Abstract Background Organizational Health Literacy (OHL) refers to the extent to which organizations facilitate equitable access, comprehension, and use of health information and services for informed decision-making. Objective This study aimed to (1) review and map existing OHL frameworks and (2) propose an innovative OHL framework that addresses gaps identified in current models. Methods A systematic search of academic (Web of Science, Scopus, MEDLINE) and grey literature from the past 15 years was conducted to identify OHL frameworks. This scoping review followed the PRISMA-ScR guidelines and the Arksey and O’Malley model. A new OHL intervention framework was developed to address gaps in existing models, based on the principles of preventive medicine and the public health action cycle. Results A total of 19 records were included (10 from academic databases and 9 from grey literature), covering diverse approaches and contexts related to OHL. Four intervention levels were identified: integrating HL into formal education, implementing HL assessments, developing interventions for vulnerable populations, and enhancing accessibility to health resources. The proposed framework emphasizes intersectoral collaboration and communication pathways between education and healthcare sectors, facilitating information exchange to continuously adapt interventions to population needs. Conclusion OHL development requires intersectoral collaboration; however, interoperability between sectors remains unaddressed in existing frameworks. This study proposes an innovative model that fosters sectoral connections toward a shared goal, creating a truly collaborative framework.

Human Noroviruses (HuNoVs) are the leading etiologic agents responsible for viral gastroenteritis. Drinking water (DW) serves as a significant vehicle for the transmission of HuNoVs. This study aimed to assess the occurrence of HuNoVs in drinking water sources (DWS) and DW. A systematic search spanning Web of Science, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials was executed up to July 15, 2024. Following rigorous screening, 76 eligible studies underwent meta-analysis with heterogeneity assessment via Stata 14.0 using a random-effects model. The results indicated that the pooled occurrence of HuNoVs was 11 % (95 % CI: 8-14), with occurrence of 15 % (95 % CI: 10-21) in DWS and 6 % (95 % CI: 3-9) in DW. Subgroup meta-analysis demonstrated that genogroup II (GII) of HuNoVs exhibited the highest contamination occurrence of 7 % (95 % CI: 4-10), with GII.4 and GII.17 being the predominant genotypes. The two continents with the highest number of studies were Asia (n = 27) and Europe (n = 19), with HuNoVs occurrence of 14 % (95 % CI: 8-22) and 15 % (95 % CI: 7-26), respectively. Furthermore, the occurrence showed no significant differences across the four seasons: in spring, the occurrence was 11 % (95 % CI: 3-23); in summer, 15 % (95 % CI: 7-25); in autumn, 11 % (95 % CI: 2-24); and in winter, 18 % (95 % CI: 10-27). These findings provided valuable epidemiological insight into the global occurrence, seasonal variation, and genotypic distribution of HuNoVs in DWS and DW, aiding policy development and public health strategies.

Abstract Background: Despite Australia's universal health insurance scheme, Medicare, out-of-pocket costs (OOPC) for health care comprises 14 % of total health expenditure. People with chronic conditions spend a greater proportion of their incomes on health care than people without a chronic condition. Objective: To review the qualitative literature examining experiences of OOPC of out-of-hospital care by people with chronic conditions and to discuss this in relation to current Australian health policy. Methods: Systematic review and narrative synthesis of the qualitative literature examining OOPC for people with chronic conditions in Australia. Search: Pubmed, CINAHL Complete, Cochrane Library, PsycINFO and EconLit databases from 1999 to 10th April 2025. Results: 37 studies met the inclusion criteria. Reduced or lost employment due to ill-health led to income loss, aggravating the financial burden of health management. While many people were able to access bulk-billing general practitioners, challenges in affording upfront and copayments for medical and allied health consultations, and medication costs were reported. Cost was the greatest barrier to accessing dental care. Trade-offs were described between health management and meeting basic living needs, particularly for people who earned too much to qualify for government welfare payments. Conclusion: While Australian health policies effectively reduce the financial burden of health care for many people, distinct challenges exist for groups ineligible for concessional thresholds. Future research to identify the priorities and preferences of people with chronic conditions can further inform policy to improve the equity of health financing in Australia.

