Health Promotion

健康促进
  • 文章类型: Journal Article
    简介通过一个独特的,跨部门和跨专业倡议,教育从业者,卫生和社会服务部门被邀请参加实践社区,促进在线。重点是建设劳动力能力,以满足儿童和青年的心理健康需求。目的本文通过将海外开发的心理健康促进计划中的知识转化为新西兰Aotearoa的背景,探讨了跨专业劳动力的发展。方法在6个月的时间内,从业者从事迭代,能力建设进程,在那里他们可以获得倡议材料和资源,分享实践故事,联网,并讨论了实施的障碍和促进因素。定性主题分析用于解释数据。结果实践社区的成员参与讲故事,并根据他们以前的知识和经验理解了主动性:实践和思维得到了验证。心理健康促进被定位为所有部门的责任,有效的跨专业合作的必要性被认为是至关重要的。此外,将该倡议转化为Aotearoa新西兰的双文化背景需要并值得持续关注。讨论这项研究为建立劳动力能力以满足儿童和青年的心理健康需求提供了跨专业和部门间的证据。有必要进行进一步的研究,以调查所服务的儿童和青年的结果。事实证明,跨专业实践社区提供了一种可持续的机制,可以通过这种机制获得知识,转化为实践。
    Introduction Through a unique, inter-sectoral and interprofessional initiative, practitioners from education, health and social service sectors were invited to participate in communities of practice, facilitated online. The focus was on building workforce capacity to address the mental health needs of children and youth. Aim This paper explores interprofessional workforce development by translating knowledge from a mental health promotion initiative developed overseas into the Aotearoa New Zealand context. Methods Over a 6-month period, practitioners engaged in an iterative, capacity-building process, where they had access to the initiative materials and resources, shared practice stories, networked, and discussed barriers and facilitators for implementation. Qualitative thematic analysis was used to interpret data. Results Members of the communities of practice engaged in storytelling and made sense of the initiative in relation to their previous knowledge and experiences: practice and thinking were validated. Mental health promotion was positioned as the responsibility of all sectors and the need for effective interprofessional collaboration was deemed essential. Furthermore, translation of the initiative into the bicultural context of Aotearoa New Zealand demanded and deserved sustained attention. Discussion This study contributes interprofessional and inter-sectoral evidence for building workforce capacity to address the mental health needs of children and youth. Further research is warranted to investigate the outcomes for the children and youth served. Interprofessional communities of practice were shown to provide a sustainable mechanism by which knowledge can be received, transformed and translated into practice.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    变性女性(TGW)和与其他男性发生性关系的男性(MSM)在获得艾滋病毒检测方面经常遇到差异,导致诊断延迟和预后恶化。我们分析了巴西TGW和MSM获得艾滋病毒快速检测的障碍和促进者,2004-2023年。引文包括研究人群是否由年龄≥18岁的个体组成,和研究涉及艾滋病毒检测,并已在巴西进行。研究方案基于JoannaBriggs的范围审查建议。我们纳入了11项关于TGW的研究和17项关于MSM的研究。相信一个人没有感染艾滋病毒的风险,以不同方式表达的恐惧(例如缺乏机密性)和年龄是主要障碍。感觉有感染艾滋病毒的危险,好奇心,以及进行测试的环境的有利特征被认为是主要的促进因素。专门针对艾滋病毒自我检测的障碍和促进者包括,分别,对单独进行测试的担忧与自主性/灵活性。如果不将测试差异最小化,巴西就不可能实现联合国95-95-95目标。在测试设置中消除对TGW和MSM的偏见,以及确保机密性的教育活动和透明协议,可以帮助增加这些人群中的艾滋病毒检测。
    Transgender women (TGW) and men who have sex with other men (MSM) often encounter disparities in accessing HIV testing, leading to delayed diagnoses and worse prognoses. We analysed barriers and facilitators for accessing HIV rapid testing by TGW and MSM in Brazil, 2004-2023. Citations were included whether the study population consisted of individuals aged ≥18y old, and studies addressed HIV testing and have been conducted in Brazil. The study protocol was based on Joanna Briggs\' recommendations for scoping reviews. We included 11 studies on TGW and 17 on MSM. The belief that one is not at risk of contracting HIV infection, fear expressed in different ways (e.g. lack of confidentiality) and younger age were the main barriers. Feeling at risk for HIV infection, curiosity, and favourable characteristics of the setting where the testing takes place were cited as the main facilitators. Barriers and facilitators specifically for HIV self-testing included, respectively, concerns about conducting the test alone vs. autonomy/flexibility. Brazil is unlikely to achieve the UN\' 95-95-95 goal without minimising testing disparities. Combating prejudice against TGW and MSM in testing settings, along with educational campaigns and transparent protocols to ensure confidentiality, can help increase HIV testing among these populations.
