International Journal of Environmental Research and Public Health

15 pages, 581 KB

Open AccessArticle

A Qualitative Consolidated Framework for Implementation Research Evaluation of Innovative PrEP Delivery During COVID-19 Among Adolescent Girls and Young Women in North West Province, South Africa

by Lerato Lucia Olifant, Edith Phalane, Yegnanew A. Shiferaw, Hlengiwe Mhlophe and Refilwe Nancy Phaswana-Mafuya

Int. J. Environ. Res. Public Health 2025, 22(10), 1602; https://doi.org/10.3390/ijerph22101602 - 21 Oct 2025

Viewed by 176

Abstract

Background: Innovative interventions, such as social media platforms and telemedicine, were implemented during the COVID-19 lockdown period for HIV prevention and treatment services. However, limited studies have reported on the facilitators and barriers of these innovations for HIV pre-exposure prophylaxis (PrEP) service continuity. [...] Read more.

Background: Innovative interventions, such as social media platforms and telemedicine, were implemented during the COVID-19 lockdown period for HIV prevention and treatment services. However, limited studies have reported on the facilitators and barriers of these innovations for HIV pre-exposure prophylaxis (PrEP) service continuity. Therefore, this study aimed to identify the barriers and facilitators of the implemented PrEP innovative interventions during COVID-19 among adolescent girls and young women (AGYW). Methods: A qualitative exploratory design was used to conduct semi-structured interviews with twelve stakeholders in the Dr Kenneth Kaunda District, North West Province of South Africa. Participants included various TB HIV Care programme stakeholders, comprising professional nurses, case managers, peer educators, and counsellors. The Consolidated Framework for Implementation Research (CFIR) 2.0 domains and constructs guided the interview questions and the analysis process. Additionally, all interviews were audio-taped, transcribed verbatim, and analyzed through thematic analysis. The facilitators and barriers of the PrEP innovative interventions were categorized according to the five CFIR domains. Results: The findings showed that despite the COVID-19 disruptions in healthcare services, the implemented innovative PrEP interventions enhanced the HIV prevention services. Facilitators included sufficient mobile data, teamwork, clear communication from managers, resilience, and existing media pages that supported social media-based PrEP service continuity. The implementation barriers included service users’ lack of cell phone devices, incorrect personal information, fear of contracting COVID-19, and limited individual movements. Conclusion: Social media and digital technologies played a crucial role in the continuation of HIV PrEP services among AGYW. These evaluations also illustrated the potential of social media platforms to be leveraged for HIV service delivery during periods of disruption, such as the COVID-19 lockdown period, for HIV service delivery. Furthermore, lessons learned from this study are significant and offer practical considerations for sustaining PrEP during service disruptions. Full article

(This article belongs to the Special Issue Women and Pre-Exposure Prophylaxis for HIV Prevention)

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12 pages, 527 KB

Open AccessSystematic Review

Community Forests and Public Health: A Research Agenda

by Pooja S. Tandon, Shelby Semmes, Kim Garrett, Liv Ellerton, Susan Charnley and Howard Frumkin

Int. J. Environ. Res. Public Health 2025, 22(10), 1601; https://doi.org/10.3390/ijerph22101601 - 21 Oct 2025

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Abstract

The natural environment is integral to supporting healthy and resilient communities. Community forests (CFs) are forested parcels, typically in rural areas, where community members have access, share governance, and receive various benefits. While considerable research demonstrates that urban parks and forests are important [...] Read more.

The natural environment is integral to supporting healthy and resilient communities. Community forests (CFs) are forested parcels, typically in rural areas, where community members have access, share governance, and receive various benefits. While considerable research demonstrates that urban parks and forests are important for human health, similar assessments are less available for CFs specifically. Although CFs exist in multiple countries, their policy, ecological, ownership, and governance contexts differ significantly. This review focuses on CFs in the United States. The goals of this project were to systematically review current evidence on the relationship between CFs and human health, identify knowledge gaps in the existing research, and propose a scientific research agenda that identifies critical questions related to CFs and public health in the U.S., with application in other contexts. We conducted a systematic review of the literature, screening 351 studies and assessing twenty-four full-text articles, only one of which met inclusion criteria. This mixed-methods study characterized 70 CFs in the Eastern U.S. and featured four case studies. The majority of CFs (93%) and all case studies identified recreational use as their most common purpose. The evidence base on the health implications of CFs is very thin. Targeted research on CFs and their impact on health could provide evidence to inform CF processes and help optimize their health outcomes. We propose a research agenda on CFs in the U.S. based on several pathways of public health promotion: nature contact, climate mitigation/adaptation, economic opportunities, community cohesion, and equity. Full article

(This article belongs to the Special Issue Means of Promoting Health Benefits Derived from the Forest Environment to the General Public)

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9 pages, 225 KB

Open AccessCommentary

Thriving in the First 1000 Days: Lessons from Positive Deviance Among Young Families

by Andrew P. Hills, Sisitha Jayasinghe, Kylie Mulcahy and Nuala M. Byrne

Int. J. Environ. Res. Public Health 2025, 22(10), 1600; https://doi.org/10.3390/ijerph22101600 - 21 Oct 2025

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Abstract

The first 1000 days (F1D), from conception to a child’s second birthday, constitute a critical window for shaping long-term health, development, and wellbeing. While conventional approaches often rely on external interventions to support young families, the Positive Deviance (PD) framework offers a compelling [...] Read more.

The first 1000 days (F1D), from conception to a child’s second birthday, constitute a critical window for shaping long-term health, development, and wellbeing. While conventional approaches often rely on external interventions to support young families, the Positive Deviance (PD) framework offers a compelling alternative: identifying and amplifying successful behaviours already present within communities facing similar constraints. This paper explores how PD can be harnessed to foster sustainable, community-led change during the F1D. By uncovering local success stories, promoting participatory engagement, and strengthening caregiver self-efficacy, PD enables communities to co-create solutions that are culturally relevant and contextually grounded. However, effective application of PD requires careful attention to structural inequities, ethical storytelling, and rigorous methodological standards to avoid inadvertently shifting responsibility onto individuals. When implemented thoughtfully, PD reveals “what works” in resource-limited settings, empowering communities to build child-inclusive environments rooted in local expertise and resilient practices. Full article

14 pages, 307 KB

Open AccessArticle

Impact of COVID-19 on Mental Health: Sociodemographic Differences and the Moderating Effect of Religiosity

by Ivica Fotez, Zudi Osmani, Aleksandar Vcev, Lara Fotez, Darko Kotromanovic, Lucija Fotez, Mate Car, Gordana Horvat, Ivan Miskulin and Maja Miskulin

Int. J. Environ. Res. Public Health 2025, 22(10), 1599; https://doi.org/10.3390/ijerph22101599 - 21 Oct 2025

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Abstract

Background and Objectives: This research aimed to examine the impact of sociodemographic characteristics on mental health during the COVID-19 pandemic, with religiosity as a moderator. Materials and Methods: The cross-sectional study was conducted in family medicine clinics within the Primary Healthcare Center of [...] Read more.

