International Journal of Environmental Research and Public Health

15 pages, 1481 KiB

Open AccessArticle

Cost-Effectiveness of Screening and Treating Chronic Hepatitis C Virus Infection in Zimbabwe

by Blessing Dzingirai, Leolin Katsidzira, Maarten J. Postma, Marinus van Hulst and Nyashadzaishe Mafirakureva

Int. J. Environ. Res. Public Health 2025, 22(4), 509; https://doi.org/10.3390/ijerph22040509 (registering DOI) - 27 Mar 2025

Abstract

Background: The aim of this study was to assess the cost effectiveness of a screening and treatment intervention approach for chronic HCV infection in Zimbabwe. Methods: Using a decision tree and a validated Markov model, we estimated the lifetime costs and health effects [...] Read more.

Background: The aim of this study was to assess the cost effectiveness of a screening and treatment intervention approach for chronic HCV infection in Zimbabwe. Methods: Using a decision tree and a validated Markov model, we estimated the lifetime costs and health effects of screening for and treating HCV infections from a healthcare perspective. We evaluated three screening strategies, namely the following: i. no screening; ii. screening among the general population; and iii. screening among high-risk groups. Incremental cost effectiveness ratios were calculated for the strategies that were not dominated. We used deterministic and probabilistic sensitivity analyses to explore the impacts of parameter uncertainty on cost effectiveness outcomes. Results: The strategy of screening among high-risk groups and treating with sofosbuvir/velpatasvir had an incremental cost of USD 1201 and incremental quality-adjusted life years (QALY) of 2.01, yielding an incremental cost effectiveness ratio (ICER) of USD 604 per QALY gained as compared to no screening. The ICER was below the 0.5 times the gross domestic product per capita parameter (USD 796), making the intervention potentially cost effective. The strategy to screen among the general population was dominated, because it costed more and resulted in fewer QALYs than its comparators. Conclusions: Screening for HCV among high-risk populations followed by treatment using sofosbuvir/velpatasvir is cost effective under the assumptions made in this study. Full article

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1 pages, 170 KiB

Open AccessRetraction

RETRACTED: Asweto et al. Combined Effect of Silica Nanoparticles and Benzo[a]pyrene on Cell Cycle Arrest Induction and Apoptosis in Human Umbilical Vein Endothelial Cells. Int. J. Environ. Res. Public Health 2017, 14, 289

by Collins Otieno Asweto, Jing Wu, Hejing Hu, Lin Feng, Xiaozhe Yang, Junchao Duan and Zhiwei Sun

Int. J. Environ. Res. Public Health 2025, 22(4), 508; https://doi.org/10.3390/ijerph22040508 (registering DOI) - 27 Mar 2025

Abstract

The journal retracts the article titled “Combined Effect of Silica Nanoparticles and Benzo[a]pyrene on Cell Cycle Arrest Induction and Apoptosis in Human Umbilical Vein Endothelial Cells” [...] Full article

20 pages, 458 KiB

Open AccessArticle

The Influence of Distributed Leadership on Chinese Teachers’ Job Satisfaction: The Chain Mediation of Teacher Collaboration and Teacher Self-Efficacy

by Xiaodong Fan and Zuwang Chu

Int. J. Environ. Res. Public Health 2025, 22(4), 507; https://doi.org/10.3390/ijerph22040507 (registering DOI) - 26 Mar 2025

Abstract

The leadership structure within educational institutions has a significant bearing on teacher job satisfaction (TJS). This study employs data from the OECD’s Teaching and Learning International Survey (TALIS 2018) specific to Shanghai to construct a structural equation model that investigates how distributed leadership [...] Read more.

