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        <title>International Journal of Public Health | New and Recent Articles</title>
        <link>https://www.ssph-journal.org/journals/international-journal-of-public-health</link>
        <description>RSS Feed for International Journal of Public Health | New and Recent Articles</description>
        <language>en-us</language>
        <generator>Frontiers Feed Generator,version:1</generator>
        <pubDate>2026-07-08T01:52:14.843+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609473</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609473</link>
        <title><![CDATA[Mapping the availability of climate and health education in European schools of public health: a baseline assessment for indicator development]]></title>
        <pubdate>2026-06-26T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Eric Phillip Twomey</author><author>Fadilah Fitri Arsy</author><author>Robert Otok</author><author>Laurent Chambaud</author>
        <description><![CDATA[ObjectivesClimate and health education is increasingly recognised as essential for preparing a climate-competent public health workforce, yet reliable European baseline data remain limited. This cross-sectional study assessed the availability of climate and health education in degree-granting Schools of Public Health across the World Health Organization European Region.MethodsA survey of Association of Schools of Public Health in the European Region member institutions was combined with a large-language-model-assisted web scan and manual verification of institutional websites, curricula, syllabi, and programme descriptions.ResultsOverall, 268 Schools of Public Health were identified across 53 countries, including 131 ASPHER members and 137 non-members. Of these, 111 institutions (41.4%) offered at least one verified climate and health education programme or course in 2024/2025. Availability was similar among ASPHER members (41%) and non-members (43%). Most identified programmes were offered at master’s level, while vocational, bachelor, doctoral, and continuing professional development opportunities were less frequent.ConclusionClimate and health education is present across much of Europe but remains uneven and concentrated at postgraduate level. The findings provide a verifiable baseline for future monitoring and policy action.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609165</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609165</link>
        <title><![CDATA[Effects of a family home-based intervention on global health and 24h movements: an exploratory family cluster-based approach to childhood obesity]]></title>
        <pubdate>2026-06-25T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Julie Siroux</author><author>Juliette Lemay</author><author>Inès Ramos</author><author>Vicky Drapeau</author><author>Jean-Phillipe Chaput</author><author>Elodie Vedrine</author><author>Carla Dalmais</author><author>Victoria Rousset-Thiry</author><author>David Thivel</author><author>Yves Boirie</author><author>Magalie Miolanne</author>
        <description><![CDATA[ObjectivesThis study aimed at (i) exploring the effects of a 12-month home-based family intervention on perceived global health and 24 h movement patterns among children with overweight/obesity (OW/OB) and their family members; (ii) identifying intra-family behavioral clusters and their influence on the intervention’s effectiveness.Methods142 families (n = 223 legal guardians) with at least one child with OW/OB were included. At baseline and 12 months, perceived health, sleep, physical activity (PA) and sedentary behaviors (SB) were assessed.ResultsChildren with OW/OB showed poorer physical and mental quality of life (QoL) than normal weight (NW) ones (p < 0.001), and decreased body mass index (BMI) z-score over time (p = 0.001). Guardians with OW/OB improved physical QoL at the end of the program (p = 0.002). For all outcomes, clusters analysis suggested a distinction between NW children and those with OW/OB. Children tended to resemble their guardians of same weight status (WS). Changes in BMI z-scores among children with OW/OB might vary by QoL and behavioral profiles with greatest reductions in clusters having higher baseline global health or PA.ConclusionThis study suggests the potential of family-centered strategies addressing childhood obesity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609386</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609386</link>
        <title><![CDATA[Individual placement and support (IPS) integrated with specialized substance use disorder treatment: a socioeconomic analysis based on a randomized controlled trial]]></title>
