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> PAGEPress Scientific Publications, Pavia, Italy en-US Journal of Public Health Research 2279-9028 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(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:</p> <ol> <li>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.</li> <li>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.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>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.</li> <li>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.</li> <li>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.</li> </ol> SHARE: a data set for ageing research <p>not available</p> Guglielmo Weber ##submission.copyrightStatement## 2018-04-30 2018-04-30 10.4081/jphr.2018.1397 Framing and visual type: Effect on future Zika vaccine uptake intent <p><em>Introduction</em>: The Zika virus is associated with the birth defect microcephaly, and while a vaccine was not available in early- 2017, several were under development. This study’s purpose was to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age.<br><em>Design and methods</em>: In order to study the effects of Zika message framing (gain vs. loss) and visual type (photo vs. infographic) on future Zika vaccine uptake intent, a 2×2 between-subjects experiment was performed via an online survey in 2017 among 339 U.S. women of reproductive age (18-49 years). Participants were exposed to one of four messages, all resembling Instagram posts: gain-framed vs. loss-framed infographic, and gain-framed vs. loss-framed photo. These messages were followed by questions about Zika vaccine uptake intent as well as intermediate psychosocial variables that could lead to intent. <br><em>Results</em>: There was no interaction between framing and visual type (P=0.116), and there was no effect for framing (P=0.185) or visual type (P=0.724) on future Zika vaccine uptake intent, which is likely indicative of insufficient dosage of the intervention. However, when focusing on intermediate psychosocial constructs that are known to influence behavior and intent, gain-framed messages were more effective in increasing subjective norms (P=0.005) as related to a future Zika vaccine, as well as perceived benefits (P=0.016) and self-efficacy (P=0.032). <br><em>Conclusions:</em> Gain-framed messages seem to be more effective than loss-framed messages to increase several constructs that could, in turn, affect future Zika vaccine uptake intent. This is a novel finding since, traditionally, loss-framed messages are considered more beneficial in promoting vaccine-related health behaviors.</p> Jeanine P.D. Guidry Kellie E. Carlyle Jessica G. LaRose Paul Perrin Mark Ryan Marcus Messner Jay Adams ##submission.copyrightStatement## 2018-04-30 2018-04-30 10.4081/jphr.2018.1162 Effectiveness of a multicomponent school based intervention to reduce bullying among adolescents in Chandigarh, North India: A quasi-experimental study protocol <p><em>Background</em>: Bullying perpetration and victimization is associated with significant academic, psychosocial and health related problems among adolescents. There is a need to develop effective interventions to prevent bullying among adolescents, especially in low and middle income countries. This paper presents the study protocol to develop, and evaluate the effect of multi-component school based prevention program for bullying in India. <br><em>Design</em>: Quasi-experimental study. <br><em>Methods</em>: The study will be conducted among 846 students of grade 7th and 8th in the intervention and control schools in Chandigarh, Union Territory, North India. A government and a private school will be selected purposively in each of the intervention and control arm. The intervention is based on socio-ecological model, and will be administered at individual, relationship (parents and teachers) and school level. The primary study outcome will be the proportion of students experiencing any kind of bullying (bullying, victimization, or both), in each study arm. The effectiveness of the intervention will be measured by performing difference in difference analysis and generalized estimating equations. <br><em>Expected impact for public health</em>: Bullying is an aggressive behaviour with significant morbidities, including psychological or physical trauma, affecting individuals not only in their adolescence, but also later in their adulthood. This quasi-experimental study is expected to provide evidence on whether multi-component bullying prevention intervention program, can reduce the burden of bullying perpetration and victimization among school adolescents in India. The results of the study will add in the exiting literature on bullying intervention program, especially, from the low middle-income countries, as there are limited studies available on this topic in these countries.</p> Monica Rana Madhu Gupta Prahbhjot Malhi Sandeep Grover Manmeet Kaur ##submission.copyrightStatement## 2018-04-26 2018-04-26 10.4081/jphr.2018.1304 Racial/ethnic differences in health insurance adequacy and consistency among children: Evidence from the 2011/12 National Survey of Children’s Health <p><em>Background</em>: Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children’s (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). <br><em>Design and methods</em>: We used data from the 2011/2012 National Survey of Children’s Health (n=79,474). Descriptive statistics and logistic regression analyses were conducted to examine the distribution and influence of several sociodemographic/family related factors on insurance adequacy and consistency across different racial/ethnic groups. <br><em>Results</em>: Stratified analyses by race/ethnicity revealed that white and black children living in households at or below 299% of the Federal Poverty Level (FPL) were approximately 29 to 42% less likely to have adequate insurance compared to children living in families of higher income levels. Regardless of race/ethnicity, we found that children with public health insurance were more likely to have adequate insurance than their privately insured counterparts, while adolescents were at greater risk of inadequate coverage. Hispanic and black children were more likely to lack consistent insurance coverage. <br><em>Conclusions</em>: This study provides evidence that racial/ethnic differences in adequate and consistent health insurance exists with both white and minority children being affected adversely by poverty. Establishing outreach programs for low income families, and cross-cultural education for healthcare providers may help increase health insurance adequacy and consistency within certain underserved populations.</p> Tulay G. Soylu Eman Elashkar Fatemah Aloudah Munir Ahmed Panagiota Kitsantas ##submission.copyrightStatement## 2018-04-23 2018-04-23 10.4081/jphr.2018.1280 Lack of school requirements and clinician recommendations for human papillomavirus vaccination <p><em>Background</em>: A strong recommendation from a clinician is one of the best predictors of human papillomavirus (HPV) vaccination among adolescents, yet many clinicians do not provide effective recommendations. The objective of this study was to understand how the lack of school entry requirements for HPV vaccination influences clinicians’ recommendations. <br><em>Design and Methods:</em> Semi-structured interviews with a purposive sample of 32 clinicians were conducted in 2015 in Connecticut USA. Data were analysed using an iterative thematic approach in 2016-2017. <br><em>Results</em>: Many clinicians described presenting HPV vaccination as optional or non-urgent because it is not required for school entry. This was noted to be different from how other required vaccines were discussed. Even strong recommendations were often qualified by statements about the lack of requirements. Furthermore, lack of requirements was often raised initially by clinicians and not by parents. Many clinicians agreed that requirements would simplify the recommendation, but that parents may not agree with requirements. Personal opinions about school entry requirements were mixed. <br><em>Conclusions</em>: The current lack of school entry requirements for HPV vaccination is an important influence on clinicians’ recommendations that are often framed as optional or non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that remains strong and focused on disease prevention yet uncoupled from the lack of requirements that may encourage delays. Additionally, greater support for requirements among clinicians may be needed to successfully enact requirements in the future.</p> Linda M. Niccolai Anna L. North Alison Footman Caitlin E. Hansen ##submission.copyrightStatement## 2018-04-23 2018-04-23 10.4081/jphr.2018.1324 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## 2018-04-20 2018-04-20 10.4081/jphr.2018.1239 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## 2018-04-20 2018-04-20 10.4081/jphr.2018.1269 #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## 2018-04-20 2018-04-20 10.4081/jphr.2018.1166 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## 2018-04-20 2018-04-20 10.4081/jphr.2018.957 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## 2018-02-05 2018-02-05 10.4081/jphr.2018.1129