ObjectivesUrban residential characteristics, including racial and ethnic composition, may be associated with cardiometabolic health. We synthesized the literature on neighborhood co-ethnic exposure and cardiometabolic outcomes among racial and ethnic minoritized populations.MethodsWe searched PubMed and Web of Science for studies published through October 2023 examining ethnic density or segregation and cardiometabolic conditions (adiposity, cardiovascular disease, and diabetes). Study quality was assessed using the U.S. National Institutes of Health’s Quality Assessment Tool.ResultsForty-five articles representing 34 unique studies were included. Over half relied on self-reported outcomes, and nine were longitudinal. The most common exposure measure was percentage of census tract residents sharing participant’s racial/ethnic classification. Over 40% of studies including Black and Hispanic/Latine populations reported an association of greater co-ethnic exposure with poorer cardiometabolic outcomes, compared with 7% of studies including Asian populations. Across all three groups, 25%–40% of studies reported inverse associations.ConclusionAssociations between neighborhood co-ethnic exposure and cardiometabolic outcomes vary both across and within racial/ethnic groups, reflecting interactions among structural (dis)advantage, community stressors, and neighborhood resources. Future research should integrate theoretical frameworks and sociohistorical context.
ObjectivesTo examine how ESG indicators and related frameworks are being translated from corporate disclosure into public health governance.MethodsFollowing PRISMA-ScR and the PCC framework, we synthesized 25 studies and grey-literature documents to map definitions, implementation levels, governance uses, barriers, and research gaps. ESG integration was defined as the use of environmental, social, and governance indicators to support accountability, transparency, stakeholder engagement, sustainability alignment, and strategic control in health systems.ResultsESG-related frameworks may strengthen reporting practices, multisectoral coordination, and alignment with the Sustainable Development Goals when supported by leadership, technical capacity, harmonized indicators, and standardized reporting systems. However, the evidence remains heterogeneous and exploratory. Direct effects on governance performance, health outcomes, or equity are rarely demonstrated. Key gaps include unclear conceptual boundaries between ESG, CSR, SDG monitoring, and sustainability reporting, limited appraisal of reporting versus actual performance, measurement inconsistency, and under-representation of low-resource and Global South contexts.ConclusionFuture research should validate sector-specific ESG indicators and evaluate whether ESG integration improves accountability, equity, and sustainable public health governance.
ObjectivesThis systematic literature review evaluates the availability and impact of stress management interventions on mental wellbeing within higher education institutions (HEIs).MethodsA systematic review of literature was conducted across Scopus, PubMed and PsycINFO, applying the PRISMA method. Data extraction was performed manually based on pre-defined criteria. Data synthesis focuses on research design, methodology, geographical coverage, and outcomes of the interventions.ResultsThirty-two research papers met the selection criteria, exhibiting diversity in methodologies, study designs, types of interventions, outcomes, and limitations. Common patterns included a predominance of student-focused interventions and notable gaps in addressing the mental health needs of academic and administrative staff members of HEIs.ConclusionDespite a wide range of approaches have been employed to address the mental wellbeing of students in higher education, comprehensive interventions for staff members are lacking. Additionally, there is a critical need for future research to incorporate insights and data from non-Western contexts as well, such as the CEE region, to ensure the relevance and applicability of intervention strategies across diverse cultural and socio-economic contexts.
ObjectivesTo evaluate and critically interpret economic evidence on workplace interventions targeting healthcare personnel, distinguishing return on investment from related economic evaluation approaches and grouping interventions by underlying mechanisms.MethodsPubMed, Scopus, and Web of Science were searched for peer-reviewed studies published from 2006 to 2024. Eligible empirical studies reported return on investment, benefit-cost ratios, net savings, cost-effectiveness metrics, societal returns, or comparable monetized outcomes for workplace interventions involving healthcare workers. Methodological quality was assessed using CHEERS and ECOBIAS.ResultsTwenty-eight studies met the inclusion criteria. Most reported positive or potentially favorable economic returns, particularly for preventive health measures, workplace mental health and disability-management programs, and educational or human-capital initiatives. Findings were highly context-dependent. Some interventions produced modest, neutral, or unfavorable returns, while the highest estimates often came from model-based analyses or broad societal extrapolations. Comparability was limited by differences in perspective, time horizon, monetization assumptions, health-system structure, labor costs, and implementation.ConclusionEvidence supports workplace interventions as part of health workforce strategies, but return on investment should not be used as a stand-alone decision criterion. Future evaluations require standardized methods, transparent assumptions, and explicit perspectives and time horizons.