        <pubdate>2026-06-25T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Kristoffer Andreas Aamodt Andersen</author><author>Linn Nathalie Støme</author><author>Erlend Marius Aas</author><author>Espen Ajo Arnevik</author><author>Marianne Riksheim Stavseth</author><author>Eline Borger Rognli</author>
        <description><![CDATA[ObjectivesTo conduct a socioeconomic analysis of Individual Placement and Support (IPS) integrated with specialized substance use disorder treatment. Additionally, we explored group differences in the use of social and welfare services and assessed the validity of a previous simulation model.MethodsWe used Early Health Technology Assessment (eHTA) to estimate socioeconomic gain using data extracted from a completed randomized controlled trial comparing IPS and enhanced treatment as usual (enhanced TAU) for patients in specialized substance use disorder treatment.ResultsIPS was socioeconomically beneficial compared to enhanced TAU during the first year after end of the intervention (€992,224 for IPS, and €778,121 for enhanced TAU), equal to a group difference of €214,103 (modelled for 100 patients). During the trial period, IPS participants showed a total cost saving of €157,593 due to less use of social and welfare services, compared to participants receiving enhanced TAU. These estimates are comparable to our previous eHTA simulation.ConclusionOur estimates indicate a net socioeconomic gain of IPS starting during the intervention year, which exceeds that of enhanced TAU in the first year following the intervention. Additional cost savings were found in favor of IPS. Our early simulated eHTA proved valid in one scenario.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609856</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609856</link>
        <title><![CDATA[COVID-19 disrupted patterns of cause-specific mortality in Switzerland]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Anthony Hauser</author><author>Moritz Wagner</author><author>Anna Fesser</author><author>Karim Abawi</author><author>Anne Laube</author><author>Garyfallos Konstantinoudis</author><author>Julien Riou</author>
        <description><![CDATA[ObjectivesTo understand disruptions in mortality patterns during the COVID-19 pandemic beyond deaths directly attributed to SARS-CoV-2.MethodsWe analysed Swiss weekly deaths (2011–2021) by age, sex, region, and nine cause groups. For each age group, a Bayesian multivariate Poisson model was fitted to 2011–2019 data, accounting for seasonality, long-term trends, and cross-cause dependence. Comparing predictions with 2020–2021 observations revealed age- and cause-specific excesses.ResultsCardiovascular deaths peaked during the autumn 2020 wave, while no cause showed sustained excess across 2020–2021. In individuals aged ≥80 years, non-COVID respiratory (−25%) and mental/neurological (−12%) deaths declined, largely offset by COVID-19 deaths, leaving a modest +4.5% all-cause excess. Cardiovascular and mental/neurological excesses correlated with COVID-19 and other respiratory excesses, reflecting strong pre-pandemic cross-cause correlations (ρ>0.80).ConclusionThese patterns likely reflect three overlapping mechanisms: reduced circulation of non-COVID-19 respiratory pathogens, unrecognized COVID-19 deaths (especially cardiovascular), and mortality displacement, pointing to possible underestimation of the true respiratory burden.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609624</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609624</link>
        <title><![CDATA[Concurrent utilisation of cancer screening tests in the general population aged 50–69: an analysis of the 2017 Swiss Health Survey]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Audrey Butty Dettwiler</author><author>Jessica Nakiyingi-Miiro</author><author>Jean-Luc Bulliard</author>
        <description><![CDATA[ObjectivesThis study assessed the extent and factors of concurrent utilisation of cancer screenings in Switzerland.MethodsData from the 2017 Swiss Health Survey, representing 1,091,813 females and 1,072,940 males aged 50–69, were analysed. Weighted descriptive analyses estimated sex-specific proportions of individuals concurrently up to date with recommended screening for cervical, breast, colorectal, prostate and skin cancer. Multivariable binomial weighted logistic regressions examined associations between concurrent utilisation and sociodemographic, lifestyle, health, health services utilisation, security and social support factors.ResultsApproximately one in three Swiss residents were concurrent screening users. Concurrent utilisation increased with age and frequent medical visits. Among females, concurrent utilisation was positively associated with living in French- or Italian-speaking Switzerland and having tertiary education, and negatively associated with being divorced, separated or widowed, and with non-European origin. Among males, concurrent utilisation was positively associated with income, and negatively associated with unhealthy lifestyles, low health concern, and higher health insurance deductibles.ConclusionFurther research is needed to clarify the factors underlying differences in screening behaviours. Given the temporal instability of these behaviours, the findings should be interpreted cautiously.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609281</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609281</link>