The leadership structure within educational institutions has a significant bearing on teacher job satisfaction (TJS). This study employs data from the OECD’s Teaching and Learning International Survey (TALIS 2018) specific to Shanghai to construct a structural equation model that investigates how distributed leadership (DL) impacts TJS in China. Findings reveal that DL has a markedly positive effect on the job satisfaction of teachers in China. Teacher self-efficacy (TSE) serves as an independent mediator in this relationship, while teacher collaboration (TC) does not mediate independently; nonetheless, both collaborate sequentially in a mediation pathway. These findings affirm the relevance of DL in the Chinese educational setting, offering empirical evidence to inform policymakers. Furthermore, it underscores that enhancing TC and TSE can lead to increased job satisfaction under DL. The results highlight the practical implications of this study for the advancement of educational governance and the optimization of school management models in China. Full article

(This article belongs to the Topic Leadership and Employee Well-Being: Fostering a Healthy Work Environment)

14 pages, 669 KiB

Open AccessArticle

Integrating AAA Care Coordinators in Primary Care for Dementia Support: Implementation Challenges and Lessons Learned

by Mary C. Ehlman, Suzanne Leahy, Reagan Lawrence and Della Evans

Int. J. Environ. Res. Public Health 2025, 22(4), 506; https://doi.org/10.3390/ijerph22040506 (registering DOI) - 26 Mar 2025

Abstract

Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with [...] Read more.

Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with dementia, interventions must take a more comprehensive approach, addressing provider education and helping families be aware of the community supports available. Methods: Through a retrospective evaluation utilizing secondary data sources, researchers examine the results of a dementia care intervention that involved a clinical workflow, semiannual dementia training, and the integration of a care coordinator from an Area Agency on Aging (AAA) into the primary care team. Results: Seventeen caregivers received education and referrals to support during the intervention year and again in the final year. This represented 5.3% of the 322 patients diagnosed with dementia and with medical visits at the three clinics in 2023 During the last two grant years, there also was a large increase in provider referrals; thus, dementia care referrals decreased in proportion to patient referrals overall. Conclusions: Utilizing AAA care coordinators is a promising model for addressing health-related social needs in primary care. Yet, findings point to the complexities that remain in managing dementia in this setting. Full article

(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)

21 pages, 426 KiB

Open AccessReview

Examining the Environmental Ramifications of Asbestos Fiber Movement Through the Water–Soil Continuum: A Review

by Gergely Zoltán Macher, András Torma and Dóra Beke

Int. J. Environ. Res. Public Health 2025, 22(4), 505; https://doi.org/10.3390/ijerph22040505 (registering DOI) - 26 Mar 2025

Abstract

The environmental pollution potential of asbestos products is a worldwide health issue, but their dissemination through the water–soil continuum is often an overlooked aspect. Similarly, the behavior of asbestos fibers released from the products is still not fully understood, although our knowledge is [...] Read more.

The environmental pollution potential of asbestos products is a worldwide health issue, but their dissemination through the water–soil continuum is often an overlooked aspect. Similarly, the behavior of asbestos fibers released from the products is still not fully understood, although our knowledge is based on studies concerning their mineralogical characteristics, health effects, and waste disposal. It has been claimed and contradicted that asbestos harm is only found in air and humans. Asbestos fibers are found not only in industrial settings but also through the industrial use of asbestos cement products, which has contributed to asbestos emissions and its movement in water and soil. Asbestos fibers are diverse in their physicochemical properties, and this diversity has a significant influence on their behavior in the environment. Recent research has confirmed that asbestos can be transported by water and spread to other parts of the environment. However, the mechanisms underlying this, such as the settling of fibers, their attachment to soil particles, or their movement in groundwater, as well as the environmental and health implications, require further investigation. This paper examines the process and impact of asbestos contamination in the interconnected water, soil, and plant environmental sectors, providing a systematic review of the latest literature. Full article

11 pages, 594 KiB

Open AccessArticle

Reported Behavioral Patterns and Concern Surrounding Well Water Testing for Arsenic in Midwestern Homeowners with Children

by Dominika A. Jegen, Julie Maxson, Natalie Averkamp, Rachael Passmore, Jessica L. Sosso, Stephen K. Stacey and Tom D. Thacher

Int. J. Environ. Res. Public Health 2025, 22(4), 504; https://doi.org/10.3390/ijerph22040504 (registering DOI) - 26 Mar 2025

Abstract

Toxins from ingested water can significantly affect overall physical health in children and adults. In the United States, domestic water wells are not commonly tested for any heavy metal contaminants. It is well-known that chronic arsenic ingestion from water is linked to serious [...] Read more.

