{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:02:45Z","timestamp":1792252965535,"version":"4.4.0"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Social prescribing (SP) has not yet been officially introduced in Japan. This qualitative case study aimed to identify the challenges and facilitating factors in the implementation of SP among the socially isolated older population in Akita Prefecture, Japan, based on the perspectives of general practitioners (GP), link workers (LW), and patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      We conducted a qualitative case study using semi-structured interviews and Braun &amp;amp; Clarke-informed thematic analysis in seven medical districts in Akita, Japan, with GP (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f7), LW (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f10), and older patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (GP and LW) emphasized that SP needed to be tailored to individual needs and that LW played a vital role as social resources in sparsely populated rural communities. The project was publicly funded; participants emphasized that, in the absence of financial support, intrinsic motivation would be important to sustaining implementation. Both groups raised concerns about ensuring LW\u2019s competencies, the accessibility and cost of community resources, and the limited availability of such resources in rural areas. Patients highlighted that the effectiveness of SP varied by personal characteristics, and that transport barriers significantly restricted participation, highlighting the need for local support to mitigate this challenge. Establishing patients\u2019 trust in LW and GP, along with effective communication, was viewed as essential for identifying and addressing patient-level barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In rural, resource-constrained settings such as Akita, successful SP depends on tailoring to individual needs, ensuring LW competence, and addressing transport barriers. These findings suggest that future policies should focus on sustainable funding for LW, integration with existing health and welfare systems, and mobility solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1659713","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T04:18:26Z","timestamp":1760588306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Social prescribing for socially isolated older adults in rural Japan: a qualitative case study"],"prefix":"10.3389","volume":"13","author":[{"given":"Naho","family":"Ota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Ebihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Iwasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiichiro","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songee","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Makabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Rothwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Illing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref1","year":"2022"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1017\/s0144686x11000642","article-title":"Age and loneliness in 25 European nations","volume":"31","author":"Yang","year":"2011","journal-title":"Ageing Soc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"113514","DOI":"10.1016\/j.psychres.2020.113514","article-title":"The effect of loneliness on distinct health outcomes: a comprehensive review and Meta-analysis","volume":"294","author":"Park","year":"2020","journal-title":"Psychiatry Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"697","DOI":"10.3233\/jad-230901","article-title":"Social loneliness in older adults with mild cognitive impairment: predictive factors and associated clinical characteristics","volume":"97","author":"Crespo","year":"2024","journal-title":"J Alzheimer's Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"104980","DOI":"10.1016\/j.archger.2023.104980","article-title":"Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: findings from a longitudinal study","volume":"110","author":"Zhang","year":"2023","journal-title":"Arch Gerontol Geriatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1177\/1745691614568352","article-title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","volume":"10","author":"Holt-Lunstad","year":"2015","journal-title":"Perspect Psychol Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1111\/psyg.12957","article-title":"Social isolation, loneliness, and their correlates in older Japanese adults","volume":"23","author":"Kino","year":"2023","journal-title":"Psychogeriatrics"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e008524","DOI":"10.1136\/bmjgh-2022-008524","article-title":"Global developments in social prescribing","volume":"7","author":"Morse","year":"2022","journal-title":"BMJ Glob Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3399\/bjgp11x572517","article-title":"Social prescribing in very deprived areas","volume":"61","author":"Cawston","year":"2011","journal-title":"Br J Gen Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1111\/hsc.13295","article-title":"Link worker perspectives of early implementation of social prescribing: a \u2018researcher-in-residence\u2019 