ObjectiveThis scoping review aims to develop a competency framework, based on the four wellbeing economy capitals, to support education, training and up-skilling of public health professionals and practitioners.MethodsThe JBI methodological guidance and the PRISMA Extension for scoping reviews were used. We searched Medline via PubMed, EMBASE via Ovid, Global Health via EBSCOHost, and ERIC via EBSCOHost. Data extraction focused on four capitals and was mapped against four actions of wellbeing economy.ResultsThe proposed Competency Framework organizes 31 competencies within five domains including: Ethics and professionalism, Determinants of health and wellbeing, Digital transformation and data literacy, Policy, politics and governance, and Building capacity for sustainable wellbeing economy.ConclusionDeveloping a competency framework for wellbeing economy in public health is an important step towards defining the field, providing the basis for training and performance assessment, as well as public health policy and capacity development. It can serve as an actionable tool showing how public health stakeholders and leaders can best improve the wellbeing of their communities and citizens.
BackgroundOrganizational-level leadership competencies are critical for the development and governance of resilient public health systems that can endure and thrive in an ever-evolving economic, social, and political context.AnalysisA mixed-methods research study identified 20 organizational leadership competencies for public health in Canada, across eight domains, including: systems thinking (e.g., leaders are able to adapt, are nimble, and innovate), policy development/implementation/evaluation (e.g., leaders engage multiple actors in policy) and resource stewardship (e.g., leaders develop a resource allocation strategy that balances efficiency and equity).Policy OptionsRecommendation: Governments across Canada should undertake legislative and regulatory efforts to implement organizational-level leadership competencies in public health organizations to strengthen system-level governance. Status quo: Without a systemic approach, some organizations will continue to undertake actions that strengthen their governance, while others will not. This could exacerbate inequities in population health outcomes and organizational performance.ConclusionStrengthening organizational leadership competencies is critical for the effective and equitable governance of public health organizations in Canada. Failure to do so could undermine their resilience in a resource-constrained and changing context.
Vaccination is a key public health intervention, and Muslims who comprise a quarter of the world’s population, have shown mixed responses to it. Previous research has addressed Islamic perspectives on vaccination but understanding its efficacy from secular and religious points of view across Islamic countries is limited. This narrative review utilised database search (Google Scholar, PubMed, Scopus, SSRN, and Web of Science) followed by curation based on expert knowledge. It offers theological and technological insights, and the potential impacts of climate change on vaccination in Islamic countries. Though Islamic teachings support vaccination, hesitancy results from a complex mixture of sociological and technological barriers that include misinformation, lack of trust, poor living conditions, and vaccine inequity in resource-limited communities. Climate change will act as a threat multiplier, particularly in areas inhabited by over 80 percent of the world’s Muslims. Successful approaches from Islamic countries highlight the role of cultural and religious perspectives, infrastructure, and biological factors on the coverage and efficacy of childhood, adolescent and adult vaccines. The learnings offer strategies to improve vaccination everywhere, but particularly in Muslim populations.
ObjectivesTo examine how public health activities addressing extreme heat align with Canada’s Essential Public Health Functions; the roles taken by public health authorities in collaborative responses; and the extent of heat response evaluations to date in three Canadian provinces.MethodsFollowing Arksey and O’Malley’s Framework, we conducted a scoping review of academic and grey literature on public health heat strategies in British Columbia, Ontario, and Quebec, Canada between 2005 and 2026. We searched ten academic databases, and scanned government and non-government websites. Academic sources were double-screened using Covidence software.ResultsWe identified 26 peer-reviewed articles (British Columbia: 7, Ontario: 8, and Quebec: 16) and 429 grey literature sources. Nine sources evaluated heat responses across the three provinces. Public health authorities across the provinces fulfilled similar Essential Public Health Functions, focused on downstream response including establishing heat alert systems and communicating preventative health information. Public health actors primarily play advisory roles in intersectoral heat responses, though some co-lead responses.ConclusionOur findings suggest ongoing gaps in upstream public health heat strategies, and meaningful collaborations with at-risk communities.
