International Journal of Environmental Research and Public Health

12 pages, 306 KiB

Open AccessArticle

Health Problems, Unhealthy Behaviors and Occupational Carcinogens Exposures Among Night Shift Brazilian Workers: Results from National Health Survey, 2019

by Fernanda de Albuquerque Melo Nogueira, Giseli Nogueira Damacena, Ubirani Barros Otero, Débora Cristina de Almeida Mariano Bernardino, Christiane Soares Pereira Madeira, Marcia Sarpa and Celia Landmann Szwarcwald

Int. J. Environ. Res. Public Health 2025, 22(8), 1215; https://doi.org/10.3390/ijerph22081215 (registering DOI) - 1 Aug 2025

Abstract

Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample [...] Read more.

Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample of 47,953 workers from the 2019 National Health Survey. NSW prevalence was estimated according to sociodemographic characteristics. To investigate the associations of NSW with all study variables, gender stratified logistic regression models were used. The odds-ratio and 95% confidence intervals were estimated. Results: Among men, there was a significant association of NSW with sleep disorders (OR = 1.39; 95% CI: 1.17–1.65), tiredness (OR = 1.68; 95% CI: 1.41–2.00), obesity (OR = 1.41; 95% CI: 1.20–1.66), unhealthy food consumption (OR = 1.28; 95% CI: 1.12–1.46), handling of radioactive material (OR = 2.45; 95% CI: 1.61–3.72), and biological material (OR = 3.18; 95% CI: 3.15–4.80). Among females, NSW was associated with the same variables except obesity, but depressive feelings (OR = 1.35 95% CI: 1.09–1.67), frequent alcohol intake (OR = 1.48; 95% CI: 1.23–1.78), handling of chemical substances (OR = 1.54; OR = 1.54; 95% CI: 1.20–1.97), and passive smoking at work (OR = 1.45; 95% CI: 1.12–1.86) were highly significant. Conclusion: Night shift workers are more vulnerable to occupational carcinogen exposure, experience greater impacts on their well-being, and are more likely to engage in unhealthy behaviors. These findings should be considered in managing and organizing night work in the workplace. Actions to promote healthy work environments should be encouraged to protect workers’ health. Full article

27 pages, 830 KiB

Open AccessSystematic Review

What Pushes University Professors to Burnout? A Systematic Review of Sociodemographic and Psychosocial Determinants

by Henry Cadena-Povea, Marco Hernández-Martínez, Gabriela Bastidas-Amador and Hugo Torres-Andrade

Int. J. Environ. Res. Public Health 2025, 22(8), 1214; https://doi.org/10.3390/ijerph22081214 (registering DOI) - 1 Aug 2025

Abstract

Burnout syndrome is a growing concern in higher education, affecting the psychological well-being and performance of university professors. This systematic review presents a narrative synthesis of findings from quantitative studies on sociodemographic and psychosocial determinants of academic burnout. Following PRISMA 2020 guidelines, sixty [...] Read more.

Burnout syndrome is a growing concern in higher education, affecting the psychological well-being and performance of university professors. This systematic review presents a narrative synthesis of findings from quantitative studies on sociodemographic and psychosocial determinants of academic burnout. Following PRISMA 2020 guidelines, sixty peer-reviewed articles published between Jan 2019 and May 2024 were selected from Scopus and Web of Science. Inclusion criteria required validated psychometric instruments and exclusive focus on university faculty. Methodological quality was assessed using the Newcastle-Ottawa Scale and CASP checklist. Data from approximately 43,639 academic staff were analyzed. Key risk factors identified include excessive workload, lack of institutional support, and workplace conflict. In contrast, collegial support, participative leadership, and job satisfaction functioned as protective elements. Variables such as age, gender, academic rank, and employment stability significantly influenced burnout vulnerability. While general patterns were observed across studies, differences in design and sampling require caution in generalization. The evidence supports the implementation of integrated strategies encompassing mental health programs, workload regulation, participatory governance, and culturally responsive approaches. These findings inform the development of institutional policies aimed at preventing burnout and fostering academic well-being. Future research should adopt longitudinal and cross-cultural designs to further explore burnout trajectories and support educational reform. Full article

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11 pages, 642 KiB

Open AccessArticle

Leveraging Social Needs Assessments to Eliminate Barriers to Diabetes Self-Management in a Vulnerable Population

by Jennifer Odoi, Wei-Chen Lee, Hani Serag, Monica Hernandez, Savannah Parks, Sarah B. Siddiqui, Laura C. Pinheiro, Randall Urban and Hanaa S. Sallam

Int. J. Environ. Res. Public Health 2025, 22(8), 1213; https://doi.org/10.3390/ijerph22081213 - 1 Aug 2025

Abstract

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program [...] Read more.