Toxins from ingested water can significantly affect overall physical health in children and adults. In the United States, domestic water wells are not commonly tested for any heavy metal contaminants. It is well-known that chronic arsenic ingestion from water is linked to serious health effects. We surveyed patients at our academic institution via emailed questionnaires in 2023 to determine whether those with children living at home reported different patterns of behavior around well water testing as compared to those without. Survey data were collected from 8994 respondents in the U.S. Midwest who reported using residential well water. Results were used to evaluate the influence of children in the home on testing behaviors, and secondarily, whether parental demographics affected testing frequency. Respondents with children at home did not report increased testing frequency compared to those without. In parents who did report testing, having more children, being younger, and living in Wisconsin were associated with an increased frequency. Parental gender, race, and ethnicity did not correlate with testing behaviors. A total of 70% of respondents did not feel concerned about their water safety and 85% were not concerned about arsenic specifically in their water. Increased risk of toxicity to children from arsenic does not appear to influence reported well water testing behavior among parents. Full article

(This article belongs to the Special Issue Research on Environmental Exposure, Pollution, and Epidemiology)

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13 pages, 475 KiB

Open AccessReview

Exploring Middle Ear Pathologies in Adults with Diabetes Mellitus: A Scoping Review of Available Evidence and Research Gaps

by Ben Sebothoma, Katijah Khoza-Shangase, Gift Khumalo and Boitumelo Mokwena

Int. J. Environ. Res. Public Health 2025, 22(4), 503; https://doi.org/10.3390/ijerph22040503 (registering DOI) - 26 Mar 2025

Abstract

Diabetes mellitus (DM) is a common chronic health condition, affecting millions of people worldwide, and its incidence is projected to increase by almost 50% in the next two decades. The effects of DM on the auditory system have been reported. However, there is [...] Read more.

Diabetes mellitus (DM) is a common chronic health condition, affecting millions of people worldwide, and its incidence is projected to increase by almost 50% in the next two decades. The effects of DM on the auditory system have been reported. However, there is limited evidence on the association between DM and middle ear pathologies. This scoping review aimed to map the available evidence and identify research gaps regarding DM and middle ear pathologies in the adult population. Five electronic databases, namely Scopus, CINAHL, MEDLINE, PubMed, and Web of Science, were searched using a combination of specific key terms. This review followed the guidelines stipulated by the Joanna Briggs Institute (JBI) methodology for scoping reviews and reporting using PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. A thematic narrative analysis was used to synthesize key findings. Of the 1809 articles, only 2 articles met the inclusion criteria. Neither of these studies focused exclusively on middle ear pathologies in DM, but they did report incidental findings related to middle ear function. Available evidence suggests that middle ear pathologies may occur in individuals with DM, with a reported prevalence ranging from 3.1% to 19.6%. Otitis media with effusion and conductive hearing loss were common middle ear pathologies identified. Additionally, recent studies have provided new evidence suggesting ossicular joint changes in individuals with DM and a causal link between DM and acute suppurative otitis media. However, age-related hearing loss (presbycusis) and sensorineural hearing loss (SNHL) were more commonly associated with DM, with studies reporting a high prevalence of SNHL in younger to middle-aged adults with diabetes. This review highlights a significant research gap in the literature, as no studies directly investigated the relationship between DM and middle ear function as a primary focus. Further research is required to investigate this potential association using methodologies explicitly designed for middle ear assessment. While some evidence suggests a possible association, the lack of age-stratified analyses, imaging data, and comprehensive diagnostic testing limits the ability to draw strong conclusions. Further research incorporating age-based analyses, radiological assessments, and microbiome studies is needed to fully understand the potential impact of DM on middle ear health. Full article

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21 pages, 686 KiB

Open AccessArticle

Dietary Patterns in Relation to Asthma and Wheeze Among Adolescents in a South African Rural Community

by Funzani Rathogwa-Takalani, Thabelo Rodney Mudau, Sean Mark Patrick, Joyce Shirinde and Kuku Voyi

Int. J. Environ. Res. Public Health 2025, 22(4), 502; https://doi.org/10.3390/ijerph22040502 (registering DOI) - 26 Mar 2025

Abstract

Background: The rise of asthma prevalence in recent decades has been attributed to changes in dietary patterns, especially in developing countries. Studies have also suggested that dietary patterns play an important role in both asthma development and management. This study aimed to investigate [...] Read more.

