Journal of Preventive Medicine and Public Health

Brief Report

Long Working Hours and Risk of Ischemic Heart Disease Among Japanese Workers: The Jichi Medical School Cohort Study: Mayumi Saiki, Akizumi Tsutsumi, Jian Li; Received July 18, 2025 Accepted November 29, 2025 Published online February 5, 2026; DOI: https://doi.org/10.3961/jpmph.25.577 [Accepted]

125 View
14 Download

Abstract PDF: Objectives
Karoshi, or “death from overwork,” has been recognized for decades; however, epidemiological findings regarding long working hours (LWH) and ischemic heart disease (IHD) remain inconsistent. This study aimed to provide new evidence on the association between LWH and IHD, while accounting for job strain among Japanese workers, both male and female.
Methods
This study utilized data from 6,670 workers participating in the Jichi Medical School Cohort Study. Baseline working hours were categorized as <5, 5 to 6.9, 7 to 8.9 (reference), 9 to 10.9, and 11 hours/day. Fatal and non-fatal incident IHD cases were determined during follow-up using International Classification of Diseases, 10th Revision codes. Multivariable Cox proportional hazards models were used to examine associations, adjusting for sociodemographic factors, lifestyle behaviors, cardiometabolic characteristics, and job strain.
Results
During a mean follow-up of 12 years, 58 incident IHD cases (42 men and 16 women) were documented. Long working hours (≥11 hours/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39), and the overall pattern of associations was similar in sex-stratified analyses.
Conclusions
These findings suggest that LWH independently increases the risk of IHD among Japanese workers, even after adjustment for job strain, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.; Summary

Original Article

Measuring Trends in Disability-adjusted Life Years and Life Expectancy in Korea: 2008 to 2021: Chung-Nyun Kim, Dawit Urgi Gurmu, Young-Eun Kim, Yoon-Sun Jung, Yongseok Choi, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2026;59(1):25-34. Published online January 29, 2026; DOI: https://doi.org/10.3961/jpmph.25.604

265 View
47 Download

Abstract Summary PDF Supplementary Material: Objectives
This study, part of the ongoing Korean National Burden of Disease (KNBD) updates, assesses disability-adjusted life years (DALYs) and disability-adjusted life expectancy (DALE) in Korea, taking into account the effects of coronavirus disease 2019 and emphasizing the importance of analyzing these metrics jointly.
Methods
Data were obtained from Statistics Korea, the National Health Insurance Service, and the Korea Disease Control and Prevention Agency. DALYs and DALE were calculated using an incidence-based approach, following disease classification, disability weights, and estimation procedures consistent with prior KNBD research.
Results
Compared with earlier estimates, DALYs showed a slight decline in 2020 followed by an increase in 2021, with this pattern observed across all income quintiles. For DALE, both men and women experienced modest gains relative to earlier studies; however, a decrease occurred across all income levels in 2021 compared with 2020. Regional disparities in DALE also narrowed beginning in 2020, with a more marked reduction among women.
Conclusions
Unlike previous studies, this research presents DALYs and DALE concurrently, offering a more comprehensive perspective on summary measures of population health. The post-2020 rise in DALYs underscores the growing need for effective chronic disease management. Additionally, widening income-based disparities in DALE highlight the urgency of addressing health inequities. Continued monitoring and updates of DALYs and DALE are necessary to understand and respond to these evolving trends.; Summary

Korean summary
한국인의 질병부담과 건강수명을 2021년까지 추가적으로 측정하였다. 그 결과 2021년은 2020년에 비해 질병부담은 증가하였고 건강수명은 감소하였다.

Key Message
The burden of disease and disability-adjusted life expectancy of Korea was measured through 2021. The results showed that the burden of disease increased and disability-adjusted life expectancy decreased, compared to 2020.

Systematic Reviews

Association of Particulate Matter (PM_2.5) With COVID-19 Infection and Mortality in Low-and Middle-income Asian Countries: A Systematic Review and Meta-analysis: Frisca Rahmadina, Riris Andono Ahmad, Aditya Lia Ramadona; J Prev Med Public Health. 2026;59(1):12-24. Published online January 17, 2026; DOI: https://doi.org/10.3961/jpmph.25.499

496 View
62 Download

Abstract Summary PDF Supplementary Material: Objectives
Low-income and middle-income countries in Asia bear a disproportionate burden of particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM_2.5) pollution, yet data remain scarce. This systematic review and meta-analysis aimed to quantify the association between PM_2.5 exposure and the risks of coronavirus disease 2019 (COVID-19) infection and mortality in this vulnerable region.
Methods
A systematic search was conducted in PubMed, Scopus, and other major databases for studies published up to December 31, 2024. We included observational studies reporting associations between PM_2.5 and COVID-19 outcomes in low-income and middle-income Asian countries. Pooled effect sizes and 95% confidence intervals (CIs) were calculated using a random-effects model. The study was registered with PROSPERO (CRD42022316008).
Results
Fourteen studies met the inclusion criteria. Separate analyses demonstrated statistically significant positive associations between PM_2.5 exposure and COVID-19 infection for both short-term exposure (pooled risk ratio [RR], 1.12; 95% CI, 1.07 to 1.18) and long-term exposure (pooled RR, 1.41; 95% CI, 1.28 to 1.56). For mortality, the analysis identified a statistically non-significant positive association with short-term exposure (pooled RR, 1.37; 95% CI, 0.80 to 2.33). Substantial heterogeneity was observed across all analyses (I²>75%); however, sensitivity analyses confirmed that the findings for infection were robust.
Conclusions
Our findings provide robust evidence that PM_2.5 exposure is a significant risk factor for COVID-19 infection in low-income and middle-income Asian countries. The available evidence was insufficient to establish a clear association with mortality. These results underscore the urgent need for strengthened air quality control policies as a critical component of public health strategies to mitigate the burden of respiratory pandemics.; Summary

Key Message
This systematic review and meta-analysis confirms that both short-term and long-term PM 2.5 exposure significantly increase COVID-19 infection risks in Asian LMICs, with long-term exposure showing a substantially higher risk ratio. These findings highlight a critical intersection between air quality and infectious disease vulnerability. Consequently, integrating air quality management into public health strategies is essential for strengthening preparedness against future respiratory pandemics.

Reporting Quality for Comorbidity Adjustment in Studies Using Korean Health Insurance Claims Data: A Scoping Review: Kyoung-Hoon Kim; Received October 18, 2025 Accepted December 9, 2025 Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.839 [Accepted]

96 View
7 Download

Abstract PDF: Objectives
Adjustment for comorbidity is essential in observational studies using administrative data to ensure the reproducibility and transparency of research findings. However, the reporting quality of comorbidity adjustment in studies using the National Health Insurance Claim Data (NHICD) has not yet been evaluated. This study aimed to assess the reporting quality of comorbidity adjustment in health outcome studies that used the NHICD.
Methods
We conducted a PubMed search in April 2025 using the terms “(Korea OR Korean) AND (‘health insurance claim*’ OR claims data OR NHIS OR HIRA) AND (2024).” Of the 239 retrieved studies, 82 outcome studies that exclusively used the NHICD and adjusted for comorbidities as confounding variables were included. Reporting quality was evaluated across 3 domains: (1) scope of data, (2) range of diagnostic codes, and (3) length of the look-back period.
Results
Among the 82 studies, 33 (40.2%) used ad hoc selection, 33 (40.2%) used the Charlson Comorbidity Index, and 13 (15.9%) applied both methods. The Elixhauser comorbidity measure was rarely used, appearing in only 3 studies. Only 3 studies explicitly described the scope of data used, and 6 reported the diagnostic code range. The look-back period was specified in 26 studies (31.7%), with 1 year being the most commonly reported duration.
Conclusions
The reporting quality of comorbidity adjustment in studies using the NHICD remains suboptimal. Transparent and standardized reporting of data scope, diagnostic code range, and look-back period is essential to improve the reproducibility and comparability of research findings.; Summary

Original Articles

Obstetric Outcomes of Jehovah’s Witness Women Under Patient Blood Management: A Single-center, Propensity Score–Matched Cohort Study in Korea: Jeong-Won Oh, Seug Yun Yoon, Jeong Jae Lee, Kyu Yeon Choi, Seong Soon Kwon; Received July 25, 2025 Accepted November 4, 2025 Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.596 [Accepted]

209 View
18 Download

Abstract PDF: Objectives
Patient blood management (PBM) is increasingly recognized as an essential strategy in obstetric care for reducing transfusion-related risks and improving maternal safety. Jehovah’s Witness (JW) women, who categorically refuse blood transfusion, represent a unique clinical population in which to evaluate the effectiveness of PBM. This study aimed to assess obstetric outcomes of JW women compared with non-JW women at a PBM-based center in Korea.
Methods
We retrospectively reviewed delivery outcomes and PBM practices among JW women (n = 205) with singleton pregnancies and non-JW women (n = 601) who were matched at a 1:3 ratio using propensity scores at Soonchunhyang University Seoul Hospital between 2018 and 2023. The primary outcomes included obstetric morbidities, with particular attention to complications related to postpartum hemorrhage and the interventions used for its management.
Results
JW women were more likely to receive intravenous iron administration (7.3% vs. 2.8%, p = 0.008) and had higher hemoglobin (Hb) levels during the first trimester (12.6 ± 1.1 vs. 11.8 ± 3.4 g/dL, p = 0.012) than non-JW women. Blood loss during cesarean section and the incidence of severe postpartum anemia (Hb < 7 g/dL) were lower among JW women; however, these differences did not reach statistical significance. In the hemorrhage-related high-risk subgroup, JW women were managed according to PBM protocols without transfusion, and their obstetric outcomes were comparable to those observed in non-JW women.
Conclusions
This study identified no significant differences in hemorrhage-related obstetric outcomes between JW and non-JW women at a PBM-based center. The systematic application of PBM enables safe delivery in transfusion-restricted settings and may reduce reliance on blood transfusion while maintaining maternal safety.; Summary

Development of Machine Learning Models to Predict Health Insurance Claim Costs Among Older Indonesians: A Retrospective Predictive Modeling Study: Yeni Mahwati, Dhihram Tenrisau, Syarif Rahman Hasibuan, Bhirau Wilaksono, Yeni Indriyani, Andi Afdal Abdullah, Halik Malik, Andi Alfian Zainuddin; Received May 3, 2025 Accepted October 27, 2025 Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.350 [Accepted]

256 View
18 Download

Abstract PDF: Objectives
The objective of this study was to develop machine learning models to predict health insurance claim costs among older adults in Indonesia.
Methods
This study utilized secondary data from the Indonesian National Health Insurance program (Jaminan Kesehatan Nasional [JKN]) spanning 2017 to 2023. Three modeling techniques—linear regression, random forest, and XGBoost—were employed to predict individual claim costs. Model performance was assessed using the root mean square error (RMSE), coefficient of determination (R2), and mean absolute error (MAE). Additionally, variable importance analysis was conducted to identify key predictors.
Results
XGBoost with 500 boosting rounds yielded the best performance, with an RMSE of 11,360,283, an R2 of 0.81, and an MAE of 4,485,917, outperforming both linear regression (RMSE, 13,710,035; R2=0.72) and random forest (RMSE, 12,434,238; R2=0.78). Notably, outpatient care was identified as the most consistent predictor across all models. Other significant predictors included length of stay (LOS), diagnosis type (International Classification of Diseases, 10th Revision chapter), facility type, facility classification, and severity of illness, particularly for moderate cases. Although LOS and diagnosis type were important predictors, these findings should be interpreted in the context of Indonesia’s fixed Indonesian Case-Based Groups payment system.
Conclusions
XGBoost provides reliable predictions of claim costs among older adults, capturing clinical, utilization, and structural drivers. These findings can inform targeted interventions, improve chronic disease management, optimize the referral system, and support integration of predictive tools into JKN to enhance responsiveness and promote sustainable, equitable financing.; Summary

Systematic Review

Patient Education to Reduce Anxiety Among Cancer Patients Undergoing Radiotherapy Procedure: A Systematic Review of Interventional Studies: Fathiya Juwita Hanum, Rizanda Machmud, Soehartati Gondhowiardjo, Daan Khambri, Wirsma Arif Harahap, Aisyah Elliyanti, Firdawati Firdawati, Rima Semiarty; Received April 23, 2025 Accepted October 13, 2025 Published online December 21, 2025; DOI: https://doi.org/10.3961/jpmph.25.318 [Accepted]

164 View
9 Download

Abstract PDF: Objectives
Nearly one in three cancer patients undergoing radiotherapy experience anxiety, which can negatively affect both quality of life and prognosis. This systematic review aimed to synthesize the evidence on patient education and its impact on anxiety levels among cancer patients undergoing radiotherapy.
Methods
We conducted a systematic review of the current literature using three scientific databases-PubMed, EBSCOhost, and Web of Science-to identify intervention studies. Data were analyzed using a narrative synthesis approach, integrating findings across studies to draw comprehensive conclusions.
Results
Fifteen studies involving 1,988 participants were included. Baseline anxiety levels, measured using various instruments, ranged from 2.9% to 88.2% before radiotherapy and declined over time in both intervention and control groups. Most studies reported no significant difference in anxiety reduction between intervention groups receiving educational programs and control groups receiving standard education. However, interventions that were more intensive and delivered by professional staff were more likely to produce statistically significant reductions in anxiety.
Conclusions
This review suggests that patient education remains relevant for reducing anxiety among cancer patients undergoing radiotherapy. Routine screening for anxiety prior to radiotherapy is recommended, along with the development of more intensive and tailored educational interventions rather than passive or minimal approaches.; Summary

Perspective

Firefighters as a Key Alliance Group to Advocate for Tobacco Control Policies in Korea: Heewon Kang, Susan Park, Sung-il Cho; J Prev Med Public Health. 2026;59(1):105-108. Published online December 14, 2025; DOI: https://doi.org/10.3961/jpmph.25.528

232 View
31 Download

Abstract Summary PDF: Tobacco control is a public health priority. However, Korea has recently experienced a reversal in its long-term decline in smoking prevalence. To address this trend, it is essential to broaden advocacy networks by engaging new stakeholders. We propose that firefighters represent a strategic yet under-represented partner in tobacco control because their professional interests closely align with tobacco-related policy goals. First, cigarette butts have consistently been the leading cause of fire incidents, and tobacco use directly undermines firefighters’ core mission to protect life and public safety. Moreover, firefighters face elevated health risks due to occupational exposure to harmful substances, and tobacco use and exposure to tobacco smoke can further compound these risks. Additionally, a portion of tobacco tax revenue is allocated to fire service funding, creating a direct fiscal linkage between tobacco control and firefighting resources. A logical next step is to promote collaboration through intergovernmental partnerships between public health authorities and national fire services. This collaboration includes targeted health promotion initiatives that assess tobacco use among firefighters and provide cessation support. Broader strategies, such as mass media campaigns and coordinated advocacy for increases in tobacco taxes, should also be jointly implemented. Such an alliance could improve firefighters’ well-being, reduce fire-related risks, and strengthen the overall tobacco control response.; Summary

Korean summary
담배 사용이 화재 위험과 소방관의 건강에 미치는 영향을 바탕로, 소방관을 담배규제 정책 옹호를 위한 핵심 협력 집단으로 제안한다. 담배꽁초로 인한 화재, 소방관의 직업적 건강 위험, 그리고 담뱃세의 소방 재정 기여라는 구조적 연계를 통해 공중보건과 소방 안전 간의 공동 이익을 실현할 수 있다. 공중보건과 소방 조직 간의 협력은 담배 사용 감소와 화재 예방을 동시에 달성할 수 있는 전략적 기회가 될 수 있을 것이다.