Background and Objectives: This research aimed to examine the impact of sociodemographic characteristics on mental health during the COVID-19 pandemic, with religiosity as a moderator. Materials and Methods: The cross-sectional study was conducted in family medicine clinics within the Primary Healthcare Center of Virovitica-Podravina County among 1131 participants, divided into 2 groups: RC (Recovered from COVID-19; N = 423) and NRC (Not Recovered from COVID-19; N = 708). To ensure clear differentiation, RC participants were defined as individuals with documented positive PCR results for SARS-CoV-2 (prior infection and clinical recovery), whereas NRC participants exhibited consistently negative PCR results and lacked any clinical history of the disease. Group allocation was rigorously based on the review of medical records and corresponding PCR documentation obtained both at the time of recruitment and retrospectively. All data were collected through a questionnaire from September 2022 to September 2023. Participants completed questionnaires measuring their sociodemographic characteristics (gender, age, education, and marital status), levels of depression, anxiety, stress, and level of religiosity. Results: Older participants were more prone to depression, whereas younger participants showed relatively better mental-health indicators. Sociodemographic characteristics were significantly associated with mental health during the pandemic. Religiosity was found to be a significant moderator in the relationship between sociodemographic characteristics and mental health. Individuals with higher levels of religiosity reported higher levels of depression and anxiety, suggesting that religiosity may act as a negative factor in times of crisis. Conclusions: Sociodemographic characteristics were significant predictors of mental health during the pandemic. Religiosity emerged as an important factor, particularly in moderating the relationship between sociodemographic characteristics and mental health. Further research is recommended to develop targeted interventions for vulnerable groups such as women, younger individuals, and those with lower incomes. Full article

19 pages, 999 KB

Open AccessSystematic Review

Effectiveness of Psychological Treatments for Problematic Use of Internet, Video Games, Social Media and Instant Messaging: A Systematic Review and Meta-Analysis

by Mateo Pérez-Wiesner, Kora-Mareen Bühler, José Antonio López-Moreno and Maria Dolores López-Salmerón

Int. J. Environ. Res. Public Health 2025, 22(10), 1598; https://doi.org/10.3390/ijerph22101598 - 21 Oct 2025

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Abstract

Adolescence is a developmental stage characterized by increased vulnerability to technology use. Several models have been proposed to explain the psychological processes involved in addictive use. In response to this evidence, therapeutic and preventive intervention programs aim to reduce key symptoms in order [...] Read more.

Adolescence is a developmental stage characterized by increased vulnerability to technology use. Several models have been proposed to explain the psychological processes involved in addictive use. In response to this evidence, therapeutic and preventive intervention programs aim to reduce key symptoms in order to promote health and protect adolescents. This study presents a systematic review and meta-analysis on the effectiveness of psychological therapeutic and preventive interventions for problematic use of Information and Communication Technologies (ICTs) in adolescents (aged 10–21). A total of nine studies (five RCTs and four non-RCTs) with 744 participants were analyzed. The search was conducted following PRISMA guidelines and using the PICO framework. Included studies involved face-to-face or online psychological therapeutic and preventive interventions targeting adolescents, with a particular focus on cognitive behavioral therapy (CBT). Results indicate significant effects in favor of the experimental group in reducing symptoms associated with Internet, video game, social media, and instant messaging addiction, with pooled effect sizes of SMD = −1.53 (RCTs) and SMD = −1.13 (non-RCTs). Despite heterogeneity and potential publication bias, the evidence supports the effectiveness of these interventions, particularly CBT, family therapy, and executive function training. A multidisciplinary approach, early detection, and treatment personalization are recommended. Methodological limitations were identified, highlighting the need for more rigorous future research with attention to gender differences and cultural adaptation. Full article

(This article belongs to the Section Behavioral and Mental Health)

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11 pages, 484 KB

Open AccessArticle

The Impact of Anosmia on Intimacy: A Linear Mixed-Effects Model Analysis of Sexual Wellbeing Following COVID-19

by Arianna Miclet, Daniele Mollaioli, Marco Lauriola, Giacomo Ciocca, Andrea Sansone, Emmanuele A. Jannini and Erika Limoncin

Int. J. Environ. Res. Public Health 2025, 22(10), 1597; https://doi.org/10.3390/ijerph22101597 - 21 Oct 2025

Viewed by 352

Abstract

Olfaction is thought to have a role in intimate relationships and sexuality, despite the major roles that other senses, like sight, might have for human beings. Moreover, one of the specific symptoms of the COVID-19 infection, a disease largely impacting human sexuality at [...] Read more.

Olfaction is thought to have a role in intimate relationships and sexuality, despite the major roles that other senses, like sight, might have for human beings. Moreover, one of the specific symptoms of the COVID-19 infection, a disease largely impacting human sexuality at various levels, has been the absence of smell. This study aimed to examine the impact of olfaction on partner selection and on different phases of sexual response. Moreover, we evaluated whether the absence of smell could influence aspects of sexual function, such as orgasmic intensity, by comparing subjects with and without COVID-19 olfactory dysfunction. A group of 259 participants has been initially enrolled through social media. Of the 138 sexually active subjects included in the final analysis, 61 (44.2%) reported olfactory dysfunction (anosmia group) and 77 (55.8%) did not (no-anosmia group). Perceived orgasmic intensity was evaluated retrospectively at two time points—during the COVID-19 infection and in the four weeks preceding the evaluation—using the male and female versions of the Orgasmometer. The results revealed a significant interaction between time and olfactory condition, indicating opposite recovery trajectories. Participants without anosmia showed a significant improvement in orgasmic intensity post-COVID-19 infection; in contrast, the anosmia group reported a significant decline over the same period. Although the presence of anosmia was not a direct predictor of orgasmic intensity per se, it critically determined the orgasmic intensity evolution over time. These findings suggest that, beyond its perceived importance, the actual absence of olfaction may have a specific and negative long-term impact on core components of the sexual experience, such as the intensity of orgasm. Full article

(This article belongs to the Special Issue Sexual Health and Sexual Behavior in the 21st Century)

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13 pages, 282 KB

Open AccessArticle

Improving Decision-to-Incision Interval (DDI) of Emergency Cesarean Sections Through Mobile-Based Obstetric Emergency System (MORES) and Midwife-Led Triage in Bong County, Liberia: A Quasi-Experimental Study

by HaEun Lee, Sunghae Kim, Joseph Sieka, Wahdae-Mai Harmon-Gray, Philip T. Veliz and Jody R. Lori

Int. J. Environ. Res. Public Health 2025, 22(10), 1596; https://doi.org/10.3390/ijerph22101596 - 21 Oct 2025

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Abstract

Background: Delays in emergency cesarean section (CS) remain a major contributor to maternal and neonatal morbidity in low-resource settings. This study evaluated the combined effect of a mobile-based obstetric emergency system (MORES) and a midwife-led triage program on the decision-to-incision interval (DDI) [...] Read more.

Background: Delays in emergency cesarean section (CS) remain a major contributor to maternal and neonatal morbidity in low-resource settings. This study evaluated the combined effect of a mobile-based obstetric emergency system (MORES) and a midwife-led triage program on the decision-to-incision interval (DDI) and related outcomes in Liberia. Methods: A quasi-experimental study with an interrupted time series design was conducted in Bong County across two district hospitals receiving referrals from 20 rural health facilities. Seventy-two women referred for emergency CS were observed at baseline, midline, and endline. MORES used WhatsApp-based communication to improve referral coordination, while the triage program trained midwives to rapidly assess cases using a color-coded system. Data were analyzed using descriptive statistics, Wilcoxon rank-sum, chi-squared tests, and logistic regression. Results: By endline, the median DDI decreased by 117.5 min compared to baseline (95% CI: −205.1 to −29.9). Women were significantly more likely to receive a CS within 75 min (AOR: 11.7; 95% CI: 1.32 to 104.5). No maternal deaths occurred. Neonatal mortality was observed but not significantly associated with DDI. Conclusions: MORES and midwife-led triage substantially improved the timeliness of emergency CS in a resource-constrained setting. These low-cost, feasible strategies warrant further evaluation for sustainability and impact on neonatal outcomes. Full article

(This article belongs to the Special Issue Improving the Quality of Maternity Care)

11 pages, 872 KB

Open AccessArticle

Observational Study on Actual Cancer Screening Participation and Outcomes Among Patients with Lung Cancer Based on Linkage of Cancer Registry and Kyoto City Integrated Database Data from 2014 to 2018

by Tomonari Shimamoto, Yukiko Tateyama, Daisuke Kobayashi, Keiichi Yamamoto, Norihiro Nishioka, Yoshimitsu Takahashi, Hiroaki Ueshima, Kosuke Sasaki, Kosuke Kiyohara, Takeo Nakayama and Taku Iwami

Int. J. Environ. Res. Public Health 2025, 22(10), 1595; https://doi.org/10.3390/ijerph22101595 - 21 Oct 2025

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Abstract

Background: Lung cancer is a major cause of death. Japan has a higher rate of early detection of lung cancer, which is attributed to the impact of chest X-ray examinations implemented as mass screening. This study describes the characteristics and outcomes of patients [...] Read more.