Background: Oral health is a crucial component of overall well-being, particularly in childhood and adolescence when lifetime habits are established. Health education and theory-Based health promotion interventions can enhance oral health outcomes more effectively than traditional knowledge-transfer methods. Objective: The present systematic review and meta-analysis were performed with the objective of assessing the effectiveness of theory-Based health education and promotion interventions in impacting oral health outcomes among children and adolescents. Methods: Based on PRISMA and PROSPERO registration, the systematic search in seven databases was performed up to March 2025. Only RCTs involving participants aged 5 to 18 years old and with use of theoretical models like the Health Belief Model, Theory of Planned Behavior, or Social Cognitive Theory were taken into account. Primary outcomes included oral health behavior, knowledge, attitudes, self-efficacy, and clinical indicators like dental plaque, periodontal status, and DMFT. The data were combined through random-effects meta-analysis, and risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Nineteen RCTs were included. Interventions had a significant boost in self-efficacy (SMD = 1.49, 95% CI: 0.99,2.00), oral health-related quality of life (SMD = 7.38, 95% CI: 5.57,9.19), knowledge (SMD = 1.09, 95% CI: 0.80,1.39), attitudes (SMD = 9.32, 95% CI: 7.08,11.55), and behavior (SMD = 2.58, 95% CI: 2.03,3.12). Significant declines in dental plaque (SMD = -1.92, 95% CI: -2.42,-1.42) and periodontal health (SMD = -1.18, 95% CI: -1.83,-0.53) but not in DMFT scores (SMD = -0.11, 95% CI: -0.27,0.04) also occurred. High heterogeneity and small sample of evidence of publication bias were detected. Conclusions: Theory-Based health education and promotion interventions are effective in enhancing oral health outcomes across a wide range of outcomes in children and adolescents. Future research should have long-term follow-up, standardization of outcomes measures, fidelity of intervention, economic evaluations, and equitable provision across diverse populations. Clinical trial number: Not applicable. Trial registration: This systematic review has been registered prospectively in PROSPERO (International Prospective Register of Systematic Reviews) with registration number CRD420251026862.

Background: Tension-type headache (TTH) is a prevalent primary headache disorder significantly impacting quality of life and healthcare resource utilization, with females typically bearing a higher disease burden. However, comprehensive analyses and predictive studies on the global TTH burden stratified by gender are currently lacking. Aim: This study utilized data from the Global Burden of Disease (GBD) Study to analyze the global burden of tension - type headache by sex from 1990 to 2021 and conducted a 15 - year projection (up to 2036). Methods: We conducted a systematic review of GBD 2021 data, employing Joinpoint regression analysis and decomposition analysis to assess TTH incidence, prevalence, YLDs, and DALYs. Additionally, we used the ARIMA model for a 15-year predictive analysis of TTH burden trends. Results: From 1990 to 2021, global female TTH cases rose from 669.54 million (95% UI: 586.2-751.8 million) to 1.04 billion (95% UI: 923.0-1.1 billion), with incidence increasing from 242.9 million (95% UI: 218.8-267.0 million) to 369.86 million (95% UI: 332.5-407.2 million). Male cases grew from 616.82 million (95% UI: 537.2-696.4 million) to 970 million (95% UI: 851.0-1.0 billion). Decomposition analysis indicated population growth was the primary driver of the increase in female TTH prevalence. Projections suggest that by 2036, the incidence will reach 9,174.84 per 100,000 females (95% UI: 8,854.8-9,494.9), prevalence will be 25,135.1 per 100,000 females (95% UI: 23,977.2-26,283.0), YLD rate will be 62.76 per 100,000 females (95% UI: 58.8-66.7), and DALY rate will be 60.97 per 100,000 females (95% UI: 56.7-65.2). Conclusion: This study highlights the significance of gender in TTH burden, particularly the heightened risk for females. Through temporal trend analysis and predictive modeling, we provide insights into future TTH disease trajectories, aiding global public health policy formulation and healthcare resource allocation.