Background: The rise of asthma prevalence in recent decades has been attributed to changes in dietary patterns, especially in developing countries. Studies have also suggested that dietary patterns play an important role in both asthma development and management. This study aimed to investigate the association between consumption of various foods and environmental factors with asthma and wheeze among adolescents. Methods: A self-administered standardized International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to collect data on demographics, respiratory health, exposure to air pollution, and diet on n = 2855 adolescents residing in Vhembe District, South Africa. Results: The prevalence of asthma and wheeze were 18.91% and 37.69%, respectively. Consuming various foods such as fast foods (OR = 1.41; 95% CI: 1.06–1.88), bread (OR = 0.60; 95% CI: 0.45–1.81), pasta (OR = 1.39; 95% CI: 1.06–1.84), seafood (OR = 1.79; 95% CI: 0.65–1.24), and nuts (OR = 0.85; 95% CI: 0.65–1.12) were significantly associated with asthma in the crude logistic regression analysis. Further analysis in the multiple regression model indicated a strong association of asthma with consumption of nuts (OR = 1.55; 95% CI: 1.11–2.17), seafood (OR = 1.60; 95% CI: 1.03–2.49), and cereal (OR = 0.67; 95% CI: 0.45–0.99). In relation to wheeze, consumption of meat (red) (OR = 0.77; 95% CI: 0.60–0.99) was a protective factor in the crude analysis. The multiple logistic regression model showed that, seafood (OR = 0.76; 95% CI: 0.59–0.96), fruit (OR = 0.55; 95% CI: 0.32–0.94), nuts (OR = 1.88; 95% CI: 1.50–2.66), and olive oil (OR = 1.48; 95% CI: 1.09–2.00) were significantly associated with wheeze. Conclusion: Diet plays a major role in respiratory health, especially in asthma and wheeze. Dietary changes may play a role in reducing the burden of asthma and other respiratory symptoms in adolescents. Full article

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20 pages, 1638 KiB

Open AccessArticle

The Impact of Social Isolation on the Subjective Well-Being of Older People in China: An Empirical Analysis Based on the 2021 China General Social Survey

by Keikoh Ryu and Zaiqing Chen

Int. J. Environ. Res. Public Health 2025, 22(4), 501; https://doi.org/10.3390/ijerph22040501 (registering DOI) - 26 Mar 2025

Abstract

This study focuses on the psychological state and economic preparedness of socially isolated older individuals in China’s rapidly aging society. Both a simple model and an extended model were developed and tested to explore the impact of social isolation on the subjective well-being [...] Read more.

This study focuses on the psychological state and economic preparedness of socially isolated older individuals in China’s rapidly aging society. Both a simple model and an extended model were developed and tested to explore the impact of social isolation on the subjective well-being of older adults by analyzing how social isolation, self-assessment of health, and anxiety about old age affect subjective well-being. The results indicated that both social isolation and self-assessment of health have a strong influence on subjective well-being, and that social isolation significantly alters older individuals’ perception of caregiving responsibility. While private insurance participation had a significant impact on the well-being of younger individuals, its effect on older adults was limited. These findings provide valuable insights for improving support systems for older people. Full article

(This article belongs to the Topic Healthy, Safe and Active Aging, 2nd Edition)

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1 pages, 174 KiB

Open AccessCorrection

Correction: Khan et al. Examining the Association between Sports Participation and Mental Health of Adolescents. Int. J. Environ. Res. Public Health 2022, 19, 17078

by Asaduzzaman Khan, Kazi R. Ahmed, Tarissa Hidajat, Tracy Kolbe-Alexander and Elizabeth J. Edwards

Int. J. Environ. Res. Public Health 2025, 22(4), 500; https://doi.org/10.3390/ijerph22040500 (registering DOI) - 26 Mar 2025