study","volume":"29","author":"Hazeldine","year":"2021","journal-title":"Health Soc Care Community"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e017734","DOI":"10.1136\/bmjopen-2017-017734","article-title":"Preparing the prescription: a review of the aim and measurement of social referral programmes","volume":"7","author":"Rempel","year":"2017","journal-title":"BMJ Open"},{"key":"ref12","year":"2024"},{"key":"ref13","year":"2021"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/1471-2288-11-100","article-title":"The case study approach","volume":"11","author":"Crowe","year":"2011","journal-title":"BMC Med Res Methodol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1108\/rausp-05-2019-0109","article-title":"Case study research: opening up research opportunities","volume":"55","author":"Takahashi","year":"2020","journal-title":"RAUSP Manag J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1111\/j.1365-2648.2009.04998.x","article-title":"Qualitative case study methodology in nursing research: an integrative review","volume":"65","author":"Anthony","year":"2009","journal-title":"J Adv Nurs"},{"key":"ref17","first-page":"162","article-title":"The revised Hasegawa\u2019s dementia scale (HDS-R)-evaluation of its usefulness as a screening test for dementia","volume":"4","author":"Imai","year":"1994","journal-title":"Hong Kong J Psychiatry"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A short scale for measuring loneliness in large surveys: results from two population-based studies","volume":"26","author":"Hughes","year":"2004","journal-title":"Res Aging"},{"key":"ref19","first-page":"12","author":"Murai","year":"2020"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1186\/s12877-022-03341-8","article-title":"Catastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS","volume":"22","author":"Li","year":"2022","journal-title":"BMC Geriatr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1111\/scs.12041","article-title":"Social provision and loneliness among older people suffering from chronic physical illness. A mixed-methods approach","volume":"28","author":"Kvaal","year":"2014","journal-title":"Scand J Caring Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"826945","DOI":"10.3389\/fpsyg.2022.826945","article-title":"Social withdrawal (hikikomori) conditions in China: a Cross-sectional online survey","volume":"13","author":"Hu","year":"2022","journal-title":"Front Psychol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12882-021-02373-3","article-title":"The relationship between financial hardship and incident diabetic kidney disease in older US adults \u2013 a longitudinal study","volume":"22","author":"Corwin","year":"2021","journal-title":"BMC Nephrol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/s0140-6736(12)60240-2","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study","volume":"380","author":"Barnett","year":"2012","journal-title":"Lancet"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"E221","DOI":"10.1503\/cmaj.121349","article-title":"The effect of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned admissions to hospital: a retrospective cohort study","volume":"185","author":"Payne","year":"2013","journal-title":"Can Med Assoc J"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.socscimed.2017.11.008","article-title":"The relationship between physical and mental health: a mediation analysis","volume":"195","author":"Ohrnberger","year":"2017","journal-title":"Soc Sci Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"5713","DOI":"10.3390\/ijerph17165713","article-title":"Oral health and care for elderly people with alzheimer\u2019s disease","volume":"17","author":"Gao","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e693","DOI":"10.1016\/s2666-7568(23)00211-8","article-title":"Associations of socioeconomic status and healthy lifestyle with incident early-onset and late-onset dementia: a prospective cohort study","volume":"4","author":"Li","year":"2023","journal-title":"Lancet Heal Longev"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s00784-017-2264-2","article-title":"Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues","volume":"22","author":"Delwel","year":"2018","journal-title":"Clin Oral Investig"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1146\/annurev-psych-122216-011902","article-title":"Why social relationships are important for physical health: a systems approach to understanding and modifying risk and protection","volume":"69","author":"Holt-Lunstad","year":"2018","journal-title":"Annu Rev Psychol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"104992","DOI":"10.1016\/j.healthpol.2024.104992","article-title":"A comparison of social prescribing approaches across twelve high-income countries","volume":"142","author":"Scarpetti","year":"2024","journal-title":"Health Policy"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e70286","DOI":"10.1111\/hex.70286","article-title":"Reimagining dementia care: a complex intervention systematic review on optimising social prescribing (SP) for carers of people living with dementia (PLWD) in the United Kingdom","volume":"28","author":"Marshall","year":"2025","journal-title":"Health