        <title><![CDATA[Rising clustering of metabolic risk factors and behavioral-metabolic profiles in Viet Nam, 2015–2021: repeated cross-sectional surveys]]></title>
        <pubdate>2026-06-19T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Duy Quang Pham</author><author>Thi Tu Quyen Bui</author><author>Hung Minh Nguyen</author><author>Minh Van Hoang</author>
        <description><![CDATA[ObjectivesEvidence on the burden and clustering of metabolic non-communicable disease risks and on data-driven risk profiles remains limited. This study assessed trends in the clustering of metabolic risk factors in Viet Nam from 2015 to 2021 and identified behavioral–metabolic profiles in 2021.MethodsA repeated cross-sectional design was used, using national STEPS data from 2015 (n = 3,074) and 2021 (n = 3,712), both of which included participants who completed all survey components. Behavioral risk factors (smoking, alcohol use, physical inactivity, and low fruit and vegetable intake) and metabolic risk factors (elevated blood pressure, fasting glucose, body mass index (BMI), and total cholesterol) were defined using Asian-calibrated cutoffs. Clustering was defined as the co-occurrence of two or more metabolic risk factors within an individual. Weighted analyses estimated prevalence and clustering, and latent class analysis (LCA) identified behavioral–metabolic profiles.ResultsAll metabolic risks increased between 2015 and 2021, most sharply for raised fasting glucose (12.0% → 37.7%). This increase was a major contributor to intensified clustering, with the prevalence of ≥2 risk factors increasing from 27.6% to 46.6% and ≥3 risk factors increasing from 8.7% to 20.1%. LCA revealed three profiles: “Health-Conscious” (38.1%, low behavioral and metabolic risks), “Metabolic Risk-Aware” (34.6%, low behavioral but high metabolic risks, linked to older age), and “High Behavioral Risk with Moderate Metabolic Comorbidity” (27.3%, characterized by high smoking and alcohol use together with moderate metabolic abnormalities, concentrated among socioeconomically disadvantaged men).ConclusionMetabolic risks in Viet Nam increased markedly between 2015 and 2021, with elevated glucose levels playing an important role in multi-risk clustering. These distinct profiles underscore the need for integrated, multi-risk screening and management in primary care, especially targeting older adults and socioeconomically disadvantaged men.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609152</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609152</link>
        <title><![CDATA[Substance use among second-generation immigrants in France: heritage language as a protective factor]]></title>
        <pubdate>2026-06-15T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Stéphane Legleye</author><author>Myriam Khlat</author><author>Damien Bricard</author>
        <description><![CDATA[ObjectivesStudy substance use among second-generation immigrants in France (G2) in comparison with first-generation immigrants (G1) and majority population, and particularly the variation according to practice of heritage language.Methodsin a nation-wide probability sample, we focused on the two largest groups (from Maghreb and Southern-Europe: n = 2,736), analysing their use of alcohol, tobacco and cannabis. The main factor of interest was practice of heritage language at home at age 15 (vs. exclusive use of French), and we also considered type of parentage: homogenous (two immigrant parents from the same country) vs. mixed (only one, the other being French).ResultsIn comparison with the majority population (neither G1 nor G2: n = 19,185), G1 had lower levels of substance use, followed by G2 speaking the heritage language and by G2 with homogeneous parentage. The other G2 reported higher levels of substance use, close to those of the majority population (even higher for tobacco among Maghrebins and cannabis among South-Europeans). These associations remained robust after adjusting for potential individual and contextual confounding variables.ConclusionIntegrating those specificities may help in designing culturally grounded prevention policies benefitting the population at large.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609906</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609906</link>