Background: The paucity of actionable data on the epidemiological profile of dental caries among adolescents in Nigeria poses significant challenges to policy formulation and implementation. This study aimed to estimate the prevalence of dental caries among adolescents in Nigeria and identify dental caries preventive behaviours associated with dental caries experience among adolescents in Nigeria over 10 years. Methods: A systematic review and meta-analysis of studies on dental caries among adolescents was undertaken in September 2023. Literature searches were conducted across Academic Info, Cochrane Library, Refseek, and PubMed databases and Google Scholar, to identify studies on dental caries prevalence and dental caries preventive behaviour among adolescents in Nigeria that were published between January 2013 and December 2022. Eligible studies included cross-sectional, cohort, and case-control studies. Studies were also included if they presented data for at least one of the primary outcomes. Excluded were studies without information on the sample size, those with incomplete or overlapping samples, case reports, case series, editorials, or reviews without primary data. Heterogeneity was assessed using I2 percentages, and a funnel plot evaluated publication bias. A random effects model was used to determine the prevalence of dental caries with subgroup analysis by sex. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist to assess the quality and integrity of the included studies. The systematic review was registered on PROSPERO (CRD42024458849). Results: Sixteen studies met the eligibility criteria. The pooled prevalence of dental caries among adolescents in Nigeria was 23.0% (95% CI: 16-30). The pooled prevalence for males was 16.0% (95% CI: 9-23) and that for females was 22.0% (95% CI: 11-32). The commonest dental caries preventive practices reported were daily tooth brushing, use of fluoride-containing toothpastes, and dental service utilization. Factors associated with dental caries included a history of dental service utilization, poor oral hygiene practices, and consumption of refined carbohydrates in-between-meals. Conclusion: The high prevalence of dental caries among adolescents in Nigeria warrants programmatic attention with an emphasis on improving oral hygiene practices and controlling the consumption of refined carbohydrates in-between-meals. Dental service utilization for dental caries preventive needs to be encouraged.

Background: Health inequalities are differences in health status or in the distribution of resources and opportunities between different population groups. Bayesian models are well-suited to address the special features and uncertainties in inequality analyses, making them useful for informing policymaking. This research reviewed the use of Bayesian models in racial health equity studies focused on non-communicable diseases. Methodology: A systematic review was conducted to assess the applications and utility of Bayesian inference in racial health equity studies for non-communicable diseases (PROSPERO Registry No. CRD42024568708). A total of 2274 articles were identified through electronic databases, and 46 studies met inclusion criteria. All but three articles were from high-income countries, and all were published between 2008 and 2024. We summarized the information qualitatively, and each document included was assessed using the Bennett-Manuel checklist tool. Findings: Studies on cancer and cardiovascular diseases were the most frequent. The most frequently used models were Poisson, spatial, and logistic regressions, with Markov-chain Monte Carlo and Integrated nested Laplace approximations being the dominant sampling strategies. The studies found that Black individuals, followed by those of Hispanic ethnicity, are the racial/ethnic groups most affected by health inequities. Data on other racial groups (e.g., Indigenous populations, people of Asian heritage) was insufficient for drawing definitive conclusions. The main factor contributing to these disparities lies within the health system, particularly in terms of access and quality, which can be understood in the context of each disease. Interpretation: The integration of Bayesian modeling into health equity studies holds promise for developing methodologies that lead to insights and foster meaningful change.

Gastrointestinal (GI) cancers are among the leading causes of cancer-related morbidity and mortality worldwide, presenting a significant public health challenge. Even with medical research advancements, their incidence remains rising due to modifiable and non-modifiable risk factors across lifestyle, environmental, genetic, and socioeconomic factors. This narrative review identifies and synthesizes key risk factors contributing to GI cancers, including unhealthy diets (high consumption of processed foods, red meat, and added sugars), physical inactivity, obesity, smoking, alcohol use, infections (e.g., Helicobacter pylori), environmental pollution, chronic stress, and socioeconomic disparities. The review emphasizes the interaction among these factors and how this interplay is responsible for the development and progression of GI cancer. It emphasizes the importance of early detection, lifestyle modifications, and public health interventions tailored to specific populations. Understanding these interconnected risk factors provides critical insights for guiding prevention strategies, policymaking, and health education. Addressing modifiable risk factors through a comprehensive, multi-sectoral approach may significantly reduce the global burden of GI cancers and improve long-term health outcomes.

