Journal of Public Health Research <p><strong>The Journal of Public Health Research</strong> is an online Open Access, peer-reviewed scholarly journal in the field of public health science. The aim of the journal is to stimulate debate and dissemination of knowledge in the public health field in order to improve efficacy, effectiveness and efficiency of public health interventions to improve health outcomes of populations. This aim can only be achieved by adopting a global and multidisciplinary approach. <br><br> <strong>The Journal of Public Health Research </strong>publishes contributions from both the 'traditional' disciplines of public health, including hygiene, epidemiology, health education, environmental health, occupational health, health policy, hospital management, health economics, law and ethics as well as from the area of new health care fields including social science, communication science, eHealth and mHealth philosophy, health technology assessment, genetics research implications, population-mental health, gender and disparity issues, global and migration-related themes. In support of this approach, the Journal of Public Health Research strongly encourages the use of real multidisciplinary approaches and analyses in the manuscripts submitted to the journal. In addition to <em>Original research</em>, <em>Systematic Review,</em> <em>Meta-analysis</em>, <em>Meta-synthesis</em> and <em>Perspectives</em> and <em>Debate</em> articles, the Journal of Public Health Research publishes newsworthy <em>Brief</em> <em>Reports</em>, <em>Letters</em> and <em>Study Protocols</em> related to public health and public health management activities.</p> en-US <p>PAGEPress has chosen to apply the <a href="" target="_blank" rel="noopener">Creative Commons Attribution NonCommercial 4.0 License</a> (CC BY-NC 4.0) to all manuscripts to be published. <br><br>An Open Access Publication is one that meets the following two conditions:<br><br> 1. The author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.<br> 2. A complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.<br><br>Authors who publish with this journal agree to the following terms: 1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. 3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</p> (Emanuela Fusinato) (Tiziano Taccini) Mon, 05 Feb 2018 00:00:00 +0100 OJS 60 Gender differences in the relationship between built environment and non-communicable diseases: A systematic review <p>Non-communicable diseases are on the rise globally. Risk factors of non-communicable diseases continue to be a growing concern in both developed and developing countries. With significant rise in population and establishment of buildings, rapid changes have taken place in the built environment. Relationship between health and place, particularly with non-communicable diseases has been established in previous literature. This systematic review assesses the current evidence on influence of gender in the relationship between built environment and non-communicable diseases. A systematic literature search using PubMed was done to identify all studies that reported relationship between gender and built environment. All titles and abstracts were scrutinised to include only articles based on risk factors, prevention, treatment and outcome of non-communicable diseases. The Gender Analysis Matrix developed by the World Health Organization was used to describe the findings of gender differences. Sex differences, biological susceptibility, gender norms/ values, roles and activities related to gender and access to/control over resources were themes for the differences in the relationship. A total of 15 out of 214 articles met the inclusion criteria. Majority of the studies were on risk factors of non-communicable diseases, particularly cardiovascular diseases. Gender differences in physical access to recreational facilities, neighbourhood perceptions of safety and walkability have been documented. Men and women showed differential preferences to walking, engaging in physical activity and in perceiving safety of the neighbourhood. Girls and boys showed differences in play activities at school and in their own neighbourhood environment. Safety from crime and safety from traffic were also perceived important to engage in physical activity. Gender norms and gender roles and activities have shown basis for the differences in the prevalence of non-communicable diseases. Sparse evidence was found on how built environment affects health seeking behaviour, preventive options or experience with health providers. Though yet unexplored in the developing or low/middle income countries, there seems to be a major role in the gendered perception of how men and women are affected by noncommunicable diseases. Large gaps still exist in the research evidence on gender-based differences in non-communicable diseases and built environment relationship. Future research directions could bring out underpinnings of how perceived and objective built environment could largely affect the health behaviour of men and women across the globe.