        <title><![CDATA[Closing the implementation gap: the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) as a proof of-concept for Europe’s Safe Hearts Plan]]></title>
        <pubdate>2026-06-15T00:00:00Z</pubdate>
        <category>Commentary</category>
        <author>Benedetta Armocida</author><author>Beatrice Formenti</author><author>Albert Aszalos</author><author>Hector Bueno</author><author>Ewelina Chawłowska</author><author>Hanna Elonheimo</author><author>Mounia El Yamani</author><author>Irati Erreguerena</author><author>Sinikka Kyto</author><author>Matilde Leonardi</author><author>Jaana Lindström</author><author>Agnes Makai</author><author>Bernardino Morillo</author><author>Luigi Palmieri</author><author>Roberta Papa</author><author>Markku Peltonen</author><author>Helena Safadi</author><author>Natalia Skogberg</author><author>Anna Tarhanchuk</author><author>Hanna Tolonen</author><author>Edwin Wouters</author><author>Jelka Zaletel</author><author>Katarzyna Zukowska</author><author>Graziano Onder</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609990</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609990</link>
        <title><![CDATA[The emergency events database, EM-DAT, must be preserved as a global public good]]></title>
        <pubdate>2026-06-15T00:00:00Z</pubdate>
        <category>Commentary</category>
        <author>Niko Speybroeck</author><author>Ilan Noy</author><author>Albert Kettner</author><author>Regina Below</author><author>Gabriele Messori</author><author>Wim Thiery</author><author>Valentin Wathelet</author><author>Aglaé Jézéquel</author><author>Damien Delforge</author><author>Dewald Van Niekerk</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1608979</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1608979</link>
        <title><![CDATA[Assessing Unmet Need for Mental Healthcare Among Adults in Germany – Results from a Nationwide Study with Data Linkage]]></title>
        <pubdate>2026-06-11T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Diana Peitz</author><author>Felicitas Vogelgesang</author><author>Heike Hölling</author><author>Thomas G. Grobe</author><author>Timm Frerk</author><author>Ursula Marschall</author><author>Julia Thom</author>
        <description><![CDATA[ObjectivesTo estimate the prevalence of self-reported (un)met need for mental healthcare and associated barriers among adults in Germany and to compare this information with documented mental healthcare use in order to assess the suitability of this indicator for mental health surveillance.MethodsSelf-report survey and routine data documented by healthcare providers from 6,558 randomly sampled adults insured with a major German health insurance company built the basis of bivariate and multivariate analyses, also examining influences of sociodemographic determinants and mental health literacy. Prevalence estimates were additionally replicated with representative data from two national health surveys (n = 10,676 and n = 27,102).Results57% of individuals with perceived need reported no mental healthcare use in the previous 12 months. Unmet need was associated with younger age, but not with sex or education. Most individuals with an unmet need reported internal barriers in terms of low mental health literacy. Self-report corresponds with documented mental healthcare use.ConclusionMonitoring self-reported met and unmet need can inform healthcare planning from a patient perspective and addresses the mental health treatment gap.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609244</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609244</link>
        <title><![CDATA[Pakistan’s HPV vaccination drive: navigating trust, culture, and misinformation in a new era of immunization]]></title>
        <pubdate>2026-06-11T00:00:00Z</pubdate>
        <category>Commentary</category>
        <author>Umaima Mir</author><author>Maria Asghar</author><author>Nayab Amjad</author><author>Urooj Amjad</author><author>Iqra Khan</author><author>Shandana Kifayat</author><author>Shanlina Kifayat</author><author>Muhammad Ali Jan Khan</author><author>Khadija Tul Kobra</author><author>Zeeshan Wali</author><author>Baber Wali</author><author>Sobia Shafiq</author><author>Asad Ullah</author><author>Fazal Jamil</author><author>Muhammad Ittefaq</author><author>Muhammad Salar Khan</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609740</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609740</link>
        <title><![CDATA[Invisible victims of border conflict: health and wellbeing of border communities between Cambodia and Thailand]]></title>
        <pubdate>2026-06-10T00:00:00Z</pubdate>
        <category>Commentary</category>
        <author>Virak Sorn</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609179</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609179</link>
