Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.6 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
Latest Articles
Enhancing Emotion Regulation Skills in High-Risk Adolescents Due to the Existence of Psychopathology in the Family: Feasibility and Uncontrolled Pilot Study of a Group Intervention in a Naturalistic School Setting
Int. J. Environ. Res. Public Health 2024, 21(6), 738; https://doi.org/10.3390/ijerph21060738 - 5 Jun 2024
Abstract
Background: Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents’ emotion regulation skills, focusing on those at risk for mental health problems. Methods: Adolescents
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Background: Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents’ emotion regulation skills, focusing on those at risk for mental health problems. Methods: Adolescents 12–18 years old were referred to a six-session group program by their school counselors, based on inclusion criteria related to family sociodemographic and mental health characteristics. Group sessions took place during school hours to facilitate participation and reduce dropout. The intervention targeted emotion regulation skills, drawing from central components of different cognitive behavioral approaches. To assess clinical outcomes, participants answered questionnaires before and after the program, which covered emotion regulation strategies, addictive behaviors, and internalizing and externalizing symptoms. The acceptability of the program was also assessed. Results: Emotion regulation skills improved after the program, and there was a significant reduction in internalizing and externalizing problems. The program was evaluated as useful by participants. Counsellors reported satisfaction with the program. Conclusions: Targeted emotion regulation skills training is a potentially useful transdiagnostic intervention to prevent mental health problems in youth. Bringing the intervention to the school setting and involving counsellors in referring at-risk students can facilitate uptake and reduce dropout.
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(This article belongs to the Special Issue Research on Emotional and Cognitive Development in Children)
Open AccessArticle
Heat Risk Perceptions and Coping Strategies of the Unhoused
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Brett W. Robertson, Kirstin Dow, Julie Salinas and Susan L. Cutter
Int. J. Environ. Res. Public Health 2024, 21(6), 737; https://doi.org/10.3390/ijerph21060737 - 5 Jun 2024
Abstract
The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on disseminating knowledge about heat vulnerability. These efforts aim to equip diverse stakeholders with practical heat planning and forecasting tools. The
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The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on disseminating knowledge about heat vulnerability. These efforts aim to equip diverse stakeholders with practical heat planning and forecasting tools. The success of these communication initiatives hinges on understanding the nuanced perceptions of risk and the priority assigned to addressing heat as a health risk. This paper delves explicitly into the unhoused population’s risk perceptions and coping strategies. Acknowledged as one of the most underserved and vulnerable groups to extreme heat, unhoused individuals face prolonged exposure, a heightened frequency of mental and physical health issues, and limited coping resources during extreme heat events. Despite widespread acknowledgment of their vulnerability, little attention has been directed towards researching health behavior within this demographic about excessive heat. We developed a survey instrument using the theory of planned behavior (TPB) to bridge this gap. We collected quantitative survey data from unhoused populations in Columbia, South Carolina, an area of the United States that experiences extreme heat events and has a sizeable unhoused population. Using a series of hierarchical multiple regression models, our findings indicate that TPB variables predict the intention to avoid the heat while considering additional coping strategies common among unhoused individuals. These findings offer valuable insights for public health researchers, practitioners, and community officials engaged in direct interactions with unhoused populations, informing how this underserved group manages excessive heat exposure.
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Open AccessSystematic Review
Could Nature Contribute to the Management of ADHD in Children? A Systematic Review
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Maddison Hood and Oliver Baumann
Int. J. Environ. Res. Public Health 2024, 21(6), 736; https://doi.org/10.3390/ijerph21060736 - 5 Jun 2024
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of
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Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of the symptomatology of individuals with ADHD, this provides a rationale to investigate the potential benefits of exposure to nature for this population. Four electronic databases (PubMED, PsycINFO, Embase, and Web of Science) were searched for empirical studies investigating the effects of nature on ADHD prevalence and/or symptom severity in populations of school-aged children. Key characteristics, methodologies, and outcomes of included studies were extracted and evaluated. Out of the 458 studies identified, 7 met the inclusion criteria. Despite the large heterogeneity in methodological approaches, the included articles consistently reported that exposure to nature is associated with reduced ADHD diagnoses and symptom severity. Furthermore, when several covariates, such as age, gender, annual household income, parental income, and education level, as well as several pre-natal factors, were controlled for, the relationship between nature and ADHD remained significant. The reviewed literature provides strong support for the benefits of exposure to nature on ADHD in school-aged children.