Background: Lung cancer is a major cause of death. Japan has a higher rate of early detection of lung cancer, which is attributed to the impact of chest X-ray examinations implemented as mass screening. This study describes the characteristics and outcomes of patients with lung cancer in Japan, where chest X-ray screening is recommended for everyone aged >40 years old. Methods: This observational study linked the Kyoto City Integrated Database with data from a nationwide cancer registry in Japan. This study assessed individuals aged ≥65 years diagnosed with primary lung cancer between 2014 and 2018. Patients were categorized into the screened or unscreened groups based on their screening history within 1 year before diagnosis. Results: Of 4473 patients with lung cancer, 231 were included in the screened group. The screened group had a mortality rate of 25% at 1.7 years and 50% at 5.6 years, versus 25% at 0.5 years and 50% at 1.8 years for the unscreened group. Conclusions: Patients with primary lung cancer who underwent lung cancer screening had longer survival and better overall health at diagnosis than those who did not undergo screening. Further study is required to estimate the effectiveness of chest X-ray lung cancer screening. Full article

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19 pages, 7347 KB

Open AccessArticle

Benefits of an Innovative 90-Day Longevity Workplace Program on Health in the United Arab Emirates (UAE)

by Ghanem Al Hassani, Erik Koornneef, Mariam Al Harbi, Salah El Din Hussein, Ghuwaya Al Neyadi, Omar Al Hammadi, Yasser Ghoneim, Mostafa Abdrabo and Stephen G. Holt

Int. J. Environ. Res. Public Health 2025, 22(10), 1594; https://doi.org/10.3390/ijerph22101594 - 21 Oct 2025

Viewed by 184

Abstract

Unhealthy lifestyle behaviors, such as physical inactivity and an unhealthy diet, can decrease quality of life and increase the risk of obesity, depression, and chronic diseases like diabetes and cardiovascular disease. In workplace settings, these health issues are associated with increased healthcare costs [...] Read more.

Unhealthy lifestyle behaviors, such as physical inactivity and an unhealthy diet, can decrease quality of life and increase the risk of obesity, depression, and chronic diseases like diabetes and cardiovascular disease. In workplace settings, these health issues are associated with increased healthcare costs and reduced productivity. The Pure Health 2K Longevity Study (PHLS) evaluated the effectiveness of a 90-day incentive-based lifestyle intervention among working adults in the United Arab Emirates (UAE). A single-arm interventional study was conducted by Abu Dhabi Health Services Company (SEHA) over a 4-month period. A total of 2300 participants aged 18–59 were enrolled, with 1688 (73.4%) completing the program. Participants underwent baseline and endline assessments, including physical measurements (weight, body mass index (BMI), waist circumference), biochemical parameters (blood pressure, glucose, Glycosylated hemoglobin (HbA1c), lipid profile, C-reactive protein (CRP), Gamma-glutamyl transferase (GGT), and self-reported health behaviors and adverse events. Significant reductions were observed in weight (77.0 to 75.9 kg), BMI (26.8 to 26.4 kg/m²), and waist circumference (95 to 93 cm) (all p < 0.001). Notably, 4.6% of participants transitioned from overweight to normal weight, and 3.4% from obese to overweight. No adverse events were reported. A short-term, workplace-based lifestyle intervention can produce meaningful improvements in anthropometric and biochemical health indicators, particularly among high-risk individuals. Full article

(This article belongs to the Special Issue Exercise in Living Environments: A Healthy Lifestyle)

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20 pages, 479 KB

Open AccessArticle

Equipping Change Agents: Applying Mixed Methods to Learn About the Outcomes of the Co-Designed Caregiver-Centered Care Champions Education Program

by Tanya L’Heureux, Jasneet Parmar, David Nicholas, Lesley Charles, Cheryl Pollard, Myles Leslie, Kimberly Shapkin, Shannon Saunders, Cindy Sim, Paige Walker, Ginger Bitzer, Safia Khalfan and Sharon Anderson

Int. J. Environ. Res. Public Health 2025, 22(10), 1593; https://doi.org/10.3390/ijerph22101593 - 20 Oct 2025

Viewed by 511

Abstract

Family caregivers provide most daily care for people living with chronic illness or frailty, yet they remain under-recognized in health and social care systems. To address this gap, we co-designed the Caregiver-Centered Care Champions Education Program, which equips frontline providers with the competencies [...] Read more.

Family caregivers provide most daily care for people living with chronic illness or frailty, yet they remain under-recognized in health and social care systems. To address this gap, we co-designed the Caregiver-Centered Care Champions Education Program, which equips frontline providers with the competencies needed to lead caregiver-inclusive change. Guided by the Kirkpatrick-Barr Health Workforce Education Framework, we conducted a mixed methods interpretive description evaluation of learner satisfaction, knowledge and confidence gains, and self-reported behaviour change. Sixty-seven interdisciplinary participants completed three online modules. Quantitative results from pre/post surveys (Wilcoxon signed rank tests) showed significant improvements across all competencies (p < 0.001; large effect sizes) alongside high satisfaction (means 6.56–6.96/7). Qualitative findings revealed that 94% of participants applied program content within three months, and 61% implemented five or more distinct behaviour changes (e.g., collaborative care planning, system navigation support). The analysis illuminated how learners integrated caregiver-centred principles with change leadership strategies. Time constraints and staffing shortages emerged as key barriers. Our co-designed, theory-informed approach effectively bridged individual learning and system change, demonstrating the potential to transform caregiver inclusion practices when supported by organizational policies. Full article

(This article belongs to the Special Issue Family Caregiving, Nursing and Health Promotion)

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17 pages, 1902 KB

Open AccessReview

A Scoping Review of Preventive and Treatment Interventions of Parental Psychological Distress in the NICU in the United States

by Kiara A. I. Barnett, Ahnyia Sanders, Rebecca Kyser, Bahar Babagoli, Deepika Goyal and Huynh-Nhu Le

Int. J. Environ. Res. Public Health 2025, 22(10), 1592; https://doi.org/10.3390/ijerph22101592 - 20 Oct 2025

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Abstract

Parents of premature infants in the Neonatal Intensive Care Unit (NICU) are at elevated risk of anxiety, depression, stress, and trauma, which may impair bonding and infant development. This scoping review synthesized preventive and treatment interventions designed to reduce parental psychological distress in [...] Read more.

Parents of premature infants in the Neonatal Intensive Care Unit (NICU) are at elevated risk of anxiety, depression, stress, and trauma, which may impair bonding and infant development. This scoping review synthesized preventive and treatment interventions designed to reduce parental psychological distress in the United States. Guided by PRISMA-ScR, systematic searches were conducted in PubMed, Scopus, MEDLINE, and PsycINFO. Eligible studies were those that examined interventions for parents of preterm infants (<37 weeks’ gestation) initiated before, during, or within one year after NICU discharge. Excluded were studies limited to abstracts or qualitative designs; those not addressing parental depression, anxiety, post-traumatic stress disorder, or stress; and those involving congenital anomalies or conducted outside the United States. Eighteen studies met the inclusion criteria, including ten prevention-focused and seven treatment-focused studies. Eight reported significant reductions in distress, with cognitive behavioral therapy (CBT) and the Creating Opportunities for Parent Empowerment (COPE) program showing the strongest evidence. However, most interventions targeted mothers, highlighting underrepresentation of fathers. Overall, findings underscore the need for interventions that address both parents, include diverse populations, and evaluate participant engagement to improve clinical applicability. Full article

(This article belongs to the Special Issue Advances in Maternal and Family Mental Health: Relational, Clinical, and Systemic Approaches Across the Reproductive and Perinatal Spectrum)

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22 pages, 1754 KB

Open AccessArticle

Meta-Analysis of the Gut Microbiome: An African American Representation

by Anushka KC and Roshan Paudel

Int. J. Environ. Res. Public Health 2025, 22(10), 1591; https://doi.org/10.3390/ijerph22101591 - 20 Oct 2025

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Abstract

The human gut hosts approximately 100 trillion microbes, forming a complex ecosystem critical to the body’s metabolism, nutrition, and immune function. Despite growing research, African Americans remain underrepresented in clinical studies. This study addresses the gap through a comprehensive meta-analysis of gut microbiome [...] Read more.