Key Message
This perspective argues that firefighters represent a strategic yet underutilized alliance group for advancing tobacco control in Korea. Tobacco use directly contributes to fire incidents, exacerbates firefighters’ occupational health risks, and is fiscally linked to fire services through earmarked tobacco taxes. Strengthening collaboration between public health authorities and fire services could reduce smoking prevalence, improve firefighter well-being, and enhance fire safety, creating mutually reinforcing public health and safety gains.

Original Articles

The Effect of an Educational Program Based on Orem’s Self-Care Model on Treatment Adherence, Self-Care Behaviors, and Quality of Life in Hemodialysis Patients: A Randomized Controlled Clinical Trial: Samira Rezaei, Mostafa Bijani, Azizallah Dehghan, Zhila Fereidouni; Received September 9, 2025 Accepted November 4, 2025 Published online December 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.727 [Accepted]

182 View
18 Download

Abstract PDF: Objectives
Patients undergoing hemodialysis encounter a wide range of complex challenges, underscoring the essential role of self-care in disease management. The present study aimed to examine the effectiveness of an educational intervention grounded in Orem’s Self-Care Model for enhancing treatment adherence, self-care behaviors, and quality of life among hemodialysis patients in southern Iran.
Methods
This single-blind randomized controlled trial included 120 hemodialysis patients who met the predetermined eligibility criteria. Data were collected between April and August 2023 at 2 university-affiliated teaching hospitals located in southern Iran. After providing informed consent, participants were randomly allocated to either the intervention group (n = 60) or the control group (n = 60) through a simple randomization procedure. Three psychometrically robust instruments were used to collect data: the End-Stage Renal Disease Adherence Questionnaire, the Kidney Disease Quality of Life Short Form, and the Self-Management Behavior Scale. Statistical analyses were performed using SPSS software (version 23), and p-values < 0.05 were considered statistically significant.
Results
At baseline, no statistically significant differences were observed between the intervention and control groups in the mean scores of the measured variables. However, immediately following the intervention and at the 3-month follow-up, the intervention group demonstrated statistically significant improvements across all 3 variables.
Conclusions
The findings underscore the effectiveness of an educational program based on Orem’s Self-Care Model in significantly improving self-care behaviors, treatment adherence, and quality of life among hemodialysis patients.; Summary

Determinants of Smoking Relapse Among Indonesian Children: A National Cross-Sectional Analysis Using Global Youth Tobacco Surveillance Data: Risky Kusuma Hartono, Muhammad Abdul Rohman, Renny Nurhasana, Aryana Satrya, Salsabila Nadya, Ni Made Shellasih, Fadhilah Rizky Ningtyas, Astri Hanna Grace Waruwu; Received September 2, 2025 Accepted November 29, 2025 Published online December 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.703 [Accepted]

193 View
16 Download

Abstract PDF: Objectives
This study aimed to identify the determinants associated with 4 smoking trajectories (never smoking, current smoking, consistently quitting smoking, and smoking relapse) among Indonesian children using pooled national data.
Methods
This study analyzed children’s smoking trajectories using pooled data from the Indonesian Global Youth Tobacco Survey (2006, 2009, 2014, and 2019). Multinomial logistic regression was applied to examine 4 categories of smoking behavior, and Propensity Score Matching (PSM) was used to address potential selection bias related to advertising exposure.
Results
Higher prices (> Rp31,000/$1.87) (relative risk ratio [RRR] = 0.527) were protective against relapse. This policy effect was systematically undermined by single-stick purchasing, which increased relapse risk by 57.41 times (p = 0.00). Peer smoking (RRR = 3.696) and exposure to advertisements in sports events (RRR = 1.477) were also significant risk factors for relapse. Free cigarette distribution demonstrated the strongest association, corresponding to a 33.5 percentage-point increase in relapse probability.
Conclusions
The findings indicate that children’s smoking relapse in Indonesia is shaped by distinct behavioral trajectories. Relapse was influenced by the widespread availability of single-stick cigarettes, pervasive marketing, peer dynamics, and relatively affordable prices. These results underscore the urgent need for a comprehensive strategy that includes substantially increasing excise taxes, eliminating single-stick sales, and fully banning tobacco advertising. Simultaneous implementation of these measures is crucial to prevent relapse and interrupt the progression toward lifelong nicotine addiction.; Summary

Feasibility and Preliminary Impacts of a Diabetes Education Chatbot Simulation on Glycemic Targets, Loneliness, and Health Beliefs in Indonesia: An Explanatory Mixed-methods Study: Yohanes Andy Rias, Wildan Akasyah, Tri Ana Mulyati, Harwina Widya Astuti, Herminio Noronha, Fakhrudin Nasrul Sani, Hsiu-Ting Tsai; J Prev Med Public Health. 2026;59(1):56-65. Published online December 3, 2025; DOI: https://doi.org/10.3961/jpmph.25.334

840 View
68 Download

Abstract Summary PDF Supplementary Material: Objectives
Chatbot technology improves access to and engagement with diabetes education. However, few studies have evaluated the feasibility and rigorously assessed the impact of chatbots among individuals with type 2 diabetes (T2DM) using theory-based approaches. This pilot study assessed the feasibility and preliminary impact of a chatbot on glycemic targets, loneliness, and perceived health beliefs among adults with T2DM.
Methods
An explanatory mixed-methods approach, comprising a one-group experimental design and qualitative interviews, was used. The chatbot simulation, named “TakonGendhis,” was developed based on conceptual models derived from the technology acceptance model and the health belief model. Feasibility included usefulness, ease of use, and intention to use. Preliminary impact was evaluated based on changes in glycemic targets, loneliness, and health beliefs from baseline to 12 weeks post-intervention. Qualitative data were gathered through individual interviews and focus group discussions and were analyzed thematically. Narrative synthesis was employed to integrate findings from the quantitative and qualitative phases of the study.
Results
The scores for usefulness, ease of use, and intention to use were 26.55, 27.32, and 34.03, respectively. Quantitative analysis revealed reduced loneliness, improved health beliefs, and lower glycemic scores after the 12-week intervention. The qualitative study identified 4 themes: feasibility, beliefs, emotional support, and areas for improvement.
Conclusions
The intervention was feasible and had beneficial preliminary impacts on glycemic targets, loneliness, and health beliefs. Addressing feasibility, beliefs, emotional support, and identified areas for improvement may increase patients’ willingness to use the chatbot.; Summary

Key Message
This mixed-methods study highlights that a diabetes education chatbot simulation is both feasible and beneficial in its preliminary impact for individuals with diabetes in Indonesia. The preliminary results indicate possible enhancements in glycemic targets, reduced feelings of loneliness, and more encouraging health beliefs, confirmed by qualitative insights about user feasibility, beliefs, emotional support, and areas for improvement.

The Relationship Between Social Support and Health-Promoting Behaviors among Older Adults in Fasa, Iran: A Cross-sectional Study: Afsaneh Ghasemi, Zhale Zandieh, Navid Alinejad, Zahra Khiyali, Ramin Hayati, Azizallah Dehghan, Zahra Hosseini Nejad, Mohammadreza Keshtkar; Received June 26, 2025 Accepted September 24, 2025 Published online December 1, 2025; DOI: https://doi.org/10.3961/jpmph.25.502 [Accepted]

11,961 View
51 Download

Abstract PDF: Objectives
Health-promoting behaviors are essential for maintaining independence and enhancing quality of life in aging populations. This study aimed to investigate the relationship between social support and health-promoting behaviors among older adults in Fasa, Iran in 2024.
Methods
A cross-sectional study was conducted involving 300 older adults attending a specialized outpatient clinic in Fasa, Iran. Data were collected using a demographic questionnaire, the Walker Health-Promoting Lifestyle Profile, and the Canty Perceived Social Support Scale, administered either through self-report or structured interviews. Statistical analyses were performed using SPSS version 23 and included descriptive statistics, analysis of variance, the chi-square test, and multiple linear regression analyses.
Results
The mean age of participants was 68.9 ± 7.8 years. Most participants were female (56.6%), married (81.7%), and had less than a high school education (41.3%). The mean scores for health-promoting behaviors and perceived social support were 124.2 ± 31.3 and 24.4 ± 9.4, respectively. A statistically significant positive association was observed between perceived social support and health-promoting behaviors (r=0.1, p=0.04). Social support, gender, and education level were identified as significant predictors of health-promoting behaviors, collectively explaining 34% of the variance.
Conclusions
These findings emphasize the pivotal role of social support in promoting health-related behaviors among older adults. Interventions that strengthen social support networks, foster enabling environments, and address gender and educational disparities are recommended to improve health outcomes and quality of life in aging populations. Policymakers and healthcare planners should incorporate these determinants into the design of targeted, evidence-based interventions for older adults.; Summary

The Role of Family Interaction Frequency on Depressive Symptoms in Korean Older Adults Aged ≥80 and Living Alone: Horim A. Hwang, Bo Yung Bae, Hyunsuk Jeong, Minsun Yun, Jungeun Choi, Yujin Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2026;59(1):86-94. Published online December 1, 2025; DOI: https://doi.org/10.3961/jpmph.25.222

519 View
48 Download

Abstract Summary PDF Supplementary Material: Objectives
Korea is one of the fastest-aging societies, and a large proportion of its older population lives alone. This study examined the impact of family interaction frequency on the association between living alone and depressive symptoms among older adults aged ≥80 years using nationally representative survey data.
Methods
Among the 229 099 participants of the 2019 Korea Community Health Survey, 15 672 participants aged ≥80 years who either lived with close family or lived alone were included in the analysis. Participants living alone were classified according to the frequency of family interaction, ranging from less than once a month to more than once a week. The outcome variable was moderate to severe depressive symptoms, defined as a Patient Health Questionnaire-9 score of ≥10.
Results
The prevalence of depressive symptoms was higher among older adults living alone (9.4–14.1%, depending on the frequency of family interaction) than among those living with close family (6.5%). Older adults living alone who interacted with family less than once a month were more likely to report depressive symptoms compared with those living with close family (adjusted odds ratio [aOR], 1.71; 95% confidence interval [CI], 1.36 to 2.15). Weekly family interaction mitigated the impact of living alone on the prevalence of depressive symptoms (aOR 1.10; 95% CI, 0.84 to 1.42). The influence of family interaction on the association between living alone and depressive symptoms remained consistent across subgroups of men, women, and those with difficulty in daily activities.
Conclusions
Encouraging regular interaction among family members could serve as an effective strategy to protect the mental health of older adults.; Summary

Korean summary
본 연구는 2019년 지역사회건강조사에 참여한 만 80세 이상의 노인 15,672 명의 자료를 활용하여, 가족과의 정기적인 소통이 독거로 인한 우울증상 유병률의 증가에 미치는 요인을 확인하고자 하였다. 가까운 가족인 배우자 또는 자식과 동거하는 노인들과 비교해 보았을 때, 주 1회 이상의 소통을 하는 독거 노인들의 우울증상 교차비는 유의하게 높지 않았다. 가족과의 정기적인 소통의 보호효과는 성별 또는 일상생활에 어려움에 따른 층화 분석을 한 경우에도 일관된 효과를 보였다.

Key Message
This study explored whether sufficiently frequent family interactions mitigate the increased odds of reporting depressive symptoms due to living alone among older adults aged ≥80. Family interaction of once a week or more frequent mitigated the impact of living alone among the older adults. The protective effect of family interaction remained consistent across gender and difficulty in daily activities.

Frailty Index Predicts Future All-cause Mortality and Quality of Life: A 2-Year Follow-up Study Among Korean Older Adults From a Population-based Cohort Study: Woolim Ko, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(6):572-580. Published online November 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.210

1,879 View
171 Download

Abstract Summary PDF Supplementary Material: Objectives
The frailty index (FI), a proxy measure of accelerated biological aging, predicts adverse outcomes in older adults. We investigated whether the FI predicts mortality in a community-based Korean older adult population and its association with subjective health status over 2 years.
Methods
This prospective cohort study included 936 community-dwelling individuals aged ≥60 years. The FI, calculated from 28 self-reported baseline variables, was scored on a scale from 0 to 1 (<0.25: non-frail; 0.25-0.34: mildly frail; ≥0.35: moderately to severely frail). The primary outcome was 2-year all-cause mortality. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Quality of life was assessed using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L), with the proportions reporting extreme problems and prevalence ratios of problems across frailty groups. Analyses were conducted using the GENMOD procedure in SAS version 9.4.
Results
Of the 936 participants, 111 (11.9%) were non-frail, 230 (24.6%) were mildly frail, and 595 (63.6%) were moderately to severely frail. The prevalence of moderate to severe frailty increased with age. The moderate-severe frailty group had a ≥5-fold increased risk of mortality compared to the non-frail group (adjusted RR, 5.79; 95% CI, 1.39 to 24.07). Among those completing follow-up, the moderate-severe frailty group reported more problems across all EQ-5D-3L domains at 2 years.
Conclusions
Frail older adults are at increased risk of mortality, but this risk was significant only for those in the moderate-to-severe frailty category at 2-year follow-up. The FI is a valuable predictor of premature death and health challenges in older adults.; Summary

Korean summary
2년의 추적 관찰 기간 동안, 기저 시점의 중등도에서 중증의 노쇠 상태에 있던 노인은 노쇠하지 않은 노인에 비해 사망 위험이 5배 이상 높았으며, EQ-5D-3L로 평가한 다양한 삶의 질 영역에서도 더 큰 어려움을 겪는 것으로 나타났다. 이러한 결과는 특히 중등도에서 중증의 노쇠 상태가 임상적 위험뿐만 아니라 주관적 삶의 질을 개선하기 위한 우선적 개입이 필요할 수 있음을 시사한다. 본 연구는 노인의 건강 결과를 향상시키기 위해서는 개별 질환 관리뿐 아니라 노쇠 상태를 체계적으로 평가하고 관리하는 것이 중요함을 제안한다.