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

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

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14 pages, 374 KiB

Open AccessArticle

Domains of Housing Instability and Intimate Partner Violence Risk Among U.S. Tenants

by Anairany Zapata, Leila G. Wood, Annalynn M. Galvin, Wenyaw Chan, Timothy A. Thomas, Jack Tsai, Heather K. Way, Elizabeth J. Mueller and Daphne C. Hernandez

Int. J. Environ. Res. Public Health 2025, 22(8), 1212; https://doi.org/10.3390/ijerph22081212 - 31 Jul 2025

Abstract

While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between [...] Read more.

While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between four housing instability domains and IPV among a sample of tenants that had either experienced eviction or were at high risk for eviction. Tenants in Harris and Travis counties (Texas, USA) completed an online survey (n = 1085; March–July 2024). Housing instability was assessed across four domains: homelessness, lease violations, utility hardship, and poor housing quality. IPV was measured using the Hurt, Insult, Threaten, Scream Screener. Covariate-adjusted logistic regression models suggest indicators within the four housing instability domains were associated with IPV risk. Within the homelessness domain, experiences with lifetime homelessness (AOR = 1.92, 95%CI 1.61–2.28), in the past 12 months living in unconventional spaces (AOR = 2.10, 95%CI 1.92–2.29), and moving in with others (AOR = 1.20, 95%CI 1.06–1.36) were associated with IPV. Within the lease violations domain, missed rent payments (AOR = 1.69, 95%CI 1.68–1.71) and non-payment lease violations (AOR = 2.50, 95%CI 2.29–2.73) in the past 12 months were associated with IPV. Utility shutoffs (AOR = 1.62, 95%CI 1.37–1.91) and unsafe housing (AOR = 1.65, 95%CI 1.31–2.09) in the past 12 months were associated with IPV. Homelessness, housing-related economic hardships and substandard living conditions predict an elevated risk of IPV. Full article

(This article belongs to the Special Issue Factors Associated with Intimate Partner Violence Perpetration and Victimisation)

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16 pages, 333 KiB

Open AccessArticle

Changes, Desire, Fear and Beliefs: Women’s Feelings and Perceptions About Dental Care During Pregnancy

by Natália Correia Fonseca Castro, Vânia Maria Godoy Pimenta Barroso, Henrique Cerva Melo, Camilla Aparecida Silva de Oliveira Lima, Rafaela Silveira Pinto and Lívia Guimarães Zina

Int. J. Environ. Res. Public Health 2025, 22(8), 1211; https://doi.org/10.3390/ijerph22081211 - 31 Jul 2025

Abstract

Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This [...] Read more.

Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This study aimed to analyze oral health and the use of dental services during pregnancy through the perception of pregnant women. It represents the qualitative phase of a mixed-method study conducted with 25 pregnant women (with and without dental care) receiving prenatal care in the Brazilian Unified Health System (SUS). Participants were selected through saturation sampling, and data were collected via semi-structured interviews, followed by content analysis. The findings revealed four major themes: barriers and facilitators to dental care, changes during pregnancy and oral health. Discomfort from oral changes was a common concern. Barriers included misinformation, fear, cultural beliefs, and service organization. In contrast, facilitating factors were identified, such as care prioritization, support from healthcare teams, health education, and access through SUS. This study concludes that emotional, cultural, and contextual aspects shape the use of dental services during pregnancy. Access through SUS is perceived as an important facilitator, which simultaneously presents organizational weaknesses that need to be addressed. Full article

(This article belongs to the Special Issue Perceptions of Women, Child and Adolescents' Oral Health)

20 pages, 815 KiB

Open AccessStudy Protocol

Can Dietary Supplements Be Linked to a Vegan Diet and Health Risk Modulation During Vegan Pregnancy, Infancy, and Early Childhood? The VedieS Study Protocol for an Explorative, Quantitative, Cross-Sectional Study

by Wolfgang Huber-Schneider, Karl-Heinz Wagner and Ingrid Kiefer

Int. J. Environ. Res. Public Health 2025, 22(8), 1210; https://doi.org/10.3390/ijerph22081210 - 31 Jul 2025

Abstract

As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, [...] Read more.