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  • 文章类型: Journal Article
    背景:尽管健康素养和自我护理技能在改善个人和社会健康以及降低健康成本方面的重要性,科学证据表明,在大多数社会中,妇女对自我保健需求的认识不足,对生殖和性健康的认识较低。本研究旨在说明提高健康意识对新婚妇女自我保健需求以及生殖和性健康素养的影响。
    方法:这项随机对照临床试验是在德黑兰对64名15-45岁的新婚女性进行的,伊朗从2021年8月到2021年12月底。参与者被随机分为干预组(n=32)和对照组(n=32)。干预组接受了四次个人健康意识促进教育会议。生殖和性自我照顾的需要,和性健康素养问卷,在干预前和干预后4周通过访谈完成。数据采用SPSS26软件进行分析。使用独立t检验和ANCOVA来比较平均得分,并且考虑P<0.05的显著性水平。
    结果:这项研究的结果表明,经过咨询,与对照组[平均值(SD):87.1(23.42)]相比,干预组[平均值(标准差(SD)):125.70(24.70)]的生殖和性自我护理需求的平均总分显著降低[P=0.001].此外,干预后干预组性和生殖健康素养平均得分[平均值(SD):125.50(14.09)]显著高于对照组[平均值(SD):97.15(14.90)][P=0.01]。
    结论:结果表明,健康促进意识教育对新婚女性的生殖和性自我护理需求以及健康素养具有积极作用。因此,应将健康促进干预措施纳入综合保健中心为新婚妇女提供的保健服务计划,以改善妇女和家庭的健康状况。
    背景:伊朗临床试验注册(IRCT):IRCT20171007036615N7注册日期:2021-09-21。URL:https://fa.irct.ir/trial/58597。
    BACKGROUND: Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women\'s poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women.
    METHODS: This randomized controlled clinical trial was conducted on 64 newly married women aged 15-45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered.
    RESULTS: The results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01].
    CONCLUSIONS: The results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families.
    BACKGROUND: Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597 .
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  • 文章类型: Journal Article
    在过去的40年里,体育活动研究人员投入了大量资金来确定“什么是有效的”,以促进学校的健康行为。以体育教育为目标的单一和多组分学校干预措施,主动运输,和/或课堂活动中断有效地增加了儿童和青少年的身体活动。然而,这些干预措施中很少有人在现实世界的条件下和不同的人群中扩大和实施。为了实现人口水平的健康福利,有必要设计基于学校的健康促进干预措施,以提高可扩展性,并考虑扩大规模过程的关键方面。在这篇评论文章中,我们的目标是确定挑战,并推进知识和行动,以扩大基于学校的体育活动干预措施。我们从一开始就强调扩大规模规划的关键作用,放大途径,合作伙伴之间的信任和计划支持,程序适应,扩大规模的评估,以及扩大规模的障碍和促进者。我们借鉴我们的经验,扩大有效的基于学校的干预措施,并提供坚实的基础,其他人可以努力弥合实施到扩大差距。
    Over the last 4 decades, physical activity researchers have invested heavily in determining \"what works\" to promote healthy behaviors in schools. Single and multicomponent school-based interventions that target physical education, active transportation, and/or classroom activity breaks effectively increased physical activity among children and youth. Yet, few of these interventions are ever scaled-up and implemented under real-world conditions and in diverse populations. To achieve population-level health benefits, there is a need to design school-based health-promoting interventions for scalability and to consider key aspects of the scale-up process. In this opinion piece, we aim to identify challenges and advance knowledge and action toward scaling-up school-based physical activity interventions. We highlight the key roles of planning for scale-up at the outset, scale-up pathways, trust among partners and program support, program adaptation, evaluation of scale-up, and barriers and facilitators to scaling-up. We draw upon our experience scaling-up effective school-based interventions and provide a solid foundation from which others can work toward bridging the implementation-to-scale-up gap.