        <title><![CDATA[Individual placement and support in Mexico: barriers and facilitators]]></title>
        <pubdate>2026-06-10T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>J. Carlos Arámbula-Román</author><author>Elsy Cárdenas-García</author><author>Sol Durand-Arias</author><author>Ricardo Saracco-Alvarez</author><author>Jaime Carmona-Huerta</author><author>Jesús Alejandro Aldana-López</author><author>Eveling Villafuerte-Jacob</author><author>Shoshana Berenzon</author><author>Ana Carolina Florence</author><author>Bob Drake</author><author>Ezra Susser</author><author>Franco Mascayano</author>
        <description><![CDATA[ObjectivesThe Individual Placement and Support (IPS) model has proven effective in different high-income countries. However, its implementation in low- and middle-income countries presents a new challenge. This study identified potential barriers and facilitators for IPS implementation in the metropolitan area of Guadalajara, México, to prepare for a clinical trial.MethodsThe study explored potential barriers and facilitators to implementing IPS in the metropolitan area of Guadalajara, Mexico, from the perspectives of 61 diverse stakeholders in mental health interest groups: policymakers, administrators, providers, service users, and potential employers. The study used semi-structured, qualitative interviews and structured questionnaires tailored to each participant group and their specific roles.ResultsMajor themes of barriers were stigma, limitations in treating people with serious mental illness, difficulties related to users and their support networks, and systems barriers. Potential facilitators included the effectiveness of programs and specific activities, institutional collaboration, patient-centered approach, and characteristics of IPS.ConclusionThe study provided critical information on challenges and potential strategies prior to an upcoming trial of IPS supported employment services in a large, middle-income country.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609454</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609454</link>
        <title><![CDATA[Bridging the implementation gap in cardiovascular prevention: a narrative review and call to action]]></title>
        <pubdate>2026-06-10T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Grzegorz Kubielas</author><author>Jacek Gonos</author><author>Christopher S. Lee</author><author>Angela Durante</author><author>Michela Barisone</author><author>Nicola Straiton</author><author>Adrian Jurczyk</author><author>Katarzyna Kułaga</author><author>Maria Jędrzejczyk</author><author>Izabella Uchmanowicz</author>
        <description><![CDATA[ObjectivesCardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, yet substantial gaps persist between evidence-based prevention strategies and their real-world implementation. This narrative review aimed to identify and synthesize contemporary models, programmes, and implementation strategies in preventive cardiovascular care, highlighting factors that facilitate or hinder adoption at scale.MethodsNarrative synthesis drawing on searches in MEDLINE (PubMed), Embase, and the Cochrane Library (to July 2025), prioritising systematic reviews, major guideline statements, and large multicentre studies.ResultsCommunity programmes yield modest but meaningful reductions in blood pressure, lipids, and glucose. Clinical programmes achieve greater individual-level effects but are constrained by limited reach. Key barriers include misaligned incentives, workforce limitations, and persistent inequities. The Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) frameworks remain underutilised. Emerging digital tools and updated cardiovascular risk models offer new opportunities but require pragmatic integration.ConclusionStrengthening preventive cardiovascular care requires aligning health-system incentives, integrating implementation science, and leveraging technology to support scalable and equitable prevention models.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609143</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609143</link>
        <title><![CDATA[Large trials of psychosocial interventions: examples from individual placement and support]]></title>
        <pubdate>2026-06-09T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Justin D. Metcalfe</author><author>Kim T. Mueser</author><author>Robert E. Drake</author>