Background: Despite advances in precision medicine, the translation of genetic and genomic technologies into routine practice is hampered by a heterogeneous and limited evidence base and the absence of standardized evaluation methodologies. Health Technology Assessment (HTA) plays a critical role in bridging this gap, yet assessment approaches and comprehensiveness vary widely. This systematic review aims to map the landscape of the assessment reports on genetic and genomics applications, analyze their methodological aspects and identify gaps. Methods: PubMed, Scopus, Web of Science, and the international HTA database, were searched for assessment reports of genetic/genomic technologies. Information on reports general characteristics, assessment domains and their components, consulted sources of evidence and reported gaps was extracted. Findings were synthesized narratively. Results: Out of 27,331 screened records, 41 reports were included, predominantly from Canada, the United Kingdom, and Australia, mainly aimed at informing policy making for single or multiple gene tests for cancer patients. Most reports used a generic HTA methodology and assessment domains varied across reports. Key clinical aspects, such as clinical accuracy and safety, suffered from evidence gaps (39.0% and 22.0%), while personal and societal aspects were the least investigated assessment domain (48.8-78.0%). Overall, lack of evidence and limited generalizability of findings were the most commonly reported gaps across multiple domains. Conclusions: The review highlighted significant fragmentation in current evaluation methodologies of genetic and genomic applications, with underassessment of analytical/clinical accuracy, safety, and non-health outcomes, alongside evidence gaps and limited generalizability. These issues compromise both evaluation and decision-making process, underscoring the urgent need for alternative study designs and standardized, comprehensive assessment frameworks to facilitate the successful implementation of emerging genetic and genomic technologies.

Background: The SARS-CoV-2 pandemic had a major impact on nursing and healthcare as well as on research. The aim of this study was to analyse the characteristics of nursing- and SARS-CoV-2-related research in Germany. Methods: A scoping review was conducted. We systematically searched (06/2023) Medline, CINAHL, the German Register of Clinical Trials, abstract books of conferences and conducted a manual literature search. We included empirical studies addressing aspects of nursing and the pandemic and involving German researchers. Study selection and data extraction were conducted independently by two reviewers. Results were analysed descriptively. Results: We included 131 publications (85 quantitative, 27 qualitative, 6 mixed-/multi-methods studies, 12 systematic reviews, 1 discussion paper); 49 % of the studies were published in 2021. First authors were mostly from medicine, psychology and nursing science, last authors from medicine. Most studies were explorative. Most of the quantitative studies used observational designs, only four were experimental. Nurses and other healthcare professionals were the most common target group; people with care needs or relatives were rarely addressed. The most common topics included health, perceived burden, working conditions, and characteristics of care during the pandemic. A quarter of the studies were not externally funded, 32 % did not provide information on funding. The Federal Ministry of Education and Research (21 %) was the most common funding body. Conclusion: Pandemic-related nursing research was published to a limited extent by nursing scientists; clinical nursing research was particularly underrepresented. Dependable funding and the development of a research infrastructure for nursing research are necessary to ensure evidence-based nursing in times of crisis and to generate findings that are relevant to clinical practice and health policy decision-makers.

Background Although taxes that raise retail tobacco prices and industry-initiated price increases have been shown to decrease tobacco consumption, the scarcity of studies in Latin America and the Caribbean using household- or individual-level data in existing reviews limits their policy relevance. Objective To conduct a systematic review and meta-analysis to assess the association between prices and taxes and the use of tobacco products in Latin America and the Caribbean. Methods We searched six electronic bibliographic databases, two online search engines, two working paper repositories, and hand-searched seven journals. We included all quantitative studies that used any measures of individual or household tobacco use as an outcome, written in English, Portuguese or Spanish. We used random-effects meta-analyses to pool results across studies. Results We found consistent evidence that in Latin American countries, higher cigarette prices were associated with lower cigarette smoking participation, consumption and initiation and that effect sizes were large enough to be policy meaningful. Pooled own-price elasticities indicate that higher prices were associated with a less than proportional decrease in tobacco use (pooled own-price elasticities, participation: –0.14 [95%CI –0.22, –0.06]; consumption: –0.54 [95%CI –0.75, –0.34]; total: -0.75 [95%CI -1.14, -0.36]). We found no consistent evidence that socioeconomic status, age, sex, rurality, or geographic regions affected price responsiveness. Conclusions Our review confirms that taxes that raise tobacco prices can effectively lower tobacco use. Moreover, raising tobacco prices through increased taxes is anticipated to boost tax revenue due to the inelastic nature of the demand for tobacco.