Key Message
During the two-year follow-up period, older adults who were moderately to severely frail at baseline had a more than fivefold higher risk of death compared with those who were non-frail, and they also experienced greater difficulties across various quality-of-life domains as measured by the EQ-5D-3L. These findings suggest that moderate to severe frailty may require high-priority interventions to improve not only clinical risks but also subjective quality of life. This study indicates that, to improve health outcomes in older adults, it is important to systematically assess and manage frailty in addition to addressing individual diseases.

Exposure to Benzene, Toluene, Ethylbenzene, and Xylenes and Risk of Depression: A Cross-sectional Study of a National Sample of Korean Adults: Hyun-Wook Park, Byung-Sun Choi, Bomi Park, Wanhyung Lee, Weon-Young Lee; J Prev Med Public Health. 2026;59(1):95-104. Published online November 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.522

729 View
50 Download

Abstract Summary PDF Supplementary Material: Objectives
Benzene, toluene, ethylbenzene, and xylenes (BTEX) are co-occurring neurotoxicants that are structurally similar aromatic hydrocarbons sharing common metabolic pathways and mechanisms of toxicity. This study investigated the effects of BTEX exposure on depression and aimed to identify the primary contributors to depression risk.
Methods
We conducted a cross-sectional analysis of 1733 adults from the 2020–2021 Korea National Health and Nutrition Examination Survey. BTEX exposure was quantified based on urinary metabolite concentrations: S-phenylmercapturic acid (SPMA) for benzene, benzylmercapturic acid for toluene, the sum of phenylglyoxylic acid and mandelic acid for ethylbenzene, and methylhippuric acid for xylenes. Depression was defined according to self-reported physician diagnosis. Logistic regression was used to estimate the risk associated with individual chemicals, while weighted quantile sum (WQS) regression was employed to assess mixture effects and identify the primary toxicant. Sensitivity analyses were performed to address potential confounding by tobacco smoke.
Results
Urinary SPMA concentrations were significantly higher in individuals with depression. Logistic regression revealed a significant association between SPMA levels and depression (odds ratio, 2.62; 95% confidence interval, 1.34 to 5.13). Although the overall BTEX mixture was not significantly associated with depression after covariate adjustment in WQS models, SPMA consistently emerged as the major contributor. The association between SPMA and depression remained robust in sensitivity analyses excluding participants exposed to tobacco smoke.
Conclusions
Benzene exposure was associated with an increased risk of depression in the general Korean adult population. Therefore, strengthened environmental regulations on benzene could help reduce the public health burden of depression.; Summary

Korean summary
본 연구는 2020–2021년 국민건강영양조사 자료를 활용하여 한국 성인에서 요중 벤젠, 톨루엔, 에틸벤젠, 자일렌 대사체 농도와 우울증 위험 간의 연관성을 분석하였다. 분석 결과, 벤젠의 대사체인 요중 S-phenyl-mercapturic acid는 우울증 위험 증가와 연관성을 보였다. 흡연 요인을 제외한 민감도 분석에서도 연관성은 일관되게 유지되어, 벤젠 노출 저감을 위한 환경적 관리 강화가 우울증 예방에 기여할 수 있음을 시사한다.

Key Message
This study investigated the association between urinary metabolites of benzene, toluene, ethylbenzene, and xylene and depression risk among Korean adults, using data from the Korea National Health and Nutrition Examination Survey 2020–2021. The findings indicated a significant association between urinary S-phenyl-mercapturic acid, a metabolite of benzene, and an increased risk of depression. This association remained robust after excluding smoking factors, underscoring the potential benefits of improved environmental management in reducing benzene exposure to prevent depression.

Associations Between Poor Appetite, Sarcopenia, and Cognitive Function in Community-dwelling Malaysian Older Adults: Sook Yee Lim, Yoke Mun Chan, Maw Pin Tan, Shahrul Bahyah Kamaruzzaman, Rahimah Ibrahim; J Prev Med Public Health. 2025;58(6):589-598. Published online November 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.196

1,147 View
142 Download

Abstract Summary PDF: Objectives
This study aimed to explore the associations between poor appetite, sarcopenia, and cognitive function among Malaysian older adults.
Methods
This nationwide study involved 1086 community-dwelling older adults aged 55 years and above. Poor appetite was defined using a self-reported question, while cognitive function was assessed with the Montreal Cognitive Assessment. Sarcopenia was identified based on handgrip strength, 6-meter gait speed, and muscle mass, in accordance with the Asian Working Group for Sarcopenia 2019 criteria. Associations between poor appetite, sarcopenia, and cognitive function were analyzed using both univariate and multivariate analyses.
Results
Multivariate analysis revealed that handgrip strength (β=0.067, p=0.012) and gait speed (β=1.080, p=0.017) were significantly associated with cognitive function after adjusting for confounders such as age, ethnicity, marital status, education, and alcohol and smoking consumption. However, no significant association was observed between poor appetite and cognitive function, nor was any moderation effect found between poor appetite and sarcopenia-related traits on cognitive function.
Conclusions
Our study confirms that low muscle strength and reduced physical performance are significantly associated with an increased risk of cognitive impairment among community-dwelling older adults. These findings underscore the critical importance of muscle strength and physical performance in preserving cognitive function—a decline that is not inevitable with age. Routine screening and early detection of muscle health and cognitive function are essential, and should be followed by intervention strategies targeting muscle health to mitigate cognitive decline in aging populations.; Summary

Key Message
Lower muscle strength and slower gait speed were independently associated with poorer cognitive function in Malaysian older adults, while poor appetite showed no direct or moderating effect on cognition. These findings underscore the importance of routine screening and early interventions targeting muscle health to help prevent cognitive decline in aging populations.

Psychometric Properties of the Areas of Worklife Survey in an Industrial Context in Thailand: Jate Ratanachina, Inthuon Hongsiri, Watcharakorn Chuthong, Wiroj Jiamjarasrangsi; J Prev Med Public Health. 2026;59(1):75-85. Published online October 16, 2025; DOI: https://doi.org/10.3961/jpmph.25.569

65,535 View
79 Download

Abstract Summary PDF Supplementary Material: Objectives
The Areas of Worklife Survey (AWS) is widely used to assess organizational factors contributing to burnout. However, evidence regarding its construct and criterion validity has been reported primarily in human service settings. This study evaluated the construct validity of the AWS measurement model and the criterion validity of the AWS–burnout relationship among industrial workers in Thailand.
Methods
In this cross-sectional study, a Thai-language electronic questionnaire was administered to 446 industrial workers between June 2024 and August 2024. Of these, 390 participants (87.4%) completed both the AWS and the Maslach Burnout Inventory–General Survey. Data were analyzed using confirmatory factor analysis within a structural equation modeling framework.
Results
A modified 6-factor (chi-square/degree of freedom [χ²/df], comparative fit index [CFI], Tucker– Lewis index [TLI], root mean square error of approximation [RMSEA], and standardized root mean square residual [SRMR]) AWS model—excluding 5 items and allowing 2 correlated error terms—demonstrated satisfactory fit (χ²(213)=436.02, p<0.001; χ²/df=2.05; CFI=0.94; TLI=0.92; RMSEA=0.053; SRMR=0.053). Convergent validity (composite reliability=0.74–0.87; average variance extracted [AVE]=0.49–0.58) and discriminant validity were acceptable for most dimensions; however, the Fairness dimension (AVE=0.36) and the Reward–Fairness correlation remained problematic. The partial mediation model demonstrated acceptable criterion validity, with all mediation paths—except reward to values—reaching statistical significance.
Conclusions
The AWS is a valid measure for assessing factors contributing to burnout among Thai industrial workers. Nevertheless, further refinement is necessary to ensure strong dimension-specific validity with minimal modification.; Summary

Key Message
• The Areas of Worklife Survey (AWS) demonstrated acceptable construct and criterion validity for assessing organizational risk factors related to burnout among Thai industrial workers after model refinement. • A modified 18-item, six-factor structure showed good model fit and meaningful associations with burnout dimensions, supporting the AWS as a useful tool beyond human service settings.

Systematic Review

Digital Technologies in Hospital Pharmacy: A Systematic Review of Their Impact on Efficiency, Safety, and Inventory Management: Eka Pranata Bagus Abimanyu, Satibi , Dwi Endarti; J Prev Med Public Health. 2026;59(1):1-11. Published online October 5, 2025; DOI: https://doi.org/10.3961/jpmph.25.495

2,117 View
146 Download

Abstract Summary PDF Supplementary Material: Objectives
Digital transformation in hospital pharmacies is a strategic priority to improve medication safety, optimize inventory management, and streamline dispensing. Although healthcare digitalization has been widely studied, evidence of its impact on key performance indicators within hospital pharmacy operations remains limited. This review consolidates available evidence on how digital technologies affect hospital pharmacy performance, focusing on dispensing time, medication safety, and inventory practices.
Methods
A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Web of Science, PubMed, and Scopus were searched for English-language studies (2014–2024) conducted in general, academic, or tertiary hospitals. Eligible interventions included automation technologies (e.g., automated dispensing cabinets, robotic dispensing), digital systems (e.g., computerized physician order entry, electronic prescribing), or hybrid platforms. Outcomes included measures of dispensing efficiency, medication safety, and inventory management. Two reviewers independently screened studies and extracted data.
Results
Of 319 records, 9 studies met the inclusion criteria, spanning Saudi Arabia, the United States, Denmark, Iran, Jordan, Australia, and France. Most reported improvements in dispensing efficiency, safety (through lower error rates), and inventory control. Secondary gains included streamlined workflows and higher staff satisfaction. Challenges included resource-intensive implementation, workflow disruption, technological downtime, interoperability issues, and reliance on user compliance. Operational gains did not always yield measurable clinical benefits such as reduced morbidity or length of stay.
Conclusions
Digital technologies can improve efficiency, safety, and inventory control in hospital pharmacies; however, their success depends on institutional readiness, infrastructure, and human factors. Robust studies are needed to evaluate long-term impacts, cost-effectiveness, and implementation strategies.; Summary

Key Message
Digital technologies such as automated dispensing cabinets, electronic prescribing, barcode medication administration, and robotic systems can substantially improve dispensing efficiency, medication safety, and inventory control in hospital pharmacies. This systematic review shows consistent reductions in dispensing time, medication errors, stock-outs, and expired drugs across diverse healthcare settings. However, the benefits of digitalization depend on institutional readiness, adequate infrastructure, staff training, and sustained user compliance, highlighting the need for context-sensitive implementation strategies.

Original Articles

Assessing Hospital Surgical Functions in Korea: A Functional Analysis Using the Disease Control Priorities, 3rd Edition Essential Surgery List (2013-2022): Haibin Bai, Jin-Hwan Kim, Yukyung Park; J Prev Med Public Health. 2025;58(6):635-646. Published online September 23, 2025; DOI: https://doi.org/10.3961/jpmph.25.407

1,516 View
163 Download

Abstract Summary PDF Supplementary Material: Objectives
Korea has achieved near-universal health coverage through a predominantly privatized healthcare system. However, this structural fragmentation has created significant ambiguity regarding the roles of different healthcare organizations, particularly in ensuring equitable provision of essential surgical services across geographic and institutional boundaries.
Methods
We conducted a retrospective study using the full national health insurance claims database provided by the Health Insurance Review & Assessment Service (2013-2022). Essential surgical procedures from the Disease Control Priorities, 3rd edition Essential Surgery List were mapped to insurance claims codes, and their provision was analyzed across healthcare facilities and regions. Functional capacity was defined using minimum annual volume thresholds of 12, 24, 60, and 120 procedures.
Results
Essential surgery more than doubled between 2013 and 2022, increasing from 2.79 million to nearly 6 million cases. Superior general hospitals and general hospitals consistently delivered high volumes of essential surgeries, while hospital-level facilities experienced marked functional decline, particularly in obstetric services. We observed increasing centralization of surgical services in higher-tier and metropolitan facilities, alongside selective decentralization for lower-risk procedures such as cataract surgery. Regional disparities were especially pronounced for obstetric care.
Conclusions
Functional capacity for essential surgery remains highly uneven across hospitals and regions, undermining equitable access. Policy efforts should focus on strengthening lower-tier hospitals in underserved areas and implementing minimum functionality standards tailored to local needs. Clarifying institutional roles within Korea’s mixed healthcare system is essential to improving accountability and ensuring equitable distribution of essential surgical services.; Summary

Korean summary
본 연구는 DCP3 Essential Surgery List를 한국의 건강보험 청구자료(2013–2022)에 적용하여 필수수술 제공기관의 기능적 변화를 평가하였다. 전체 필수수술 건수는 크게 증가했음에도 불구하고 이를 제공하는 의료기관 수는 지속적으로 감소하며 지역 간 격차도 확대되고 있었다. 필수수술 접근성을 강화하기 위해서는 우선 의료기관 수준별로 제공해야 할 필수 기능을 명확히 규정하는 정책적 가이드가 필요하며, 이를 기반으로 지역 단위의 종합병원·병원급 기능을 지속적으로 모니터링하고 관리하는 체계를 마련해야 한다.

Key Message
This study applies the DCP3 Essential Surgery List to South Korea’s national health insurance claims data (2013–2022) and shows that, despite a substantial rise in essential surgery volumes, the number of institutions providing these procedures has declined, widening regional disparities. Strengthening access to essential surgery requires first establishing clear guidance on the functions expected at each level of care, followed by systematic monitoring to ensure that general and hospital-level facilities maintain the capacity to deliver these core services. Such a combined approach is critical for securing equitable and regionally sustained surgical access.

