International Journal of Environmental Research and Public Health

This study aimed to assess post-outbreak COVID-19 prevention, patient care, and counseling practices among healthcare professionals (HCPs) compared to recalled outbreak practices and to determine factors associated with post-outbreak practices. A cross-sectional survey was conducted among physicians, pharmacists, and nurses working in two university hospitals from December 2023 to February 2024. Practices for both periods were self-reported at a single survey time point. The COVID-19 outbreak period was from 11 March 2020 to 1 July 2022 and the post-outbreak period from 1 July 2022, onward. Of 820 invited HCPs, 444 responded (54.1% response rate). Most practices were reported less frequently in the post-outbreak period. However, HCPs, in both periods, consistently practiced screening or asking about COVID-19 symptoms before initiating services and providing hand sanitizers and face masks for patients (p = 0.389 and p = 0.132, respectively). Providing accurate information and preventive advice to patients was the most frequent counseling activity in both periods (outbreak, 65.6%, and post-outbreak, 52.2%; p < 0.001). Multiple logistic regression showed that nurses (aOR = 5.810; p < 0.001) and HCPs who spent 30–50% (aOR = 3.412; p = 0.034) or more than 50% (aOR = 3.389; p = 0.021) of work time in direct patient care had higher levels of preventive practices. Participation in COVID-19-related training or academic conferences was associated with enhanced counseling practices in the post-outbreak period (1–2 times: aOR = 2.171; p = 0.021; ≥3 times: aOR = 5.171; p < 0.001). The findings indicated that the reported frequency of several practices declined in the post-outbreak period. Further strategies are needed to sustain quality in preventive and care practices among HCPs.

Household food production (HFP) has been proposed as a strategy to promote healthier and more sustainable food environments, although its association with dietary practices among rural populations remains unclear. This study aimed to evaluate the association between household food production and the dietary habits of schoolchildren and their families. This cross-sectional study evaluated 465 schoolchildren aged 6–13 years from eight rural schools in the Maule Region, Chile, and their families. Household characteristics, HFP, and dietary intake were assessed using caregiver-administered questionnaires. Overall, 46.5% of households reported HFP. Among schoolchildren, HFP was associated with a higher frequency of daily water consumption (97.0% vs. 92.0%; p = 0.035); however, no significant differences were observed in fruit, vegetable, or sugar-sweetened beverage (SSB) consumption. At the family level, households engaged in food production reported a lower prevalence of daily SSB consumption than those without HFP (20.0% vs. 34.0%; p = 0.014). School snacks were predominantly characterized by fried snacks and ultra-processed beverages regardless of HFP status. Overall, these findings suggest that HFP may be associated with specific healthier dietary practices but may not be sufficient to modify children’s dietary patterns when considered in isolation. These findings support integrated strategies to promote healthier dietary practices.

Preterm birth is a pressing public health issue, with short- and long-term implications for newborns, their families, and society. Although studies are increasingly examining the structural determinants of this birth outcome, few have considered the role of regional equity—residents’ access to resources, opportunity, and power within a region. This study merges U.S. birth certificate data (2023) with a metropolitan-level Racial Equity Index generated by the National Equity Atlas project to investigate the overall and race-specific associations between racial equity, including its constituent measures of prosperity and inclusion, and preterm birth. Multivariable logistic regression models were fit for the overall sample (N = 2,359,347) and stratified by race. Regional prosperity reduced the odds of preterm birth, but the effect of racial inclusion depended on whether it was measured as past or current performance. Combining past inclusion with current prosperity resulted in 4% lower odds of preterm birth. The results provide some support for proponents who emphasize the importance of historic legacies of exclusion, but they also suggest that attention should extend to regional growth and prosperity since those set the basis for the resources to distribute more equitably. Addressing preterm birth will require sustained commitment to both closing racial gaps and ensuring shared prosperity.