ObjectivesDental anxiety remains a significant barrier to effective oral healthcare, contributing to treatment avoidance and poorer clinical outcomes. This systematic review aimed to evaluate the effectiveness of non-pharmacological and physical interventions in reducing dental anxiety and improving patient cooperation.MethodsA systematic search was conducted in PubMed/MEDLINE, Scopus, Dentistry & Oral Sciences Source, and Google Scholar for studies published between 1971 and 2024. Randomized controlled trials, quasi-experimental, and observational studies assessing non-pharmacological or technology-assisted interventions in children and adults were included. Study selection and data extraction were performed independently by two reviewers. The certainty of evidence was assessed using the GRADE framework.ResultsA total of 126 studies were included in the qualitative synthesis. Interventions were grouped into three categories: technological/physical (e.g., computer-controlled anesthesia, Er:YAG laser, TENS), sensory-relaxation (e.g., aromatherapy, breathing techniques, hypnosis), and digital/interactive (e.g., mobile applications, audiovisual distraction, humanoid robots). The majority of studies reported reductions in anxiety or improvements in patient cooperation. The strongest evidence supported computer-controlled anesthesia systems while moderate-certainty evidence was identified for aromatherapy, laser-based interventions, and audiovisual distraction. Several additional interventions demonstrated potentially beneficial effects, although the certainty of evidence remained limited due to methodological weaknesses.ConclusionNon-pharmacological and physical interventions can effectively reduce dental anxiety and enhance treatment acceptance across diverse patient populations. Integrating these strategies into routine clinical practice and dental education may improve patient-centered care and reduce reliance on pharmacological methods. Further high-quality studies are needed to confirm long-term effectiveness and support implementation.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251229878, identifier CRD420251229878.
Objectives:Low-dose computed tomography lung cancer screening (LDCT-LCS) significantly reduces mortality, yet identifying high-risk individuals while reducing over-screening remains challenging. Risk-based eligibility models are promising to optimize participant selection. Within the European context, we assessed the types, outcomes, and impact of these risk-based eligibility models for LDCT-LCS. Methods:We systematically reviewed prediction model studies (PROSPERO CRD42025648906) across EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trials. We included original research on adults aged 18+ at risk for LC, excluding East-Asian populations. Study characteristics, model type, performance and outcomes were extracted for narrative synthesis. Results:The review included 46 articles (2003-2025), identifying 39 risk-prediction models. Models were primarily statistical (72%); PLCOm2012 was most frequent. Age (100%), smoking duration (91%), and intensity (72%) were the most common variables. Risk models improved eligibility and demonstrated cost-effectiveness over traditional criteria, though heterogeneity and population-specific calibration remain challenges. Conclusion:Risk-based eligibility models improve LDCT-LCS efficiency by enhancing detection rates and personalization. While PLCOm2012 is prominent, addressing model heterogeneity, ensuring population-specific validation, and calibration are crucial to optimize LDCT-LCS outcomes in Europe. Systematic Review Registration:Identifier CRD42025648906.
ObjectiveThis scoping review examines evidence on ventilation and filtration strategies in schools and their association with respiratory infection incidence and proxy indicators such as CO2, particulate levels, and absenteeism.MethodsFollowing PRISMA-ScR guidelines, we searched PubMed, Embase, and Web of Science (19 March 2025) for studies published between 2020 and 2025 in English, French, or Italian. Eligible designs included interventional, observational, and modelling studies, as well as reviews. Screening and data extraction were performed using Rayyan, and similar publications were verified with LiteRev.ResultsSixty-two studies met inclusion criteria. Mechanical ventilation, especially with high-efficiency filtration, was associated with lower CO2, fewer airborne particles, and reduced infection incidence or absenteeism. Natural ventilation showed variable effectiveness influenced by climate and window use. Hybrid systems and multilayered approaches provided the greatest reductions in estimated infection risk.ConclusionVentilation and filtration strategies reduce respiratory infection risk in schools. Mechanical and hybrid systems perform more reliably than natural ventilation. Further research should address feasibility, safety, sustainability, and implementation in low-resource settings.