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(This article belongs to the Section Behavioral and Mental Health)
Open AccessArticle
Oral Health Literacy and Determinants among an Elderly Community in Portugal
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Helder Costa, Pedro Lopes, Maria José Correia, Patrícia Couto, Ana Margarida Silva, Joaquin Francisco López-Marcos and Nélio Veiga
Int. J. Environ. Res. Public Health 2024, 21(6), 735; https://doi.org/10.3390/ijerph21060735 - 5 Jun 2024
Abstract
High average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health,
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High average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy, oral health perception and quality of life in a sample of elderly participants of a physical activity program in Portugal. An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, DMFT, PSR and the plaque index were registered, and a questionnaire was applied in the form of a “face-to-face” interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0–14), 43.7% a moderate level (score 15–22) and 33.6% a high level (score 23–29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. A considerable proportion of the sample studied present a moderate level of oral health literacy. Therefore, educating each person about their oral health when participating in a specific health program and developing proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention. Future oral health literacy sessions should be held in order to improve oral health and quality of life among the community.
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(This article belongs to the Section Health Care Sciences)
Open AccessArticle
Use of Dietary Supplements and Influencing Factors in Children
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Orkut Koç, Merve Tosyalı, Şule Gökçe and Feyza Koç
Int. J. Environ. Res. Public Health 2024, 21(6), 734; https://doi.org/10.3390/ijerph21060734 - 5 Jun 2024
Abstract
Introduction: In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this
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Introduction: In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this use, and the attitudes of parents about these products. Methods: A total of 1038 children aged 2–18 years without any chronic disease who presented to the pediatric outpatient clinics of Ege University Children’s Hospital were included in this study. Parents (n = 1000) who agreed to participate in the study were interviewed face-to-face, and a comprehensive questionnaire including questions about children’s use of dietary supplements, sociodemographic characteristics, and parents’ attitudes towards dietary supplements was administered. Analyses were performed with SPSS 25.0. Results: The mean age of the children included in our study was 8.6 ± 4.8 years, and 51% (n = 510) were male. It was found that 32.5% of the children used nutritional supplements, and vitamin–mineral preparations (23.2%) were the most frequently used. Omega-3 (19.3%) and immune support products (9.4%) were the second and third most frequently used supplements, respectively. A significant relationship was found between the use of dietary supplements and the child’s age, body weight, body mass index, parents’ educational level, being health worker, and economic status (p < 0.05). It was found that most of the families thought that vitamin–mineral and omega-3 products were beneficial for growth and development and that they received information from doctors most frequently before taking these products. However, it was found that families followed the media as the second most frequent source of information for these products. Conclusions: Approximately one-third of the children in our study use dietary supplements. It is very important to raise awareness among families about the use of these products when necessary and with the recommendation of a physician. To prevent families from using dietary supplements that are not necessary for their children, especially due to misinformation in the media, pediatricians should provide correct information to parents about these products at every clinic visit. A concerted effort is needed from policy makers, media organizations, and health care providers to guide the safe use of DS. The results obtained from this study will shed light on future randomized controlled prospective studies.
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Open AccessArticle
Assessment of Human Health Risk Indices Due to Metal Contamination in the Surface Water of the Negro River Sub-Basin, Áncash
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Walter Bravo-Zevallos, Yadira Fernández-Jerí, Juan C. Torres-Lázaro and Karol Zuñiga-Bardales
Int. J. Environ. Res. Public Health 2024, 21(6), 733; https://doi.org/10.3390/ijerph21060733 - 5 Jun 2024
Abstract
The accelerated loss of glacial cover in the Cordillera Blanca in Áncash, Peru, exposes the underlying rocks with high concentrations of sulfides from the Chicama Formation to oxidation and leaching processes, generating acid rock drainage (ARD) in glacial and periglacial areas. These are
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The accelerated loss of glacial cover in the Cordillera Blanca in Áncash, Peru, exposes the underlying rocks with high concentrations of sulfides from the Chicama Formation to oxidation and leaching processes, generating acid rock drainage (ARD) in glacial and periglacial areas. These are transported by surface runoff, contaminating the surface water with high concentrations of metals and sulfates, as well as increasing the acidity, which poses a risk to human health and the ecosystem. Therefore, the risk indices for human health due to metal contamination were evaluated at 19 surface water sampling points distributed in the Río Negro sub-basin. Hydrochemical analyses revealed average metal concentrations in the following order: Fe (28.597 mg/L), Al (3.832 mg/L), Mn (1.085 mg/L), Zn (0.234 mg/L), Ni (0.085 mg/L), Co (0.053 mg/L), Li (0.036 mg/L), Cu (0.005 mg/L), and Pb (0.002 mg/L). The risk was determined by calculating the Heavy Metal Pollution Index (HPI) and the Hazard Index (HI). The average HPI value was 360.959, indicating a high level of contamination (HPI ≥ 150). The human health risk assessment indicated that adverse effects caused by iron, lithium, and cobalt in children and adults should be considered. Through the use of Pearson correlation analysis, principal component analysis, and cluster analysis, it was identified that SO42−, Fe, S, Al, Co, Mn, Ni, Zn, and Li originate from natural sources, associated with the generation of ARD in glacial and periglacial areas.