This study provides a comprehensive overview of wastewater surveillance studies on pathogens, identifies key characteristics of studies that are associated with public health actions, and highlights the actions resulting from these studies. Many studies refer to the value of wastewater surveillance in public health decision-making, but it remains unclear how many studies support public health action and whether this is incorporated into study designs. Therefore, we conducted a scoping review following PRISMA guidelines and used the machine learning tool ASReview to identify wastewater surveillance studies monitoring pathogen circulation in human populations, followed by correlational analyses. A total of 974 studies were included, of which only 84 described public health action. Merely 28 of these incorporated strategies to facilitate action within their study designs. Studies leading to public health action primarily monitored viruses, e.g., SARS-CoV-2 and poliovirus, and since 2024 also influenza A and B virus, respiratory syncytial virus, hepatitis A virus and mpox virus. Furthermore, studies conducted by public health institutes or targeting non-standard locations are more likely to result in action, whereas those with larger population sizes or focusing on residential areas are less likely to result in action. The most common public health actions included informing health authorities and identifying cases. Our findings highlight the value of learning from existing use cases. While wastewater surveillance can support public health actions, evidence of its use is limited. Future studies should improve study designs by, e.g., incorporating strategies for public health actions to maximize their effectiveness and impact on decision-making.

Purpose of review: Early Gestational Diabetes Mellitus (eGDM) is an emerging public health issue in India, characterised by varying prevalence estimates, healthcare access disparities, and inconsistent screening practices. This scoping review aims to map the existing literature on eGDM screening in India, identify evidence gaps, and inform future research, policy formulation, and resource allocation. Recent findings: The review, guided by the Arksey and O'Malley framework, includes studies published between 2000 and 2024 that highlight significant eGDM screening and management disparities across public and private healthcare settings, rural-urban locations, and socioeconomic groups. Several screening initiatives have been introduced, but challenges persist, including a lack of standardised diagnostic criteria, low healthcare provider awareness, limited accessibility of screening, and sociocultural barriers. Economic evaluations suggest that eGDM screening can be cost-effective, yet India-specific assessments remain scarce. The integration of eGDM screening within India's national healthcare programs, including NPCDCS, remains minimal. There is a significant gap in knowledge translation, with limited efforts in adapting research findings into policy and practice. Addressing these challenges requires robust policy and programmatic responses, including standardised diagnostic guidelines, improved healthcare provider training, equitable service access, and culturally sensitive community engagement. Strengthening research-to-policy pathways is critical to improving eGDM screening and outcomes across India.

Fluoridation of community water supplies constitutes one of the most effective public health interventions for preventing dental caries. In recent years, questions have been raised about its effectiveness and safety. This study aims to systematically review and summarize the existing evidence on community water fluoridation (CWF) and dental caries in permanent and deciduous teeth. Five databases and 3 gray databases were searched for relevant studies. Paired reviewers independently screened the studies, extracted data, and assessed their methodological quality. Standard mean differences (SMDs) for dmf(s)/DMFT(S) (decayed, missing, and filled teeth/surface) and odds ratios (ORs) for caries prevalence were measured between exposure or not to CFW for deciduous and permanent teeth. Subgroup analysis was performed to explore whether the study design, continent, or decade of publication changed the point estimates. Seventy-four studies were included in the qualitative analysis: 57 cross-sectional, 13 before-and-after, and 4 cohort studies. Thirty-two studies provided sufficient data for meta-analyses. The overall SMD of DMFT and dmf in those exposed to CWF compared with unexposed were -0.32 (95% confidence interval [CI]: -0.48 to -0.17, I2 = 96%, P < 0.01) and -0.30 (95% CI: -0.39 to -0.21, I2 = 88%, P < 0.01), respectively. The prevalence of caries was smaller in those exposed to CWF for both the permanent (OR = 0.52, 95% CI: 0.43 to 0.63) and deciduous (OR = 0.60, 95% CI: 0.48 to 0.76) dentitions. Study design, continent, or decade of publication satisfactorily explained the heterogeneity between studies. Communities where water was fluoridated experienced less caries and differences expressed in terms of SMD and prevalence (OR) where of high magnitude, both in children and in adults. The results of the meta-analyses revealed significant differences in caries experience and prevalence in favor of CWF, which represents an effective and comprehensive public health intervention for caries prevention, especially in the primary dentition.Knowledge Transfer Statement:Based on the published literature, the results of this study show that fluoridation of community water supplies is still an effective public health intervention to prevent dental caries, both in children and adults, despite the widespread availability of fluoride-containing dental products, especially toothpaste. This result adds to the existing evidence to support its incorporation into public oral health policies.