BackgroundThis study aimed to contextualize structural barriers to the implementation of Individual Placement and Support (IPS) in Japan.AnalysisWe examined the position of Japan’s employment service policies for individuals with mental illness within the OECD framework for IPS implementation and identified key challenges. A mixed-methods approach was employed, combining a narrative search of Japanese policy documents with systematic searches of Japanese IPS research. According to the OECD framework, Japan’s IPS implementation was positioned between the stages of “Building the foundations for integrated mental health, skills, and work policy” and “Shifting from trials to a scaled-up integrated approach.” A major barrier was the absence of a comprehensive vocational service system for individuals with a diagnosis of severe mental illness.Policy OptionsAdvancing IPS dissemination in Japan requires multifaceted strategies, including grassroots efforts by service providers, strengthened advocacy, incorporation of employer and client perspectives, and consideration of resource allocation across populations with varying levels of needs.ConclusionWhile macro-level research on IPS implementation remains scarce in Japan, the practical and feasible policy considerations identified in this study could be beneficial in Japan as well as other non-Western contexts encountering similar implementation challenges.
BackgroundLight is a daily environmental exposure that can influence circadian timing, sleep, alertness, mood, and cognition, yet public health guidance still focuses mainly on optical-radiation hazards rather than healthy patterns of visible light and darkness.AnalysisThis policy brief translates recent evidence and expert consensus on the non-visual effects of ocular light exposure into public health guidance. The evidence supports a practical 24-h pattern: brighter light during the morning and daytime, lower light in the evening, and darkness or near-darkness during sleep. This principle should be communicated as general guidance rather than a universal dose, because responses vary with timing, intensity, spectrum, duration, prior light exposure, age, work schedules, health status, and geography.Policy optionsPublic health organizations can communicate plain-language guidance, integrate light into workplaces, schools, healthcare, elder care, housing, and public buildings, align daylight messages with sun-safety advice, and support research, measurement, and melanopic labeling.ConclusionClear, proportionate guidance on light and darkness can help people and institutions structure daily environments to support circadian alignment, sleep, alertness, mental health, and wellbeing.
Objectives:This systematic review examined healthcare career promotional initiatives targeting secondary-level students to characterize initiative types, evaluate their effectiveness at influencing students' knowledge, interest, attitudes, and healthcare career pathways, and identify factors influencing program success. Methods:A pre-registered systematic review was conducted following PRISMA guidelines. Seven databases were searched. Analysis and interpretation were guided by a modified Motivation-Opportunity-Ability (MOA) model. Study quality was assessed with adapted checklists. Results:Fifty studies with a total of 5,315 participants were included. Forty-four initiatives were North American, targeting grades eleven and twelve through camps, courses, internships, mentorships, and continuum programs. Studies observed short-term improvements in interest, attitudes, knowledge, and career pathways. The success of initiatives was associated with flexibility, accessibility, funding, cultural relevance, and community involvement. Risk of bias assessment was heterogeneous, ranging from moderate to high. Conclusion:Current healthcare career promotional initiatives are promising but constrained by moderate quality, geographical limitation, and heterogeneity. The Integrated MOA-Informed Model offers a valuable framework for the design and evaluation of future initiatives, highlighting the need for more rigorous, diverse, and longitudinal evaluations. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD42024515728, identifier CRD42024515728.