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(This article belongs to the Collection Environmental Risk Assessment)
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Open AccessArticle
Validity and Reliability of an Arabic Version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain Studies: A Cross-Sectional Study
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Mohammad Z. Darabseh, Aseel Aburub, Thamer A. Altaim, Badrieh Al Abbad and Khaldoon Bashaireh
Int. J. Environ. Res. Public Health 2024, 21(6), 732; https://doi.org/10.3390/ijerph21060732 - 5 Jun 2024
Abstract
Background and Objectives: Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP is not an easy job for healthcare professionals. To overcome this issue, The Survey Instrument for
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Background and Objectives: Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP is not an easy job for healthcare professionals. To overcome this issue, The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain (SNAPPS), which is a self-reporting questionnaire instrument, was designed to identify PFP in many languages. However, the Arabic version of the SNAPPS is not validated yet. This study was performed to assess the validity and reliability of the Arabic version of the SNAPPS (A-SNAPPS). Materials and Methods: A cross-sectional study was conducted to achieve the study goals. To assess reliability, 38 participants were asked to complete the A-SNAPPS two times on the same day with a 30 min break in between. Convergent validity of the A-SNAPPS was assessed by exploring the correlations of the SNAPPS total score with the visual analogue scale (VAS) scores, including VAS for usual pain, VAS for worst pain, and VAS for pain during activities such as jumping, running, ascending and descending stairs, and squatting. Results: The validity test findings suggested that SNAPPS has a strong correlation with the VAS during ascending and descending stairs (r = 0.71) and moderate correlations during jumping (r = 0.54) and squatting (r = 0.57). The test–retest reliability ICC was 0.92, indicating a very strong test–retest reliability of the A-SNAPPS. Conclusions: The A-SNAPPS was cross-culturally adapted and validated, demonstrating very strong reliability.
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(This article belongs to the Special Issue Musculoskeletal Physiotherapy and Rehabilitation)
Open AccessArticle
On the Efficacy of Indigenous Knowledge Systems in Responding to the COVID-19 Pandemic: Unsettling Coloniality
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Jabulile H. Mzimela and Inocent Moyo
Int. J. Environ. Res. Public Health 2024, 21(6), 731; https://doi.org/10.3390/ijerph21060731 - 5 Jun 2024
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Indigenous groups across Africa mobilized Indigenous Knowledge (IK) practices, albeit not without challenges, to respond to the COVID-19 pandemic. Yet Indigenous Knowledge Systems (IKS) continue to be sidelined in formal healthcare policies and programmes. This underscores the urgency to liberate Africa’s epistemologies. Employing
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Indigenous groups across Africa mobilized Indigenous Knowledge (IK) practices, albeit not without challenges, to respond to the COVID-19 pandemic. Yet Indigenous Knowledge Systems (IKS) continue to be sidelined in formal healthcare policies and programmes. This underscores the urgency to liberate Africa’s epistemologies. Employing the decoloniality lens, this paper examined the colonial influences inherent in African responses to COVID-19 while also exploring the role of IKS in the uMkhanyakude District Municipality (UKDM). The argument is made that, in the case of the UKDM, the efficacy of IKS was demonstrated in the response to and fight against the COVID-19 pandemic. This is the basis for the call to embrace and recognize that IKS is a legitimate body of knowledge comparable to Western science. Such recognition paves the way for more equitable, contextually relevant, and sustainable health strategies that can better address the complexities of current and future pandemics.