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  • 文章类型: Journal Article
    背景:心理困扰(抑郁症状,焦虑,和压力)在美国成年人中需要有效的心理健康干预措施。尽管基于智能手机应用程序的程序很普遍,对其功效的研究是有限的,只有14%的人显示出临床验证的证据。我们的研究评估了Noom情绪,一种商用的基于智能手机的应用程序,使用认知行为疗法和基于正念的编程。在这项研究中,我们通过研究干预后的结局以及对心理健康的更广泛影响来解决现有文献中的差距.
    目的:NoomMood是一个基于智能手机的心理健康计划,旨在供普通人群使用。这项前瞻性研究评估了NoomMood的疗效和干预后结果。我们的目标是解决美国成年人日益增长的心理困扰。
    方法:采用单臂研究设计,参与者可以使用NoomMood计划16周(N=273)。调查是在基线进行的,第4周,第8周,第12周,第16周和第32周(项目后随访16周)。这项研究评估了一系列心理健康结果,包括焦虑症状,抑郁症状,感知压力,幸福,生活质量,应对,情绪调节,睡眠,和工作场所生产力(旷工或出勤)。
    结果:参与者的平均年龄为40.5(SD11.7)岁。焦虑症状有统计学意义的改善,抑郁症状,和感知的压力在第4周观察到,并通过16周的干预和32周的随访维持。在前4周观察到最大的变化(降低了29%,降低25%,焦虑症状降低15%,抑郁症状,和感知的压力,分别),之后只观察到很小的改善。从计划开始到16周干预和32周随访,临床相关焦虑(7项广泛性焦虑障碍量表)和抑郁(8项患者健康问卷抑郁量表)标准的降低也得以维持。工作效率也显示出统计上显著的结果,参与者在16周时从基线获得2.57个生产性工作日,并在随访(32周)时保持相对稳定(增加2.23个生产性工作日)。此外,影响所有应对,睡眠障碍(32周时降低23%),情绪失调变量在所有时间点都表现出积极和显著的趋势(高出15%,降低23%,32周时分别高出25%)。
    结论:这项研究有助于了解NoomMood对心理健康和幸福感的积极影响,超越干预阶段。尽管需要更严格的研究来了解作用机制,这项探索性研究解决了文献中的关键空白,强调基于智能手机的心理健康计划的潜力,以减少心理健康支持的障碍,并改善福祉的不同方面。未来的研究应该探索可扩展性,可行性,以及此类干预措施在不同人群中的长期依从性。
    BACKGROUND: Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness interventions. Despite the prevalence of smartphone app-based programs, research on their efficacy is limited, with only 14% showing clinically validated evidence. Our study evaluates Noom Mood, a commercially available smartphone-based app that uses cognitive behavioral therapy and mindfulness-based programming. In this study, we address gaps in the existing literature by examining postintervention outcomes and the broader impact on mental wellness.
    OBJECTIVE: Noom Mood is a smartphone-based mental wellness program designed to be used by the general population. This prospective study evaluates the efficacy and postintervention outcomes of Noom Mood. We aim to address the rising psychological distress among adults in the United States.
    METHODS: A 1-arm study design was used, with participants having access to the Noom Mood program for 16 weeks (N=273). Surveys were conducted at baseline, week 4, week 8, week 12, week 16, and week 32 (16 weeks\' postprogram follow-up). This study assessed a range of mental health outcomes, including anxiety symptoms, depressive symptoms, perceived stress, well-being, quality of life, coping, emotion regulation, sleep, and workplace productivity (absenteeism or presenteeism).