ObjectivesAdoption of recommended self-management behaviors has been associated with a lower risk of disease progression, cardiovascular morbidity, and mortality in patients with chronic kidney disease (CKD). This systematic review aims to identify factors associated with the adherence of non-dialysis-dependent CKD (NDD-CKD) patients to recommended self-management practices.MethodsFollowing PRISMA guidelines, we searched PubMed, Embase, Scopus, Medline, and CINAHL Plus databases from 1st January 2010 to 30th June 2024. The extracted data included associations of variables with self-management scores. The findings were descriptively presented in a grouped tabular form. The study was registered with the PROSPERO, CRD42024547304.ResultsFrom 1,914 studies identified, 16 cross-sectional studies with 3,658 participants were selected for inclusion. Objective CKD knowledge, health literacy, self-efficacy and social support consistently showed positive associations with self-management across multiple studies.ConclusionThis systematic review revealed multiple factors associated with self-management in NDD-CKD patients, with disease-related knowledge, health literacy, and self-efficacy showing the most consistent positive associations across studies. Healthcare providers and policymakers should develop and implement health literacy and awareness programs as a strategy for improving patient outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=547304, identifier CRD42024547304.
ObjectivesPoor adherence significantly compromises the effectiveness and success of cancer treatment. Understanding the full scope and contributing factors of poor adherence is essential for improving patient care. Therefore, this review aimed to determine the pooled prevalence of poor adherence to cancer therapy in Ethiopia.MethodsThe preliminary concepts were registered into PROSPERO. Comprehensive searches of multiple databases were conducted to identify relevant articles. A random-effects model was used to estimate the pooled effect size. Heterogeneity was assessed using the I2 statistic. Publication bias was evaluated through both qualitative and quantitative methods. Additionally, a sensitivity analysis was done to ensure the robustness of the studies.ResultsThe analysis includes 15 studies with a total of 7,115 cancer patients. The result indicates that, the overall pooled prevalence of poor adherence to cancer therapy in Ethiopia was 41.45% (95% CI: 33.37–49.52). Comorbidity, treatment side-effects, and residency settings are factors independently associated with poor adherence.ConclusionPoor adherence to cancer therapy in Ethiopia is significant. Therefore, efforts are needed to increase adherence. Comprehensive and timely management of comorbid conditions and treatment adverse effects can increase adherence to treatment.
ObjectivesThe PHEIC status of COVID-19 was officially lifted by the WHO on May 5, 2023. However, many nations continue to grapple with its impacts, particularly those that have not fully embraced the emergency culture. This study aims to explore ways to enhance emergency culture that rose during the COVID-19 response, ultimately contributing to effective pandemic management.MethodsA systematic literature review, including the PRISMA 2020 flow diagram and checklist, was used to compare cultural unawareness with cultural awareness across six nations: Japan, Sweden, South Africa, the United States, Brazil, and Australia.ResultsTo varying degrees, all six nations exhibited cultural unawareness during their COVID-19 responses, which manifested in issues such as personal responsibilities, herd immunity, inequalities, individualism, economic priorities, language barriers, and other factors.ConclusionThese six nations must adaptively transform their cultural unawareness into cultural awareness while enhancing leadership, communication, cultural competence, emergency preparedness, and international cooperation. This study offers a comprehensive perspective on the emergency culture surrounding the coronavirus pandemic, emphasizing the critical importance of cultural awareness.
BackgroundCardiovascular disease and diabetes remain the leading causes of premature mortality in Europe, despite longstanding political commitments and the availability of cost-effective preventive interventions. As the global public health community approaches the 40th anniversary of the Ottawa Charter for Health Promotion, persistent gaps between prevention principles and implementation require renewed policy focus.AnalysisThis policy brief synthesises evidence from international reports and European initiatives to examine why prevention efforts for cardiovascular disease and diabetes have not achieved sufficient scale or impact. It highlights the role of obesity, diabetes, and early-life risk exposure in shaping cardiovascular risk, alongside fragmented surveillance systems and continued reliance on reactive, treatment-centred care. While current policy frameworks demonstrate ambition, implementation and accountability remain inconsistent.Policy OptionsPriority actions include embedding life-course prevention across cardiovascular and diabetes strategies, strengthening primary and community-based prevention, investing in equity-oriented surveillance, and scaling collaborative initiatives such as JACARDI and JA PreventNCD.ConclusionAchieving equitable prevention of cardiovascular disease and diabetes requires a shift from reactive care to sustained life-course prevention.