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Open AccessArticle
Double-Duty Carers’ Health and Wellbeing during COVID-19: Exploring the Role of Mobility of the Care Economy in Southern Ontario, Canada
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Léa Ravensbergen, Sakshi Mehta, Bharati Sethi, Catherine Ward-Griffin and Allison Williams
Int. J. Environ. Res. Public Health 2024, 21(6), 730; https://doi.org/10.3390/ijerph21060730 - 4 Jun 2024
Abstract
Double-Duty Carers (DDCs) refer to people who work in the healthcare industry while also providing unpaid care to relatives, friends, or neighbours. The expectations placed on DDCs is expected to grow, and these employees already experience a high caring burden. As such it
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Double-Duty Carers (DDCs) refer to people who work in the healthcare industry while also providing unpaid care to relatives, friends, or neighbours. The expectations placed on DDCs is expected to grow, and these employees already experience a high caring burden. As such it is important to understand how best to support their health and wellbeing. This paper explores DDCs’ wellbeing during the COVID-19 pandemic, focusing an understudied factor: their mobility constraints. Following the Mobility of the Care Economy framework and a qualitative research design, it does so through a thematic analysis of 16 semi-structured interviews with female DDCs in Southern Ontario, Canada. Once data saturation was reached, three mobility pathways during the pandemic were identified, all of which negatively affected DDCs wellbeing. First, some COVID-19 policies (e.g., testing requirements) resulted in increased mobility demands and increased spatiotemporal constraints. Second, the closure of institutions that care for dependents (schools, daycares, day centres) resulted in forced reduced mobility, which increased financial stress. Finally, indirect mobility effects were identified: the reduced mobility of other informal carers increased the workload and emotional strain on DDCs. The paper concludes with a discussion of mobility-related policies that could improve DDC wellbeing.
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(This article belongs to the Section Global Health)
Open AccessArticle
Addressing Water Contamination and Associated Health Issues through Community-Based Interventions: A Case Study in Khon Kaen Province
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Weerakanya Maneeprakorn, Gamolwan Tumcharern, Suwussa Bamrungsap, Kantapat Chansaenpak, Khoonsake Segkhoonthod, Chanoknan Rattanabut, Kullavadee Karn-orachai, Aroonsri Ngamaroonchote, Prapaporn Sangkaew, Pornpimol Wongsuwan, Dechnarong Pimalai, Nararat Yong, Tik Ouiram, Peraya Phattrapornpisit, Aurachat Lert-itthiporn, Satita Gerdsapaya, Nuttaporn Pimpha, Eknarin Thanayupong, Pitak Ngammuangtueng, Sopita Rattanopas, Pornthip Piyanuch, Preeyanut Butmee, Phongthep Noipitak, Thitiya Bunsri, Armote Somboonkaew, Sirajit Rayanasukha, Uayphorn Wannason, Sataporn Chanhorm, Kosom Chaitavon, Mongkol Thananawanukul, Ubon Cha’on, Sirirat Anutrakulchai and Deanpen Japrungadd
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Int. J. Environ. Res. Public Health 2024, 21(6), 729; https://doi.org/10.3390/ijerph21060729 - 4 Jun 2024
Abstract
A recent study conducted in Khon Kaen Province, Thailand, evaluated the effectiveness of a technology-assisted intervention aimed at improving water quality and addressing related health issues in communities around key water bodies. The intervention targeted health concerns associated with water contamination, including chronic
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A recent study conducted in Khon Kaen Province, Thailand, evaluated the effectiveness of a technology-assisted intervention aimed at improving water quality and addressing related health issues in communities around key water bodies. The intervention targeted health concerns associated with water contamination, including chronic kidney diseases, skin conditions, hypertension, and neurological symptoms. The study included water quality assessments and health evaluations of 586 residents and implemented a Learning Innovation Platform (LIP) across 13 communities. Results showed significant improvements in the community, including a decrease in hypertension and skin-related health issues, as well as enhanced community awareness and proficiency in implementing simple water quality assessments and treatment. The study demonstrated the value of a comprehensive, technology-driven community approach, effectively enhancing water quality and health outcomes, and promoting greater community awareness and self-sufficiency in managing environmental health risks.