As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, and social environments, that affect the diet of vegan pregnant women, parents, and their children, as well as their approach towards dietary supplementation, have not yet been investigated. Various sources of information, combined with a lack of expertise, sparse food and nutritional health literacy, and qualitatively heterogeneous information provision by medical experts, unsettle vegan pregnant women and parents and affect their dietary choices and potentially the health of their children. The VedieS study aims to investigate potential connections between external influences and associated impacts on a vegan diet and the intake of dietary supplements (DS) of pregnant women and children. Two surveys are being conducted within the study: one targeting 1000 vegan pregnant women and parents, and another targeting 60 experts in each of five healthcare groups: gynecologists, pediatricians, general practitioners, pharmacists, and dietitians. This study is the first to examine how socio-economic, social, and further informational factors influence dietary practices during vegan pregnancy and childhood. It highlights the need for reliable, expert-led guidance, as current information sources are often inconsistent and may put these vulnerable groups at risk. Full article

(This article belongs to the Special Issue Holistic Approach to Pregnancy, Childbirth and Postpartum Period)

16 pages, 324 KiB

Open AccessArticle

Determinants of Non-Adherence to Anti-Tuberculosis Treatment in a Public Primary Healthcare Clinic in South Africa: Improving the Quality of Long-Term Care

by Lucky Norah Katende-Kyenda

Int. J. Environ. Res. Public Health 2025, 22(8), 1209; https://doi.org/10.3390/ijerph22081209 - 31 Jul 2025

Abstract

Background: Non-adherence to anti-tuberculosis treatment remains a major obstacle to increasing tuberculosis treatment success rates and enhancing healthcare expenditure. The aim of this study was to identify determinants contributing to non-adherence to anti-tuberculosis treatment in a public primary healthcare clinic in South Africa. [...] Read more.

Background: Non-adherence to anti-tuberculosis treatment remains a major obstacle to increasing tuberculosis treatment success rates and enhancing healthcare expenditure. The aim of this study was to identify determinants contributing to non-adherence to anti-tuberculosis treatment in a public primary healthcare clinic in South Africa. Method: A cross-sectional study was carried out to collect data from 65 participants using face-to-face interviews with a structured questionnaire. Data were analyzed using SPSS. Results: Of the 65 participants interviewed, 41 (63.08%) were males and 24 (36.92%) were females. A total of 45 (69.23%) were adherents and 20 (30.77%) were non-adherents. Gender was the major predictor of non-adherence with more males committed to treatment than females with a significant association (X² = 65.00 and p of <0.001). Conclusions: The major contributing factors to non-adherence were long dis-tances to the clinics, a lack of family support, and unemployment. Comprehensive programs addressing these multifactorial factors are needed for successful treatment and eradication of tuberculosis. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

13 pages, 585 KiB

Open AccessArticle

Coping Processes of Congolese Refugee Women Newly Resettled in the United States: A Qualitative Exploration

by Na’Tasha Evans, Kamesha Spates, Cedric Mubikayi Kabasele and Chelsey Kirkland

Int. J. Environ. Res. Public Health 2025, 22(8), 1208; https://doi.org/10.3390/ijerph22081208 - 31 Jul 2025

Abstract

The present study aimed to provide Congolese refugee women with an opportunity to narrate firsthand experiences coping with resettlement challenges in the United States. Translator-assisted, face-to-face semi-structured individual interviews were conducted with newly resettled Congolese refugee women (n = 20) aged 18 and [...] Read more.