        <description><![CDATA[ObjectivesLarge demonstration projects for health interventions often use randomized controlled trials (RCTs) to test the effectiveness of interventions implemented at larger scales, serving as crucial contributors to policy and funding decisions. Such trials are subject to limitations common to all RCTs, but their size and importance magnify the costs of failure to satisfy the assumptions for valid causal inference and generalizability. We examine common reasons for such threats to validity.MethodsWe examined large (N > 1,000) IPS RCTs for aspects of design and execution that undermine the validity of their results.ResultsWe identified three large IPS RCTs and identified threats to validity associated with treatment adherence and attrition.ConclusionLarge trials should rely on pilot studies to ensure that difficulties with recruitment, implementation of and participation in interventions, and follow-up measurement do not compromise study validity; intervention fidelity and participation should be measured to permit evaluation of study success. Funders should require and support the use of pilot studies and other prior research to justify the introduction of an intervention to a population and anticipate potential threats to validity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609283</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609283</link>
        <title><![CDATA[Integrating equity and justice in rheumatic heart disease policy: addressing reproductive health challenges]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Theory & Concept</category>
        <author>Panduleni Penipawa Shimanda</author><author>Tekla Shipahu Natangwe Shiindi-Mbidi</author>
        <description><![CDATA[Rheumatic Heart Disease (RHD), a preventable disease of poverty, disproportionately affects women of reproductive age, highlighting a crisis at the intersection of cardiac and reproductive health. Despite effective interventions, RHD remains neglected in policy priorities. This paper uses the case of reproductive health dilemmas to demonstrate the need for the application of equity frameworks. We analyse how consequentialist, communitarian, and feminist principles can guide policymakers toward more effective and just interventions. The paper proposes a community-based model, justified through this ethical lens, and calls for policies prioritising equity to finally address RHD’s preventable burden.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609449</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609449</link>
        <title><![CDATA[Tool for identifying occupational exposures and risks in agriculture (TIERRA): application in coffee farming in Uganda]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Hannah Wey</author><author>Lena Jäggi</author><author>Aggrey Atuhaire</author><author>Felix Boos</author><author>Peter Ssekkadde</author><author>Sandra Abeine</author><author>Ruth Mubeezi</author><author>Samuel Fuhrimann</author>
        <description><![CDATA[ObjectivesThis study developed a practical, context-sensitive assessment tool to prioritize occupational risks in agriculture (TIERRA). We applied TIERRA in a case study with smallholder coffee farmers in Uganda (FarmCoUganda) to demonstrate its effectiveness.MethodsTIERRA follows a stepwise, participatory process beginning with an inventory of 80 occupational hazards, reviewed by local experts for clarity and prioritized by community stakeholders through a Delphi workshop. Participants rate the likelihood, severity, and risk of hazards. In the Ugandan case study, 31 stakeholders rated 59 hazards relevant to smallholder coffee farmers in Mbale District.ResultsStakeholders prioritized 23 hazards across six categories: biological, chemical, ergonomic, and physical hazards, each comprising three items, plus five environmental and six psychosocial hazards. “Contact with a pesticide” received the highest overall risk score. “Mosquito bites” emerged as the most significant biological risk. Ergonomic hazards received the highest categorical risk rating.ConclusionTIERRA fosters stakeholder ownership and facilitates dialogue toward action. It supports the development of tailored farmer surveys, training and safer working conditions. It offers a methodological blueprint for adaptation across diverse agricultural contexts, including in LMICs.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609134</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609134</link>
        <title><![CDATA[COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Kiran Saqib</author><author>Vivek Goel</author><author>Joel A. Dubin</author><author>Jeremy VanderDoes</author><author>Zahid Ahmad Butt</author>