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(This article belongs to the Section Environmental Health)
Open AccessArticle
Improving Outcomes for Regional Families in the Early Years: Increasing Access to Child and Family Health Services for Regional Australia
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Jessica Appleton, Deborah A. Stockton, Marie Dickinson and Deborah Debono
Int. J. Environ. Res. Public Health 2024, 21(6), 728; https://doi.org/10.3390/ijerph21060728 - 4 Jun 2024
Abstract
Providing child and family health (CFH) services that meet the needs of young children and their families is important for a child’s early experiences, development and lifelong health and well-being. In Australia, families living in regional and rural areas have historically had limited
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Providing child and family health (CFH) services that meet the needs of young children and their families is important for a child’s early experiences, development and lifelong health and well-being. In Australia, families living in regional and rural areas have historically had limited access to specialist CFH services. In 2019, five new specialist CFH services were established in regional areas of New South Wales, Australia. The purpose of this study is to understand the regional families’ perceptions and experiences of these new CFH services. A convergent mixed-methods design involving a survey and semi-structured interviews with parents who had used the service was used for this study. Data collected include demographics, reasons for engaging with the service, perception, and experience of the service, including if the service provided was family centred. Triangulation of the quantitative and qualitative analysis uncovered three main findings: (i) The regional location of the service reduced the burden on families to access support for their needs; (ii) providing a service that is family-centred is important to achieve positive outcomes; and (iii) providing a service that is family-centred advances the local reputation of the service, enabling a greater reach into the community. Providing local specialist CFH services reduces the burden on families and has positive outcomes; however, providing services that are family-centred is key.
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(This article belongs to the Special Issue Public Health: Rural Health Services Research)
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Association between Physical Activity and Dengue and Its Repercussions for Public Health: New Insights
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Francisco José Gondim Pitanga and Victor Keihan Rodrigues Matsudo
Int. J. Environ. Res. Public Health 2024, 21(6), 727; https://doi.org/10.3390/ijerph21060727 - 4 Jun 2024
Abstract
Dengue is an endemic disease in tropical countries, mainly in South America, Southwest Asia, and Africa, which, despite having a low lethality rate, can overwhelm health systems. Strengthening the immune system through regular physical activity can be an important tool to prevent contagion,
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Dengue is an endemic disease in tropical countries, mainly in South America, Southwest Asia, and Africa, which, despite having a low lethality rate, can overwhelm health systems. Strengthening the immune system through regular physical activity can be an important tool to prevent contagion, worsening, hospitalizations, and deaths caused by the disease, as seen in the COVID-19 pandemic. Therefore, this point of view aims to analyze the possible association between physical activity and dengue and its repercussions on public health. Comments were made on the main characteristics of dengue as well as on the main vaccines available to date. It was also discussed the impacts of dengue on health systems, in addition to the main repercussions for public health when a very large number of people are infected. It was also commented on the main factors that contribute to the worsening of the clinical stage of dengue, in addition to discussions and reflections on physical activity, strengthening the immune system, and dengue. There are assumptions that regular physical activity can be an important public health strategy to prevent contagion, severity, and hospitalizations caused by dengue and that it needs to be promoted by governments around the world as a tool for preventing and treating not only chronic communicable diseases but also infectious diseases.
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(This article belongs to the Special Issue The Effect of the Physical Activity on the Health of People)
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Preferences for Follow-Up Procedures among Patients Lost to Follow-Up after Smoking Cessation Intervention among Therapists—An Interview Study
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Sanne Wärjerstam, Camilla Dew-Hattens, Mette Rasmussen, Berit Lilienthal Heitmann, Rie Raffing and Hanne Tønnesen
Int. J. Environ. Res. Public Health 2024, 21(6), 726; https://doi.org/10.3390/ijerph21060726 - 3 Jun 2024
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Achieving high follow-up rates after smoking cessation interventions (SCIs) is a general challenge. The aim of this study was to identify preferences among patients and therapists for improving follow-up rates and to assess smoking status at 6 months among patients lost to follow-up.
