community engagement, academic institutions can ensure that research findings directly inform policy improvements and programmatic decisions. However, achieving this requires a realignment of research agendas and recognition of the value of community engagement. Establishing Programme Science networks involving academia, government and funding entities can further reinforce academic accountability and enhance the impact of public health programmes.

The carbon footprint of health care delivery in Western Australia's public health system

Health systems have a dual imperative to take action on climate change. First, they must develop climate resilient health services in response to the direct and indirect impacts of climate change on health. Second, they must reduce their own carbon footprint since health systems are a significant contributor to global greenhouse gas emissions. An environmentally-extended multi-region input-output analysis was carried out, incorporating National Accounts data for Australia and annual expenditure data from WA Health for financial year 2019-20. Expenditure data were categorised to one of 344 economic sectors and by location of the provider of goods or services purchased. WA Health contributes 8% of WA's total carbon footprint, driven by expenditure on chemicals (23.8% of total), transport (20.2% of total), and electricity supply (19.7% of total). These 3 sectors represent 63.7% of WA Health's carbon footprint, but only 10.8% of its total expenditure. Reducing emissions related to health service provision in WA will require a holistic approach that leverages carbon footprinting insights and integrates them into organisational decision-making across all health programs. The high carbon-intensity of the transport and chemicals sectors supports previous research calling for a reduction in unnecessary pathology testing and the transition to delivery of non-urgent health care via sustainable models of telehealth. The impact of WA's size and location presents challenges, with a predominantly non-renewable energy supply and reliance on transport and supply chains from other states adding significantly to emissions. The study received funding from the Australian Research Council, The University of Sydney, and the WA Department of Health. The full list of funding information can be found in Acknowledgements.