    RESULTS: The mean age of participants was 40.5 (SD 11.7) years. Statistically significant improvements in anxiety symptoms, depressive symptoms, and perceived stress were observed by week 4 and maintained through the 16-week intervention and the 32-week follow-up. The largest changes were observed in the first 4 weeks (29% lower, 25% lower, and 15% lower for anxiety symptoms, depressive symptoms, and perceived stress, respectively), and only small improvements were observed afterward. Reductions in clinically relevant anxiety (7-item generalized anxiety disorder scale) and depression (8-item Patient Health Questionnaire depression scale) criteria were also maintained from program initiation through the 16-week intervention and the 32-week follow-up. Work productivity also showed statistically significant results, with participants gaining 2.57 productive work days from baseline at 16 weeks, and remaining relatively stable (2.23 productive work days gained) at follow-up (32 weeks). Additionally, effects across all coping, sleep disturbance (23% lower at 32 weeks), and emotion dysregulation variables exhibited positive and significant trends at all time points (15% higher, 23% lower, and 25% higher respectively at 32 weeks).
    CONCLUSIONS: This study contributes insights into the promising positive impact of Noom Mood on mental health and well-being outcomes, extending beyond the intervention phase. Though more rigorous studies are necessary to understand the mechanism of action at play, this exploratory study addresses critical gaps in the literature, highlighting the potential of smartphone-based mental wellness programs to lessen barriers to mental health support and improve diverse dimensions of well-being. Future research should explore the scalability, feasibility, and long-term adherence of such interventions across diverse populations.
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  • 文章类型: Journal Article
    目标:对不健康食品征税有助于改善英国(英国)的人口健康,但是这些税收导致的食物替代品对健康的影响通常是不清楚的。我们调查了盐和糖税对假设的类别内食物替代的潜在影响,成本,身体质量指数(BMI),和环境足迹。
    方法:来自Kantar(2017年)的采购小组数据用于确定八个“盐密集型”/“糖密集型”食品类别中最受欢迎的高盐或高糖食品。在食物类别中,还确定了最受欢迎的低盐(≤1.5g盐/100g产品)和低糖(≤22.5g糖/100g产品)替代品。探索了高盐/糖食品和低盐/糖替代品之间的假设互换,关注成本的变化,热量摄入和BMI,以及对英国人口的环境影响。
    结果:建议的类别内替换在很大程度上是相似的,并且不会给消费者带来额外的总体成本。这些替代减少了约200千卡/天的卡路里摄入量,并将英国的超重和肥胖症患病率从约60-65%降低到约40-45%。拟议的食物替代品导致温室气体总量减少-2.7Mt,-500.000公顷的土地,-0.5km3的蓝色水,-12km3的稀缺加权水,-12.000吨磷,由于卡路里摄入量的减少,英国人口在一年内减少了近-14.000吨的二氧化硫。
    结论:对盐和糖征税后的食品替代可能会对健康和环境带来重大好处,不一定导致人们在熟悉的咸和含糖零食上的支出发生重大变化。
    OBJECTIVE: Taxes on unhealthy foods can help improve population health in the United Kingdom (UK), but the health effects of food substitutions resulting from these taxes are often unclear. We investigated the potential impacts of a salt and sugar tax on hypothetical intra-category food substitutions, cost, body-mass index (BMI), and environmental footprints.
    METHODS: Purchase panel data from Kantar (2017) were used to determine the most popular foods high in salt or sugar within eight \'salt-intensive\'/\'sugar-intensive\' food categories. Within food categories, the most popular lower salt (≤ 1.5 g salt/100 g product) and lower sugar (≤ 22.5 g sugar/100 g product) substitutes were also identified. Hypothetical swaps between high salt/sugar foods and lower salt/sugar substitutes were explored, focusing on changes to cost, caloric intake and BMI, and environmental impacts in the UK population.