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Achieving high follow-up rates after smoking cessation interventions (SCIs) is a general challenge. The aim of this study was to identify preferences among patients and therapists for improving follow-up rates and to assess smoking status at 6 months among patients lost to follow-up. From the Danish STOPbase for Tobacco and Nicotine, which collects data on SCI across health care, 20 representative patients lost to follow-up by routine procedures were identified together with 11 therapists. All participated in individual semi-structured phone interviews, which for patients also included 6-month smoking status. Deductive and inductive analyses were performed. Four themes emerged from the analyses with several subthemes, all regarding contacts. Both patients and therapists preferred to intensify the follow-up process by boosting it with additional attempts and using voice messages, e-mail and/or SMS, calling at specified times of the day and avoiding calls from unknown numbers. In addition, some patients mentioned that they were busy or were not carrying their mobile devices at the time of a call as a barrier. Some therapists mentioned that barriers could include an expectation of relapse, but also a poor mental state, the time of day and patient fear of public systems. Among the patients originally lost to follow-up, 35% (95% CI 16%–59%) experienced continuous smoking cessation for 6 months, and the overall national rate was 22% (21.6–23.3%). In conclusion, both patients and therapists preferred intensified follow-up. The 6-month smoking status for patients lost to follow-up seemed to be similar to that of the routinely followed-up patients. These findings will be examined experimentally in a larger study.
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Identifying Challenges and Solutions for Improving Access to Mental Health Services for Rural Youth: Insights from Adult Community Members
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Janessa M. Graves, Demetrius A. Abshire, Elissa Koontz and Jessica L. Mackelprang
Int. J. Environ. Res. Public Health 2024, 21(6), 725; https://doi.org/10.3390/ijerph21060725 - 3 Jun 2024
Abstract
In the rural United States, provider shortages, inadequate insurance coverage, high poverty rates, limited transportation, privacy concerns, and stigma make accessing mental healthcare difficult. Innovative, localized strategies are needed to overcome these barriers, but little is known about what strategies may be feasible
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In the rural United States, provider shortages, inadequate insurance coverage, high poverty rates, limited transportation, privacy concerns, and stigma make accessing mental healthcare difficult. Innovative, localized strategies are needed to overcome these barriers, but little is known about what strategies may be feasible in, or acceptable to, rural communities. We aimed to identify barriers youth face in accessing mental healthcare in rural Washington State and to generate ideas to improve access. Methods: Semi-structured, key informant interviews were conducted by telephone with adult community members, including parents, teachers, and healthcare providers. Participants answered questions related to barriers to mental healthcare access that confront youth and approaches to improving access. Detailed, de-identified field notes were analyzed using conventional content analysis. Results: Limited resources and stigma were the two primary barriers to accessing mental healthcare that youth encounter in the community. Limited resources included lack of services and transportation, inconsistent funding and mental health programming, and workforce shortages. Stigma associated with seeking mental healthcare was of particular concern for youth with diverse identities who experience additional stigma. Conclusions: Improving access to mental healthcare for rural youth will require building a strong mental health workforce and championing efforts to reduce stigma associated with help-seeking.
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(This article belongs to the Special Issue Public Health: Rural Health Services Research)
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Cardiorespiratory Performance, Physical Activity, and Depression in Thai Older Adults with Sarcopenia and No Sarcopenia: A Matched Case-Control Study
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Nuntiya Boontanom, Patcharee Kooncumchoo and Kornanong Yuenyongchaiwat
Int. J. Environ. Res. Public Health 2024, 21(6), 724; https://doi.org/10.3390/ijerph21060724 - 1 Jun 2024
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Background: Older adults have a high risk for musculoskeletal, cardiorespiratory, and mental health problems. We compared respiratory muscle strength, cardiovascular endurance, physical activity (PA), and depression between older adults with and without sarcopenia. Methods: This matched case–control study included 200 Thai older adults
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Background: Older adults have a high risk for musculoskeletal, cardiorespiratory, and mental health problems. We compared respiratory muscle strength, cardiovascular endurance, physical activity (PA), and depression between older adults with and without sarcopenia. Methods: This matched case–control study included 200 Thai older adults (100 participants with and without sarcopenia). According to the Asian Working Group for Sarcopenia 2019, participants completed a handgrip dynamometer, a 6 m walk test, and bioimpedance analysis for sarcopenia screening. Individuals were required to evaluate their cardiovascular endurance and respiratory muscle strength and complete a set of questionnaires (i.e., depression and PA). Participants with and without sarcopenia were compared using a t-test, and ANOVA was used for subgroup analysis. Results: Participants with sarcopenia had significantly lower inspiratory muscle strength (p < 0.001), functional capacity (p = 0.032), PA (p < 0.001), and higher depression scores (p < 0.001) than those without sarcopenia. Respiratory muscle strength and PA were significantly reduced in those with severe sarcopenia, followed by those with sarcopenia, possible sarcopenia, and no sarcopenia. Older adults with severe sarcopenia had higher depression scores than those with sarcopenia, possible sarcopenia, or no sarcopenia. Conclusions: Older adults with sarcopenia may exhibit lower cardiorespiratory performance, less PA, and higher depression than those without sarcopenia.