The human gut hosts approximately 100 trillion microbes, forming a complex ecosystem critical to the body’s metabolism, nutrition, and immune function. Despite growing research, African Americans remain underrepresented in clinical studies. This study addresses the gap through a comprehensive meta-analysis of gut microbiome datasets. Fecal sample data from amplicon sequencing were analyzed using a bioinformatics pipeline that incorporated DADA2 for sequence processing and Phyloseq for diversity analysis within RStudio (v2024.09.0+375). Statistical approaches, including Wilcoxon tests, Kruskal–Wallis tests, PERMANOVA, and ANCOM-BC, identified significant microbial differences. Results revealed that African Americans exhibited lower microbial diversity. Beta diversity metrics demonstrated a stronger effect of ethnicity compared to diet, age, sex, and BMI, highlighting its significance in microbiome variation. Similarly, ANCOM-BC identified Clostridium sensu stricto 1 significantly enriched in healthy African Americans, while Dialister was depleted, a finding with potential clinical relevance given previous research linking reduced Dialister abundance with depression. Additionally, machine learning approaches were found to potentially complement traditional statistical methods by handling class imbalance and identifying complex microbial associations. By addressing critical gaps in microbiome research, this study underscores the importance of inclusive datasets in enhancing disease risk prediction and ensuring that microbiome-based health interventions are equitable and broadly applicable. Full article

(This article belongs to the Special Issue Proceedings of the 2024 and 2025 Research Centers in Minority Institutions (RCMI) Consortium National Conferences)

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Graphical abstract

32 pages, 2059 KB

Open AccessSystematic Review

Evidence of Face Masks and Masking Policies for the Prevention of SARS-CoV-2 Transmission and COVID-19 in Real-World Settings: A Systematic Literature Review

by Noe C. Crespo, Savannah Shifflett, Kayla Kosta, Joelle M. Fornasier, Patricia Dionicio, Eric T. Hyde, Job G. Godino, Christian B. Ramers, John P. Elder and Corinne McDaniels-Davidson

Int. J. Environ. Res. Public Health 2025, 22(10), 1590; https://doi.org/10.3390/ijerph22101590 - 20 Oct 2025

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Abstract

Objectives: Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease COVID-19 is a public health priority. The efficacy of non-pharmaceutical interventions such as wearing face masks to prevent SARS-CoV-2 infection has been well established in controlled settings. However, evidence for [...] Read more.

Objectives: Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease COVID-19 is a public health priority. The efficacy of non-pharmaceutical interventions such as wearing face masks to prevent SARS-CoV-2 infection has been well established in controlled settings. However, evidence for the effectiveness of face masks in preventing SARS-CoV-2 transmission within real-world settings is limited and mixed. The present systematic review evaluated the effectiveness of face mask policies and mask wearing to prevent SARS-CoV-2 transmission and COVID-19 in real-world settings. Methods: Following PRISMA guidelines, scientific databases, and gray literature, were searched through June 2023. Inclusion criteria were as follows: (1) studies/reports written in or translated to English; (2) prospectively assessed incidence of SARS-CoV-2 or COVID-19; (3) assessed the behavior and/or policy of mask-wearing; and (4) conducted in community/public settings (i.e., not laboratory). Studies were excluded if they did not parse out data specific to the effect of mask wearing (behavior and/or policy) and subsequent SARS-CoV-2 transmission or COVID-19 disease or if they relied solely on statistical models to estimate the effects of mask wearing on transmission. A total of 2616 studies were initially identified, and 470 met inclusion and exclusion criteria for full-text review. The vote counting method was used to evaluate effectiveness, and risk of bias was assessed using JBI critical appraisal tools. Results: A total of 79 unique studies met the final inclusion criteria, and their data were abstracted and evaluated. Study settings included community/neighborhood settings (n = 34, 43%), healthcare settings (n = 30, 38%), and school/universities (n = 15, 19%). A majority of studies (n = 61, 77%) provided evidence to support the effectiveness of wearing face masks and/or face mask policies to reduce the transmission of SARS-CoV-2 and/or prevention of COVID-19. Effectiveness of mask wearing did not vary substantially by study design (67–100%), type of mask (77–100%), or setting (80–91%), while 85% of masking policies specifically reported a benefit. Conclusions: This systematic literature review supports public health recommendations and policies that encourage the public to wear face masks to reduce the risk of SARS-CoV-2 infection and COVID-19 in multiple real-world settings. Effective communication strategies are needed to encourage and support the use of face masks by the general public, particularly during peak infection cycles. Full article

(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)

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15 pages, 24877 KB

Open AccessArticle

The Relationship Between Food Environments and Health Outcomes: A Case Study in Lansing, Michigan

by Zeenat Kotval-K and Olivia R Nedd

Int. J. Environ. Res. Public Health 2025, 22(10), 1589; https://doi.org/10.3390/ijerph22101589 - 20 Oct 2025

Viewed by 199

Abstract

Chronic disease, for which diet is a major risk factor, remains the leading cause of death in the United States, responsible for 8 out of 10 deaths. A continually growing body of research has been looking at food environments, relating them to characteristics [...] Read more.

Chronic disease, for which diet is a major risk factor, remains the leading cause of death in the United States, responsible for 8 out of 10 deaths. A continually growing body of research has been looking at food environments, relating them to characteristics of residents living in those environments and impacts on health outcomes. However, most of the research has been looking at Body Mass Index or obesity as the primary health outcome of such environments. This study looks at multiple health outcomes (chronic and perceived) from the Center for Disease Control’s PLACES—Local Data for Better Health dataset for Lansing, Michigan, and assesses the corresponding food environments, specifically the prevalence of fast-food outlets and convenience stores, to assess the impacts these food environments have, either directly or indirectly, on health. We find that fast-food outlets have a direct impact on certain health outcomes, while convenience stores impact certain health outcomes indirectly through food insecurity. These findings suggest that strategically balancing such environments with healthier options in underserved areas could help improve overall health. Full article

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26 pages, 1176 KB

Open AccessArticle

Impact of Face-to-Face and Online Mindfulness-Based Public Health Interventions on Health-Related Quality of Life in Older People: A Comparative Study

by Denis Juraga, Tomislav Rukavina, Mihaela Marinović Glavić, Darko Roviš, Aleksandar Racz, Lovorka Bilajac, Maša Antonić, Hein Raat and Vanja Vasiljev

Int. J. Environ. Res. Public Health 2025, 22(10), 1588; https://doi.org/10.3390/ijerph22101588 - 20 Oct 2025

Viewed by 310

Abstract

Health-related quality of life (HRQoL) is an important indicator of well-being among older people, especially those living with chronic diseases. Mindfulness-based interventions have shown promise in improving HRQoL. However, in the literature there is a limited number of studies that compare the effectiveness [...] Read more.