Impact of COVID-19 on the Profitability of General Hospitals in Korea: Jun Young Park, Tae Hyun Kim, Suk-Yong Jang, Sang Gyu Lee; J Prev Med Public Health. 2026;59(1):46-55. Published online September 11, 2025; DOI: https://doi.org/10.3961/jpmph.25.303

642 View
43 Download

Abstract Summary PDF Supplementary Material: Objectives
This study was performed to quantify the impact of coronavirus disease 2019 (COVID-19) on hospital profitability in Korea by analyzing changes in the medical revenue-to-profit ratio (MRPR) and net income before reserve fund allocation (NIBR) before and after the pandemic onset. Additionally, it examined how financial outcomes varied by hospital ownership, geographic location, and type (secondary or tertiary), providing insights into the financial resilience of various hospital types during public health crises.
Methods
We conducted a longitudinal analysis using publicly available financial disclosure data from 243 general hospitals in Korea (2016–2022). We then performed a quadrant analysis to classify hospitals based on changes in MRPR and NIBR, identifying patterns of financial impact. For inferential analysis, we employed linear mixed-effects models incorporating a difference-in-differences framework, enabling estimation of both time-varying and hospital-specific effects.
Results
Following the onset of COVID-19, MRPR declined significantly, reaching −10.62% in 2020. NIBR initially dropped but later increased, reaching 21.09 billion Korean won per 100 beds in 2022. Quadrant analysis revealed substantial heterogeneity in financial responses, with national/public hospitals experiencing the most severe MRPR decline, whereas educational foundation and medical corporation hospitals displayed stronger financial recovery. Regression results confirmed significant interactions between outcomes after COVID-19 onset and hospital ownership type, indicating differential financial impacts across hospital categories.
Conclusions
The findings highlight the uneven financial effects of COVID-19 on Korean hospitals, emphasizing the importance of targeted government financial support. Policy measures should prioritize structural financial reforms to ensure hospital sustainability beyond short-term crisis management.; Summary

Korean summary
본 연구는 2016–2022년 국내 종합병원 243개소의 재무자료를 활용하여 COVID-19 팬데믹이 병원 수익성에 미친 영향을 분석하였다. 팬데믹 이후 의료수익 대비 이익률은 전반적으로 감소한 반면, 정부 지원 등의 영향으로 적립금 차감 전 순이익은 증가하는 이중적 양상이 관찰되었다. 이러한 영향은 병원 소유 형태와 규모에 따라 상이하게 나타났으며, 공공병원의 재무적 취약성이 두드러졌다.

Key Message
Using longitudinal financial data from 243 Korean general hospitals (2016–2022), this study examined the impact of COVID-19 on hospital profitability. Medical revenue-to-profit ratios declined markedly after the pandemic onset, while net income before reserve fund allocation increased, reflecting substantial heterogeneity by ownership and hospital type. These findings highlight the need for targeted and structurally differentiated financial support policies to strengthen hospital resilience during future public health crises.

Changes in Adolescents’ Compliance Rate in Response to Policy Changes: COVID-19 Toothbrushing Restrictions in Schools for Korea: Suhyun Choi, Yubeen Kim, Joo Mi Kim, Joohyeon Kim, Jaewon Jeon, Jae-Seok Song, Yeunhee Kwak, Se-Hwan Jung, Nam-jun Kim; J Prev Med Public Health. 2026;59(1):35-45. Published online September 8, 2025; DOI: https://doi.org/10.3961/jpmph.25.448

502 View
61 Download

Abstract Summary PDF: Objectives
This study investigated changes in toothbrushing in adolescents in response to public health policy changes during coronavirus disease 2019 (COVID-19) focusing on behavioral trends before, during, and after policy enforcement according to socio-demographic subgroups.
Methods
Data from the Korean Youth Risk Behavior Survey (2018–2024) were divided into 3 periods: before (2018–2019), during (2020–2022), and after (2023–2024) the implementation of COVID-19 school restrictions. A total of 354 943 middle and high school students were included. The primary outcome variable was self-reported toothbrushing after lunch at school. Multivariable logistic regression was conducted, adjusting for confounders such as sex, academic performance, school level, school type, handwashing, and oral health status (toothache and gum bleeding).
Results
The compliance rate for toothbrushing declined significantly during the restriction period across all groups. It varied by sex, school type, school level, health-related behaviors (drinking, smoking, handwashing), and oral health status. Female students, middle schoolers, students in single-sex schools, non-smokers, and those practicing hand hygiene showed higher compliance. After restrictions were lifted, toothbrushing rates improved but remained lower than pre-pandemic levels. Recovery of the toothbrushing rate was observed in most groups, particularly among female students, high schoolers, and those with positive health-related behaviors. However, academic performance and oral health status were not significantly associated with recovery rate in adjusted analyses.
Conclusions
This study highlights that adolescents’ health behaviors are highly sensitive to environmental and policy changes. Variations in compliance and recovery rates underscore the need for adolescent-centered policies that account for both compliance and recovery, especially during crises such as pandemics.; Summary

Korean summary
청소년의 점심식사 후 칫솔질 행동은 COVID-19 학교 방역 제한 기간 동안 감소하였으며, 제한 해제 이후에도 부분적인 회복에 그쳤다. 순응도와 회복 양상은 집단별 특성에 따라 다르게 나타났다. 따라서 공중보건 정책은 행동의 순응뿐 아니라 회복까지 고려하여, 집단별 특성에 맞게 설계할 필요가 있다.

Key Message
Adolescents’ toothbrushing after lunch declined during COVID-19 school restrictions and showed only partial recovery after restrictions were lifted. Patterns of compliance rate and recovery rate varied according to subgroup characteristics. Therefore, public health policies should be designed to consider both compliance and recovery rates, tailored to subgroup-specific characteristics.

Loneliness and E-cigarette Use Among Adolescents in England: Evidence From the Smoking, Drinking and Drug Use Survey 2023: Yusuff Adebayo Adebisi, Najim Z. Alshahrani, Isaac Olushola Ogunkola; J Prev Med Public Health. 2026;59(1):66-74. Published online September 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.476

598 View
46 Download

Abstract Summary PDF: Objectives
Adolescent e-cigarette use is an increasing public health concern in England, yet the psychosocial drivers of this trend remain poorly understood. This study examines the association between loneliness and current e-cigarette use among secondary school students aged 11–15.
Methods
We analysed data from 13 725 pupils who participated in the 2023 wave of the nationally representative Smoking, Drinking and Drug Use among Young People in England survey. Loneliness was assessed using a validated composite score derived from 3 indirect questions on social isolation, categorised as low, medium, and high. Current e-cigarette use was defined as self-reported use “sometimes” or “every week.” Logistic regression models estimated crude and adjusted odds ratios (ORs) for the association between loneliness and vaping, adjusting for age, gender, current smoking, ethnicity, family affluence, and alcohol use.
Results
Overall, 8.0% of adolescents (n=1104) reported current e-cigarette use. Compared with those reporting low loneliness, adolescents with medium and high loneliness had significantly greater odds of vaping, with adjusted ORs of 1.48 (95% confidence interval [CI], 1.24 to 1.76; p<0.001) and 2.46 (95% CI, 2.00 to 3.04; p<0.001), respectively. Findings were consistent in sensitivity analyses using weekly e-cigarette use as the outcome. Adolescents with medium and high loneliness had significantly higher adjusted odds of weekly use (adjusted ORs, 1.39; 95% CI, 1.11 to 1.75; p=0.005; and 2.04; 95% CI, 1.55 to 2.71; p<0.001, respectively) compared with those reporting low loneliness.
Conclusions
Loneliness is a strong and graded correlate of adolescent e-cigarette use.; Summary

Key Message
This study of 13,725 adolescents in England reveals that loneliness is a powerful, independent, and graded predictor of e-cigarette use. Adolescents reporting high levels of loneliness had nearly 2.5 times the adjusted odds of current vaping compared to those with low loneliness. These findings suggest that public health strategies should prioritize social connectedness and emotional well-being as critical components of youth vaping prevention frameworks.

From Rich to Poor: A Decomposition Analysis of Socioeconomic Inequality in Health-related Quality of Life in Iran: Satar Rezaei; J Prev Med Public Health. 2025;58(5):538-547. Published online August 20, 2025; DOI: https://doi.org/10.3961/jpmph.25.383

3,375 View
215 Download

Abstract Summary PDF Supplementary Material: Objectives
Socioeconomic status (SES) is a well-established predictor of health outcomes across an individual’s lifespan. People from lower socioeconomic backgrounds generally have shorter life expectancies and lower levels of health-related quality of life (HRQoL) compared with those from higher-income groups. This study aimed to quantify income-related inequalities in HRQoL among adults in Iran.
Methods
A total of 3518 adults aged 18 years and older were selected using a convenience sampling method across 9 provinces in Iran. HRQoL was assessed with the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) instrument, which evaluates 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The concentration index (CI) approach was used to measure income-related inequality in worse HRQoL (disutility=1–utility value) and to identify the socioeconomic factors contributing to the observed inequality.
Results
The CI for worse HRQoL was -0.116, while the CI for the EuroQol visual analogue scale (EQ-VAS) score was 0.027. The CIs for reporting any problems in the EQ-5D-5L dimensions were: mobility (-0.122), self-care (-0.070), usual activities (-0.074), pain/discomfort (-0.139), and anxiety/depression (-0.139). Decomposition analysis showed that income (38.00%), educational level (31.53%), age (8.05%), and physical activity (7.30%) were the main factors contributing to socioeconomic inequality in poorer HRQoL in Iran.
Conclusions
This study identified a pro-poor distribution of poorer HRQoL and reported problems across all dimensions of the EQ-5D-5L in Iran. Targeted interventions should focus on reducing disparities in income, education, and physical activity levels.; Summary

Key Message
The study of 3518 adults across 9 Iranian provinces revealed significant pro-poor socioeconomic inequality in health-related quality of life (HRQoL), with worse HRQoL concentrated among lower-income groups (concentration index: -0.116). Income (38%) and education level (31.53%) were the largest contributors to this inequality, followed by age (8.05%) and physical activity (7.30%) based on decomposition analysis. All five EQ-5D-5L health dimensions showed more reported problems in lower socioeconomic groups, emphasizing the need for targeted interventions addressing income, education, and lifestyle factors to reduce HRQoL disparities in Iran.

Integrating Cognitive and Motor Dual-task Training to Prevent Fall Risk Among Community-dwelling Elderly in Thailand: A Randomized Controlled Study: Wilawan Jattanond, Chatchada Sutalangka, Ploypailin Namkorn, Ekalak Sitthipornvorakul, Siripatra Atsawakaewmongkhon, Boonsita Suwannakul, Aunyachulee Ganogpichayagrai, Sitang Kongkratoke, Raksuda Taniguchi, Wilawan Chaiut; J Prev Med Public Health. 2025;58(6):609-619. Published online August 19, 2025; DOI: https://doi.org/10.3961/jpmph.25.165

1,599 View
144 Download
3 Crossref

Abstract Summary PDF

Objectives
Falls are a leading cause of morbidity and mortality among older adults, often resulting in severe injuries and a loss of independence. Dual-task training, which integrates cognitive and motor exercises, has emerged as a promising intervention for fall prevention. This study aimed to evaluate the effects of a structured cognitive and motor dual-task training program on fall risk, balance, and cognitive function in community-dwelling older adults.
Methods
Seventy-two participants aged 60 years or older were randomly assigned to either an intervention group (IG, n=36) or a control group (CG, n=36). The IG underwent 3 sessions per week for 8 weeks (totaling 24 sessions) that incorporated simultaneous cognitive and motor exercises, while the CG continued their usual total body stretching exercise. Assessments were conducted at baseline, week 4, and week 8, and included gait speed (10-meter walk test), functional performance (Timed Up and Go test), cognitive function (Montreal Cognitive Assessment), and quality of life (World Health Organization Quality of Life Assessment).
Results
Participants in the IG demonstrated significant improvements in functional performance (p<0.05) and enhanced cognitive function compared to the CG after both 4 weeks and 8 weeks of training. Functional performance and cognitive function significantly improved after 8 weeks of training (p<0.01). However, the intervention did not produce changes in gait speed or quality of life.
Conclusions
Integrating cognitive and motor dual-task training into fall prevention programs may enhance functional stability and cognitive resilience in older adults. Future studies should investigate long-term adherence and determine the optimal training intensity.

Summary

Key Message
Integrating cognitive–motor dual-task training into fall-prevention programs can significantly enhance balance, mobility, and cognitive responsiveness in older adults. This approach improves adaptability to real-world challenges, reduces fall risk, and supports independent living. Evidence-based, engaging training protocols can further promote long-term safety and quality of life in aging populations.

Citations

Citations to this article as recorded by

Osteoarthritis Falls Origins, Risks, and Prevention: Do we Need an Ecological Guiding Explanatory Framework?
Marks Ray
Journal of Aging Research And Healthcare.2026; 5(3): 24. CrossRef
Osteoarthritis Falls Origins, Risks and Implications 2020-2025
Ray Marks
Journal of Orthopaedic Science and Research.2026; 7(1): 1. CrossRef
Surgical Delay of Proximal Hamstring Ruptures Results in Increased Risk of Post-Operative Pain and Stiffness: A Systematic Review
Laura CM Ndjonko, Ahmed Ebada, James Li, Samantha Watson, Siddhartha Kalala, Anoop Sunkara, Vehniah Tjong
Journal of Orthopaedic Science and Research.2026; 7(1): 1. CrossRef

Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study: Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh; J Prev Med Public Health. 2025;58(6):629-634. Published online August 9, 2025; DOI: https://doi.org/10.3961/jpmph.25.363

1,327 View
213 Download

Abstract Summary PDF: Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.; Summary

Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.

Impact of COVID-19 Control Measures on Birth Outcomes in Ho Chi Minh City, Vietnam: Tinh Ho Huu, Nguyen Do Phuc Nhu, Nhan Ho The, Hang Tran Thi Thuy, Chinh Dang Van; J Prev Med Public Health. 2025;58(6):620-628. Published online August 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.177

1,640 View
140 Download

Abstract Summary PDF Supplementary Material: Objectives
Studies of the associations between coronavirus disease 2019 (COVID-19) control measures and infant health in Vietnam are limited. This study investigated differences in birth outcomes between pregnancies during the COVID-19 pandemic and those before the pandemic.
Methods
Data on infants born alive between 2016 and 2023 in Ho Chi Minh City (HCMC) were collected. For each infant, the estimated first day of pregnancy was calculated based on birth date and gestational age. Linear and logistic regression analyses were conducted to identify significant associations. The birth outcomes examined included decreased birth weight (BW), low birth weight (LBW), term LBW, and preterm birth (PTB). The models were adjusted for infant sex, birth order, gestational age, and maternal age. The COVID-19 pandemic period in HCMC was defined as April 2020 to December 2022.
Results
Among 172 017 infants, 31.4% had at least 1 trimester of gestation during the COVID-19 pandemic, 44.2% were first births, and 52.0% were male. Infants with full gestation during the pandemic had significantly lower BW (by 20.7 g) compared to those born pre-pandemic. Pregnancy during the COVID-19 pandemic was associated with higher rates of LBW, term LBW, and PTB compared to the pre-pandemic period. The odds ratios (95% confidence intervals) were 1.21 (1.15 to 1.27), 1.28 (1.18 to 1.39), and 1.10 (1.06 to 1.15), respectively.
Conclusions
The COVID-19 pandemic was associated with elevated risk of adverse birth outcomes. Lessons learned from the COVID-19 response should be applied to prepare for future outbreaks.; Summary

Key Message
This study examined birth outcomes among 172,017 infants in Ho Chi Minh City, Vietnam, comparing pregnancies during the COVID-19 pandemic (April 2020-December 2022) with pre-pandemic periods. Infants with full gestational exposure to the pandemic had significantly lower birth weights (by 20.7 g) and increased risks of low birth weight, term low birth weight, and preterm birth, with odds ratios ranging from 1.10 to 1.28. These findings suggest that COVID-19 control measures were associated with adverse birth outcomes, underscoring the importance of applying lessons learned for future outbreak preparedness.