Expect"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/26895269.2022.2129597","article-title":"Toward good practice in thematic analysis: avoiding common problems and be(com)ing a knowing researcher","volume":"24","author":"Braun","year":"2023","journal-title":"Int J Transgender Health"},{"key":"ref34","first-page":"448","volume-title":"Fourth generation evaluation","author":"Guba","year":"1989"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1002\/jgf2.551","article-title":"Social prescribing from the patient\u2019s perspective: a literature review","volume":"23","author":"Araki","year":"2022","journal-title":"J Gen Fam Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12875-021-01407-x","article-title":"Social prescribing for people with complex needs: a realist evaluation","volume":"22","author":"Wood","year":"2021","journal-title":"BMC Fam Pract"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"11849","DOI":"10.3390\/ijerph182211849","article-title":"Solving social problems in aging rural japanese communities: the development and sustainability of the osekkai conference as a social prescribing during the covid-19 pandemic","volume":"18","author":"Naito","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1471-2296-9-27","article-title":"Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation","volume":"9","author":"Grayer","year":"2008","journal-title":"BMC Fam Pract"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1396614","DOI":"10.3389\/fpubh.2024.1396614","article-title":"Social prescribing for suicide prevention: a rapid review","volume":"12","author":"Dash","year":"2024","journal-title":"Front Public Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1177\/1742395319845427","article-title":"Does self-determination theory help explain the impact of social prescribing? A qualitative analysis of patients\u2019 experiences of the Glasgow \u2018deep-end\u2019 community links worker intervention","volume":"17","author":"Hanlon","year":"2021","journal-title":"Chronic Illn"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12916-020-1510-7","article-title":"Supporting social prescribing in primary care by linking people to local assets: a realist review","volume":"18","author":"Tierney","year":"2020","journal-title":"BMC Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e015203","DOI":"10.1136\/bmjopen-2016-015203","article-title":"Link worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions","volume":"7","author":"Moffatt","year":"2017","journal-title":"BMJ Open"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1252157","DOI":"10.3389\/fpubh.2023.1252157","article-title":"Community-based social healthcare practices in China for healthy aging: a social prescription perspective analysis","volume":"11","author":"Menhas","year":"2023","journal-title":"Front Public Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1017\/s146342360800087x","article-title":"Can social prescribing provide the missing link?","volume":"9","author":"South","year":"2008","journal-title":"Prim Health Care Res Dev"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e40125","DOI":"10.2196\/40125","article-title":"Effectiveness of technology interventions in addressing social isolation, connectedness, and loneliness in older adults: systematic umbrella review","volume":"5","author":"Balki","year":"2022","journal-title":"JMIR Aging"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.2196\/jmir.5260","article-title":"Long-term condition self-management support in online communities: a meta-synthesis of qualitative papers","volume":"18","author":"Allen","year":"2016","journal-title":"J Med Internet Res"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"12980","DOI":"10.1073\/pnas.1605554113","article-title":"Online social integration is associated with reduced mortality risk","volume":"113","author":"Hobbs","year":"2016","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1108\/itp-02-2013-0040","article-title":"Online health communities: an assessment of the influence of participation on patient empowerment outcomes","volume":"26","author":"Johnston","year":"2013","journal-title":"Inf Technol People"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/s12469-023-00333-8","article-title":"What can be done with today\u2019s budget and demand? Scenarios of rural public transport automation in M\u00fchlwald (South Tyrol)","volume":"16","author":"Dianin","year":"2024","journal-title":"Public Transp"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"750609","DOI":"10.3389\/fpubh.2021.750609","article-title":"A technology training program to alleviate social isolation and loneliness among homebound older adults: a community case study","volume":"9","author":"Jim\u00e9nez","year":"2021","journal-title":"Front Public Health"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s41062-022-00763-6","article-title":"Exploring the implications of autonomous vehicles: a comprehensive review","volume":"7","author":"Othman","year":"2022","journal-title":"Innov Infrastruct Solut"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e34221","DOI":"10.2196\/34221","article-title":"Customized information and communication technology for reducing social isolation and