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Open AccessArticle
While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure
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Wendy C. Birmingham, Raphael M. Herr, Mikel Cressman, Neha Patel and Man Hung
Int. J. Environ. Res. Public Health 2024, 21(6), 723; https://doi.org/10.3390/ijerph21060723 - 1 Jun 2024
Abstract
Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in
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Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one’s own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.
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Open AccessArticle
Impact of Airborne Exposure to PM10 Increases Susceptibility to P. aeruginosa Infection
by
Sharon A. McClellan, Robert Wright, Farooq Muhammed and Linda D. Hazlett
Int. J. Environ. Res. Public Health 2024, 21(6), 722; https://doi.org/10.3390/ijerph21060722 - 31 May 2024
Abstract
The effects of exposure to airborne particulate matter with a size of 10 μm or less (PM10) on C57BL/6 mouse corneas, their response to Pseudomonas aeruginosa (PA) infection, and the protective effects of SKQ1 were determined. C57BL/6 mouse corneas receiving PBS
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The effects of exposure to airborne particulate matter with a size of 10 μm or less (PM10) on C57BL/6 mouse corneas, their response to Pseudomonas aeruginosa (PA) infection, and the protective effects of SKQ1 were determined. C57BL/6 mouse corneas receiving PBS or SKQ1 were exposed to control (air) or PM10 for 2 weeks, infected, and the disease was documented by clinical score, PMN quantitation, bacterial plate count, RT-PCR and Western blot. PBS-treated, PM10-exposed corneas did not differ at 1 day postinfection (dpi), but exhibited earlier (3 dpi) corneal thinning compared to controls. By 3 dpi, PM10 significantly increased corneal mRNA levels of several pro-inflammatory cytokines, but decreased IL-10, NQO1, GR1, GPX4, and Nrf2 over control. SKQ1 reversed these effects and Western blot selectively confirmed the RT-PCR results. PM10 resulted in higher viable bacterial plate counts at 1 and 3 dpi, but SKQ1 reduced them at 3 dpi. PM10 significantly increased MPO in the cornea at 3 dpi and was reduced by SKQ1. SKQ1, used as an adjunctive treatment to moxifloxacin, was not significantly different from moxifloxacin alone. Exposure to PM10 increased the susceptibility of C57BL/6 to PA infection; SKQ1 significantly reversed these effects, but was not effective as an adjunctive treatment.
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(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
Open AccessArticle
Users’ Perceptions of Access to and Quality of Unified Health System Services in Brazil: A Cross-Sectional Study and Implications to Healthcare Management Challenges
by
Jhoyce S. Souza, Edna A. Reis, Brian Godman, Stephen M. Campbell, Johanna C. Meyer, Luann W. P. Sena and Isabella P. D. Godói
Int. J. Environ. Res. Public Health 2024, 21(6), 721; https://doi.org/10.3390/ijerph21060721 - 31 May 2024
Abstract
Evaluating the access to and quality of healthcare services from the users’ perspective is an important assessment process to identify priorities. This study assessed the profile of health service usage and the views of the Unified Health System (SUS) users about the access
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Evaluating the access to and quality of healthcare services from the users’ perspective is an important assessment process to identify priorities. This study assessed the profile of health service usage and the views of the Unified Health System (SUS) users about the access to and quality of SUS public health services. A cross-sectional study was conducted with participants from the Coastal Lowlands Region of the Rio de Janeiro State/Brazil, between August and November 2023. The association between categorical variables was analyzed using the Pearson Chi-Square test, using R software 4.3. A total of 200 individuals were interviewed using a 66-question survey instrument. Participants who reported using SUS services more frequently rated this system as essential (p-value = 0.031). However, overall, 64% of participants rated the quality of care to be very bad/bad and 34.9% rated access as very bad/bad. Access was considered poor by respondents who used public services rarely or sometimes (p-value = 0.002). In terms of accessing SUS services consultations provided by specialists (e.g., neurologists), these were available only in another municipality (p-value = 0.001). Many participants were SUS dependent for health services, and gaps and weaknesses were observed regarding users’ perspectives of the access to and quality of SUS health care. Policymakers should prioritize evaluations and dialogue with the community to make SUS services responsive and to optimize value-for-money in health service planning.