Health-related quality of life (HRQoL) is an important indicator of well-being among older people, especially those living with chronic diseases. Mindfulness-based interventions have shown promise in improving HRQoL. However, in the literature there is a limited number of studies that compare the effectiveness of face-to-face and online mindfulness-based public health interventions. This study aimed to evaluate and compare the effectiveness of face-to-face and online mindfulness-based public health interventions on HRQoL among older people with chronic conditions. A quasi-experimental pre-test–post-test non-randomized study design with non-equivalent groups was conducted among 388 participants aged 65 and older in Rijeka, Croatia. Participants chose to join either a seven-week face-to-face or online mindfulness program or were included in a control group. HRQoL was measured using the SF-12 and EQ-5D-5L questionnaires at baseline and six months post-intervention. Participants in the online intervention showed significant improvements in subjective HRQoL perception regarding physical (p < 0.001, η² = 0.066) and mental dimension (p = 0.052; η² = 0.010) as well as self-assessed health (EQ-5D-5L = p < 0.001, η² = 0.055; EQ-VAS = p < 0.001, η² = 0.067) compared to the control group. The face-to-face group also showed improvements, although to a lesser extent. The control group showed no significant change. Both face-to-face and online mindfulness-based interventions may be associated with improvements in HRQoL among older people with chronic conditions, with the online approach demonstrating slightly greater effects. These findings support the use of online approach in community-based public health interventions targeting older populations. Full article

(This article belongs to the Special Issue The Health-Related Quality of Life of Older People with Chronic Disease)

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14 pages, 826 KB

Open AccessArticle

The Impact of Prolonged Stress of COVID-19 Pandemic and Earthquakes on Internet-Based Addictive Behaviour and Quality of Life in Croatia

by Zrnka Kovačić Petrović, Tina Peraica, Mirta Blažev and Dragica Kozarić-Kovačić

Int. J. Environ. Res. Public Health 2025, 22(10), 1587; https://doi.org/10.3390/ijerph22101587 - 19 Oct 2025

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Abstract

Prolonged stress caused by the COVID-19 pandemic and two concurrent earthquakes in 2020 increased Internet-based addictive behaviour, leading to decrease in mental health and quality of life (QoL) in the adult Croatian population. This study examined the association between Internet-based addictive behaviour and [...] Read more.

Prolonged stress caused by the COVID-19 pandemic and two concurrent earthquakes in 2020 increased Internet-based addictive behaviour, leading to decrease in mental health and quality of life (QoL) in the adult Croatian population. This study examined the association between Internet-based addictive behaviour and QoL during prolonged stress (pandemic and earthquakes). Specifically, it explored direct associations between QoL domains and overall/specific Internet use, problematic Internet use (PIU), and symptoms of anxiety, depression, and stress, as well as the indirect role of these symptoms in mediating the relationship between PIU and QoL. A cross-sectional online survey was conducted in autumn 2021 with a convenience sample (N = 1004; 82.2% women; M age = 34.98, SD = 12.24). Measures included increased overall and specific Internet use, PIU, stress (Impact of Event Scale), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), and QoL (WHOQoL-BREF). Structural equation modelling showed that increased Internet use and PIU were directly associated with more severe symptoms of depression, anxiety, and stress, and with lower QoL. Significant indirect effects were also found: higher PIU, social media use, online shopping, and pornography viewing predicted greater depression, anxiety, and stress symptoms, which in turn predicted reduced QoL across multiple domains. These findings suggest that problematic and increased Internet use during periods associated with prolonged stress contribute to lower QoL through elevated psychological distress. Full article

(This article belongs to the Special Issue Psychosocial Impact in the Post-pandemic Era)

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7 pages, 735 KB

Open AccessViewpoint

Psychological Integrity and Ecological Repair: The Impact on Planetary Public Mental Health (A Narrative Review)

by Matthew Jenkins and Sabine Egger

Int. J. Environ. Res. Public Health 2025, 22(10), 1586; https://doi.org/10.3390/ijerph22101586 - 19 Oct 2025

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Abstract

Human rights frameworks have historically emphasised physical integrity, yet psychological integrity, the right to mental stability, identity, and emotional safety all remain neglected in health policy and law. This narrative review and commentary argues that psychological integrity is inseparable from ecological integrity, and [...] Read more.

Human rights frameworks have historically emphasised physical integrity, yet psychological integrity, the right to mental stability, identity, and emotional safety all remain neglected in health policy and law. This narrative review and commentary argues that psychological integrity is inseparable from ecological integrity, and that contemporary mental health crises are rooted in ruptured human–nature attachments. Drawing on Mother Nature Attachment Theory (MNAT) and supported by emerging empirical evidence, this review traces a trajectory from pre-attachment, through rupture via colonisation, displacement, and ecological collapse, to reconnection through cultural and ecological repair. Gaza exemplifies a contemporary site of deliberate ecological–psychological rupture, where environmental destruction compounds trauma and erodes cultural continuity. In contrast, Indigenous frameworks in Australasia, such as Te Whare Tapa Whā, provide culturally grounded models of reconnection that demonstrate how ecological repair and psychological restoration can proceed together. These contrasting cases illustrate MNAT’s trajectory and emphasise that safeguarding psychological integrity requires embedding ecological security into public health systems. The review concludes that planetary mental health depends on recognising healing of mind and Earth as an indivisible task. Healing mind and Earth must be understood as a single, urgent task within planetary public mental health. Full article

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21 pages, 307 KB

Open AccessArticle

Raising a Public Health Concern: Women Overlooked in UK Drug Policy and Disadvantaged in Mixed-Gender Community Services

by Sarah Page, Fiona McCormack, Sophie Oldfield, Stephen Whitehead and Hannah Jeffery

Int. J. Environ. Res. Public Health 2025, 22(10), 1584; https://doi.org/10.3390/ijerph22101584 - 19 Oct 2025

Viewed by 411

Abstract

The British From Harm to Hope drugs strategy seems limited in gender responsiveness. Evidence is presented from a West Midlands case study where a qualitative participatory methodology with thematic analysis was employed. The project was co-designed by academics, women with lived-experience and third-sector [...] Read more.

The British From Harm to Hope drugs strategy seems limited in gender responsiveness. Evidence is presented from a West Midlands case study where a qualitative participatory methodology with thematic analysis was employed. The project was co-designed by academics, women with lived-experience and third-sector research leaders. To identify community drug and alcohol treatment issues and solutions, interviews and focus groups were conducted with female service users (N = 28), a range of drug and alcohol workers and managers, and women’s sector practitioners (N = 17). Frontline professionals (N = 9) also took part in an online-adapted world café to enrich understanding and ascertain solutions. The study found that many women using illicit drugs have trauma and mental health issues linked to (1) adverse childhood experiences, (2) child removal by local authorities, (3) domestic abuse and sexually exploitative relationships, and (4) criminal justice system engagement. Based on findings, the study recommends that women’s public health pertaining to substance use, mental health and the interplay with childhood and adulthood abuse and violence needs better addressing in policy and practice. This paper highlights the need to better address women’s health through developing drug and alcohol services with improved referral pathways to domestic violence and mental health services. Full article

(This article belongs to the Section Behavioral and Mental Health)

10 pages, 457 KB

Open AccessArticle

Prevalence and Risk Factors of Musculoskeletal Pain Among Kuwaiti Pilgrims During Hajj 2024

by Tahra Aleid, Nowall Al-Sayegh, Sultan E. Alsalahi and Abdulaziz Alhenaidi

Int. J. Environ. Res. Public Health 2025, 22(10), 1585; https://doi.org/10.3390/ijerph22101585 - 18 Oct 2025

Viewed by 206

Abstract

Background: Musculoskeletal pain (MSP) is one of the leading causes of disability worldwide and is frequently reported during the Muslim Hajj Pilgrimage; however, its prevalence and associated risk factors among Kuwaiti pilgrims have not been studied thus far. Methods: This is a retrospective [...] Read more.