The present study aimed to provide Congolese refugee women with an opportunity to narrate firsthand experiences coping with resettlement challenges in the United States. Translator-assisted, face-to-face semi-structured individual interviews were conducted with newly resettled Congolese refugee women (n = 20) aged 18 and older who arrived in the United States between 2011 and 2018. All participants were receiving assistance from a resettlement agency, located in the Midwestern US, at the time of the study. Data were analyzed using descriptive coding and thematic analysis. Three overarching themes were developed, indicating that Congolese refugee women adopt three main coping mechanisms to deal with challenges they face after resettling in the United States: (1) use of social support, (2) acceptance of the situation, and (3) spirituality. Resettlement support services, such as those provided by resettlement agencies, mental health providers, and community-based organizations, should integrate both economic and cultural dimensions into their services to address the complex physiological, mental, and emotional impacts of resettlement. These services should prioritize culturally and spiritually sensitive techniques that are linguistically accessible. Full article

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

15 pages, 287 KiB

Open AccessArticle

Exploring the Link Between Social and Economic Instability and COPD: A Cross-Sectional Analysis of the 2022 BRFSS

by Michael Stellefson, Min-Qi Wang, Yuhui Yao, Olivia Campbell and Rakshan Sivalingam

Int. J. Environ. Res. Public Health 2025, 22(8), 1207; https://doi.org/10.3390/ijerph22081207 - 31 Jul 2025

Abstract

Despite growing recognition of the role that social determinants of health (SDOHs) and health-related social needs (HRSNs) play in chronic disease, limited research has examined their associations with Chronic Obstructive Pulmonary Disease (COPD) in population-based studies. This cross-sectional study analyzed 2022 Behavioral Risk [...] Read more.

Despite growing recognition of the role that social determinants of health (SDOHs) and health-related social needs (HRSNs) play in chronic disease, limited research has examined their associations with Chronic Obstructive Pulmonary Disease (COPD) in population-based studies. This cross-sectional study analyzed 2022 Behavioral Risk Factor Surveillance System (BRFSS) data from 37 U.S. states and territories to determine how financial hardship, food insecurity, employment loss, healthcare access barriers, and psychosocial stressors influence the prevalence of COPD. Weighted logistic regression models were used to assess the associations between COPD and specific SDOHs and HRSNs. Several individual SDOH and HRSN factors were significantly associated with COPD prevalence, with financial strain emerging as a particularly strong predictor. In models examining specific SDOH factors, economic hardships like inability to afford medical care were strongly linked to higher COPD odds. Psychosocial HRSN risks, such as experiencing mental stress, also showed moderate associations with increased COPD prevalence. These findings suggest that addressing both structural and individual-level social risks may be critical for reducing the prevalence of COPD in populations experiencing financial challenges. Full article

(This article belongs to the Special Issue Health, Social Problems and Well-Being of Patients with Chronic Diseases, Quality of Life, and the Need for Emotional and Social Support)

10 pages, 270 KiB

Open AccessArticle

“Young Care”: A Community-Based Intervention to Transform Youth Mindsets on Elder Care in Thailand—Program Development and Outcome Evaluation

by Ranee Wongkongdech, Darunee Puangpronpitag, Tharinee Srisaknok, Kukiat Tudpor, Niruwan Turnbull, Souksathaphone Chanthamath and Adisorn Wongkongdech

Int. J. Environ. Res. Public Health 2025, 22(8), 1206; https://doi.org/10.3390/ijerph22081206 (registering DOI) - 31 Jul 2025

Abstract

Background: Thailand is rapidly transitioning into an aging society, creating an intergenerational caregiving gap that strains existing support systems. Objective: This study evaluated the effectiveness of “Young Care,” a community-based intervention designed to enhance youth knowledge, attitudes, and caregiving practices (KAP) toward older [...] Read more.

Background: Thailand is rapidly transitioning into an aging society, creating an intergenerational caregiving gap that strains existing support systems. Objective: This study evaluated the effectiveness of “Young Care,” a community-based intervention designed to enhance youth knowledge, attitudes, and caregiving practices (KAP) toward older adults. Methods: A two-day structured training was conducted in Maha Sarakham Province in 2023 using a pre-post mixed-methods design. Middle and high school students participated in lectures, multimedia sessions, and experiential learning activities related to caregiving. Quantitative data were collected using validated KAP questionnaires, while qualitative insights were obtained from focus group discussions involving students, older persons, caregivers, and local leaders. Results: Post-intervention analysis revealed significant improvements in knowledge and attitudes (p < 0.001), accompanied by increased empathy, caregiving initiative, and a sense of moral responsibility among participants. Conclusions: The initiative fostered formal partnerships among schools, local governments, healthcare providers, and universities through memoranda of understanding. These collaborations enabled budgetary support and outreach to out-of-school youth, positioning “Young Care” as a scalable, youth-centered strategy to address Thailand’s long-term care challenges. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