    RESULTS: The suggested intra-category substitutions were largely like-for-like and did not accrue an added overall cost to consumers. The substitutions reduced calorie intake by about 200 kcal/day and lowered the prevalence of overweight and obesity in the UK from approximately 60-65% to about 40-45%. The proposed food substitutions led to a total reduction of -2.7Mt of greenhouse gases, ∼ -500.000 ha of land, -0.5km3 of blue water, -12km3 of scarcity weighted water, ∼ -12.000t of phosphorus, and nearly - 14.000t of sulphur dioxide over one year for the UK population due to reductions in calorie intake.
    CONCLUSIONS: Food substitutions following a tax on salt and sugar could lead to significant benefits for health and the environment, without necessarily resulting in major changes to people\'s expenditure on familiar salty and sugary snacks.
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  • 文章类型: Journal Article
    背景:跨性别女性(TGW)的智能手机使用正在增加,包括那些从事性工作的人。当前政府支持的艾滋病毒预防干预措施侧重于TGW之间基于物理场所的外联,错过了通过基于智能手机的干预措施与他们接触的机会。
    目标:我们检查了TGW中智能手机的使用情况,特别是在社交和性网络方面,并探讨了他们对使用基于智能手机的艾滋病毒预防干预措施的意愿的看法。
    方法:通过探索性描述性解释定性研究设计,我们在钦奈和海德拉巴进行了6个焦点小组,其中有30个TGW(性工作占70%)的目的样本和4个关键线人深度访谈,印度。使用框架分析对数据进行了探索。
    结果:通过智能手机,TGW使用社交媒体(例如,WhatsApp和Facebook)和社交约会应用程序,遇到性伴侣,和娱乐。低识字率TGW使用语音或视频消息。TGW表示有兴趣接收有关艾滋病毒的健康相关短片和短信,心理健康,性别转型。
    结论:有风险的TGW可能通过基于智能手机的在线健康促进干预措施来达到,但这些干预措施需要整体-超越艾滋病毒。
    BACKGROUND: Smartphone use is increasing among transgender women (TGW), including those who engage in sex work. Current government-supported HIV prevention interventions focus on physical venue-based outreach among TGW, missing the opportunity to reach them through smartphone-based interventions.
    OBJECTIVE: We examined the use of smartphones among TGW, especially in relation to social and sexual networking, and explored their perspectives on their willingness to use smartphone-based HIV prevention interventions.
    METHODS: Through an exploratory descriptive-interpretive qualitative research design, we conducted 6 focus groups with a purposive sample of 30 TGW (70% in sex work) and 4 key informant in-depth interviews in Chennai and Hyderabad, India. Data were explored using framework analysis.
    RESULTS: Through smartphones, TGW used social media (e.g., WhatsApp and Facebook) and dating applications for socialization, meeting sexual partners, and entertainment. Low-literacy TGW used voice or video messaging. TGW expressed interest in receiving short health-related videos and text messages on HIV, mental health, and gender transition.
    CONCLUSIONS: At-risk TGW could potentially be reached through smartphone-based online health promotion interventions, but those interventions need to be holistic - moving beyond HIV.
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  • 文章类型: Journal Article
    背景:在泰国,公共卫生服务角色已由公共卫生部定义,而基本公共卫生职能(EPHF)未被指定为响应初级保健单位任务的必要卫生保健服务活动。
    目的:目的是确定EPHF,并根据街道卫生促进医院(SHPHs)的公共卫生人员的EPHF比较绩效和实际绩效的必要性。
    方法:采用混合方法的探索性顺序设计。第一阶段包括三种方法:焦点小组讨论,一种名义分组技术,以及用于确定EPHF的横截面调查。第二阶段是使用横断面调查根据人员的EPHF比较绩效和实际绩效的必要性。通过随机聚类选择第二健康区域中的285个SHPH导演作为样本。
    结果:研究结果表明,在14个EPHF和212个指标中,14个EPHF和绩效平均值的必要性高于实际绩效平均值,在0.05的水平上具有显著性。健康评估和初级医疗保健(EPHF3)的手段差异最小,而泰国传统药物和替代药物(EPHF11)的平均差异最大。
    结论:EPHF将被应用于制定工作范围框架,作为政策,EPHF可以被推荐用作个人指南或组织评估手册,以有效地发展组织。
    BACKGROUND: In Thailand, public health service roles have been defined by the Ministry of Public Health, while essential public health functions (EPHFs) were not assigned as necessity health-care service activities responding to the missions of primary care units.