Background: Musculoskeletal pain (MSP) is one of the leading causes of disability worldwide and is frequently reported during the Muslim Hajj Pilgrimage; however, its prevalence and associated risk factors among Kuwaiti pilgrims have not been studied thus far. Methods: This is a retrospective cross-sectional study of Kuwaiti pilgrims conducted during the year 2024. Pilgrims were contacted by phone before and after Hajj to answer a survey regarding MSP during their pilgrimage. Risk ratios were computed using binomial generalised linear models with a log link. Results: A total of 557 participants (Mean BMI 28.0 ± 8.0 kg/m²), comprising 340 women (61%) and 217 men (39%), participated in the study. Most were between 33 and 45 years of age (n = 173, 31%), with 24% of the sample (n = 136) reporting MSP. Our regression analysis revealed that female gender (aRR 1.49, 95% CI 1.08–2.06), short sleep duration (<6 h; aRR 1.37, 95% CI 1.02–1.84), and smoking (aRR 0.66, 95% CI 0.46–0.95) were significantly associated with MSP, while participants who did not report hypertension were also less likely to report MSP (aRR 0.64, 95% CI 0.46–0.89). Conclusions: This study, the first to focus on Kuwaiti pilgrims in this regard, showed that their reported prevalence of MSP during Hajj was lower than reported previously in studies of other nationalities. Several factors that increased the risk of MSP included smoking, hypertension, poor sleep, and female gender. The results of this study emphasise the necessity of both conducting a screening programme before Hajj and raising awareness of the factors that increase the prevalence of MSP, subsequently reducing the readiness of pilgrims. Full article

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14 pages, 303 KB

Open AccessArticle

Clinical-Functional Vulnerability of Older Adults in Primary Care in a Brazilian Municipality: Associated Factors

by Cleomar Ana de Souza Valentim, André Silva Valentim, Maria da Luz Rosário de Sousa and Marília Jesus Batista

Int. J. Environ. Res. Public Health 2025, 22(10), 1583; https://doi.org/10.3390/ijerph22101583 - 18 Oct 2025

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Abstract

Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, [...] Read more.

Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, Brazil, in 2023. Sociodemographic data, health behaviors, and data on oral health (number of teeth; chewing: good/fair/poor), cognitive function (10-CS), nutritional status (MNA), health literacy (HLS-14), sarcopenia (SARC-F+CC) and frailty (IVCF-20) were collected. Descriptive and bivariate analyses between the outcome (CFV) and the independent variables were performed using the chi-squared test and binary logistic regression models (p < 0.05). Results: A total of 211 older adults participated in this study; 72% were female and the mean age was 70.41 years (±7.45). Regarding CFV, a high risk was identified in 9.5% of the participants (n = 19), a moderate risk in 34.6% (n = 73), and a low risk in 55.9% (n = 118). After adjusting the regression model, the following variables were associated with CFV: lower income (OR = 1.90; 95%CI: 1.02–3.55), poor (OR = 5.18; 95%CI: 2.13–12.63) and fair (OR = 2.36; 95%CI: 1.10–5.05) chewing, risk of malnutrition or malnourished (OR = 2.36; 95%CI: 1.23–5.52), and low literacy (OR = 1.86; 95%CI: 1.09–3.45). Conclusion: Socioeconomic factors, nutritional status (underweight or malnourished), poor or fair chewing, and low health literacy were associated with CFV among older people. Strengthening primary health care through targeted interventions may help prevent frailty or delay its progression. Understanding the predictors of frailty can guide health professionals, managers, and researchers in designing preventive and health promotion strategies, as well as public policies within Primary Health Care. Full article

(This article belongs to the Section Health Care Sciences)

15 pages, 285 KB

Open AccessArticle

Linking Life Aspirations to Functional Medical Conditions: A Goal Contents Theory Perspective

by Adam Neufeld and Emma L. Bradshaw

Int. J. Environ. Res. Public Health 2025, 22(10), 1582; https://doi.org/10.3390/ijerph22101582 - 17 Oct 2025

Viewed by 311

Abstract

Psychological and motivational factors are implicated in various medical conditions, yet the link between physical health and life aspirations, as defined in Self-Determination Theory (SDT), remains underexplored. To address this gap and advance theory, we conducted a preliminary investigation of associations between aspirations [...] Read more.

Psychological and motivational factors are implicated in various medical conditions, yet the link between physical health and life aspirations, as defined in Self-Determination Theory (SDT), remains underexplored. To address this gap and advance theory, we conducted a preliminary investigation of associations between aspirations and self-reported symptoms across five functional medical conditions—gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), headaches, sleep disturbances, and sexual dysfunction. We surveyed 392 Canadian medical patients (Mage = 42.8 years, SD = 12.7, 50.5% women, 82.1% white, 75.3% with higher education) to assess whether the relative importance, likelihood, and attainment of intrinsic (e.g., personal growth, relationships, community, health) and extrinsic (e.g., wealth, fame, image) aspirations were associated with symptoms. Consistent with hypotheses, greater relative prioritization of intrinsic goals was linked to fewer symptoms—especially sleep disturbance—while extrinsic aspirations were associated with increased symptoms, particularly GERD. Sociodemographic factors, such as age, gender, education, religiosity, and subjective financial status, also showed associations with goal orientations and symptom burden, broadly aligning with SDT predictions. Findings highlight the potential relevance of people’s personal goals in patient-centered care for functional conditions and underscore the need for further research exploring mechanisms and moderators of these effects. Full article

25 pages, 1500 KB

Open AccessArticle

How Personality Shapes Emotional Reactions to Explicit, Implicit, and Positive Media Images of Terror? An Experimental Investigation

by Tal Morse, Avi Besser and Virgil Zeigler-Hill

Int. J. Environ. Res. Public Health 2025, 22(10), 1581; https://doi.org/10.3390/ijerph22101581 - 17 Oct 2025

Viewed by 235

Abstract

This study investigates the public health consequences of media exposure to terrorism by examining individuals’ emotional responses to photographs from the October 7th terror attack, assessing how such imagery interacts with personality traits to influence emotional states. The research aims to explore how [...] Read more.

This study investigates the public health consequences of media exposure to terrorism by examining individuals’ emotional responses to photographs from the October 7th terror attack, assessing how such imagery interacts with personality traits to influence emotional states. The research aims to explore how these reactions are moderated by personality traits—specifically the Big Five. A diverse sample comprising Israeli Jews (final sample N = 826) viewed media-sourced images categorized as explicit negative (n = 279; e.g., photos of bodies or deceased individuals), implicit negative (n = 269; images depicting destruction and devastation without explicit death symbols), and positive (n = 278; images of reconstruction and renewal). Participants’ affective states and specific emotions were assessed both before and after exposure to capture potential shifts. Results revealed a significant increase in negative emotions and a corresponding decrease in positive emotions following exposure to negative images. Personality traits moderated these emotional responses in nuanced ways. Neuroticism exacerbated negative emotional reactions, particularly among men exposed to implicit negative imagery, likely reflecting heightened sensitivity to ambiguous threats. Similarly, agreeableness was associated with heightened anger responses—specifically among men exposed to implicit negative imagery and women exposed to explicit negative images—although this effect was limited to anger and did not extend to other negative emotions. In contrast, openness was linked to decreased anger but only for men exposed to implicit negative imagery. Together, these findings underscore the complex interplay between media exposure, personality traits, and emotional responses to terror-related content. From a public health perspective, the results highlight the need for the following: (a) targeted mental health interventions that account for personality-based vulnerabilities, (b) responsible media reporting practices that minimize unnecessary harm, and (c) media literacy initiatives that empower individuals to manage exposure to distressing content. By linking personality, media imagery, and emotional outcomes, this study provides actionable insights for strengthening resilience, guiding ethical media practices, and promoting psychological well-being in communities affected by terrorism. Full article

(This article belongs to the Special Issue Mental Health and Psychological Resilience: The Mental Health Burden of Terrorism, Epidemiology, Risk Factors and Global Disparities)

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16 pages, 315 KB

Open AccessArticle

“I Haven’t Had Anyone Talk to Me About Phone Use, At All”: Primiparous Mothers’ Conversations About Smartphone Use While Caregiving

by Miriam McCaleb, Rachael Dixon, Patricia Champion and Philip J. Schluter

Int. J. Environ. Res. Public Health 2025, 22(10), 1580; https://doi.org/10.3390/ijerph22101580 - 17 Oct 2025

Viewed by 373

Abstract

Our smartphone habits have implications for our mental health, including new mothers’ experience of loneliness. For a baby, whose developmental trajectory will be directly impacted by their attachment relationship, a parent’s unconscious smartphone use is likely to be of lifelong consequence given the [...] Read more.