Abstract

Tracy Kolbe-Alexander was not included as an author in the original publication [...] Full article

1 pages, 176 KiB

Open AccessCorrection

Correction: Javaid et al. WebGIS-Based Real-Time Surveillance and Response System for Vector-Borne Infectious Diseases. Int. J. Environ. Res. Public Health 2023, 20, 3740

by Momna Javaid, Muhammad Shahzad Sarfraz, Muhammad Umar Aftab, Qamar uz Zaman, Hafiz Tayyab Rauf and Khalid A. Alnowibet

Int. J. Environ. Res. Public Health 2025, 22(4), 499; https://doi.org/10.3390/ijerph22040499 (registering DOI) - 26 Mar 2025

Abstract

In the published publication [...] Full article

16 pages, 526 KiB

Open AccessArticle

School Trust and Sense of Belonging: Restoring Bonds and Promoting Well-Being in Schools

by Elisabetta Fenizia and Santa Parrello

Int. J. Environ. Res. Public Health 2025, 22(4), 498; https://doi.org/10.3390/ijerph22040498 (registering DOI) - 26 Mar 2025

Abstract

School dropout is a global issue that compromises individual and societal well-being. Researchers in psychology emphasize that dropout often results from a prolonged erosion of bonds between individuals, schools, and society, especially in socioeconomically disadvantaged contexts. School trust, described as the “connective tissue” [...] Read more.

School dropout is a global issue that compromises individual and societal well-being. Researchers in psychology emphasize that dropout often results from a prolonged erosion of bonds between individuals, schools, and society, especially in socioeconomically disadvantaged contexts. School trust, described as the “connective tissue” within the school system, fosters psychological well-being and is associated with self-esteem, self-efficacy, life satisfaction, and reduced depression. This study aimed to explore the interaction of various relational constructs related to school life, which could be used to improve student well-being and reduce the risk of dropout. A total of 645 high school students from impoverished and high-crime neighborhoods in Naples were involved in the cross-sectional study, investigating the role that school trust plays in relation to positive teaching, self-efficacy, and the sense of belonging. The results indicate that positive teaching significantly enhances the sense of school belonging through the mediating role of students’ trust in teachers. These findings highlight the crucial role of trust as a mediator in strengthening student–school relationships. Schools should prioritize fostering trust by promoting teacher transparency, consistency, and care. Such efforts can enhance students’ sense of belonging, ultimately mitigating dropout risk and restoring their connection with education. This systemic approach is especially vital in contexts with significant socioeconomic challenges. Full article

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17 pages, 311 KiB

Open AccessArticle

Changes in Bullying Experiences and Mental Health Problems Among Adolescents Before and After the COVID-19 Pandemic in Greece

by Georgios Giannakopoulos, Foivos Zaravinos-Tsakos, Maria Mastrogiannakou, Andre Sourander and Gerasimos Kolaitis

Int. J. Environ. Res. Public Health 2025, 22(4), 497; https://doi.org/10.3390/ijerph22040497 (registering DOI) - 26 Mar 2025

Abstract

Bullying poses significant challenges to adolescent health and well-being. This time-trend study examined the impact of the COVID-19 pandemic on bullying behaviors and associated emotional and behavioral difficulties among Greek adolescents. Data were collected from two cross-sectional surveys in 2016 (n = [...] Read more.

Bullying poses significant challenges to adolescent health and well-being. This time-trend study examined the impact of the COVID-19 pandemic on bullying behaviors and associated emotional and behavioral difficulties among Greek adolescents. Data were collected from two cross-sectional surveys in 2016 (n = 1574) and 2023 (n = 5753) conducted in Greece. Both samples comprised students aged 12–16 years, with near-equal gender distribution (2016, 53.4% girls; 2023, 54.5% girls) and a predominance of urban residents (approximately 73% in both samples). Traditional and cyberbullying experiences were assessed via structured questionnaires, while mental health outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ). Post-pandemic findings revealed substantial increases in bullying involvement; traditional bullying victimization rose from 12.4% to 21.7%, and cyberbullying victimization increased from 4.0% to 11.6%. Correspondingly, mean SDQ total scores increased significantly from 8.59 to 14.16, reflecting heightened emotional and behavioral problems. Logistic regression analyses identified male gender, urban residence, and non-traditional family structures as significant predictors of bullying involvement. These results underscore the amplified burden of bullying and mental health difficulties in the post-pandemic era, highlighting the urgent need for targeted prevention and intervention strategies to address both traditional and cyberbullying within diverse sociodemographic contexts. Full article

