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Enhancing the Socioecological Model to Integrate Equity and Planetary Health: A Framework for Understanding Complex Interventions Shaping Population Health and Active Living.

Physical activity is a major contributor to population health, yet opportunities for active living are inequitably distributed due to social and structural determinants of health. Climate change, urbanization, and social inequalities influence whether individuals engage in physical activity out of necessity or as a free choice.

Journal of physical activity & health

Effects of affective states on colorectal cancer screening health message persuasion depend on whether people avoid cancer information.

People frequently defensively avoid information about threatening health conditions. We tested whether, consistent with a mood-as-a-resource hypothesis, inducing high arousal positive mood (vs high arousal negative or neutral mood) would decrease colorectal cancer (CRC) information avoidance among people who avoid cancer information and are non-adherent to CRC screening. In a pilot study (N = 265), we successfully identified video clips that induced positive, neutral, or negative emotions in individuals who either do or do not tend to avoid CRC information. In the main study (N = 337), avoidance moderated the effects of affect induction on screening intentions; whereas avoiders' screening intentions tended to be stronger after the neutral affect induction than after either the positive or negative affect induction, the pattern was the opposite for non-avoiders. Messages targeting avoiders might be more effective if they do not employ emotional appeals-including fear appeals or even gain framing if it evokes high arousal positive affect.

Journal of health psychology

HIV-related stigma and academic outcomes: the mediating role of mental health among adolescents living with HIV in Uganda.

Among Adolescents living with HIV (ALHIV) in Uganda, pathways linking HIV-related stigma to mental health (depression, hopelessness and self-esteem) and academic engagement (school satisfaction and self-concept) are under-examined. Using cross-sectional data from 833 ALHIV (ages 10-17), we first estimated a fully latent structural equation model to assess these pathways. Model fit was excellent (χ²[21] = 45.16, p = .002; CFI = .987; RMSEA = .037; SRMR = .028). Stigma was associated with poorer mental health (β = -.214, SE = .058, p < .001); positive mental health predicted academic engagement (β = .956, SE = .262, p < .001), while the direct stigma to academic path was small and marginally non-significant (β = -.089, SE = .046, p = .052). Next, we examined the roles of social support and family cohesion, using an observed-variable path model with composite scores. Higher stigma predicted lower perceived social support (β = -.445, SE = .041, p < .001) and family cohesion (β = -.311, SE = .048, p < .001). Perceived social support significantly buffered mental health (β = -.184, SE = .025, p < .001), and poorer mental health strongly predicted lower academic engagement (β = -.491, SE = .037, p < .001). The findings indicate that HIV stigma undermines academic engagement primarily by eroding mental well-being, while social support is a key upstream protective factor. Interventions for ALHIV should, therefore, prioritise stigma reduction alongside integrated mental health services and programmes to strengthen social support in educational settings.Trial Registration: ClinicalTrials.gov NCT05307250; https://clinicaltrials.gov/ct2/show/NCT05307250.

AIDS care

Understanding multi-level policy implementation in the national school lunch and breakfast programs: a mixed-methods and agent-based modeling protocol.

The Healthy, Hunger-Free Kids Act (2010) improved the nutritional quality of school meals in the U.S. by aligning the National School Lunch and Breakfast Programs with updated dietary guidelines. However, 2018 federal flexibilities in sodium, whole grains, and milk standards shifted key implementation decisions to local school districts. This created variability in uptake and potential inequities in diet quality and health outcomes, particularly among students from low-resource settings. Key drivers of differential uptake, and decision-making by local districts, is not well understood.

Implementation science communications

Dementia Care Research and Psychosocial Factors.

Structural and social determinants of health (S/SDOH) are linked to dementia, yet research on Black Americans is limited. This is crucial given the exponential dementia risk among the Black population. This study examined a new S/SDOH composite index based on the multidimensional poverty-adjusted headcount ratio and explores its association with possible cognitive impairment (PCI) or poor cognitive performance (PCP) among Black Americans.

Alzheimer's & dementia : the journal of the Alzheimer's Association

Pre- and Postnatal Exposure to PM2.5 and NO2 and Blood Pressure in Children: Results from the ECHO Cohort.

There is growing interest in understanding the link between early life exposures to ambient air pollution and childhood blood pressure; however, existing findings, largely from single site/cohort studies, are inconclusive.

Environmental research

Clinical and implementation outcomes of an antimicrobial stewardship intervention for rapid blood culture diagnostics.

To evaluate the clinical and implementation outcomes of an antimicrobial stewardship program (ASP) intervention to improve antibiotic therapy for a rapid diagnostic test (RDT) for bloodstream infections (BSIs).

Antimicrobial stewardship & healthcare epidemiology : ASHE

Long COVID: What is it? Who has it? What Are Treatment Resources in Missouri?

As we pass the five-year mark since the COVID-19 pandemic hit, the prevalence of persistent (and often disabling) symptoms from the SARS-CoV-2 virus is estimated to be on par with the prevalence of heart disease. Yet, these Long COVID symptoms can masquerade as other conditions and/or normal aging, so it is believed that Long COVID is under-diagnosed and, as a result, under-treated. Although there is not yet a true cure for Long COVID, many patients benefit substantially from rehabilitation strategies, medications, and social support resources that are available in Missouri. The purpose of this article is to review the definition and epidemiology of Long COVID, provide practical guidance for Long COVID assessment and management especially in the primary care setting, and increase awareness of regional resources for people in Missouri who are living with Long COVID and for the clinicians who are caring for them.

Missouri medicine

Depression and Complicated Grief among Parents of Pediatric Cancer Patients in Cameroon: Implications for Cancer Education in Low-income Countries.

Bereaved parents of pediatric cancer patients experience severe grief and psychological distress, but studies on major depressive disorder (MDD) and complicated grief (CG) in Africa, including Cameroon, are lacking. This study aimed to determine the prevalence and predictors of MDD and CG among bereaved parents of deceased pediatric cancer patients in Cameroon. This cross-sectional study included parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital between 2015 and 2022. Multivariable stepwise logistic regression identified predictors of MDD and CG. The prevalence of CG was 86% and 66.7% of the subjects screened positive for MDD. MDD significant predictors included age [OR 1.09, 95% CI: 1.015-1.174, p = 0.018], financial hardship [OR 9.47, CI: 1.584-56.629, p = 0.014], and coping capacity [medium resilience OR 7.874, 95% CI: 1.385-23.728, p = 0.027]. Predictors of CG included age [OR 1.157, 95% CI: 1.012-1.322, p = 0.032], financial hardship [OR 11.501, 95% CI: 1.115-118.664, p = 0.04], and coping capacity [(low resilient copers OR 14.011, 95% CI: 1.136-156.867, p < 0.01), (medium resilient copers OR 19.023, 95% CI: 2.537-109.001, p < 0.01)]. The study revealed the high prevalence of MDD and CG among bereaved parents of pediatric cancer patients in Cameroon. Inaccurate knowledge about the child's prognosis and poor perceived social support were associated with compromised parental mental health. Personalized mental health support for assisting bereaved families and education for resilience to loss may improve the quality of life of families. The study may have implications for mental health and the the education of families in Cameroon and similar low-income countries.

Journal of cancer education : the official journal of the American Association for Cancer Education

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