Lifestyle and Psychological Factors Associated With Depression in College Students in Hokkaido, Japan During the COVID-19 Pandemic: A Cross-sectional Study: Atsushi Mizumoto, Reiya Tsuji, Kotomi Echizen, Yuichi Takata; J Prev Med Public Health. 2025;58(6):581-588. Published online July 22, 2025; DOI: https://doi.org/10.3961/jpmph.25.186

2,086 View
179 Download

Abstract Summary PDF: Objectives
Although studies have demonstrated a decline in mental health during the early stages of the coronavirus disease 2019 (COVID-19) pandemic, the long-term psychological effects remain insufficiently understood. This study conducted a web-based questionnaire survey to identify factors associated with depression among college students in Hokkaido, Japan, during the COVID-19 pandemic.
Methods
A total of 187 participants who responded to a questionnaire administered in April 2022 were included in this study. The survey evaluated depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) and included items on exercise habits, sleep duration, food frequency score (FFS), World Health Organization-Five Well-Being Index (WHO-5), Fear of COVID-19 Scale (FCV-19S), daily step count, part-time job participation, and involvement in club activities.
Results
The mean CES-D score was 18.2±9.9, with 95 participants (50.8%) exhibiting symptoms of depression. Compared to those in the depression group, participants in the non-depression group were significantly more likely to engage in regular exercise and part-time jobs, as well as higher FFS, WHO-5, and FCV-19S scores. Logistic regression analysis showed that, even after adjusting for confounding variables, the WHO-5 score, FCV-19S score, and participation in part-time jobs remained significantly associated with depression scores.
Conclusions
Almost half of the participants showed symptoms of depression. These symptoms were associated with poor exercise habits and lack of part-time employment, among other factors. Among college students who had experienced more than 2 years of the pandemic, engaging in part-time work may have reduced social isolation and helped lower the risk of depression.; Summary

Key Message
This study conducted a web-based survey to identify factors associated with depression among college students in Hokkaido during the COVID-19 pandemic. Compared with students in the depression group, those without depression were more likely to engage in regular exercise and part-time jobs and had higher FFS, WHO-5, and FCV-19S scores. Logistic regression showed that WHO-5, FCV-19S, and participation in part-time jobs remained significantly associated with depression after adjustment. Among students who had experienced more than two years of the pandemic, part-time employment may have reduced social isolation and lowered the risk of depression.

Associations Between Urinary Metabolites of Polycyclic Aromatic Hydrocarbons and Liver Enzyme Levels Among Korean Firefighters: Jaeyong Lee, Mun-Joo Bae, Mi-Ji Kim, Sung Soo Oh, Ki Soo Park, Chan Joo Lee, Sungha Park, Seung-Koo Lee, Sang-Baek Koh, Hyeon Chang Kim, Changsoo Kim, Jaelim Cho; J Prev Med Public Health. 2025;58(6):563-571. Published online July 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.271

1,687 View
201 Download

Abstract Summary PDF: Objectives
Polycyclic aromatic hydrocarbons (PAHs), byproducts of incomplete combustion of organic compounds, have been linked to various adverse health outcomes; however, evidence associating PAHs with liver damage remains inconsistent. This study aimed to investigate the relationship between PAH exposure and liver enzyme levels among firefighters, who have an increased risk of PAH exposure.
Methods
A total of 961 firefighters were included in the study. Urinary concentrations of 4 PAH metabolites (2-naphthol, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxypyrene) were measured and categorized into quartiles. Serum levels of liver enzymes, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were evaluated. Age, smoking status, alcohol consumption, body mass index (BMI), job position, and self-reported disease history were adjusted as covariates. Multivariable linear regression analyses were conducted to assess the association between PAH metabolites and serum AST and ALT levels. Logistic regression analyses evaluated associations between PAH metabolites and abnormal AST and ALT levels, defined as 40 IU/L or higher.
Results
Participants in the highest quartile of urinary 2-naphthol had an increased risk of abnormal ALT levels compared to those in the lowest quartile (odds ratio, 2.00; 95% confidence interval, 1.09 to 3.65). No significant associations were observed for the other PAH metabolites. The association between urinary 2-naphthol and abnormal ALT levels did not differ significantly by smoking status, alcohol consumption, or BMI.
Conclusions
Elevated urinary 2-naphthol levels were associated with abnormal liver enzyme levels among firefighters, suggesting that monitoring and managing PAH exposure may help protect liver health in this occupational group.; Summary

Korean summary
이 연구는 한국 소방관을 대상으로 요중 다환방향족탄화수소 대사체와 간 효소 수치의 연관성을 조사하였다. 연구 결과, 요중 2-naphthol 수치가 가장 높은 사분위수에 속하는 참가자들은 가장 낮은 사분위수와 비교하여 비정상 ALT 수치를 보일 위험이 유의하게 높았다. 이러한 결과는 다환방향족탄화수소 노출을 모니터링하고 관리하는 것이 소방관의 간 건강 보호에 중요한 역할을 할 수 있음을 시사한다.

Key Message
This study investigated the association between urinary polycyclic aromatic hydrocarbon (PAH) metabolites and serum liver enzyme levels among Korean firefighters. Results showed that participants in the highest quartile of urinary 2-naphthol had a significantly increased odds of having abnormal ALT levels compared to those in the lowest quartile. These findings suggest that monitoring and managing PAH exposure may play an important role in protecting the liver health of firefighters.

Association Between Disability and Participation in Sports or Physical Activities: Evidence From a Chilean Population-based Survey: Renzo Gianmarco Avila-Terrones, Leslie Paulina Quiroga-Morales, J. Jhonnel Alarco; J Prev Med Public Health. 2025;58(6):599-608. Published online July 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.249

1,814 View
153 Download

Abstract Summary PDF Supplementary Material: Objectives
This study aimed to estimate the association between disability and participation in sports or physical activity during the past month among individuals in Chile.
Methods
A cross-sectional analysis was conducted using data from the Second National Disability Study (ENDISC II) of Chile. The dependent variable was defined as participation in sports or physical activity in the last month, while the independent variable was disability status, as determined by the ENDISC II methodology. Crude and adjusted ordinal logistic regression models were employed to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
The analysis included data from 12 236 Chilean participants. Individuals with mild or moderate disability were 54% more likely to participate in lower levels of sports or physical activity (OR, 1.54; 95% CI, 1.27 to 1.87). Those with severe disability exhibited a 73% increased likelihood (OR, 1.73; 95% CI, 1.19 to 2.52) compared to individuals without disabilities, after adjusting for multiple confounding factors.
Conclusions
In Chile, individuals with disabilities participated less frequently in sports or physical activity during the past month than those without disabilities.; Summary

Key Message
This study analyzed national data from Chile to examine the relationship between disability and participation in sports or physical activity. Individuals with disabilities, particularly those with severe limitations, were significantly less likely to engage in physical activity than those without disabilities, even after adjusting for multiple confounders. These findings highlight a critical public health gap and underscore the need for inclusive and accessible physical activity strategies to reduce inequalities.

Case Report

Lead Intoxication Related to Coriander Consumption: A Case Report From the United States: Kelly Johnson-Arbor, Gloria Dike, Sammy Taha; J Prev Med Public Health. 2025;58(6):647-651. Published online July 8, 2025; DOI: https://doi.org/10.3961/jpmph.25.273

1,797 View
155 Download

Abstract Summary PDF: Spices are associated with health risks, including heavy metal exposure. We present a case of lead intoxication likely related to spice consumption, specifically coriander powder. A 61-year-old woman was diagnosed with lead intoxication during a medical evaluation for symptomatic anemia. The patient had regularly consumed imported Malaysian spices prior to symptom onset. An initial public health assessment revealed only modest concentrations of lead in spices found in her home, raising concerns about additional sources of exposure. Several months later, a relative of the patient was also diagnosed with lead intoxication. Investigation revealed markedly elevated lead concentrations in coriander powder consumed by the relative, suggesting potential economic adulteration. The index patient reported also consuming coriander purchased from a Malaysian street market prior to her lead toxicity diagnosis. Spices are susceptible to heavy metal contamination from inadvertent environmental uptake or intentional economic adulteration. Medical professionals should remain vigilant for lead-contaminated spices and collaborate with public health officials to identify sources and patterns of lead exposure.; Summary

Key Message
Although spices are valued for their culinary aspects and potential health benefits, they are also susceptible to contamination with heavy metals through intentional or unintentional processes. Spices are especially vulnerable to intentional economic adulteration, due to their often-high costs and processing requirements. This manuscript describes the case of a patient who developed significant lead toxicity after chronic consumption of powdered coriander that was potentially impacted by economic adulteration.

Original Articles

Mapping Asbestos Vulnerability in Indonesia Using Earthquake Vulnerability: Anna Suraya, Osama Priharto, Bintang Raihan Putra, Husen , Defi Arjuni, Uci Sulandari, Yunita Sari Purba, Maryuni , Lelitasari; J Prev Med Public Health. 2025;58(5):475-483. Published online June 29, 2025; DOI: https://doi.org/10.3961/jpmph.24.749

2,285 View
234 Download

Abstract Summary PDF: Objectives
This study aims to create Indonesia’s first asbestos exposure risk map by analyzing asbestos roofing prevalence, population density, and earthquake vulnerability. This represents a significant innovation by providing valuable insights to support the prevention of asbestos-related diseases in Indonesia.
Methods
This semi-quantitative study was conducted between June 2024 and September 2024. Data on asbestos roof usage and population density were obtained from the Indonesian Central Statistics Agency, while earthquake risk data were sourced from the Geological Disaster Mitigation Portal. Risk categorization was applied to each variable, and a matrix was developed to evaluate combined risks. Validation was conducted through cross-referencing, and maps were generated using Geographic Information System software.
Results
Nationally, asbestos roofing use is approximately 8.10%, although prevalence varies significantly among provinces. Bangka Belitung has the highest prevalence at 55.16%, followed by DKI Jakarta (52.10%), Riau Islands (31.99%), and Banten (21.22%). DKI Jakarta also has the highest population density, with 16 158 inhabitants per square kilometer. Combining these factors, DKI Jakarta emerges as the province with the highest asbestos exposure risk. Based on asbestos roofing prevalence, population density, and earthquake risk, provinces classified at very high asbestos exposure risk include DKI Jakarta, West Java, DI Yogyakarta, East Java, Banten, Bali, and West Nusa Tenggara. Provinces categorized as high-risk include North Sumatra, Bengkulu, Lampung, and Central Java.
Conclusions
This map supports the development of future public health policies by identifying high-risk areas, optimizing resource allocation, and informing targeted intervention strategies.; Summary

Key Message
This study developed Indonesia’s first asbestos exposure risk map by integrating asbestos roof prevalence, population density, and earthquake vulnerability. Using GIS-based semi-quantitative analysis, the authors identified significant disparities across provinces. Bangka Belitung (55.16%) and Jakarta (52.10%) had the highest asbestos roof usage, with Jakarta also exhibiting the country’s highest population density (16,158/km²). These overlapping factors placed Jakarta, West Java, DI Yogyakarta, East Java, Banten, Bali, and West Nusa Tenggara in the “very high-risk” category. The findings emphasize the urgent need for targeted public health interventions and disaster risk mitigation.

The Role of Hydrometeorological Factors in Leptospirosis Transmission in Central Java, Indonesia: Yoerdy Agusmal Saputra, Ladyka Viola Aulia Armawan, Mona Lisa, Disa Hijratul Muharramah, Laura Dwi Pratiwi; J Prev Med Public Health. 2025;58(6):553-562. Published online June 26, 2025; DOI: https://doi.org/10.3961/jpmph.25.114

27,594 View
296 Download

Abstract Summary PDF: Objectives
This study investigates the relationship between hydrometeorological factors and leptospirosis cases in Central Java to elucidate disease spread patterns.
Methods
An ecological study design was utilized, incorporating spatial elements by integrating geographic information systems (GIS) with statistical techniques. The analysis included data on temperature, humidity, rainfall, solar radiation, flooding, and monthly leptospirosis cases recorded from 2018 to 2022. Data sources comprised the Ministry of Health of the Republic of Indonesia, the Meteorology, Climatology, and Geophysics Agency, and the Central Java Provincial Water Resources Management Center. The study employed correlation tests, multiple linear regression, and spatial data visualization.
Results
Correlation analysis indicated that monthly leptospirosis cases were significantly and positively correlated with minimum temperature (r=0.423; p=0.001), humidity (r=0.589; p<0.001), and rainfall (r=0.413; p=0.001). In contrast, maximum temperature (r=-0.355; p=0.005) and solar radiation (r=-0.431; p=0.001) showed significant negative correlations. Subsequent multiple linear regression showed that higher monthly leptospirosis was associated with higher humidity.
Conclusions
The findings offer essential insights for developing a comprehensive, science-based leptospirosis management strategy. A recommended approach is to establish a spatial monitoring system aimed at identifying high-risk areas, especially those with increased humidity and frequent flooding.; Summary

Key Message
This ecological GIS-based study analyzed monthly leptospirosis cases and hydrometeorological variables (2018–2022) across Central Java to identify the hydrometeorological role in leptospirosis transmission. Correlation and multiple linear regression found humidity as the only statistically significant predictor—each 1% increase associated with 0.07 additional monthly cases—while minimum temperature and rainfall showed positive correlations and maximum temperature and solar radiation showed negative correlations. Spatial overlays highlighted higher burdens in humid, flood-prone districts and support using spatial monitoring and hydrometeorology-informed early warning systems.