    OBJECTIVE: The aims were to determine the EPHFs and compare the necessity of performance and the actual performance according to the EPHFs of public health personnel in the subdistrict health-promoting hospitals (SHPHs).
    METHODS: The exploratory sequential design of mixed methods was employed. The first phase consisted of three methods: a focus group discussion, a nominal group technique, and a cross-sectional survey used to determine the EPHFs. The second phase was to compare the necessity of performance and the actual performance according to the EPHFs of the personnel using a cross-sectional survey. The 285 SHPH directors in the second health region as samples were selected by random clusters.
    RESULTS: The findings revealed that 14 EPHFs and the necessity of performance average were higher than the actual performance average in the 14 EPHFs and 212 indicators with significance at a level of 0.05. The means of health assessment and primary medical care (EPHF3) presented the smallest difference, whereas Thai traditional and alternative medicines (EPHF11) indicated the largest average difference.
    CONCLUSIONS: EPHFs would be applied for setting a framework of working scope as policies and EPHFs could be recommended for use as individual guidelines or organizational assessment manuals to develop organizations efficiently.
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  • 文章类型: Journal Article
    背景:YuvaSpandana(YS)是在卡纳塔克邦实施的一项独特的基于社区的青年心理健康促进计划。
    目的:我们评估了2017年1月1日至2021年12月31日期间YS服务人群中影响PD的因素。
    方法:使用10,340YS的护理接受者的就诊表进行了回顾性横断面分析。建立了一个概念框架,并且该框架内的所有假设变量都被认为是暴露。单变量分析中所有P<0.10的暴露变量均包括在多变量分析中。多变量逻辑回归分析是通过使用正向步进过程从单变量分析中包括每个重要的潜在暴露变量来进行的。
    结果:有健康和生活方式问题的护理接受者患PD的风险几乎增加了两倍(调整比值比[AOR]=1.74和95%置信区间[CI]-1.52-2.00),那些有自我发育问题的人患PD的可能性几乎是其2.5倍(AOR=2.44,95%CI-2.12-2.79)。那些报告情绪状态感到担忧的人,丢失,无能力,孤独,和不信任分别在21.4,3.5,26.3,37.9和4.7倍的概率有PD,分别。
    结论:隔离与PD相关的危险因素将有助于YS为高危人群提供心理健康促进。
    BACKGROUND: Yuva Spandana (YS) is a unique community-based youth mental health promotion program implemented across Karnataka.
    OBJECTIVE: We assessed factors affecting PD among the population served by YS between January 1, 2017, and December 31, 2021.
    METHODS: A retrospective cross-sectional analysis was done utilizing the visit forms of 10,340 YS\'s care recipients. A conceptual framework was developed, and all hypothesized variables within this framework were considered exposures. All exposure variables significant at P < 0.10 in univariate analysis were included in multivariable analysis. Multivariable logistic regression analysis was performed by including each of the significant potential exposure variables from univariate analysis using a forward-stepping process.
    RESULTS: Care recipients with health and lifestyle issues were at almost two times increased risk for PD (adjusted odds ratio [AOR] =1.74 and 95% confidence interval [CI] - 1.52-2.00), and those with self-development issues were almost 2.5 times more likely to have PD (AOR = 2.44 and 95% CI - 2.12-2.79). Those who reported emotional statuses of feeling worried, lost, incapable, lonely, and distrusting were at 21.4, 3.5, 26.3, 37.9, and 4.7 times higher odds of having PD, respectively.
    CONCLUSIONS: Isolating the risk factors associated with PD will help tailor the mental health promotion provided by YS to at-risk groups.
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