Our smartphone habits have implications for our mental health, including new mothers’ experience of loneliness. For a baby, whose developmental trajectory will be directly impacted by their attachment relationship, a parent’s unconscious smartphone use is likely to be of lifelong consequence given the impact of such use on attachment. Therefore, new parents would benefit from support in assessing their smartphone habits and the impact on their relationships with their infants. This raises the question—are they receiving any such advice or guidance from perinatal health professionals? This study describes findings from semi-structured interviews and subsequent reflexive thematic analysis with primiparous women in Aotearoa|New Zealand. We found that the women in this sample had had very few discussions about their smartphone use initiated by the perinatal workforce. In fact, the most common form of communication on the matter was silence. We suggest this silence indicates a missed opportunity in offering additional support for new mothers to modify their pre-partum smartphone habits, in service of the parent–infant relationship. Full article

(This article belongs to the Section Behavioral and Mental Health)

13 pages, 599 KB

Open AccessArticle

Feasibility and Acceptability of Assessing Personal Care Product Use and Exposure to Endocrine-Disrupting Chemicals Among Black and Hispanic Breast Cancer Survivors: A Pilot Study

by Erin Speiser, Peggy-ita Obeng-Nyarkoh, Wanting Zhai, Adana A. M. Llanos, Jennifer Hicks, Chiranjeev Dash, Lucile L. Adams-Campbell, Gail E. Starr and Traci N. Bethea

Int. J. Environ. Res. Public Health 2025, 22(10), 1579; https://doi.org/10.3390/ijerph22101579 - 16 Oct 2025

Viewed by 332

Abstract

This pilot study explored the feasibility and acceptability of utilizing silicone wristbands to assess exposure to endocrine-disrupting chemicals (EDCs) among 25 Black and Hispanic breast cancer survivors recruited in Washington, DC, and Hackensack, NJ. Over half of participants (58%) were diagnosed with Stage [...] Read more.

This pilot study explored the feasibility and acceptability of utilizing silicone wristbands to assess exposure to endocrine-disrupting chemicals (EDCs) among 25 Black and Hispanic breast cancer survivors recruited in Washington, DC, and Hackensack, NJ. Over half of participants (58%) were diagnosed with Stage I breast cancer and the mean age was 58 ± 9 years. Most of the 24 survey respondents (95.83%) reported that the wristband did not interfere with daily activities and few (4) removed the wristband during the 7-day data collection period, demonstrating feasibility of use. Acceptability of passive sampling via silicone wristband was high with 73.91% of survivors reporting being “very satisfied” and 21.74% reporting being “satisfied” with their experience. The wristbands were analyzed via gas chromatography mass spectrometry for approximately 1500 semi-volatile organic compounds. This untargeted approach detected sixty distinct chemicals with an average of 21.8 per wristband. Personal care product, flame retardant, commercial product, and pesticide chemical classifications were detected in every wristband and frequently detected chemicals included biologically active compounds with potential genotoxic or endocrine-disrupting effects. This study demonstrates the feasibility of use and technical feasibility, as well as the acceptability, of utilizing silicone wristbands to assess exposure to semi-volatile organic compounds, including EDCs, among Black and Hispanic breast cancer survivors and lays the foundation towards engaging diverse cancer survivors in environmental health research. Full article

(This article belongs to the Special Issue Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship)

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23 pages, 531 KB

Open AccessSystematic Review

Promoting Mental Health Literacy of 13–16-Year-Old Students: A Systematic Review

by Aino Asplund, Maika Kummel, Camilla Laaksonen, Karmen Erjavec, Evanthia Sakellari, Elina Santala and Joonas Korhonen

Int. J. Environ. Res. Public Health 2025, 22(10), 1578; https://doi.org/10.3390/ijerph22101578 - 16 Oct 2025

Viewed by 536

Abstract

Purpose: The global rise in mental health challenges among adolescents has led to the development of targeted interventions, including those designed to promote young people’s understanding and awareness of mental health. This systematic review aims to identify and evaluate interventions implemented among secondary [...] Read more.

Purpose: The global rise in mental health challenges among adolescents has led to the development of targeted interventions, including those designed to promote young people’s understanding and awareness of mental health. This systematic review aims to identify and evaluate interventions implemented among secondary school students with the goal of enhancing mental health literacy, and to assess their effectiveness in achieving this outcome. Methods: This review was partially aligned with the PRISMA 2020 guidelines. Studies were retrieved from four electronic databases—CINAHL Complete, PubMed, Academic Search Elite, and ERIC—and supplemented by a limited number of relevant studies identified outside the systematic search. The analysis focused on the content, delivery, design, evaluation methods, and outcomes of mental health literacy (MHL) interventions conducted in secondary schools internationally. Results: A total of 16 articles met the inclusion criteria. The articles described a variety of different MHL interventions (n = 12). The findings indicate that school-based MHL interventions have a positive impact on students’ knowledge and understanding of mental health, but stigma reduction demonstrated less consistent effects. Study population, country, intervention content, delivery, methods, outcome measures, sample sizes and participants’ age range varied notably across the studies. Conclusions: Based on the evidence synthesized in this review, school-based MHL interventions appear to be effective and may serve as a valuable component in broader efforts to promote mental health in adolescence. These findings reinforce existing evidence and provide a foundation for practical implications, but future research is highly recommended for a more solid base of evidence. Full article

(This article belongs to the Special Issue Students’ Education and Mental Health)

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13 pages, 262 KB

Open AccessArticle

Assessing Zoonotic Disease Exposure and Occupational Health and Safety Practices Among Veterinary Services Fieldworkers in North West Province, South Africa

by Sboniso Mhlongo, Nisha Naicker and Tanusha Singh

Int. J. Environ. Res. Public Health 2025, 22(10), 1577; https://doi.org/10.3390/ijerph22101577 - 16 Oct 2025

Viewed by 256

Abstract

Background: Veterinary fieldworkers play an important role in managing animal and public health risks, yet they face significant occupational hazards, particularly from zoonotic diseases. In South Africa’s North West Province, the occupational health and safety (OHS) of this workforce remains understudied. This study [...] Read more.

Background: Veterinary fieldworkers play an important role in managing animal and public health risks, yet they face significant occupational hazards, particularly from zoonotic diseases. In South Africa’s North West Province, the occupational health and safety (OHS) of this workforce remains understudied. This study aimed to describe and characterize the OHS practices, zoonotic disease risk exposures, and contributing factors affecting veterinary services fieldworkers in the North West Province. Methods: A cross-sectional descriptive study was conducted among 137 veterinary fieldworkers, including animal health technicians, state veterinarians, and veterinary public health officers. Data were collected using a structured, self-administered questionnaire focusing on sociodemographics, knowledge of zoonoses, exposure history, and OHS practices. Descriptive statistics were applied using SPSS version 27. Results: Fieldworkers frequently reported contact with animals, animal waste, and body fluids without consistent access to adequate personal protective equipment (PPE) or comprehensive training. While most were aware of common zoonoses such as rabies and brucellosis, less than half received regular OHS training or vaccinations. Significant associations were found between occupational category and reported PPE use, as well as between knowledge levels and years of experience. Conclusions: This study highlights critical gaps in knowledge of zoonotic disease, inconsistent implementation of safety protocols, and inadequate PPE provision and/or use among veterinary fieldworkers. These findings highlight the urgent need to strengthen occupational health frameworks, standardize training, and improve access to protective resources to safeguard both workers and broader public health. Full article

(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)

23 pages, 376 KB

Open AccessArticle

Differences in Cannabis and Cannabidiol Attitudes, Perceptions, and Behaviors Between US Adolescents Receiving Mood Disorder Treatment and Their Parents Across Legal Contexts

by Christopher J. Hammond, Mary A. Fristad, Yoon Ji Moon, Melissa M. Batt, Richard Dopp, Neera Ghaziuddin, Leslie Hulvershorn, Jarrod M. Leffler, Manpreet K. Singh, Aimee E. Sullivan, Sally Weinstein and Leslie Miller

Int. J. Environ. Res. Public Health 2025, 22(10), 1576; https://doi.org/10.3390/ijerph22101576 - 16 Oct 2025

Viewed by 302

Abstract

Dramatic shifts in state-level cannabis laws (CLs) and federal hemp regulations have resulted in increased availability and use of cannabis and cannabidiol (CBD) products throughout the US, with unknown implications for the youth. Youth with mood disorders represent a vulnerable population that is [...] Read more.