(This article belongs to the Special Issue Lifestyle Aspects of Students in the Era of the COVID-19 Pandemic, Armed Conflict and Economic Crisis and Other Social Events)

14 pages, 640 KiB

Open AccessReview

Exploring the Association Between Problematic Internet Use, Internet Gaming Disorder in Adolescents with ADHD: A Scoping Review

by Roberto Ghiaccio, Anna Passaro, Fabrizio Stasolla, Elvira Martini, Angelo Maria De Fortuna and Raffaele De Luca Picione

Int. J. Environ. Res. Public Health 2025, 22(4), 496; https://doi.org/10.3390/ijerph22040496 (registering DOI) - 26 Mar 2025

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Adolescents with ADHD have an elevated risk of developing Internet Gaming Disorder (IGD), a condition involving excessive gaming that disrupts daily life. IGD is linked to traits such as [...] Read more.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Adolescents with ADHD have an elevated risk of developing Internet Gaming Disorder (IGD), a condition involving excessive gaming that disrupts daily life. IGD is linked to traits such as low frustration tolerance and sensation-seeking, with comorbid conditions like anxiety and depression further increasing vulnerability. Gaming frequently serves as a coping strategy due to emotional regulation difficulties. The dynamics within family units and peer relationships play a pivotal role, with dysfunctional environments heightening the risks and positive interactions serving as protective factors. Methods: This scoping review analyzed empirical studies published in the last decade exploring the association between ADHD, Problematic Internet Use (PIU), or IGD, focusing on neurobiological, psychological, and environmental factors. Results: The findings highlight that impulsivity and emotional dysregulation in ADHD contribute to IGD. Gaming is frequently used as a maladaptive coping strategy, with social and family influences modulating risk. Diagnostic complexities arise in distinguishing ADHD-related behaviors from IGD symptoms. Conclusions: Addressing these comorbid conditions requires interdisciplinary collaboration and evidence-based interventions. Future research should focus on understanding ADHD, PIU, or IGD interactions and developing targeted interventions. Longitudinal studies are necessary to establish causal links and assess effective treatment strategies. Full article

(This article belongs to the Special Issue Psychological Wellbeing, Mental Health and Problematic Internet Use among Adolescents)

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15 pages, 280 KiB

Open AccessArticle

Multi-Modal Cannabis Use Among U.S. Young Adults: Findings from the 2022 and 2023 BRFSS in 23 States

by Nayoung Kim, Sarah Flora and Casey Elizabeth Macander

Int. J. Environ. Res. Public Health 2025, 22(4), 495; https://doi.org/10.3390/ijerph22040495 (registering DOI) - 26 Mar 2025

Abstract

Cannabis use among young adults in the U.S. has nearly doubled in recent years, driven by diverse methods of consumption and evolving cannabis legalization. Multi-modal cannabis use among young adults is an emerging public health issue that remains underexplored. This study examines the [...] Read more.

Cannabis use among young adults in the U.S. has nearly doubled in recent years, driven by diverse methods of consumption and evolving cannabis legalization. Multi-modal cannabis use among young adults is an emerging public health issue that remains underexplored. This study examines the prevalence, patterns, and predictors of multi-modal cannabis use, defined as the use of two or more administration methods of cannabis use (e.g., smoking, vaping, edibles, dabbing, other forms) in the past month, among U.S. young adults aged 18–34 years. Data from the 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS) across 23 states (n = 7635; weighted n = 7,482,134) show that 57% of young adults reporting current cannabis use engaged in multi-modal use, with dual- and triple-mode use being the most common. Factors associated with higher odds of multi-modal use include sexual minority status, poor physical health, frequent cannabis use, and co-use of electronic cigarettes and alcohol. Recreational cannabis legalization (RCL) is significantly linked to higher odds of multi-modal use. These findings underscore the interplay between individual risk factors and cannabis policy environments in shaping multi-modal cannabis use behaviors. To mitigate potential harms, targeted prevention strategies should prioritize young adults at risk for cannabis use, addressing both personal and policy-related factors influencing multi-modal cannabis use. Full article