22 pages, 1945 KiB

Open AccessReview

A Bibliometric Analysis of Chrononutrition, Cardiometabolic Risk, and Public Health in International Research (1957–2025)

by Emily Gabriela Burgos-García, Katiuska Mederos-Mollineda, Darley Jhosue Burgos-Angulo, David Job Morales-Neira and Dennis Alfredo Peralta-Gamboa

Int. J. Environ. Res. Public Health 2025, 22(8), 1205; https://doi.org/10.3390/ijerph22081205 - 31 Jul 2025

Abstract

Introduction: Breakfast has emerged as a critical factor in preventing cardiovascular diseases, driven not only by its nutritional content but also by its alignment with circadian rhythms. However, gaps remain in the literature regarding its clinical impact and thematic evolution. Objective: [...] Read more.

Introduction: Breakfast has emerged as a critical factor in preventing cardiovascular diseases, driven not only by its nutritional content but also by its alignment with circadian rhythms. However, gaps remain in the literature regarding its clinical impact and thematic evolution. Objective: To characterize the global scientific output on the relationship between breakfast quality and cardiovascular health through a systematic bibliometric analysis. Methodology: The PRISMA 2020 protocol was applied to select 1436 original articles indexed in Scopus and Web of Science (1957–2025). Bibliometric tools, including R (v4.4.2) and VOSviewer (v1.6.19) were used to map productivity, impact, collaboration networks, and emerging thematic areas. Results: Scientific output has grown exponentially since 2000. The most influential journals are the American Journal of Clinical Nutrition, Nutrients, and Diabetes Care. The United States, United Kingdom, and Japan lead in publication volume and citations, with increasing participation from Latin American countries. Thematic trends have shifted from traditional clinical markers to innovative approaches such as chrononutrition, digital health, and personalized nutrition. However, methodological gaps persist, including a predominance of observational studies and an underrepresentation of vulnerable populations. Conclusions: Breakfast is a dietary practice with profound implications for cardiometabolic health. This study provides a comprehensive overview of scientific literature, highlighting both advancements and challenges. Strengthening international collaboration networks, standardizing definitions of a healthy breakfast, and promoting evidence-based interventions in school, clinical, and community settings are recommended. Full article

20 pages, 1376 KiB

Open AccessArticle

Comienzo Saludable Puerto Rico: A Community-Based Network of Care to Improve Maternal, Newborn, and Child Health Outcomes

by Edna Acosta-Pérez, Cristina Díaz, Atisha Gómez-Reyes, Samaris Vega, Carlamarie Noboa Ramos, Rosario Justinianes-Pérez, Glamarie Ferran, Jessica Carnivali-García, Fabiola J. Grau, Lili M. Sardiñas, Maribel Campos and Marizaida Sánchez Cesareo

Int. J. Environ. Res. Public Health 2025, 22(8), 1204; https://doi.org/10.3390/ijerph22081204 - 31 Jul 2025

Abstract

Background: Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Comienzo Saludable Puerto Rico, sponsored by the U.S. Department of Health and Human Services’ Healthy Start Initiative (HRSA), addresses these gaps through an integrated Networks of Care [...] Read more.