Special Article

Current Status of the National Cancer Screening Program in Korea: History, Achievements, and Future Directions: Kyeongmin Lee, Mina Suh, Kui Son Choi; J Prev Med Public Health. 2025;58(4):337-347. Published online June 21, 2025; DOI: https://doi.org/10.3961/jpmph.25.268

16,990 View
408 Download
5 Web of Science
4 Crossref

Abstract Summary PDF Supplementary Material

Cancer is the leading cause of morbidity and mortality worldwide. To reduce this burden, the Korean government established the National Cancer Screening Program (NCSP) in 1999, initially offering stomach, breast, and cervical cancer screening to Medical Aid Program (MAP) beneficiaries. By 2019, the NCSP had broadened both its eligible population and the range of cancers screened—stomach, liver, cervical, breast, colorectal, and lung—for both MAP recipients and health insurance beneficiaries. Since its inception, participation and adherence to recommended screening have risen steadily, driven by nationwide policy initiatives and expanded access. Over the past 2 decades, the NCSP has played a key role in reducing the incidence of stomach, liver, colorectal, and cervical cancers while increasing detection at precancerous stages, especially for cervical and colorectal cancers. Five-year relative survival rates for major cancers—most notably stomach, colorectal, and breast—have also improved substantially. Accumulated evidence, including cancer detection rates, stage distribution at diagnosis, and mortality reduction, underscores the program’s effectiveness in facilitating early detection and reducing cancer-specific deaths. Notably, Korea’s mortality-to-incidence ratio for major cancers remains well below the Organization for Economic Cooperation and Development average, illustrating the impact of the nation’s comprehensive cancer control strategies. Continued research, surveillance, and refinement of evidence-based screening guidelines will be critical to further enhancing the efficiency and effectiveness of the NCSP.

Summary

Korean summary
한국의 국가암검진 사업은 도입 이후 지난 20여 년간 암 발생률과 사망률 감소에 크게 기여해왔다. 본 연구에서는 한국의 국가암검진 프로그램의 도입 이후 발전과정을 살펴보고, 암 질병부담 감소에 기여한 주요성과들을 고찰하였다. 또한, 국가암검진의 효과성을 높이기 위해 근거에 기반한 암검진 권고안 개정의 필요성을 논의하고, 향후 국가암검진 사업의 지속적인 성과 향상을 위한 발전방안을 제시하였다.

Key Message
Since its inception, Korea’s National Cancer Screening Program (NCSP) has played a critical role in reducing cancer incidence and mortality over the past two decades. This study presents a comprehensive review of the NCSP’s development and its key contributions to alleviating the national cancer burden. In addition, it emphasizes the necessity of updating cancer screening guidelines in accordance with the latest scientific evidence and outlines strategic directions to further strengthen the program’s effectiveness and long-term outcomes.

Citations

Citations to this article as recorded by

Inequalities in breast cancer incidence and mortality in women with and without disabilities in South Korea: A population-based cohort study
Hee-Yeon Kang, Eunjung Park, Thi Tra Bui, Byungmi Kim, Jin-Kyoung Oh
Preventive Medicine Reports.2025; 59: 103242. CrossRef
Enhancing cancer risk awareness and screening management through artificial intelligence: a narrative review
Jiaxuan Wu, Xiaolong Tang, Qian Zheng, Xinhang Gu, Li Ma, Jinghong Xian, Hui Mao, Jiadi Gan, Guiyi Ji
Frontiers in Oncology.2025;[Epub] CrossRef
Practice of Cytopathology in Korea: A 40‐Year Evolution Through Standardization, Digital Transformation, and Global Partnership
Yosep Chong, Ran Hong, Hyeong Ju Kwon, Haeryoung Kim, Lucia Kim, Soon Jae Kim, Yoon Jung Choi
Diagnostic Cytopathology.2025;[Epub] CrossRef
Temporal trends and future projections of six major cancers among women of childbearing age in northeast Asia: analysis of data from the global burden of disease study 2021
Jingqian Liang, Baogeng Huai, Zeping Yang, Shan Zhang, Haoliang Cui, Jianyi Zhang, Deshan Liu
Frontiers in Oncology.2025;[Epub] CrossRef

Original Article

Experience of Medical Personnel Dispatched to Isolated Psychiatric Institution in Korea During COVID-19: Content Analysis: Youngjoo Kim, Jung Hee Hyun, Jacob Lee, Yoonyoung Nam, Eunshil Yim, Kyounga Lee, Baegju Na; J Prev Med Public Health. 2025;58(4):431-439. Published online June 18, 2025; DOI: https://doi.org/10.3961/jpmph.24.680

2,109 View
270 Download

Abstract Summary PDF: Objectives
This study investigates problems related to medical response, and the support system among medical personnel dispatched to the psychiatric hospital when the first cluster of infections occurred in a psychiatric hospital in Korea.
Methods
Contents analysis was conducted for the responses of the medical personnel who responded to the interview. Training about basic quarantine rules, and safety management is not provided in the early dispatch stages.
Results
No guidance is available regarding the human rights protection of medical staff. Additionally, no on-site situation-control tower is available. Participants reported that temporary quarantine measures implemented at Hospital D to restrict the movement of patients and medical staff from the external world are problematic. The most significant problem is the insufficient governmental systemic support and consideration for protecting. Both the human rights of psychiatric patients and the human rights of the medical staff who care for them.
Conclusions
Future responses to new infectious diseases should include the establishment of a continuous support system in the community by changing the collective and closed-room environments as well as isolation-centered mental healthcare systems to protect the human rights of patients with mental disorders. Additionally, response drills for people with mental illness in closed environments should be practiced in response to emerging infectious diseases at ordinary times. Finally, training and emergency measures for medical staff dispatched to these facilities and a manual for the protection of the human rights of medical staff should be prepared.; Summary

Korean summary
이 논문은 COVID-19 초기 확산 시기, 한국 청도군의 한 정신병원에서 집단감염이 발생했을 때 파견된 의료진의 경험을 질적 내용 분석을 통해 조사한 연구입니다. 연구 결과, 정부의 준비 부족, 현장 통제 시스템 부재, 감염병 대응 훈련 미비, 인권 보호 기준 부재 등 여러 문제점이 드러났으며, 향후 정신질환자 대상 감염병 대응을 위해 지역사회 기반의 지속 가능한 지원체계와 의료진 인권 보호 매뉴얼 마련이 필요하다고 제안합니다.

Key Message
This study qualitatively analyzed the experiences of medical personnel dispatched to a psychiatric hospital in Cheongdo-gun, Korea, during a COVID-19 outbreak. It revealed critical issues such as lack of governmental preparedness, absence of on-site control systems, inadequate training, and insufficient protection of human rights for both patients and staff. The findings highlight the need for a sustainable, community-based mental healthcare system and the development of emergency manuals and human rights protection protocols for medical personnel in future infectious disease responses.

Perspective

Towards Mental Health Equity: Task Shifting Strategy to Overcome Barriers in Primary Healthcare Services in India: Suganya Panneerselvam, Senthilkumar Ramasamy, Sanjana Agrawal; J Prev Med Public Health. 2025;58(5):548-551. Published online June 13, 2025; DOI: https://doi.org/10.3961/jpmph.25.144

1,910 View
287 Download

Abstract Summary PDF: Mental illness remains among the top 10 causes of the global burden of disease. According to the National Mental Health Survey of India, 10.6% of adults exhibit mental disorders. India ideally requires 3 psychiatrists per 100 000 population, yet the current ratio is only 0.7 per 100 000. The country thus faces an urgent need to strengthen mental health infrastructure and expand training programs. Vulnerable groups—particularly residents of rural and remote areas, women, and older adults—are disproportionately affected by this situation. Individuals with mental illness often suffer in silence, enduring human rights violations, stigma, and discrimination. India’s National Mental Health Programme seeks to ensure the availability and accessibility of minimum mental health care for all, with a focus on the most vulnerable and underserved populations. The World Health Organization recommends task shifting or task sharing to improve access and deliver healthcare services in remote areas. Community Health Officers (CHOs) and Accredited Social Health Activists use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders. CHOs then ensure continuity of care through regular follow-up, bridging the gap between diagnosis and ongoing treatment. This practice significantly augments the effectiveness of community-level mental health interventions. Integrating mental health into primary health care should facilitate earlier detection and treatment of mental health disorders.; Summary

Key Message
Mental illness remains among the top 10 causes of the global burden of disease. Stigma associated with these disorders exacerbates the problem, leading to social discrimination. The Ayushman Bharat initiative is a transformative step towards strengthening India’s healthcare system. CHOs and ASHAs use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders within their communities. This task-shifting approach empowers local communities and fosters participation, reducing disease burden and offering a sustainable, effective model.

Original Article

COVID-19 Vaccine Acceptance and Hesitancy: Perceptions in Kerala, the Indian State With the Highest Literacy: Dhanya Muralidharan, Arun Paul, Suhaila Panangadanakath, Sreelakshmi T. Nandakumar, Shana S. Poothotill, Rahila A. MoiduKunhi, Zainul Ameen; J Prev Med Public Health. 2025;58(5):527-537. Published online June 13, 2025; DOI: https://doi.org/10.3961/jpmph.25.137

3,604 View
210 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Public acceptance of a vaccine determines whether pandemic control is successful. Most studies assessing coronavirus disease 2019 (COVID-19) vaccine acceptance were conducted before the vaccine became publicly available, whereas the actual intent to be vaccinated often differs once the vaccine is accessible. Therefore, this study investigated COVID-19 vaccine acceptance, hesitancy, and associated determinants among the general population of Kerala, India, after the vaccine became available.
Methods
A cross-sectional descriptive online survey was conducted using a structured and validated questionnaire in both English and Malayalam. It collected information on contextual influences, individual perceptions, group influences, COVID-19 vaccine-specific factors, and attitudes toward COVID-19 vaccination.
Results
Of the 1078 participants, 85.0% (n=916) accepted the COVID-19 vaccine, while 15.0% (n=162) were hesitant. Factors predicting vaccine hesitancy included male sex, younger age, lower educational attainment (school level), lower income, being unmarried, and not having children. Key determinants of vaccine hesitancy identified were concerns regarding vaccine safety and effectiveness, lack of trust in the government, insufficient information provided through the vaccination program, disbelief in vaccination’s protective role against COVID-19, and perception of the vaccination process as complicated and inconvenient.
Conclusions
Vaccine-hesitant individuals do not perceive COVID-19 vaccination as a social responsibility to their community. Digitization of the vaccination process may not be suitable for all segments of society, indicating that additional support for persons from lower socioeconomic statuses may be necessary to enhance acceptance. The newly identified areas of concern can guide government and healthcare workers, both nationally and globally, in effectively addressing and mitigating vaccine hesitancy.

Summary

Key Message
Real intent to vaccinate varies following availability of newly introduced vaccines. Most studies assessing determinants of COVID-19 vaccine acceptance and hesitancy were performed prior to vaccine availability in India. None have assessed the degree of acceptance after vaccine was available for the general public above 18 years. The study findings provide more valid and meaningful understanding of determinants of vaccine hesitancy, emphasizing the need for identifying and educating hesitant individuals, highlighting need for greater involvement of health care workers. Newer focus areas identified will aid Government and Health care workers nationally and globally in preventing a rise in vaccine hesitancy.

Citations

Citations to this article as recorded by

Underreporting of Adverse Events Following COVID-19 Vaccination Among Healthcare Professionals in Poland: Potential Implications for Vaccine Hesitancy
Jakub Grabowski, Anna Niebrzydowska, Aleksandra Brzozowska, Przemysław Waszak, Paweł Zagożdżon, Shan Ali, Tomasz Brancewicz, Monika Wolff, Aleksandra Macul-Sanewska, Leszek Bidzan
Tropical Medicine and Infectious Disease.2025; 10(11): 320. CrossRef

Systematic Review

Effective Education Methods to Improve Glycemic Control in Type 2 Diabetes Mellitus Patients: A Systematic Review: Ika Mustikaningtias, Anna Wahyuni Widayanti, Pugud Samodro, Nanang Munif Yasin; J Prev Med Public Health. 2025;58(5):453-464. Published online June 4, 2025; DOI: https://doi.org/10.3961/jpmph.25.025

2,297 View
344 Download

Abstract Summary PDF: Objectives
Education for patients with type 2 diabetes mellitus (T2DM) is essential for reinforcing adherence and engagement to achieve therapeutic objectives, given the chronic nature of the treatment. Appropriate strategies for delivering education effectively are crucial. This study aimed to identify effective educational strategies for improving clinical outcomes in patients with T2DM.
Methods
The literature search included original publications from Science Direct, PubMed, and Scopus, published in English between 2015 and February 2024, for which full-text access was available. This review was performed by a team consisting of pharmacists and internist following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
From the initial search yielding 105 articles, 17 met the inclusion criteria. Of these 17 studies, 9 demonstrated significant improvements in clinical outcomes. Not all studies incorporated control groups for comparative analysis during the implementation of educational interventions. Most interventions were delivered via direct face-to-face methods, although there was considerable variation across studies in terms of program duration, intervention frequency, session length, education providers, and educational content.
Conclusions
Studies demonstrating improvements in clinical outcomes predominantly utilized direct face-to-face education methods, typically in sessions lasting between 30 minutes and 60 minutes, with the majority of programs extending over approximately 6 months. Pharmacists contribute significantly to the success of educational programs by providing tailored instructional information that aligns with established protocols while addressing individual patient needs.; Summary

Key Message
This systematic review identifies appropriate educational delivery patterns for patients with Type 2 Diabetes Mellitus (T2DM). This article explores the educational delivery methods, the frequency and duration of educational delivery, the length of educational programs, the providers of education, and the content of education, all of which are associated with clinical outcomes. Education must be customized to the patient's needs, necessitating a two-way conversation to investigate their difficulties or the information they need. Moreover, standardized guidelines should be established to serve as a reference for educators in patient education.

