This study explores the perspectives of cancer lay health providers and civil society on the barriers and facilitators to cancer detection and treatment among women.

In 2010, the Moroccan Ministry of Health implemented a national plan for cancer care and control. Activities focused on strengthening multisectoral collaboration in cancer care and control, including promoting early detection in primary care. Despite progress in reducing women’s cancer mortality, socio-cultural challenges impede further gains. Elucidating the perspectives of the community-based and civil society allied in cancer control is critical to addressing cancer disparities.

Data were collected through in-depth interviews with cancer lay health advisors (n = 10) and civil society members (n = 10) on topics of challenges and opportunities to improve care-seeking and treatment. Data were analysed using thematic analysis and guided by the socio-ecological model.

Barriers and facilitators to early diagnosis and treatment were identified at levels of the individual, family, community/societal, and the health system. Barriers to early detection include taboo and stigma, fear of death, and gender norms and roles. Financial and geographic barriers, lack of psychosocial support, and poor health system/provider communication were major deterrents related to treatment. Results suggest intervention targets to reduce late-stage presentation for women, including enhancing educational efforts and augmenting community outreach linkages to primary care.

This study aimed to evaluate the effects of relaxation-based exercises on individuals experiencing post-earthquake stress-related symptoms in an earthquake-prone region.

This randomized, waitlist-controlled, parallel group study included 46 participants with moderate post-traumatic stress levels (Posttraumatic Stress Diagnostic Scale, PDS) and anxiety for over 1 month (Beck Anxiety Inventory, BAI score > 8). Participants were randomly assigned to a relaxation-based exercise group (REG, n = 24) or a waitlist control group (CG, n = 25). The REG received relaxation-based structured, supervised exercises for 4 weeks, while the CG awaited treatment. Assessments included the PDS, BAI, Beck Depression Inventory, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index, and SF-12 Quality of Life Scale at baseline and 4 weeks post-intervention.

Within-group analysis showed significant improvements in anxiety (P = 0.001), depression (P = 0.001), perceived stress (P = 0.001), and sleep quality (P = 0.001) for the REG. The CG showed decreased depression symptoms (P = 0.011) and improved sleep quality (P = 0.012). There were no significant group differences in quality-of-life outcomes (P > 0.05), though REG showed greater improvement in depression and perceived stress scores (P < 0.05).

Relaxation-based exercises can improve sleep quality in individuals experiencing post-earthquake stress, and reduce depression, anxiety, and perceived stress. This approach can be used as a novel rehabilitation model in preventive mental health for the community.

To characterise the association between risk of poor glycaemic control and self-reported and area-level food insecurity among adult patients with type 2 diabetes.

We performed a retrospective, observational analysis of cross-sectional data routinely collected within a health system. Logistic regressions estimated the association between glycaemic control and the dual effect of self-reported and area-level measures of food insecurity.

The health system included a network of ambulatory primary and speciality care sites and hospitals in Bronx County, NY.

Patients diagnosed with type 2 diabetes who completed a health-related social need (HRSN) assessment between April 2018 and December 2019.

5500 patients with type 2 diabetes were assessed for HRSN with 7·1 % reporting an unmet food need. Patients with self-reported food needs demonstrated higher odds of having poor glycaemic control compared with those without food needs (adjusted OR (aOR): 1·59, 95 % CI: 1·26, 2·00). However, there was no conclusive evidence that area-level food insecurity alone was a significant predictor of glycaemic control (aOR: 1·15, 95 % CI: 0·96, 1·39). Patients with self-reported food needs residing in food-secure (aOR: 1·83, 95 % CI: 1·22, 2·74) and food-insecure (aOR: 1·72, 95 % CI: 1·25, 2·37) areas showed higher odds of poor glycaemic control than those without self-reported food needs residing in food-secure areas.

These findings highlight the importance of utilising patient- and area-level social needs data to identify individuals for targeted interventions with increased risk of adverse health outcomes.

Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous well-being and, specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally.

Four databases were searched using keywords related to ‘Food security’ or ‘Food sovereignty,’ ‘Indigenous Peoples’ and ‘Oral health.’ Duplicates were removed, and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data were summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health.

The search identified 369 articles, with forty-one suitable for full-text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from eighteen Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security are explored clinically, quantitatively and qualitatively across oral health outcomes, including early childhood caries, dental caries and oral health-related quality of life for Indigenous Communities.

Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being and doing.

This study aimed to explore the current challenges of Iran’s Iranian Primary Health Care (PHC) network and possible ways forward.

PHC network was established in 1985. It remains a core instrument of health care delivery. However, it faces several challenges that can threaten its effective functioning.

We conducted face-to-face semi-structured interviews with 26 key stakeholders. We used the deductive content analysis approach. World Health Organization’s health system framework guided our analyses. Data were analysed using MAXQDA software. To enhance data triangulation, we reviewed PHC national related plans, bylaws, and national and international published reports.

PHC network experiences financial challenges and fails to respond fully to the emerging population’s needs due to unfair distribution of resources and a lack of community health workers for PHC and a sustainable financing model for PHC. Furthermore, the insurance package is not well integrated into the PHC network system. Policy interests and resource commitments for innovative, preventive, and health promotion initiatives are lacking. Innovative, preventive, and health promotion initiatives should become the highest priority for policymakers. Well-trained community health professionals, active community participation, private sector engagements and active involvement of non-government organisations are fundamental for a well-functioning PHC network in Iran, especially to foster the delivery of evidence-based initiatives.

Studies have reported that minorities are disproportionately impacted by the COVID-19 pandemic. Few studies have elucidated the lived experiences of African American older adults, and the resiliency displayed in combatting the COVID-19 pandemic and other disasters.