Background: Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Comienzo Saludable Puerto Rico, sponsored by the U.S. Department of Health and Human Services’ Healthy Start Initiative (HRSA), addresses these gaps through an integrated Networks of Care model known as Cuidado Compartido. Comienzo Saludable Puerto Rico is a maternal, paternal, and child health program aimed at improving the health and well-being of pregnant women, mothers, fathers, newborns, and children in Puerto Rico, particularly those from disadvantaged communities. Methods: This paper presents the Comienzo Saludable Puerto Rico program’s Cuidado Compartido model to integrate a network of healthcare providers and services across hospitals, community organizations, and families. This model aims to improve maternal and newborn/child health outcomes by focusing on the importance of integrated, hospital-community-based care networks. Results: Participants experienced significant improvements in key birth outcomes: low birth weight prevalence declined by 27.2% compared to the community baseline, premature birth rates decreased by 30.9%, and infant mortality dropped by 75%, reaching 0% by 2021 and remaining there through 2023. These results were complemented by increases in maternal mental health screening, paternal involvement, and breastfeeding practices. Conclusions: The Cuidado Compartido model demonstrates a scalable, culturally responsive strategy to improve maternal, newborn, and child health outcomes. It offers critical insights for implementation in other high-need contexts. Full article

(This article belongs to the Special Issue Community Interventions in Health Disparities)

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13 pages, 403 KiB

Open AccessArticle

“It All Starts by Listening:” Medical Racism in Black Birthing Narratives and Community-Identified Suggestions for Building Trust in Healthcare

by Jasmine Y. Zapata, Laura E. T. Swan, Morgan S. White, Baillie Frizell-Thomas and Obiageli Oniah

Int. J. Environ. Res. Public Health 2025, 22(8), 1203; https://doi.org/10.3390/ijerph22081203 - 31 Jul 2025

Abstract

This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group [...] Read more.

This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group program for Black birthing people (N = 25), asking about their pregnancy, birthing, and postpartum experiences and their ideas for building trust in healthcare. Using the Daughtering Method and Braun and Clarke’s method of reflexive thematic analysis, we coded the interview data and then iteratively collated the codes into themes and subthemes. Participants described experiencing medical racism, including healthcare trauma and provider bias, during pregnancy and delivery. They drew connections between those experiences and the distrust they felt toward healthcare providers and the healthcare system. They provided actionable strategies that individual providers and the healthcare system can take to build the trust of Black birthing people: employ more Black providers, listen to Black birthing people, exhibit cultural humility, engage in shared decision-making, build personal connections with patients, and spend more time with patients. This study connects Black birthing people’s experiences of medical racism to feelings of medical distrust and provides community-identified actionable suggestions to build trust and shape how we combat racial disparities in healthcare provision and health outcomes. Full article

(This article belongs to the Special Issue Understanding and Addressing Factors Related to Health Inequalities)

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13 pages, 530 KiB

Open AccessArticle

Protective Factors for Falls Among Independent Older Adults: A Cross-Sectional Study

by Warangkana Srimoke, Chamnong Thanapop, Pimpichaya Sangchart, Sopanat Chitpong, Jirasuta Hnoophet, Nattaya Rueangkhanap and Kitipop Jantep

Int. J. Environ. Res. Public Health 2025, 22(8), 1202; https://doi.org/10.3390/ijerph22081202 - 31 Jul 2025

Abstract

As Thailand transitions into a super-aged society, falls are a rising public health issue. However, limited research focuses specifically on independent older adults in rural areas. This study examined intrinsic and extrinsic factors associated with falls among independent older adults in a rural [...] Read more.

As Thailand transitions into a super-aged society, falls are a rising public health issue. However, limited research focuses specifically on independent older adults in rural areas. This study examined intrinsic and extrinsic factors associated with falls among independent older adults in a rural district of southern Thailand, contributing to localized fall prevention strategies. A cross-sectional study was conducted using multi-stage probabilistic sampling with 325 older adults aged 60–79 years residing in Nakhon Si Thammarat. Data were collected through structured interviews, and multivariate logistic regression was used to identify fall predictors. A fall was defined as an unintended fall to a lower level within the previous 12 months. The fall prevalence was 29.8%, with the majority resulting in minor injuries. Multivariate analysis revealed protective factors, including sociodemographic factors such as higher monthly income (adjusted OR = 0.47; 95% CI: 0.30–0.74) and agricultural employment (adjusted OR = 0.50; 95% CI: 0.27–0.95), as well as the extrinsic factor of pet ownership (adjusted OR = 0.53; 95% CI: 0.35–0.81), were significantly associated with reduced fall risk. The study highlights context-specific protective factors that could inform community-based interventions. Future research should assess causality and intervention effectiveness in broader populations. Full article