Purpose: Mobile health (mHealth) applications (apps) have emerged as powerful tools for enhancing clinical decision-making, knowledge dissemination, and proactive care in traumatic dental injuries (TDIs). This systematic review aims to collate and assess the available evidence on the usefulness of mobile apps in (1) diagnosis, (2) prevention, (3) management, and (4) education of TDIs. Methods: This review examined studies published between January 2012 and August 2024, focusing on randomised controlled trials (RCTs), clinical trials, cohort studies, and cross-sectional studies that assessed the effectiveness of mobile health apps in the management of TDI care. Study quality was assessed using the Cochrane Risk of Bias Tool 2.0 for RCTs and the modified Newcastle-Ottawa Scale for cross-sectional studies. The GRADE approach was used to assess the certainty of the evidence. Results: Sixteen studies met the inclusion criteria, including 12 cross-sectional studies and 4 RCTs. The cross-sectional studies primarily assessed knowledge improvement, while the RCTs focused on skill development and practical applications. Quality assessments indicated notable methodological concerns. All four RCTs were rated as high risk of bias due to inadequate randomisation, lack of blinding, and participant attrition. According to the GRADE approach, the overall certainty of the evidence was judged to be very low. Conclusion: While mobile health applications such as ToothSOS, Dental Trauma, and Injured Tooth show promise in improving knowledge and decision-making related to TDIs, the evidence is limited by high risk of bias and low quality. Future studies should focus on rigorous RCTs and explore AI integration to enhance effectiveness.

Background: Healthcare workers (HCWs) are at high risk of acquiring and transmitting infections, including COVID-19. Vaccination is a crucial method for preventing the spread of infectious diseases; however, vaccine non-acceptance can hinder optimal vaccine coverage. This research aims to evaluate the level of COVID-19 vaccine acceptance and the associated factors among HCWs in West Africa. Methods: A structured literature review of quantitative cross-sectional studies was conducted, searching databases including Medical Literature Analysis and Retrieval System Online (MEDLINE), African Journals Online, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Google Scholar. The review focused on studies from April 2021 to February 2023 that examined factors influencing COVID-19 vaccine acceptance among HCWs in West Africa. Data extraction and quality assessment of the included studies were conducted using Joanna Briggs Institute tools. Results: Five articles met the inclusion criteria, and they reported that the acceptance level of the COVID-19 vaccine ranged from 38.3% to 73.6%. Barriers to acceptance included concerns about vaccine safety and effectiveness, side effects, short duration of clinical trials, limited and false information, and lack of social trust. Conclusions: COVID-19 vaccine acceptance among West African HCWs is influenced by sociodemographic factors, vaccine concerns, and accurate information, necessitating health promotion strategies and multisectoral collaboration for improved acceptance.

Objective: This study aims to assess research trends in the association between schizophrenia and autoimmune diseases, systematically review their relationship, and evaluate the credibility of existing evidence. Methods: Bibliometric analysis was conducted using the bibliometrix package in R, along with VOSviewer and CiteSpace. Relevant systematic reviews and meta-analyses were retrieved from six databases: PubMed, Web of Science, Embase, CINAHL, PsycINFO, and the Cochrane Library. Summary risk estimates were recalculated using the DerSimonian and Laird method under a random-effects model, and the credibility of the evidence was assessed. Results: The bibliometric analysis found that "meta-analysis" has become a frequently used keyword and may be a focal point for future research. The umbrella review included 17 articles, containing 24 report data points from 12 quantitative reviews. Results indicated that 9 reports assessed the relationship between schizophrenia and autoimmune diseases. Schizophrenia was significantly associated with autoimmune neurological disorders (RR = 1.42; 95 % CI = 1.18-1.72), providing suggestive evidence. Seven reports evaluated the impact of schizophrenia on autoimmune diseases, showing highly suggestive evidence that schizophrenia patients had a pooled relative risk of 2.22 (95 % CI = 1.95-2.52) for psoriasis. Eight reports assessed the impact of autoimmune diseases on schizophrenia, with bullous pemphigoid patients showing significantly higher schizophrenia prevalence (OR = 2.63; 95 % CI = 2.03-3.39). Conclusions: This study synthesizes evidence of varying levels, highlighting the association between schizophrenia and autoimmune diseases. It offers new insights for future exploration, fosters interdisciplinary collaboration, and provides valuable implications for public health policy development.