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

19 pages, 738 KiB

Open AccessArticle

Assessment of Psychosocial Risk and Resource Factors Perceived by Military and Civilian Personnel at an Armed Forces Medical Center

by Alicia Bouché-Bencivinni, Vanessa Kratzien, Bruno Ballester, Mohamed Boua and Christine Jeoffrion

Int. J. Environ. Res. Public Health 2025, 22(4), 494; https://doi.org/10.3390/ijerph22040494 (registering DOI) - 26 Mar 2025

Abstract

The aim of this study is to identify the factors contributing to psychosocial risks (PSR) and the specific resources available within an Army Medical Center (AMC), with a view to developing a questionnaire adapted to this unique context. A qualitative study was carried [...] Read more.

The aim of this study is to identify the factors contributing to psychosocial risks (PSR) and the specific resources available within an Army Medical Center (AMC), with a view to developing a questionnaire adapted to this unique context. A qualitative study was carried out with 56 military and civilian employees, using semi-directive interviews. The results highlight similarities with PSR and resource factors already identified in the literature, such as workload, emotion management and salary recognition. They also reveal PSR factors specific to the activity of AMC staff, such as the need for availability and mobility, discipline and rigor, task shifting and impeded quality, as well as resource factors such as sports practice and cohesion. The results were used to develop a questionnaire, currently being validated, tailored to the context of army medical centers, with the aim of improving strategies for preventing Psychosocial Risks (PSRs). Full article

(This article belongs to the Special Issue Mental Health and Wellbeing in High-Risk Occupational Groups)

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12 pages, 264 KiB

Open AccessArticle

Factors Impacting COVID-19 Vaccine Uptake and Confidence Among Immigrant and Refugee Populations in Canada

by Ilene Hyman, Ayesha Khan and Iwo Effiong

Int. J. Environ. Res. Public Health 2025, 22(4), 493; https://doi.org/10.3390/ijerph22040493 (registering DOI) - 26 Mar 2025

Abstract

Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant [...] Read more.

Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant to countries facing similar challenges in promoting vaccine uptake among migrant communities. Methods: As part of an evaluation of best practices in COVID-19 vaccination promotion and provision, data were collected using in-depth key informant interviews with a cross-section of primary care stakeholders (n = 11). Main findings: Key barriers to vaccine promotion and provision included distrust of health and government services, misinformation, lack of vaccine confidence, and access or systems-level barriers. Effective facilitators were relationship-building and equity-driven approaches, such as community engagement and development, culturally and linguistically effective communication, one-on-one supports, and collaboration with community members as valued partners and staff. These strategies were identified as best practices that enhanced vaccine confidence and uptake. Conclusion: The risk and impacts of COVID-19 are disproportionately distributed worldwide, affecting migrant populations in many countries. Primary healthcare stakeholders must understand the barriers and facilitators to vaccine promotion to effectively address health inequalities. Increasing vaccine uptake and confidence among immigrant and refugee populations requires targeted and tailored approaches that are culturally responsive and equity-informed. These findings provide valuable insights for health systems globally, supporting efforts to reduce health inequities by using inclusive vaccination strategies. Full article

(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)

19 pages, 959 KiB

Open AccessFeature PaperArticle

International Empirical Validation and Value Added of the Multilevel Job Content Questionnaire (JCQ) 2.0

by Maren Formazin, Maureen F. Dollard, BongKyoo Choi, Jian Li, Wilfred Agbenyikey, Sung-il Cho, Irene Houtman and Robert Karasek

Int. J. Environ. Res. Public Health 2025, 22(4), 492; https://doi.org/10.3390/ijerph22040492 (registering DOI) - 25 Mar 2025

Abstract

This paper investigates whether the Job Content Questionnaire (JCQ) 2.0 composite scales for demand, control, and stability-support at the task and organizational level are related to health and work-related outcomes as hypothesized in the job demand–control and Associationalist Demand–Control models. Further, the relative [...] Read more.