Dramatic shifts in state-level cannabis laws (CLs) and federal hemp regulations have resulted in increased availability and use of cannabis and cannabidiol (CBD) products throughout the US, with unknown implications for the youth. Youth with mood disorders represent a vulnerable population that is more likely to use cannabis and CBD and is at elevated risk for experiencing cannabis-related adverse health outcomes. This multisite study characterized attitudes, health perceptions, and behaviors related to cannabis and CBD use among US youth receiving mood disorder treatment and their parents, and assessed whether attitudinal differences varied as a function of respondent group and state-level CL status. Anonymous surveys were completed by 84 youths and 66 parents recruited from six child mood clinics providing care to patients living in eleven US states with variable CLs. Covariate-adjusted regressions were run using respondent group and state-level CL status as between-subject factors. Most youths (76% and 74%) and parents (65% and 68%) endorsed believing that cannabis and CBD, respectively, are safe and effective treatments for mental health conditions, and that regular use of these products reduces depression, anxiety, and suicidal behaviors. Intergenerational differences in cannabis-related attitudes and health perceptions were observed, with some associations varying as a function of state-level CL. Among the youth, male sex and positive cannabis expectancies and attitudes were associated with higher cannabis use intentions. Findings can inform prevention and public health messaging efforts. Full article

(This article belongs to the Special Issue Identifying Environmental and Biopsychosocial Risk and Protective Factors for Adolescent Cannabis Use in a Changing Global Context)

16 pages, 413 KB

Open AccessArticle

Challenges and Opportunities of Male Partner Involvement in Cervical Cancer Prevention and Control in Central Kenya: A Qualitative Analysis

by John H. Mwangi, Pretty N. Mbeje and Gloria N. Mtshali

Int. J. Environ. Res. Public Health 2025, 22(10), 1575; https://doi.org/10.3390/ijerph22101575 - 15 Oct 2025

Viewed by 320

Abstract

Background: Cervical cancer remains a significant public health concern in Kenya, with male partner involvement increasingly recognized as a key factor in effective prevention and control. However, limited research has explored the specific barriers and enablers to such involvement in the Kenyan context. [...] Read more.

Background: Cervical cancer remains a significant public health concern in Kenya, with male partner involvement increasingly recognized as a key factor in effective prevention and control. However, limited research has explored the specific barriers and enablers to such involvement in the Kenyan context. This study aimed to examine the challenges and opportunities associated with male partner involvement in cervical cancer prevention in Central Kenya. Methods: A qualitative descriptive design was employed. Purposive sampling was used to select 73 participants, including 20 couples (40 individuals), 20 nurses, 2 clinical officers, 2 gynecologists, 6 community health workers, and 3 county health directors. Data were collected through interviews and focus group discussions and analyzed thematically to identify key patterns and insights. Results: The mean age of male partners was 36.9 years, and 30.5 years for female partners. Most couples (70%, n = 28) had attained secondary education. The average duration of professional experience for nurses and clinical officers was 13 years. Key challenges included knowledge gaps, financial and logistical barriers, limited moral support, time constraints, sociocultural beliefs, stigma, and inadequate facility infrastructure. Identified opportunities included community education, shifting norms, improved couple communication, practical support from men, and integration of services. Conclusions: This study identifies key challenges and practical opportunities for increasing male involvement in cervical cancer prevention. Clarifying and promoting specific male roles such as support for screening and vaccination can enhance the effectiveness of cervical cancer prevention strategies in Central Kenya. Full article

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17 pages, 319 KB

Open AccessPerspective

Mental Health of Young People in the Post-Pandemic Era: Perspective Based on Positive Psychology and Resilience

by Daniel T. L. Shek

Int. J. Environ. Res. Public Health 2025, 22(10), 1574; https://doi.org/10.3390/ijerph22101574 - 15 Oct 2025

Viewed by 314

Abstract

With the gradual decline in COVID-19 cases, there is a need to re-visit the mental health of adolescents and emerging adults in the post-pandemic period. Several observations can be highlighted from the scientific literature. First, while some studies suggest that mental health of [...] Read more.

With the gradual decline in COVID-19 cases, there is a need to re-visit the mental health of adolescents and emerging adults in the post-pandemic period. Several observations can be highlighted from the scientific literature. First, while some studies suggest that mental health of young people has worsened in the post-pandemic period, there are inconsistent and conflicting findings. Second, there are more studies on psychological morbidity than on positive psychological attributes. Third, compared with the West, there are relatively fewer Chinese studies. Fourth, compared with adolescents, there are relatively fewer studies on emerging adults. Based on these observations of the existing literature, I have detailed several reflections on the mental health of young people, including enhancing positive psychological attributes in young people through positive youth development (PYD) programs, building up the individual resilience of young people, strengthening family resilience, adopting multidisciplinary, interdisciplinary and transdisciplinary approaches in understanding the mental health of young people, building more well-articulated theoretical models, charting future research directions, and developing intervention strategies in the post-pandemic period. Full article

(This article belongs to the Special Issue Perspectives in Behavioral and Mental Health)

18 pages, 418 KB

Open AccessArticle

Knowledge Connects Our Hearts and Lands: A Qualitative Research Study on Stewarding Indigenous Traditional Ecological Knowledges for Community Well-Being

by Danya Carroll, Desiree J. Edwards, Ramon Riley and Nicole Redvers

Int. J. Environ. Res. Public Health 2025, 22(10), 1573; https://doi.org/10.3390/ijerph22101573 - 15 Oct 2025

Viewed by 826

Abstract

Indigenous Peoples have developed and stewarded complex knowledge systems that have contributed to thriving societies. With continued threats to Indigenous lifeways, there is increasing need to further protect traditional ecological knowledges (TEK). We carried out a qualitative study to explore Indigenous community perspectives [...] Read more.

Indigenous Peoples have developed and stewarded complex knowledge systems that have contributed to thriving societies. With continued threats to Indigenous lifeways, there is increasing need to further protect traditional ecological knowledges (TEK). We carried out a qualitative study to explore Indigenous community perspectives on stewarding and protecting TEK while identifying gaps in community-level protections of TEK. We conducted ten semi-structured interviews in December 2024 and one focus group in January 2025 with Indigenous Peoples in the southwestern United States. Reflexive thematic analysis through open coding was carried out using qualitative software. Six overarching themes were characterized in the interviews, which overlapped with findings from the focus group, including the following: (1) Historical and current barriers impact the sharing of TEK; (2) Preserving our language is necessary for intergenerational transmission of our TEK; (3) Our TEK reveals changes to our Lands; (4) Protecting our Lands and medicines is vital to our health; (5) We must take the time to learn our TEK for future generations; and (6) We need to protect our TEK. Our research highlights the importance of supporting Indigenous communities’ capacities to protect their TEK for personal, community, and environmental well-being. Full article

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Int. J. Environ. Res. Public Health, Volume 22, Issue 10 (October 2025) – 139 articles

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