</p> Joanna Sara Valson, V. Raman Kutty ##submission.copyrightStatement## Fri, 20 Apr 2018 10:48:28 +0200 Alcohol brand use of youth-appealing advertising and consumption by youth and adults <p><em>Background</em>: Youth exposure to alcohol marketing has been shown to be an important contributor to the problem of underage drinking in the U.S. More work is needed on identifying and minimizing content with particular appeal to youth. <br><em>Design and Methods:</em> We tested the association between the youth-appeal of marketing content of televised alcohol advertisements and the brand-specific alcohol consumption of both underage youth and adults. We used existing data from three sources: a brand-specific alcohol consumption survey among underage youth (<em>N</em>=1032), a brand-specific alcohol consumption survey among adults (<em>N</em> ~13,000), and an analysis of content appealing to youth (CAY) in a sample of televised alcohol advertisements (n=96) aired during the youth survey. The association between CAY scores for the 96 alcohol ads and youth (age 13-20) <em>versus</em> adult (age 21+) consumption of those ads’ brands was tested through bivariate and multivariate models. <br><em>Results</em>: Brand CAY scores were (a) positively associated with brand-specific youth consumption after controlling for adult brand consumption; (b) positively associated with a ratio of youth-toadult brand-specific consumption; and (c) not associated with adult brand consumption. <br><em>Conclusions</em>: Alcohol brands with youth-appealing advertising are consumed more often by youth than adults, indicating that these ads may be more persuasive to relatively younger audiences, and that youth are not simply mirroring adult consumption patterns in their choice of brands. Future research should consider the content of alcohol advertising when testing marketing effects on youth drinking, and surveillance efforts might focus on brands popular among youth.</p> Alisa A. Padon, Rajiv N. Rimal, Michael Siegel, William DeJong, Timothy S. Naimi, David H. JernFigan ##submission.copyrightStatement## Fri, 20 Apr 2018 09:26:59 +0200 #LancerHealth: Using Twitter and Instagram as a tool in a campus wide health promotion initiative <p>The present study aimed to explore using popular technology that people already have/use as a health promotion tool, in a campus wide social media health promotion initiative, entitled<em> #LancerHealth</em>. During a two-week period the university community was asked to share photos on Twitter and Instagram of <em>What does being healthy on campus look like to you?,</em> while tagging the image with <em>#LancerHealth</em>. All publically tagged media was collected using the Netlytic software and analysed. Text analysis (N=234 records, Twitter; N=141 records, Instagram) revealed that the majority of the conversation was positive and focused on health and the university. Social network analysis, based on five network properties, showed a small network with little interaction. Lastly, photo coding analysis (N=71 unique image) indicated that the majority of the shared images were of physical activity (52%) and on campus (80%). Further research into this area is warranted.</p> Sara Santarossa, Sarah J. Woodruff ##submission.copyrightStatement## Fri, 20 Apr 2018 08:42:12 +0200 Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh <p><em>Background</em>. One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, <em>i.e.</em>, all direct and indirect expenditure. <br><em>Materials and methods.</em> The study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households’ maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern. <br><em>Results</em>. Results revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households to escape from suffering catastrophic burden due to maternity payments. <br><em>Conclusions</em>. It can be concluded that the JSY appeared to have achieved only a limited success in reducing the economic burden due to maternity. To reduce the catastrophic burden, policy makers should consider increasing the JSY reimbursement to cover not only antenatal and postnatal services but also non-medical expenditure due to maternity. The government should also take appropriate measures to curb non-medical or indirect expenditure in public health facilities.</p> Saradiya Mukherjee, Aditya Singh ##submission.copyrightStatement## Fri, 20 Apr 2018 08:01:53 +0200 A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention <p><em>Background</em>: Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-old. <br><em>Design and methods</em>: Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. <br><em>Expected impact for public health</em>: It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent.</p> Francesca Sánchez-Martínez, Olga Juárez, Gemma Serral, Sara Valmayor, Rosa Puigpinós, María Isabel Pasarín, Élia Díez, Carles Ariza, Evaluation Group POIBA Project ##submission.copyrightStatement## Mon, 05 Feb 2018 00:00:00 +0100 Are the Ethical Committees for pharmacological research bureaucratic bodies? Not available Bruno Mario Cesana ##submission.copyrightStatement## Thu, 04 Jan 2018 13:59:23 +0100 Social marketing for a farmer’s market in an underserved community: A needs assessment The aim of the present paper is to assess local residents’ awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers’ markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (LA, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers’ markets; 63% of low-income participants never attended a farmers’ market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide. Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss ##submission.copyrightStatement## Thu, 04 Jan 2018 13:05:26 +0100 Measurement of health system performance at district level: A study protocol <em>Background</em>: Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. <br /><em>Methods</em>: A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. <br /><em>Expected impact for public health:</em> The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components. Atul Sharma, Shankar Prinja, Arun Kumar Aggarwal ##submission.copyrightStatement## Tue, 02 Jan 2018 14:57:16 +0100 Fear of crime and its relationship to self-reported health and stress among men <em>Background</em>: Fear of crime is a growing social and public health problem globally, including in developed countries such as Sweden. This study investigated the impact of fear of crime on self-reported health and stress among men living in Gävleborg County.<br /><em>Design and Methods</em>: The study used data collected from 2993 men through a cross sectional survey in the 2014 Health in Equal Terms survey. Descriptive and logistic regression analyses were carried out to study the relationship between fear of crime and self-reported health and stress. <br /><em>Results</em>: There was a statistically significant association between fear of crime and self-reported poor health and stress among men residing in Gävleborg County. In the bivariate analysis, men who reported fear of crime had odds of 1.98 (CI 1.47- 2.66) and 2.23 (CI 1.45-3.41) respectively. Adjusting for demographic, social and economic variables in the multivariate analysis only reduced the odds ratio for self-reported poor health to 1.52 (CI 1.05-2.21) but not for self-reported stress with odds of 2.22 (1.27-3.86). <br /><em>Conclusions</em>: Fear of crime among men was statistically significantly associated with self-reported poor health and stress in Gävleborg County. However, the statistically significant relationship remained even after accounting for demographic, social and economic factors, which warrants further research to better understand the role played by other variables. Gloria Macassa, Rocio Winersjö, Katarina Wijk, Cormac McGrath, Nader Ahmadi, Joaquim Soares ##submission.copyrightStatement## Tue, 02 Jan 2018 14:35:33 +0100 Self-esteem, propensity for sensation seeking, and risk behaviour among adults with tattoos and piercings <em>Background</em>: In recent years, increasing numbers of adults and adolescents have opted to undergo tattoo and piercing procedures. Studies among adolescents with tattoo and piercing have usually explored the relationship between one factor and the decision to have tattoos and/or piercings. The aim of this study was to determine relationships between body cosmetic procedures and selfesteem, propensity for sensation seeking, and risk behaviours among adults. <br /><em>Materials and Methods</em>: The subjects were divided into two groups,<em> i.e.</em>, those with (n=429) and those without tattoos/piercings (n=237), and self-esteem, propensity for sensation seeking, and risk behaviour were compared between the two groups using self-report questionnaires. To analyse differences in self-esteem and the propensity for sensation seeking, general characteristics were statistically adjusted. In addition, general characteristics, self-esteem, and propensity for sensation seeking were statistically adjusted to determine differences in the propensity for risk behaviour between the two groups. <br /><em>Results</em>: Significant differences were observed in age, marital status, income level, occupation, values or sensitivity to fashion, and educational level between the group with and that without tattoos/ piercings. There was no significant difference in self-esteem, whereas there were significant differences in the propensity for sensation seeking and risk behaviour between the two groups. <br /><em>Conclusions</em>: Continuous attention to, and interest in, the increased incidence of tattooing and piercing are necessary, especially in terms of public interventions for health education and health promotion, as these forms of self-adornment are associated with behaviours that pose a risk to health. Bo-Kyung Hong, Hyo Young Lee ##submission.copyrightStatement## Wed, 13 Dec 2017 11:09:33 +0100