This paper investigates whether the Job Content Questionnaire (JCQ) 2.0 composite scales for demand, control, and stability-support at the task and organizational level are related to health and work-related outcomes as hypothesized in the job demand–control and Associationalist Demand–Control models. Further, the relative improvement of the JCQ 2.0 instrument over the JCQ 1 scales in the prediction of health and work-related outcomes is tested. The JCQ 2.0 was applied among workers in Australia and Germany. Analyses of variance and Kruskal–Wallis tests were applied for mean score comparison. In addition, path modeling as well as regression analyses were used. JCQ 2.0 task and organizational level demand, control, and stability-support as well as job strain and organizational-level active work are related to health and work-related outcomes as expected. Associations with active work at the task level are limited. A multilevel framework whereby organizational demands relate to task demands and, in turn, depression and burnout, is found in both German and Australian data. A similar organization to task process is found for control and support in German data, but for Australia, there is only a direct organizational effect on both outcomes. The task- and organizational-level composites—demand, control, and stability-support—explain unique variances in health and work-related outcomes. The JCQ 2.0 composites explain substantially more variance in all outcomes than the classic JCQ 1 DC and DCS scales. The results underline the utility of the JCQ 2.0 to assess multilevel aspects of the psychosocial work environment with broad practical value as a psychosocial risk assessment tool. Full article

(This article belongs to the Special Issue The Job Content Questionnaire 2.0: A Tool for Measurement of the Psychosocial Work Environment and Sustainable Work Globally)

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14 pages, 555 KiB

Open AccessArticle

The Impact of Ideal Cardiovascular Health Behaviors on Mental Health and Well-Being Among Baltic Countries Adolescents: Findings from the HBSC Study

by Rafaela C. Espírito Santo, Geiziane R. Melo, Viney P. Dubey and Cesar Agostinis-Sobrinho

Int. J. Environ. Res. Public Health 2025, 22(4), 491; https://doi.org/10.3390/ijerph22040491 (registering DOI) - 25 Mar 2025

Abstract

This study explored the association between ideal cardiovascular health behaviors (ICHBs) and mental health and well-being in Baltic adolescents using data from the 2018 HBSC survey. ICHBs included smoking status, body mass index, physical activity, and healthy diet adherence. Mental health included low [...] Read more.

This study explored the association between ideal cardiovascular health behaviors (ICHBs) and mental health and well-being in Baltic adolescents using data from the 2018 HBSC survey. ICHBs included smoking status, body mass index, physical activity, and healthy diet adherence. Mental health included low mood, irritability, nervousness, and sleep difficulties, while well-being included life satisfaction and self-reported health. Multi-regression analyses were performed. The study included 12,934 adolescents (mean age: 13.6 ± 1.6 years). Non-smokers, non-overweight individuals, and physically active participants were more likely to report good mental health, higher life satisfaction, and better self-reported health. Adherence to a healthy diet was linked to improved self-reported health and greater life satisfaction. Compared to those with four ICHBs (reference), adolescents with only one ICHB had higher odds of feeling low (OR = 0.28, 95% CI: 0.13–0.62), irritability (OR = 0.35, 95% CI: 0.19–0.66), nervousness (OR = 0.26, 95% CI: 0.13–0.55), and sleep difficulties (OR = 0.29, 95% CI: 0.14–0.61). Adolescents with two ICHBs had higher odds of feeling low (OR = 0.45, 95% CI: 0.20–0.97) and nervousness (OR = 0.40, 95% CI: 0.19–0.83). These findings highlight the importance of promoting multiple ideal health behaviors to improve mental health and well-being among adolescents. Full article

(This article belongs to the Special Issue The 20th Anniversary of IJERPH)

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International Journal of Environmental Research and Public Health

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