        <description><![CDATA[ObjectiveTo examine differences in mental health–related healthcare utilization for anxiety and depression between individuals who did and did not undergo COVID-19 PCR testing in Ontario. Background: The COVID-19 pandemic has been associated with changes in mental health and healthcare utilization.MethodsWe conducted a population-based retrospective cohort study using linked ICES data, including 6,175,114 adults (January 2020–March 2021). Exposure was PCR-positive, PCR-negative, or untested. The outcome was time to first mental health–related healthcare use for anxiety and depression, identified using validated codes. Adjusted hazard ratios (aHRs) were estimated using Cox models with propensity score matching.ResultsIndividuals who underwent testing had higher mental health–related healthcare utilization than untested individuals. This was observed in PCR-positive (aHR 6.37; 95% CI 6.25–6.50) and PCR-negative groups (aHR 5.91; 95% CI 5.87–5.95). Higher utilization occurred among younger individuals, females, and socioeconomically disadvantaged groups. Results were consistent in matched analyses.ConclusionIndividuals underwent testing had higher mental health service utilization; similar estimates across PCR-positive and PCR-negative groups suggest testing reflects underlying vulnerability and healthcare-seeking behavior rather than a causal effect on mental health outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609153</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609153</link>
        <title><![CDATA[Development and external validation of an interpretable machine learning model for obesity-depression comorbidity in Korean and US adults]]></title>
        <pubdate>2026-05-28T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Yuwen Shangguan</author><author>Zhenhao Lin</author><author>Young-Je Sim</author><author>Kunpeng Wu</author><author>Yu Chu</author><author>Kunyi Huang</author><author>Fangxi Chen</author><author>Kangkang Ji</author><author>Fang Chen</author><author>Shangrui Liu</author>
        <description><![CDATA[ObjectiveTo investigate the association between physical inactivity and obesity–depression comorbidity (ODC), defined as the co-occurrence of obesity and depression, and to develop an effective screening tool for identifying high-risk individuals to facilitate early intervention.MethodsData were obtained from 3,357 physically inactive adults enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2012). An XGBoost machine learning framework was applied to develop predictive models. Feature selection was conducted using random forest, and the prediction mechanism was interpreted with SHAP values. The model was validated internally using KNHANES 2011–2012 data and externally with the U.S. NHANES dataset.ResultsThe XGBoost model demonstrated good discriminative performance in internal validation (AUC = 0.783 and 0.744) and achieved an external validation AUC of 0.886. Feature importance analysis revealed that insulin concentration, white blood cell count, and height were the primary predictors of ODC, with insulin exerting the strongest influence.ConclusionThis study developed a high-performing and interpretable prediction model for ODC risk. SHAP-based interpretation identified insulin as the most influential predictor within the model, suggesting that metabolic factors may be important for ODC risk stratification.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609361</guid>
        <link>https://www.ssph-journal.org/articles/10.3389/ijph.2026.1609361</link>
        <title><![CDATA[Do youth e-cigarette users perceive smoking as attractive? The dynamics of demographics and contextual factors]]></title>
        <pubdate>2026-05-26T00:00:00Z</pubdate>
        <category>Original Article</category>
        <author>Omar B. Da’ar</author><author>Maria Alamr</author><author>Randah Alalweet</author><author>Bandar AlEissa</author><author>Farah Kalmey</author>
        <description><![CDATA[ObjectiveThis study examines whether youth e-cigarette users perceive smoking as attractive and how comfort-based norms, industry promotion, and media or environmental exposures shape these perceptions.MethodsUsing a nation-wide representative 2022 Global Youth Tobacco Survey data from Saudi Arabia, we analyzed e-cigarette users’ perceptions of smoking attractiveness with descriptive statistics and a multivariable regression model to identify associated covariates.ResultsAmong 5,455 students aged 13–15 years, 14.3% had ever used e-cigarettes, and 26% of users viewed smoking as attractive. More males rated smoking favorably in crude analyses. However, adjusted model showed males had lower odds versus females. Youth exposed to secondhand smoke in enclosed public places, point-of-sale marketing, anti-smoking messages, and counter-branding marketing had reduced odds of viewing smoking as attractive, whereas those who found it as socially comfortable, offered free tobacco products by a company representative, or owning branded items had higher odds. Secondhand smoke at school or home was not significant.ConclusionFindings suggest prevention may benefit from targeting comfort-based norms and industry promotion, and future research should examine causal effects to guide youth-focused policy.]]></description>
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