Original Article

Knowledge, Attitudes, Barriers and Uptake Rate of Influenza Virus Vaccine Among Physicians in Jordan: A Multicentric Cross-sectional Study: Munir Abu-Helalah, Tarek Rashad Gharibeh, Mohammad Al-Hanaktah, Hussam Alshraideh, Raghad Mahmoud Darweesh, Maria Alshurman, Lekaa Ja’far Al Mughrabi F, Yaqeen Ja’far Al Mughrabi F, Neveen Ghanem; J Prev Med Public Health. 2025;58(5):484-495. Published online June 3, 2025; DOI: https://doi.org/10.3961/jpmph.24.776

3,536 View
312 Download

Abstract Summary PDF Supplementary Material: Objectives
Seasonal influenza poses significant global health challenges, with healthcare professionals (HCPs) particularly vulnerable due to frequent exposure to infected patients. Influenza vaccination is a proven method to reduce morbidity and mortality. Despite recommendations by health authorities, vaccination uptake among HCPs remains suboptimal globally and within Jordan. This study aimed to assess knowledge, attitudes, barriers, and influenza vaccine uptake among physicians in Jordan.
Methods
A cross-sectional study was conducted from March 2023 to June 2023 involving 389 physicians from Ministry of Health facilities across Jordan. A structured and validated questionnaire was used to collect demographic data, vaccination history, and insights guided by the health belief model. Multivariate logistic regression analyses were performed to identify predictors of vaccine uptake and patient vaccination practices.
Results
The influenza vaccination rate during the 2022-2023 season was 47%. Vaccination uptake was associated with factors such as age, geographic location, professional designation, and training. Vaccinated physicians demonstrated better knowledge and more favorable attitudes toward vaccination. Common barriers included misconceptions about personal risk, concerns over vaccine efficacy, and forgetting to vaccinate. Physicians who received training were more likely to recommend vaccination to patients.
Conclusions
The low vaccination rate among Jordanian physicians highlights the need for targeted educational interventions and policies to address misconceptions and barriers. Improving influenza vaccination uptake among HCPs is critical to enhancing patient confidence, reducing transmission, and improving public health outcomes.; Summary

Key Message
"Despite recommendations by health authorities, vaccination uptake among HCPs remains suboptimal in Jordan and globally. This study aimed to assess knowledge, attitudes, barriers, and influenza vaccine uptake among physicians in Jordan. A cross-sectional study was conducted from March 2023 to June 2023 involving 389 physicians from the Ministry of Health, Jordan. The influenza vaccination rate during the 2022-2023 season was 47%. Common barriers included misconceptions about personal risk, concerns over vaccine efficacy, limited training, and forgetting to vaccinate. The low vaccination rate among Jordanian physicians highlights the need for targeted educational interventions and policies to address misconceptions and barriers."

Review

The Next Frontiers in Preventive and Personalized Healthcare: Artificial Intelligent-powered Solutions: Rasit Dinc, Nurittin Ardic; J Prev Med Public Health. 2025;58(5):441-452. Published online May 29, 2025; DOI: https://doi.org/10.3961/jpmph.25.080

2,272 View
294 Download
2 Web of Science
4 Crossref

Abstract Summary PDF

Artificial intelligence (AI)-enabled technologies have the potential to significantly increase diagnostic accuracy, optimize treatment strategies, and improve patient outcomes. They are revolutionizing the field of preventive and personalized medicine by providing data-driven insights. AI is capable of analyzing large and complex datasets such as genomic, environmental, and lifestyle information much faster and more conveniently than traditional methods. Advanced algorithmic architectures in AI can predict disease risks, identify biomarkers, and tailor interventions to individual needs. The enabling role of AI in real-time monitoring, predictive analysis, and drug discovery demonstrates its transformative potential in healthcare. The role of AI in multi-omics integration, wearable technologies, and precision therapies promises to redefine global healthcare paradigms, making personalized medicine more accessible and effective. However, ethical concerns that need to be addressed to ensure fair and transparent implementation include data privacy, algorithmic bias, and regulatory gaps. This article examines the integration of AI technologies with personalized healthcare. The study also highlights the need for interdisciplinary collaboration to maximize the benefits of AI in preventive and personalized healthcare and overcome barriers.

Summary

Key Message
Artificial intelligence significantly accelerates preventive and personalized medicine by analyzing complex genomic, environmental, and lifestyle datasets to predict disease risks, identify biomarkers, and tailor interventions to individual needs. Through real-time monitoring, predictive analysis, and precision therapies, AI-enabled technologies play a critical role in increasing diagnostic accuracy, optimizing treatment strategies, and improving patient outcomes. However, successful implementation requires addressing critical challenges such as data privacy concerns, algorithmic bias, regulatory gaps, and the need for interdisciplinary collaboration to provide equitable, transparent, and accessible AI-enabled healthcare solutions.

Citations

Citations to this article as recorded by

Applications of Artificial Intelligence in Selected Internal Medicine Specialties: A Critical Narrative Review of the Latest Clinical Evidence
Aleksandra Łoś, Dorota Bartusik-Aebisher, Wiktoria Mytych, David Aebisher
Algorithms.2026; 19(1): 54. CrossRef
Can AI developers avoid bias in public health applications?
Rebekah J. Harms, Rachel A. Ankeny, Lucy Carter, Aditi Mankad, Jackie Leach Scully
Frontiers in Public Health.2026;[Epub] CrossRef
How can artificial intelligence be used within occupational medicine to identify early worker needs and improve workplace accommodation? A narrative review
Bogdan Mihail Diaconescu, Bogdan Gurzu, Claudia Sava, Catalina Sava, Ilinca Sfarghiu, Delia Luchian, Irina Luciana Gurzu
Romanian Journal of Occupational Medicine.2025; 76(1): 6. CrossRef
Artificial intelligence application in the prevention of chronic non-communicable diseases: a systematic review of publications from 2022 to 2025
L.Yu. Drozdova, V.A. Egorov, O.M. Drapkina
Russian Journal of Preventive Medicine.2025; 28(12): 21. CrossRef

Original Articles

Asthma Exacerbation in Indonesia: Analysis of Mental, Socio-demographic, Behavioral, and Biological Risk Factors Using the 2018 Indonesian Basic Health Research: Siti Isfandari, Sulistyowati Tuminah, Laurentia Konadi Miharja; J Prev Med Public Health. 2025;58(3):250-259. Published online May 16, 2025; DOI: https://doi.org/10.3961/jpmph.24.719

5,387 View
468 Download

Abstract Summary PDF: Objectives
Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults.
Methods
A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE.
Results
A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81).
Conclusions
ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.; Summary

Key Message
Asthma represents a significant global health burden, with exacerbation impacting individual quality of life. Emotional distress, diagnosed heart disease, asthma diagnosis after the age of 15 years, and lower socioeconomic status were associated with an increased risk of asthma exacerbation, while physical activity was not. Our findings underscore the importance of addressing mental health comorbidities, encouraging physical activity, and considering socioeconomic disparities when developing asthma management strategies. Educating patients about asthma and its triggers can reduce exacerbations and improve disease control. Since asthma severity differs across individuals and age groups, clinicians must regularly monitor patients and adjust treatment as needed.

Relationship Between Social Isolation, Seclusion, and Suicidal Ideation Among Young Adults: An Analysis of Data From the 2022 Survey on the Lives of Young People in Korea: Jiwon Shin, Hyun Yang, Mu Won Lee, Hae Yean Park, Suyeong Bae; J Prev Med Public Health. 2025;58(5):496-504. Published online May 8, 2025; DOI: https://doi.org/10.3961/jpmph.24.792

3,581 View
223 Download

Abstract Summary PDF Supplementary Material: Objectives
This study aimed to investigate the current status of social isolation and seclusion among young adults in Korea and to analyze their association with suicide risk.
Methods
We utilized data from 14 966 young adults aged 19-34 years from the 2022 Survey on the Lives of Young People. Social isolation and seclusion were defined as independent variables, and suicidal ideation within the past year was set as the dependent variable. Propensity score matching (PSM) was employed to reduce the risk of selection bias, and logistic regression analysis was conducted to examine the associations between social isolation, seclusion, and suicidal ideation.
Results
Of the participants, 266 individuals (1.8%) were socially isolated, and 67 individuals (0.5%) were secluded. Associations were observed between social isolation and suicidal ideation (population-weighted adjusted model: odds ratio [OR], 2.43, p=0.003; population-weighted PSM model: OR, 2.03, p=0.037), as well as between seclusion and suicidal ideation (population-weighted adjusted model: OR, 4.15, p=0.004; population-weighted PSM model: OR, 3.87, p=0.010) across all models.
Conclusions
Being socially isolated or secluded is associated with an increased risk of suicidal ideation among young adults aged 19-34 years. Preventive policies and tailored support systems are urgently needed to address these risks. This study contributes to the development of specific policies for mitigating social isolation and supporting the reintegration of young adults aged 19-34 years into society.; Summary

Korean summary
본 연구는 2022년 청년 삶 실태조사 원자료를 이용하여 한국 청년의 사회적 고립·은둔과 자살 생각의 연관성을 분석하였다. 연구 결과, 사회적으로 고립되거나 은둔하는 청년은 그렇지 않은 청년에 비해 자살 생각을 할 위험이 유의하게 높은 것으로 나타났다. 이는 고립·은둔 청년들의 자살 위험성을 확인하고, 이들의 사회 재통합을 돕기 위한 예방적 정책과 맞춤형 지원 시스템 마련이 시급함을 시사한다.

Key Message
Using data from the 2022 Survey on the Lives of Young People, this study demonstrates that young adults (aged 19-34) in Korea experiencing social isolation or seclusion face a significantly increased risk of suicidal ideation. These findings identify socially isolated and secluded young people as a critical high-risk group for suicide. This underscores the urgent need for proactive public health policies and tailored support systems to prevent suicide by addressing social isolation and seclusion and promoting societal reintegration among this vulnerable population.

Mental Disorders Mediate the Relationship Between Adverse Childhood Experiences and Suicidal Behavior in a High-risk Population: A Counterfactual Analysis From Jeju Island: Yeon Woo Oh, Dongkyu Lee, Young-Eun Jung, Sun Jae Jung; J Prev Med Public Health. 2025;58(5):505-515. Published online May 7, 2025; DOI: https://doi.org/10.3961/jpmph.25.120

3,349 View
215 Download

Abstract Summary PDF Supplementary Material: Objectives
Jeju Island, Korea, is characterized by a significantly higher prevalence of adverse childhood experiences (ACE, 32.4%), elevated rates of mental disorders (34.6 vs. 22.9%), and lifetime suicidal thoughts (20.6 vs. 10.7%) compared to national averages. We investigated the mediating role of mental disorders in the pathway from ACE to suicidal behavior in Jeju.
Methods
Data from the Jeju Special Self-Governing Province Mental Health Survey 2023 (n=703) were analyzed. Exposure was defined as experiencing at least one ACE from the 10-item Adverse Childhood Experience International Questionnaire. Depressive disorder, anxiety disorder, and alcohol use disorder were diagnosed using the Korean-Composite International Diagnostic Interview. Suicidal behavior was defined as experiencing suicidal ideation, planning, or attempts. A counterfactual mediation model was used to evaluate the natural direct effect and natural indirect effect (NIE) of mental disorders.
Results
The total effect of ACE on suicidal behavior showed a risk difference of 35.3 percntage points (%p). When considering all three mental disorders simultaneously, the NIE was 27.6%p, accounting for 78.1% of the total effect. Stratification analyses revealed stronger total effects in women and older adults, while the proportion mediated was higher in women and younger adults.
Conclusions
In this ACE-prevalent population, mental disorders collectively mediated approximately three-quarters of the pathway from ACE to suicidal behavior. These findings, derived through robust counterfactual analysis, suggest that strengthening screening and management protocols for mental disorders among adults with a history of ACE may effectively prevent suicide in populations with high ACE prevalence.; Summary

Korean summary
이 연구는 제주도 성인 인구를 대상으로 아동기 역경 경험(ACE)이 자살 행동에 미치는 영향 중 정신질환(우울, 불안, 알코올 사용장애)이 약 78%를 매개한다는 것을 확인했다. 이는 ACE가 높은 지역사회에서 정신질환 대한 체계적인 선별검사와 관리가 자살 예방에 효과적일 수 있음을 시사한다.

Key Message
This study found that mental disorders(depression, anxiety, and alcohol use disorders) mediate approximately 78% of the pathway from adverse childhood experiences (ACE) to suicidal behavior in Jeju Island's adult population. The findings suggest that systematic screening and management of mental disorders could effectively prevent suicide in communities with high ACE prevalence.

Population-attributable Fractions of Lifestyle Factors for Prediabetes in Korea: A Regression-based Analysis of National Survey Data: Yeon Woo Oh, Chung Mo Nam, Eun-Cheol Park; J Prev Med Public Health. 2025;58(5):465-474. Published online May 7, 2025; DOI: https://doi.org/10.3961/jpmph.25.030

2,085 View
286 Download

Abstract Summary PDF: Objectives
Although lifestyle modification programs are widely implemented for diabetes prevention, the contributions of individual lifestyle factors remain unclear. This study investigated lifestyle risk factors for prediabetes and employed a regression-based approach for estimating their population-attributable fractions (PAFs) using nationally representative data.
Methods
We analyzed data from 3104 adults aged ≥30 years without diabetes from the 2022 Korea National Health and Nutrition Examination Survey. Seven lifestyle factors were assessed: body weight, alcohol consumption, smoking, physical activity, sleep duration, vegetable intake, and breakfast consumption. Prediabetes was defined as fasting blood glucose of 100-125 mg/dL or hemoglobin A1c levels of 5.7-6.4%. Complex survey-adjusted logistic regression was used to identify significant lifestyle risk factors, and their PAFs were estimated using a regression-based sequential method.
Results
Five lifestyle factors were significantly associated with prediabetes: abnormal body weight (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.68 to 2.50), excessive alcohol consumption (OR, 1.27; 95% CI, 1.00 to 1.62), smoking (OR, 1.35; 95% CI, 1.07 to 1.71), insufficient exercise (OR, 1.26; 95% CI, 1.05 to 1.51), and irregular breakfast consumption (OR, 1.31; 95% CI, 1.08 to 1.59). In sequential PAF estimation, abnormal body weight had the largest contribution (22.2%; 95% CI, 16.2 to 28.2), followed by smoking (6.4%; 95% CI, 1.1 to 11.6), insufficient exercise (5.8%; 95% CI, 1.2 to 10.5), irregular breakfast consumption (4.9%; 95% CI, 0.5 to 9.2), and excessive alcohol consumption (3.6%; 95% CI, 0.1 to 7.4). These results remained consistent in sensitivity analyses including undiagnosed diabetes cases.
Conclusions
Abnormal body weight emerged as the largest contributor to prediabetes (PAF>20%). Diabetes prevention programs in Korea should prioritize weight management within a comprehensive approach to lifestyle modification.; Summary

Korean summary
이 연구는 한국 성인의 전당뇨병 유병에 기여하는 생활습관 요인들의 인구집단기여분율을 분석했다. 요인별 기여도는 비정상 체중이 22.2%로 가장 높았으며, 이어 흡연(6.4%), 운동 부족(5.8%), 불규칙한 아침식사(4.9%), 과도한 음주(3.6%) 순으로 나타났다. 이는 한국을 대상으로 하는 당뇨병 예방 프로그램에서 체중 관리를 최우선으로 하는 포괄적 생활습관 개선이 필요함을 시사한다.