Background: Given trends towards greater life expectancy, there is an increasing need to promote healthy ageing and add quality and value to older adults' lives, however the evidence regarding the effects on overall health and wellbeing has not been synthesised. Active lifestyles may provide diverse health and wellbeing benefits for older adults in terms of maintaining or improving their physical, psychological, and social functions. This systematic review evaluates whether and how different types of interventions within community-based settings could benefit specific aspects of older adults' health and wellbeing. Methods: PubMed, PsycINFO, Scopus and Web of Science were systematically searched in January 2022 for experimental studies (including randomised controlled trials, non-randomised controlled trials, and quasi-experimental studies) exploring health and wellbeing benefits of community-based activities in older adults. A total of 12,707 sources were identified through database searches with 183 retained for full screening. Final inclusion was based on the following eligibility criteria: (1) participants were generally healthy and predominantly independent community-dwelling older adults aged 60 and above; (2) interventions were based in real-world settings, e.g., dance, art and technology classes, etc. held in publicly-accessible facilities; (3) pre-/post-interventions assessed at least one outcome in physical health, psychological wellbeing or social connections; (4) control groups were used, including passive and active control groups or groups that received a different type of intervention; (5) experimental studies followed a quantitative research design. Study quality was systematically assessed, and a comprehensive narrative synthesis of the findings was conducted. Results: Of the 183 studies screened, 56 were included in the final review. Among the 33 predominantly physical interventions, 31 demonstrated positive effects. Of the 16 predominantly mental interventions, 14 reported benefits. All seven predominantly social interventions reported positive effects. Discussion: The benefits of real-world interventions were reported across a range of outcomes, particularly in terms of reducing depression or anxiety, or improving physical functioning, sleep quality and social participation. However, heterogeneity in interventions, sample design, duration and dosage suggest that more research is needed to support the effects of duration and dosage of intervention exposure. As real-world interventions more closely resemble the way in which older people engage in activities, evidence of their effectiveness in promoting health and wellbeing should inform preventative healthcare provision and policymaking.

Background Organizational Health Literacy (OHL) refers to the extent to which organizations facilitate equitable access, comprehension, and use of health information and services for informed decision-making. Objective This study aimed to (1) review and map existing OHL frameworks and (2) propose an innovative OHL framework that addresses gaps identified in current models. Methods A systematic search of academic (Web of Science, Scopus, MEDLINE) and grey literature from the past 15 years was conducted to identify OHL frameworks. This scoping review followed the PRISMA-ScR guidelines and the Arksey and O’Malley model. A new OHL intervention framework was developed to address gaps in existing models, based on the principles of preventive medicine and the public health action cycle. Results A total of 19 records were included (10 from academic databases and 9 from grey literature), covering diverse approaches and contexts related to OHL. Four intervention levels were identified: integrating HL into formal education, implementing HL assessments, developing interventions for vulnerable populations, and enhancing accessibility to health resources. The proposed framework emphasizes intersectoral collaboration and communication pathways between education and healthcare sectors, facilitating information exchange to continuously adapt interventions to population needs. Conclusion OHL development requires intersectoral collaboration; however, interoperability between sectors remains unaddressed in existing frameworks. This study proposes an innovative model that fosters sectoral connections toward a shared goal, creating a truly collaborative framework.

Objective: This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Data sources: We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature. Eligibility criteria for study selection: We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention. Methods: Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention. Conclusion: Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well. Prospero registration number: PROSPERO (CRD42021296618).