loneliness among older adults: scoping review","volume":"9","author":"Thangavel","year":"2022","journal-title":"JMIR Ment Health"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e73625","DOI":"10.2196\/73625","article-title":"Exploring literature on data governance in the health Care of Older Persons: scoping review","volume":"8","author":"Garcia","year":"2025","journal-title":"JMIR Aging"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1016\/j.lanhl.2024.100664","article-title":"The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial","volume":"6","author":"Yeung","year":"2025","journal-title":"Lancet Heal Longev"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"2016261","DOI":"10.1155\/hsc\/2016261","article-title":"Green social prescribing: a before and after evaluation of a novel community-based intervention for adults experiencing mental health problems","volume":"2025","author":"Darcy","year":"2025","journal-title":"Health Soc Care Community"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"11263","DOI":"10.3390\/ijerph191811263","article-title":"What are more efficient transportation Services in a Rural Area? A case study in Yangsan City, South Korea","volume":"19","author":"Roh","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e062951","DOI":"10.1136\/bmjopen-2022-062951","article-title":"Effect of social prescribing link workers on health outcomes and costs for adults in primary care and community settings: a systematic review","volume":"12","author":"Kiely","year":"2022","journal-title":"BMJ Open"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1531801","DOI":"10.3389\/fpubh.2025.1531801","article-title":"Does social prescribing address social determinants of health?","volume":"13","author":"Islam","year":"2025","journal-title":"Front Public Health"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5334\/ijic.9127","article-title":"Integrating non-clinical supports into care: a systematic review of social prescribing referral pathways for mental health, wellbeing, and psychosocial improvement","volume":"25","author":"Spanos","year":"2025","journal-title":"Int J Integr Care"},{"key":"ref60","first-page":"226","article-title":"GPs and voluntary organizations","volume":"45","author":"Graham","year":"1995","journal-title":"Br J Gen Pract"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1093\/fampra\/18.1.84","article-title":"What prevents GPs from using outside resources for women experiencing depression? A new Zealand study","volume":"18","author":"Wilson","year":"2001","journal-title":"Fam Pract"},{"key":"ref62","first-page":"i","article-title":"General practitioners at the deep end: the experience and views of general practitioners working in the most severely deprived areas of Scotland","volume":"89","author":"Watt","year":"2012","journal-title":"Occas Pap R Coll Gen Pract"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1017\/s1463423616000219","article-title":"Developing and implementing a social prescribing initiative in primary care: insights into the possibility of normalisation and sustainability from a UK case study","volume":"18","author":"Whitelaw","year":"2017","journal-title":"Prim Health Care Res Dev"},{"key":"ref64","year":"2020"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"e320","DOI":"10.1002\/hsr2.320","article-title":"Effects of social prescribing pilot project for the elderly in rural area of South Korea during COVID-19 pandemic","volume":"4","author":"Kim","year":"2021","journal-title":"Health Sci Rep"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"11652","DOI":"10.3390\/su151511652","article-title":"Unveiling the presence of social prescribing in Romania in the context of sustainable healthcare\u2014a scoping review","volume":"15","author":"Surugiu","year":"2023","journal-title":"Sustainability"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"e338","DOI":"10.1111\/hsc.13358","article-title":"\u201c\u2018It sounded a lot simpler on the job description\u2019\u201d: a qualitative study exploring the role of social prescribing link workers and their training and support needs (2020)","volume":"29","author":"Rhodes","year":"2021","journal-title":"Health Soc Care Community"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"515469","DOI":"10.3389\/fpubh.2020.515469","article-title":"Social prescribing\u2014an effort to apply a common knowledge: impelling forces and challenges","volume":"8","author":"Islam","year":"2020","journal-title":"Front Public Health"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/hsc.12839","article-title":"What approaches to social prescribing work, for whom, and in what circumstances? A realist review","volume":"28","author":"Husk","year":"2020","journal-title":"Health Soc Care Community"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1659713\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T04:18:29Z","timestamp":1760588309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1659713\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":69,"alternative-id":["10.3389\/fpubh.2025.1659713"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1659713","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]},"article-number":"1659713"}}