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15 pages, 665 KiB

Open AccessArticle

Measurement of the Burden of Road Injuries in Colombia, 1990–2021

by Doris Cardona-Arango, Jahir Alexander Gutiérrez-Ossa, Gino Montenegro-Martínez, Ángela María Segura-Cardona, Diana Isabel Muñoz-Rodríguez, Liliana Giraldo-Rodríguez and Marcela Agudelo-Botero

Int. J. Environ. Res. Public Health 2025, 22(8), 1201; https://doi.org/10.3390/ijerph22081201 - 31 Jul 2025

Abstract

Aim: To analyze the burden of road injuries in Colombia from 1990 to 2021, disaggregated by sex, age groups, and road injury category. Methods: Observational study based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. National data on [...] Read more.

Aim: To analyze the burden of road injuries in Colombia from 1990 to 2021, disaggregated by sex, age groups, and road injury category. Methods: Observational study based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. National data on prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life-years (DALY) were obtained. Data are reported in years and age-standardized and age-specific rates per 100,000 inhabitants. A log-linear segmented regression model was employed to analyze trends in DALY rates of road injuries from 1990 to 2021. Results: From 1990 to 2021, the age-standardized prevalence and incidence rates (per 100,000 inhabitants) due to road injury decreased by −30.6% (95% UI: −34.3; −26.4) and −27.5% (95% UI: −30.7; −24.4), respectively. The age-standardized mortality rate trend of road injuries decreased by −40.6% (95% UI: −50.0; −31.0). Meanwhile, the age-standardized DALY rate decreased by −39.7% (95% UI: −47.9; −31.3) during the study period. In all indicators, men’s rates were higher than women’s. By road injury category, the age-standardized rates increased significantly for motorcyclist road injuries, particularly among men. Conclusions: Road injuries in Colombia have declined but remain significant, especially for young men. Motorcycle injuries show alarming increases in mortality and DALY rates. Full article

(This article belongs to the Special Issue 2nd Edition of Epidemiology and Global Health)

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19 pages, 474 KiB

Open AccessArticle

An Interpretive Phenomenological Inquiry into Type 1 Diabetes and Work

by Emma Victoria Shiel, Steve Hemingway, Rajeeb Kumar Sah and Kim Burton

Int. J. Environ. Res. Public Health 2025, 22(8), 1200; https://doi.org/10.3390/ijerph22081200 - 31 Jul 2025

Abstract

There is little qualitative research on the support needed by workers with type 1 diabetes to effectively self-manage at work and maintain work ability. In this UK study, 21 workers with type 1 diabetes participated in semi-structured interviews. The interviews were transcribed and [...] Read more.

There is little qualitative research on the support needed by workers with type 1 diabetes to effectively self-manage at work and maintain work ability. In this UK study, 21 workers with type 1 diabetes participated in semi-structured interviews. The interviews were transcribed and analysed using interpretive phenomenological analysis and then characterised under the Psychosocial Flags Framework. Findings highlighted several obstacles to maintaining self-management, including systemic workplace issues (black flags), individual attitudes and beliefs (yellow flags), and workplace issues (blue flags). Participants generally lacked confidence in voicing their needs, emphasising a requirement for a more supportive, inclusive workplace culture. This indicates a need for employers to foster an environment where workers with T1D feel comfortable seeking support without penalty. Addressing unhelpful perceptions of T1D seems key to this, making increased knowledge and awareness crucial for the harmonious integration of T1D with work. But delivering effective interventions may be challenging, since they must account for the complex biopsychosocial interplay of obstacles to work ability that this qualitative investigation emphasises. Full article

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12 pages, 735 KiB

Open AccessArticle

Perceived Barriers and Facilitators in Cardiovascular Risk Management in Colombia: A Qualitative Analysis of the RE-HOPE Study

by Jose P. Lopez-Lopez, Yesica Giraldo-Castrillon, Johanna Otero, Claudia Torres, Alvaro Castañeda-Hernandez, Daniel Martinez-Bello, Claudia Garcia, Marianne Lopez-Cabrera and Patricio Lopez-Jaramillo

Int. J. Environ. Res. Public Health 2025, 22(8), 1199; https://doi.org/10.3390/ijerph22081199 - 31 Jul 2025

Abstract

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to [...] Read more.