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(This article belongs to the Special Issue Social Medicine and Healthcare Management)
Open AccessArticle
The Impact of Urban Allotment Gardens on Physical and Mental Health in Norway
by
Mari Johnsrud, Ursula Småland Goth and Hilde Skjerve
Int. J. Environ. Res. Public Health 2024, 21(6), 720; https://doi.org/10.3390/ijerph21060720 - 31 May 2024
Abstract
In Norway, many communities offer low-rent plots of land on which city dwellers can build summer cottages and grow crops. These allotment gardens serve as recreational escapes from urban life. However, little is known about the impact these gardens have on their members.
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In Norway, many communities offer low-rent plots of land on which city dwellers can build summer cottages and grow crops. These allotment gardens serve as recreational escapes from urban life. However, little is known about the impact these gardens have on their members. This study attempts to shed light on today’s impact of allotment gardens in a public health setting in Norway. The study was based on 17 semi-structured interviews and 2 in-depth interviews with allotment house owners. Informants were mainly recruited by “snowball sampling.” Our data show that maintaining an allotment promotes exercise and provides a positive impact on self-perceived well-being and physical health through outdoor activities. Spending time in the garden contributes to new knowledge and experiences. Owning an allotment garden has provided new knowledge, new skills, new hobbies, and thereby an improvement in lifestyle. The allotment garden has a strong impact on perceived health, well-being, and sense of coherence (SOC) for the individuals. It promotes outdoor activities along with social interaction and can prevent feelings of loneliness and isolation.
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(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)
Open AccessArticle
Influences on COVID-19 Vaccine Adherence among Pregnant Women: The Role of Internet Access and Pre-Vaccination Emotions
by
Rosângela Carvalho de Sousa, Maria Juliene Lima da Silva, Maria Rita Fialho do Nascimento, Mayara da Cruz Silveira, Franciane de Paula Fernandes, Tatiane Costa Quaresma, Simone Aguiar da Silva Figueira, Maria Goreth Silva Ferreira, Adjanny Estela Santos de Souza, Waldiney Pires Moraes, Sheyla Mara Silva de Oliveira and Livia de Aguiar Valentim
Int. J. Environ. Res. Public Health 2024, 21(6), 719; https://doi.org/10.3390/ijerph21060719 - 31 May 2024
Abstract
Introduction: The onset of the COVID-19 pandemic brought about global uncertainties and fears, escalating the dissemination of fake news. This study aims to analyze the impact of fake news on COVID-19 vaccine adherence among pregnant women, providing crucial insights for effective communication strategies
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Introduction: The onset of the COVID-19 pandemic brought about global uncertainties and fears, escalating the dissemination of fake news. This study aims to analyze the impact of fake news on COVID-19 vaccine adherence among pregnant women, providing crucial insights for effective communication strategies during the pandemic. Methods: A cross-sectional, exploratory study was conducted with 113 pregnant women under care at a Women’s Health Reference Center. Data analysis included relative frequency and odds ratio to assess the relationship between sociodemographic and behavioral variables regarding vaccination. Results: In the behavioral context of vaccination, internet access shows a significant association with decision-making, influencing vaccine refusal due to online information. Nuances in the odds ratios results highlight the complexity of vaccine hesitancy, emphasizing the importance of information quality. Pre-vaccination sentiments include stress (87.61%), fear (50.44%), and anxiety (40.7%), indicating the need for sensitive communication strategies. Discussion: Results revealed that pregnant women with higher education tend to adhere more to vaccination. Exposure to news about vaccine inefficacy had a subtle association with hesitancy, while finding secure sources was negatively associated with hesitancy. The behavioral complexity in the relationship between online information access and vaccination decision underscores the need for effective communication strategies. Conclusions: In the face of this challenging scenario, proactive strategies, such as developing specific campaigns for pregnant women, are essential. These should provide clear information, debunk myths, and address doubts. A user-centered approach, understanding their needs, is crucial. Furthermore, ensuring information quality and promoting secure sources are fundamental measures to strengthen trust in vaccination and enhance long-term public health.
Full article
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