{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:04:10Z","timestamp":1784268250608,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Non\u2010communicable diseases (NCDs), such as type 1 diabetes, rheumatic heart disease, and sickle cell disease, impose significant health and social burdens in Nepal, particularly among children and young adults. To strengthen visibility, reduce NCD\u2010related stigma, and foster engagement with the PEN\u2010Plus program, a participatory design process was adopted to develop a national logo. This article outlines and critically reflects on the rationale, participatory development process, and symbolism behind the PEN\u2010Plus Nepal logo, situating it within the broader field of health communication and social branding. Drawing on behavioral science theories and participatory design principles, the PEN\u2010Plus logo was co\u2010created with patients, health workers, government representatives, and communication experts. Ministry of Health and Population, National Health Education, Information and Communication Center officially endorsed the PEN\u2010Plus logo, which now serves as a unifying symbol to raise awareness, foster community ownership, and support long\u2010term advocacy for equitable severe NCD care in Nepal.<\/jats:p>","DOI":"10.1002\/puh2.70242","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:26:36Z","timestamp":1778513196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visual Identity, Social Branding, and Advocacy: Development of the PEN\u2010Plus Logo for Severe Non\u2010Communicable Disease Care in Nepal"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5244-5536","authenticated-orcid":false,"given":"Dhurba","family":"Khatri","sequence":"first","affiliation":[{"name":"Kathmandu Institute of Child Health (KIOCH)  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3077-6697","authenticated-orcid":false,"given":"Shishir","family":"Paudel","sequence":"additional","affiliation":[{"name":"Kathmandu Institute of Child Health (KIOCH)  Kathmandu Nepal"},{"name":"National Centre for Epidemiology and Population Health The Australian National University Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5534-4876","authenticated-orcid":false,"given":"Yamuna","family":"Chhetri","sequence":"additional","affiliation":[{"name":"Kathmandu Institute of Child Health (KIOCH)  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-2940","authenticated-orcid":false,"given":"Bhakta Bahadur","family":"K. C.","sequence":"additional","affiliation":[{"name":"Ministry of Health and Population  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudra Prakash","family":"Hada","sequence":"additional","affiliation":[{"name":"Kathmandu Institute of Child Health (KIOCH)  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela","family":"Shrestha","sequence":"additional","affiliation":[{"name":"National Health Education, Information and Communication Center Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leela","family":"Khanal","sequence":"additional","affiliation":[{"name":"Independent Researcher  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-5604","authenticated-orcid":false,"given":"Sandeepa","family":"Karki","sequence":"additional","affiliation":[{"name":"Kathmandu Institute of Child Health (KIOCH)  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization Nepal Implements Program to Strengthen Noncommunicable Disease Services Through Capacity Building of Health Workers(World Health Organization 2022) https:\/\/www.who.int\/nepal\/news\/detail\/14\u201012\u20102022\u2010nepal\u2010implements\u2010program\u2010to\u2010strengthen\u2010noncommunicable\u2010disease\u2010services\u2010through\u2010capacity\u2010building\u2010of\u2010health\u2010workers."},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization Noncommunicable Diseases(World Health Organization 2024) https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/noncommunicable\u2010diseases."},{"key":"e_1_2_10_4_1","unstructured":"UNICEF.Non\u2010Communicable Diseases. Behaviours That Lead to Disease Often Emerge During Childhood and Adolescence(UNICEF 2024) https:\/\/www.unicef.org\/health\/non\u2010communicable\u2010diseases."},{"key":"e_1_2_10_5_1","volume-title":"PEN\u2010Plus\u2013A Regional Strategy to Address Severe Noncommunicable Diseases at First\u2010Level Referral Health Facilities","author":"World Health Organization","year":"2022"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072673"},{"key":"e_1_2_10_7_1","unstructured":"Department of Health Services Annual Health Report 2080\/81(Department of Health Services: Ministry of Health and Population 2025)."},{"key":"e_1_2_10_8_1","volume-title":"Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care in Low\u2010Resource Settings","author":"World Health Organization","year":"2010"},{"key":"e_1_2_10_9_1","volume-title":"Package of Essential Non\u2010Communicable Disease (PEN) Intervention at Primary Health Service Setting","author":"Epidemiology and Disease Control Division","year":"2019"},{"key":"e_1_2_10_10_1","unstructured":"NCDI Poverty Network Integrated Chronic Care for People Living With Severe NCDs in Impoverished Rural Areas(NCDI Poverty Network 2025) https:\/\/www.ncdipoverty.org\/penplus\u20101."},{"key":"e_1_2_10_11_1","unstructured":"Department of Health Services Ministry of Health and Population (MoHP): Annual Health Report 2079\/80(Department of Health Services 2024)."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2025-020872"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13142\u2010014\u20100272\u20101"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0043"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780199237135.001.0001"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.1"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749-5978(91)90020-T"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2885.2003.tb00287.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneb.2006.08.020"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneb.2006.05.011"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14121517"},{"key":"e_1_2_10_22_1","unstructured":"Ministry of Health and Population National Female Community Health Volunteer Program Strategy: Family Health Division(Ministry of Health and Population 2010) https:\/\/scorecard.prb.org\/wp\u2010content\/uploads\/2022\/03\/nepal_national_female_chv_program_strategy.pdf."},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12945"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2020.40"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.4103\/jncd.jncd_87_23"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/puh2.70242","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:10:29Z","timestamp":1784265029000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/puh2.70242"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70242","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"assertion":[{"value":"2025-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70242"}}