This study used 4 recorded focus groups with 26 African American older adults who have spent most of their lives living in Houston, Texas to assess safety, economic, and health concerns related to the pandemic and similarities or differences with other types of disasters that are specific to Houston/ the Gulf Region of Texas, such as Hurricane Harvey.

Key themes emerged from the thematic analysis: 1) previous disasters provided important coping and preparation skills, although each occurrence was still a major stressor, 2) while telehealth was a significant benefit, regular health maintenance and chronic disease management were not completed during the COVID-19 pandemic, 3) information from the federal and state authorities were inconsistent and spurred fear and anxiety, 4) participants experienced few to no disruptions to their income but were heavily called on to support family members, and 5) participants experienced anxiety and isolation, but many used existing social connections to cope.

These findings demonstrate how African American older adults navigate disaster response and recovery through experience and community. Providing unambiguous information to older adults could prove useful in preparing for future disaster events and coping with disasters.

To analyze the consequences of the Natech scenario of H2S toxic gas release from an oil refinery near Tehran and its effects on surrounding residential areas following an earthquake.

This research was an applied study. The Natech risk map and the end-point distance of gas release were determined using the Rapid-n software and the Worst-Case Scenario of RMP, respectively.

Regarding the high seismic vulnerability of the structures affected by the Natech risk, all residents of this area were simultaneously affected by earthquake and the toxic gas inhalation. In comparison to earthquake, response capacities were poor for Natech events, due to insufficient resources, limited accessibility, lack of planning, and unsafe evacuation places in exposed regions. Unlike earthquake, few studies have been conducted on Natech risk assessment and related consequences in Iran. Our study not only covered this gap but also revealed some dimensions of consequences of human, structural, and response capacities.

It is recommended to have plans for implementing short-term such as identifying vulnerable industries and areas, public awareness and long-term such as land use planning measures to reduce Natech risk and resilience improvement.

This study aimed to examine factors that may have contributed to community disaster resilience following Hurricane Maria in Puerto Rico.

In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities (9% of total). Transcripts were deductively and inductively coded and analyzed to identify salient topics and themes, then examined according to strategic themes from the Federal Emergency Management Association’s (FEMA) Whole Community Approach.

Municipal preparedness efforts were coordinated, community-based, leveraged community assets, and prioritized vulnerable populations. Strategies included (1) multi-sectoral coordination and strategic personnel allocation; (2) neighborhood leader designation as support contacts; (3) leveraging of community leader expertise and social networks to protect vulnerable residents; (4) Censuses of at-risk groups, health professionals, and first responders; and (5) outreach for risk communication and locally tailored protective measures. In the context of collapsed telecommunications, communities implemented post-disaster strategies to facilitate communication with the Puerto Rican Government, between local first responders, and to keep residents informed, including the use of: (1) police radios; (2) vehicles with loudspeakers; (3) direct interpersonal communication; and (4) solar-powered Internet radio stations.

Adaptive capacities and actions of Puerto Rican communities exemplify the importance of local solutions in disasters. Expanded research is recommended to better understand contributors to disaster resilience.

For more than a decade, digital health has held promise for enabling a much broader population to have access to health information, education and services. However, the increasing number of studies on the subject show mixed results and currently, there is a certain disillusionment regarding its benefits. And yet, the Covid-19 crisis has revealed the importance of developing digital-based complementary support to existing resources.

Factors associated with higher utilization rates among the target audience need to be investigated.

In 2018, 41 French cities enrolled in an intervention program aimed at promoting StopBlues®, a digital health tool that helps prevent mental distress and suicide among the general population. After two years of experimentation, a Multiple Correspondence Analysis (MCA) was performed using quantitative and qualitative data collection methods from institutional sources, questionnaires and web analytics tools.

Finding trends show that higher utilization rates were associated with the involvement of general practitioners (GPs) in the promotion of StopBlues and the use of digital marketing channels. Context-specific characteristics also played an important role in the adoption of the tool.

The local context has a strong influence on how digital tools are locally promoted and accepted. Further research is needed to understand how local actors and specifically GPs can be involved in suicide prevention. More broadly, the challenge today is to ensure acceptance of digital health technology among targeted populations by adapting the digital offer to their needs and promoting the available tools.

No significant relationships.

Although self-care can control and prevent complications in hypertensive patients, self-care adherence is relatively low among these patients. Community-based telehealth services through mhealth can be an effective solution.

This study aimed to evaluate the effect and acceptance of an mhealth application as a community-based telehealth intervention on self-care behavior adherence.

This clinical trial included sixty hypertensive patients and their matched controls from two heart clinics affiliated to Shiraz University of Medical Sciences (SUMS). Self-care behaviors were assessed using Hill-Bone questionnaire before and after the intervention. Acceptability was evaluated in the intervention group at the end of the study period. The data were analyzed via SPSS 18 software using descriptive and inferential statistics.

The results showed a significant difference between the intervention and control groups regarding the mean score of self-care behaviors (4.13 ± 0.23 versus 3.18 ± 0.27, p < .001). Additionally, a significant difference was observed between the two groups concerning the mean scores of the two subscales of self-care behaviors, including “medication taking” and “proper diet”. However, no significant difference was observed between the two groups regarding the mean score of “appointment keeping” (p = .075). Overall, the intervention group participants were satisfied (4.27 ± 0.34) with this approach for managing hypertension.

Community-based telehealth services through mhealth had the potential to improve self-care behaviors in hypertensive patients and seemed to be accepted by the patients in the intervention group.