Key Message
This study analyzed population-attributable fractions of lifestyle factors contributing to prediabetes in Korean adults. Abnormal body weight showed the highest contribution (22.2%), followed by smoking (6.4%), insufficient exercise (5.8%), irregular breakfast consumption (4.9%), and excessive alcohol consumption (3.6%). The findings suggest that diabetes prevention programs in Korea should prioritize weight management within a comprehensive lifestyle modification approach.

Mobile App-based Care Management Training to Improve Family Caregiver Competence in Caring for Children With HIV in Indonesia: A Quasi-experimental Study: Nyimas Heny Purwati, Syamikar Baridwan Syamsir, Mutmainah , Dhea Natashia, Amelia Hartika Rani, Dwi Budiyati, Agus Setiawan; J Prev Med Public Health. 2025;58(5):516-526. Published online May 7, 2025; DOI: https://doi.org/10.3961/jpmph.24.789

24,111 View
320 Download

Abstract Summary PDF: Objectives
Family caregivers play a crucial role in the care of children with human immunodeficiency virus (HIV); however, they frequently face limitations in knowledge, attitudes, and skills. Mobile application (app)-based training may offer an effective solution to enhance caregiver competence. This study aimed to assess the effectiveness of mobile app-based care management training in improving the knowledge, attitudes, and skills of family caregivers caring for children with HIV.
Methods
A quasi-experimental design, including pretest, posttest, and follow-up assessments, was conducted at a national referral hospital for infectious diseases in Jakarta, Indonesia. The study involved 44 respondents, divided equally into intervention and control groups (22 per group). The intervention group received mobile app-based training, while the control group received conventional caregiver education. Questionnaires assessing caregivers’ knowledge, attitudes, and skills in managing children with HIV were utilized. Data were analyzed using independent sample t-tests and repeated measures analysis of variance (ANOVA).
Results
Repeated measures ANOVA revealed that the intervention group experienced significant improvements in knowledge, attitudes, and skills from pretest to posttest, which were maintained at the 1-month follow-up (p<0.001). In contrast, the control group did not exhibit significant changes in any of these variables (knowledge, attitudes, and skills) throughout the study period.
Conclusions
Mobile app-based care management training significantly enhances caregiving competencies among family caregivers of children with HIV. These findings underscore the potential of digital technology as an innovative and sustainable approach for caregiver training in various healthcare settings, supporting the long-term effectiveness of educational interventions.; Summary

Key Message
This quasi-experimental study evaluated the effectiveness of a mobile app-based care management training for family caregivers of children with HIV in Indonesia. The intervention significantly improved caregivers’ knowledge, attitudes, and skills compared to the control group. These findings suggest that digital health tools can empower caregivers, enhance pediatric HIV care, and provide a scalable model for supportive training in resource-limited settings.

Enhancing TNM Stage Completeness Using the SEER Summary Stage: A Nationwide Study From Korea: Chang Kyun Choi, Mina Suh, Kyu-Won Jung, E Hwa Yun; J Prev Med Public Health. 2025;58(4):415-421. Published online April 23, 2025; DOI: https://doi.org/10.3961/jpmph.25.099

5,666 View
258 Download

Abstract Summary PDF Supplementary Material: Objectives
Accurate and complete cancer staging is essential for effective prognosis and treatment planning. This study investigated the feasibility of enhancing the completeness of tumor‐node‐metastasis (TNM) staging by integrating Surveillance, Epidemiology, and End Results (SEER) Summary Stage data.
Methods
We analyzed data from 5 cancer types (stomach, colorectum, liver, lung, and breast) in Korea (2012-2017). The study assessed the impact of supplementing missing TNM information with SEER Summary Stage data on both staging completeness and 5‐year relative survival rates.
Results
The study included 173 061 stomach cancer, 159 199 colorectal cancer, 89 639 liver cancer, 137 103 lung cancer, and 110 286 breast cancer patients. The percentage of missing TNM stage data varied by cancer type, ranging from 65.1% (breast cancer) to 93.0% (liver cancer). Supplementation significantly reduced missing values—most notably in stomach cancer, where missing data dropped by 50.6 percentage points (%p), followed by liver (21.5%p) and breast cancers (13.6%p). For stomach cancer, supplementation led to a 3.6%p decrease in stage I survival rates, whereas liver cancer exhibited the most pronounced changes, with stage IV survival rates declining from 17.7% to 7.9%.
Conclusions
Integrating SEER Summary Stage data enhances TNM staging completeness. However, further evaluation incorporating treatment information is essential.; Summary

Korean summary
본 연구는 한국 등록통계에서 SEER 요약 병기 데이터를 활용해 TNM 병기 분류 완전성 향상 가능성을 평가하였다. 데이터 보완을 통해 다섯 가지 암종에서 누락률이 최대 50.6%포인트 감소하였으나, 5년 상대 생존율은 대체로 큰 변화가 없었다. 다만 간암 등 일부 암종에서 생존율 변화가 현저하여 치료 정보 등의 추가적인 통합 평가가 필요하다.

Key Message
This study evaluated the feasibility of improving the completeness of tumor-node-metastasis (TNM) staging by integrating Surveillance, Epidemiology, and End Results (SEER) Summary Stage data. Data supplementation significantly reduced the proportion of missing TNM information across five cancer types, including a 50.6 percentage point decrease for stomach cancer, while generally resulting in minimal changes to 5-year relative survival rates. However, notable changes were observed in liver cancer, where stage IV survival rates markedly declined from 17.7% to 7.9%, highlighting the need for further evaluation that incorporates treatment information.

Sleep Disturbances in Early Pregnancy and the Risk of Preeclampsia: Qazvin Maternal and Neonatal Metabolic Outcomes Study (QMNMS): Sima Hashemipour, Fatemeh Lalooha, Milad Badri, Leila Modarresnia, Amirabbas Ghasemi, Sara Esmaeili Kelishomi, Sarah Mirzaeei Chopani, Seyyed Hamidreza Ghafelehbashi, Mahnaz Abbasi, Sepideh Kolaji; J Prev Med Public Health. 2025;58(4):406-414. Published online April 21, 2025; DOI: https://doi.org/10.3961/jpmph.24.698

4,986 View
309 Download

Abstract Summary PDF Supplementary Material: Objectives
The association between sleep disturbances and hypertension has been reported in numerous studies. However, prospective cohort data on the role of sleep disturbances in the development of preeclampsia remain limited.
Methods
This prospective cohort study was conducted on pregnant women with a in Iran. Sleep quality was assessed at the first prenatal visit (gestational age ≤14 weeks) using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Multivariate logistic regression was run to investigate the independent role of sleep abnormalities in the development of preeclampsia.
Results
The final analysis was performed on 576 participants, of whom 3.5% developed preeclampsia. In the univariate analysis, short sleep duration (< 6 hours) and prolonged sleep latency was associated with a 5.5 times and 3.5 times higher risk of developing preeclampsia (95% confidence interval [CI], 1.5 to 20.9; p=0.011, and 95% CI, 1.2 to 10.1; p=0.019, respectively). Considering the total PSQI score, fairly bad or very bad sleep quality was a risk factor for developing preeclampsia, with a relative risk of 4.9 in the univariate analysis (95% CI, 1.4 to 17.8; p=0.014). In the fully adjusted model, short sleep duration and prolonged sleep latency were associated with 7.2 times and 4.5 times higher risk of preeclampsia, respectivey (95% CI, 1.6 to 33.1; p=0.011 and 95% CI, 1.4 to 14.6; p=0.012, respectively). In this model, pregnant women with fairly bad or very bad sleep quality had 5.9 times higher risk of preeclampsia development (95% CI, 1.5 to 22.8; p=0.011).
Conclusions
This cohort study demonstrated the role of short sleep duration and prolonged sleep latency as the main components of poor sleep quality in the development of preeclampsia.; Summary

Key Message
This cohort study demonstrated that pregnant women with fairly poor or very poor sleep quality had an approximately sixfold increased risk of developing preeclampsia in the fully adjusted model. Among the components of poor sleep quality, short sleep duration and prolonged sleep latency were the most strongly associated with preeclampsia, with relative risks of approximately sevenfold and fourfold, respectively.

Longitudinal Effects of Life Satisfaction on Smoking Status of Korean Adult Men: Baksun Sung; J Prev Med Public Health. 2025;58(4):388-395. Published online April 21, 2025; DOI: https://doi.org/10.3961/jpmph.24.664

2,940 View
300 Download

Abstract Summary PDF: Objectives
The prevalence of smoking among adult men remains high in Korea. Additionally, life satisfaction can influence health behaviors. Therefore, the objective of this study was to examine the longitudinal effects of life satisfaction on smoking status among Korean adult men.
Methods
This study utilized panel data from wave 1 (2005) to wave 12 (2016) of the Korea Welfare Panel Study. Life satisfaction was measured using 8 variables, representing satisfaction with leisure, social relations, family relations, health, job, family income, residential environment, and overall life. A Cox proportional hazards model was employed to assess the causal relationship between life satisfaction and smoking status.
Results
Over the 11-year follow-up period, improved leisure satisfaction was associated with a decreased hazard of smoking (hazard ratio [HR], 0.83; p<0.01). In contrast, greater satisfaction with social relations was linked to an increased hazard (HR, 1.23; p<0.05). Improved satisfaction with family relations was associated with a decreased hazard of smoking (HR, 0.84; p<0.05).
Conclusions
Certain life satisfaction variables appear to influence the incidence of smoking among Korean adult men.; Summary

Korean summary
본 연구는 한국복지패널(2005년-2016년)을 이용해서 20세 ~ 64세 한국 성인 남성들의 삶의 만족도가 흡연여부에 미치는 종단적 효과를 분석하였다. 11년 동안 추적조사 한 결과, 다양한 삶의 만족도 변수들에 따라 흡연위험이 다르다는 것이 확인되었다. 구체적으로, 여가생활 만족도 또는 가족관계 만족도가 개선되면 흡연위험이 감소하였다. 대조적으로, 사회관계 만족도가 개선되면 흡연위험이 증가하였다. 이러한 인과관계들은 한국의 사회문화적 요소들과 얽혀 있는 것으로 추정된다.

Key Message
This longitudinal study's results demonstrated that over the 11-year follow-up period (2005-2016), the risk of smoking varied between different types of life satisfaction among Korean adult men (aged 20-64 years). Specifically, the risk of smoking decreased as satisfaction with leisure or family relations improved. In contrast, the risk of smoking increased as social relations satisfaction improved. Socio-cultural factors appear intertwined with these causal relationships.

Factors Associated With Premarital Screening Intention Among Young Adults With Higher Education in Indonesia: A Cross Sectional Study: Yuli Amran, Tsaniya Nurul Fasya, Hilda Salamah; J Prev Med Public Health. 2025;58(3):307-316. Published online April 21, 2025; DOI: https://doi.org/10.3961/jpmph.24.589

8,668 View
503 Download

Abstract Summary PDF Supplementary Material: Objectives
Premarital screening can reduce the risk of genetic disorders and sexually transmitted diseases by providing early detection before conception. College students represent a group of young adults with higher education who are approaching marriageable age. However, many students still lack a strong intention to undergo premarital screening in the future. Therefore, this study examines the factors influencing screening intentions among students at one of Indonesia’s leading universities, the State Islamic University (UIN) Jakarta.
Methods
This study used a cross-sectional design, with a total sample of 563 college students obtained through a multistage random sampling technique. Descriptive statistics were used to summarize the data, and ordinal logistic regression was applied for hypothesis testing.
Results
Among the 563 students, 97.0% indicated an intention to undergo premarital screening. The intention variable was classified into three levels: no/low (13.0%), moderate (43.5%), and high (43.5%). Ordinal logistic regression revealed that lower knowledge about premarital screening was significantly associated with a reduced intention to undergo screening (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.58 to 5.10). In addition, negative attitudes toward premarital screening (OR, 2.85; 95% CI, 1.41 to 5.75), negative perceived behavioral control (OR, 1.63; 95% CI, 1.12 to 2.37), and being enrolled in a non-health-related field of study (OR, 1.96; 95% CI, 1.04 to 3.68) were significantly linked to lower screening intentions.
Conclusions
Comprehensive premarital health education is essential for young adults, even those with a high level of formal education. Such education not only improves knowledge but also promotes more positive perceptions and attitudes toward premarital screening.; Summary

Key Message
This study explored the key factors influencing college students’ intentions to undergo premarital screening. Although 97% expressed willingness, only 43.5% reported a high level of intention, which was significantly associated with limited knowledge, negative attitudes, reduced perceived behavioral control, and enrollment in non-health-related fields. These findings highlight the need for comprehensive premarital health education that enhances knowledge and fosters more favorable attitudes and perceptions, even among highly educated populations.

Are Non-standard Work Schedules Related to Sleep Difficulty and Health-related Quality of Life in Korea? An Examination of Gender Differences: Seowoo Park, Ji Sun Park, Moo Hyuk Lee, Young Kyung Do; J Prev Med Public Health. 2025;58(4):396-405. Published online April 15, 2025; DOI: https://doi.org/10.3961/jpmph.24.378

44,786 View
284 Download

Abstract Summary PDF Supplementary Material: Objectives
The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.
Methods
Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.
Results
Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.
Conclusions
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.; Summary

Korean summary
저녁 및 밤 시간대 근무는 수면을 포함한 건강 관련 삶의 질에 부정적 영향을 끼치며, 그 영향은 여성에서 더 크게 나타난다. 비표준시간대 근무는 중요한 공중보건학적 문제이다.

Key Message
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of health-related quality of life, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia: Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda; J Prev Med Public Health. 2025;58(4):422-430. Published online April 12, 2025; DOI: https://doi.org/10.3961/jpmph.24.581

4,573 View
315 Download
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Summary

Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

Citations

Citations to this article as recorded by

The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
Pain and Therapy.2026; 15(1): 175. CrossRef

First
Prev
Page of 49
Next
Last

Search