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

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12 pages, 664 KiB

Open AccessArticle

A Quasi-Experimental Pre-Post Assessment of Hand Hygiene Practices and Hand Dirtiness Following a School-Based Educational Campaign

by Michelle M. Pieters, Natalie Fahsen, Christiana Hug, Kanako Ishida, Celia Cordon-Rosales and Matthew J. Lozier

Int. J. Environ. Res. Public Health 2025, 22(8), 1198; https://doi.org/10.3390/ijerph22081198 - 31 Jul 2025

Abstract

Hand hygiene (HH) is essential for preventing disease transmission, particularly in schools where children are in close contact with other children. This study evaluated a school-based intervention on observed HH practices and hand cleanliness in six primary schools in Guatemala. Hand cleanliness was [...] Read more.

Hand hygiene (HH) is essential for preventing disease transmission, particularly in schools where children are in close contact with other children. This study evaluated a school-based intervention on observed HH practices and hand cleanliness in six primary schools in Guatemala. Hand cleanliness was measured using the Quantitative Personal Hygiene Assessment Tool. The intervention included (1) HH behavior change promotion through Handwashing Festivals, and (2) increased access to HH materials at HH stations. Handwashing Festivals were day-long events featuring creative student presentations on HH topics. Schools were provided with soap and alcohol-based hand rub throughout the project to support HH practices. Appropriate HH practices declined from 51.2% pre-intervention to 33.1% post-intervention, despite an improvement in median Quantitative Personal Hygiene Assessment Tool scores from 6 to 8, indicating cleaner hands. Logistic regression showed higher odds of proper HH when an assistant was present. The decline in HH adherence was likely influenced by fewer assistants and changes in COVID-19 policies, while improvements in hand cleanliness may reflect observational bias. These findings emphasize the importance of sustained behavior change strategies, reliable HH material access, and targeted interventions to address gaps in HH practices, guiding school health policy and resource allocation. Full article

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23 pages, 1447 KiB

Open AccessArticle

Heat Risk Perception and Vulnerability in Puerto Rico: Insights for Climate Adaptation in the Caribbean

by Brenda Guzman-Colon, Zack Guido, Claudia P. Amaya-Ardila, Laura T. Cabrera-Rivera and Pablo A. Méndez-Lázaro

Int. J. Environ. Res. Public Health 2025, 22(8), 1197; https://doi.org/10.3390/ijerph22081197 - 31 Jul 2025

Abstract

Extreme heat poses growing health risks in tropical regions, yet public perception of this threat remains understudied in the Caribbean. This study examines how residents in Puerto Rico perceived heat-related health risks and how these perceptions relate to vulnerability and protective behaviors during [...] Read more.

Extreme heat poses growing health risks in tropical regions, yet public perception of this threat remains understudied in the Caribbean. This study examines how residents in Puerto Rico perceived heat-related health risks and how these perceptions relate to vulnerability and protective behaviors during the extreme heat events of the summer of 2020. We conducted a cross-sectional telephone survey of 500 adults across metropolitan and non-metropolitan areas of Puerto Rico, using stratified probability sampling. The questionnaire assessed heat risk perception, sociodemographic characteristics, health status, prior heat exposure, and heat-related behaviors. While most participants expressed concern about climate change and high temperatures, fewer than half perceived heat as a high level of personal health risk. Higher levels of risk perception were significantly associated with being male, aged 50–64, unemployed, and in fair health, having multiple chronic conditions, and prior experience with heat-related symptoms. Those with symptoms were nearly five times more likely to report high levels of risk perception (OR = 4.94, 95% CI: 2.93–8.34). In contrast, older adults (65+), despite their higher level of vulnerability, reported lower levels of risk perception and fewer symptoms. Nighttime heat exposure was widespread and strongly associated with heat-related symptoms. Common coping strategies included the use of fans and air conditioning, though economic constraints and infrastructure instability limited access. The findings highlight the disparity between actual and perceived vulnerability, particularly among older adults. Public health strategies should focus on risk communication tailored to vulnerable groups and address barriers to heat adaptation. Strengthening heat resilience in Puerto Rico requires improved infrastructure, equitable access to cooling, and targeted outreach. Full article

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International Journal of Environmental Research and Public Health

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