{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:04:34Z","timestamp":1790741074211,"version":"4.1.0"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-acting injectable Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP), particularly cabotegravir, presents a promising HIV prevention option in Sub-Saharan Africa (SSA), where HIV prevalence remains high. As frontline providers, healthcare workers (HCWs) are central to PrEP delivery. Given the emerging introduction of injectable PrEP in SSA, this review examines HCW perspectives on PrEP delivery broadly, including both oral and injectable formulations, with particular attention to how oral PrEP implementation experiences inform injectable PrEP readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review was conducted with a comprehensive literature search across PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar for English-language studies published 2020\u20132025. Eligible studies comprised qualitative, quantitative, and mixed-methods primary research that examined healthcare workers\u2019 knowledge, perceptions, attitudes, and readiness to deliver HIV PrEP in SSA. Relevant studies were identified, reviewed, and analyzed thematically to identify key patterns and implementation considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 742 records were identified across databases, and following review, 5 primary studies met the scope criteria, all examining oral PrEP implementation in Uganda, South Africa, Kenya, and Zimbabwe. Findings revealed varied HCW awareness and knowledge, often influenced by prior exposure to pilot initiatives. Attitudes were generally positive, emphasizing PrEP\u2019s potential to enhance adherence and reduce stigma. Reported barriers included limited training, inadequate infrastructure, increased workload, and the absence of clinical guidelines. Key facilitators included task-shifting, government commitment, targeted capacity-building, and peer-led learning. These oral PrEP implementation lessons directly inform the readiness of injectable PrEP rollout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healthcare workers in SSA display positive attitudes but uneven readiness to deliver PrEP. While most evidence derives from oral PrEP implementation, lessons learned on training needs, infrastructure requirements, task-shifting strategies, and health system readiness directly inform the introduction of injectable PrEP. Addressing gaps in training, guidelines, and resources, alongside strengthening policy and system support, is essential for the effective integration and scale-up of both oral and injectable PrEP formulations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1818059","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:38:38Z","timestamp":1782106718000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare workers\u2019 perspectives on HIV pre-exposure prophylaxis delivery in Sub-Saharan Africa: implications for injectable formulation rollout\u2014a narrative review"],"prefix":"10.3389","volume":"14","author":[{"given":"Nomvuselelo Nomzamo","family":"Mbatha","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Durban University of Technology","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomakhosi","family":"Mpofana","sequence":"additional","affiliation":[{"name":"Department of Somatology, Faculty of Health Sciences, Durban University of Technology","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dumile","family":"Gumede","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Durban University of Technology","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","volume-title":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach","year":"2021"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"100629","DOI":"10.1016\/j.eclinm.2020.100629","article-title":"Lamivudine\/tenofovir disoproxil fumarate is an appropriate PrEP regimen","volume":"29","author":"Eshleman","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0292049","DOI":"10.1371\/journal.pone.0292049","article-title":"Uptake of oral HIV pre-exposure prophylaxis (PrEP) and associated factors among female sex workers in Tanga, Tanzania","volume":"18","author":"Mwanga","year":"2023","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12960-022-00770-9","article-title":"Human resource needs and costs for HIV pre-exposure prophylaxis provision in nurse-led primary care in Eswatini and opportunities for task sharing","volume":"20","author":"Fehr","year":"2022","journal-title":"Hum Resour Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"a4671","DOI":"10.4102\/phcfm.v17i1.4671","article-title":"Knowledge, attitudes and practices of primary care nurses regarding HIV pre-exposure prophylaxis in Mhlontlo sub-district municipality, eastern cape, South Africa","volume":"17","author":"Hlongwane","year":"2025","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.eclinm.2019.04.006","article-title":"Scaling-up PrEP delivery in sub-Saharan Africa: what can we learn from the scale-up of ART?","volume":"10","author":"Nichols","year":"2019","journal-title":"EClinical Medicine"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/COH.0000000000000206","article-title":"The role of healthcare providers in the roll out of preexposure prophylaxis","volume":"11","author":"Krakower","year":"2016","journal-title":"Curr Opin HIV AIDS"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0258542","DOI":"10.1371\/journal.pone.0258542","article-title":"Adolescent girls and young women\u2019s PrEP-user journey during an implementation science study in South Africa and Kenya","volume":"16","author":"Rousseau","year":"2021","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1177\/10600280221102532","article-title":"Cabotegravir: the first long-acting injectable for HIV preexposure prophylaxis","volume":"57","author":"Durham","year":"2023","journal-title":"Ann Pharmacother"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1097\/QAD.0000000000003494","article-title":"Safety and efficacy of long-acting injectable cabotegravir as preexposure prophylaxis to prevent HIV acquisition","volume":"37","author":"Fonner","year":"2023","journal-title":"AIDS"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1056\/NEJMoa2101016","article-title":"Cabotegravir for HIV prevention in cisgender men and transgender women","volume":"385","author":"Landovitz","year":"2021","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/COH.0000000000000733","article-title":"Promises and challenges: cabotegravir for preexposure prophylaxis","volume":"17","author":"Spinelli","year":"2022","journal-title":"Curr Opin HIV AIDS"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s11904-019-00450-9","article-title":"Current and future PrEP medications and modalities: on-demand, injectables, and topicals","volume":"16","author":"Beymer","year":"2019","journal-title":"Curr HIV AIDS Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"154","DOI":"10.3390\/tropicalmed7080154","article-title":"Long-acting injectable drugs for HIV-1 pre-exposure prophylaxis: considerations for Africa","volume":"7","author":"Moyo","year":"2022","journal-title":"Tropical Med. Inf. Dis."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1097\/QCO.0000000000000511","article-title":"Scaling up pre-exposure prophylaxis in sub-Saharan Africa","volume":"32","author":"Ahmed","year":"2019","journal-title":"Curr Opin Infect Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1205925","DOI":"10.3389\/frph.2023.1205925","article-title":"Implementation determinants and strategies in integration of PrEP into maternal and child health and family planning services: experiences of frontline healthcare workers in Kenya","volume":"5","author":"Wagner","year":"2023","journal-title":"Front Reprod Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e2019093","DOI":"10.29392\/joghr.3.e2019093","article-title":"One health workers: innovations in early detection of human, animal, and plant disease outbreaks","volume":"3","author":"Wilkes","year":"2019","journal-title":"J. Global Health Rep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4102\/phcfm.v9i1.1281","article-title":"Trust of community health workers influences the acceptance of community-based maternal and child health services","volume":"9","author":"Grant","year":"2017","journal-title":"Afr. J. Primary Health Care Family Med."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12981-025-00768-y","article-title":"Knowledge, attitudes, and willingness of healthcare workers to offer pre-exposure prophylaxis in Africa: a systematic review and meta-analysis","volume":"22","author":"Femi-Lawal","year":"2025","journal-title":"AIDS Res Ther"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"658826","DOI":"10.3389\/fpubh.2022.658826","article-title":"Health care worker perspectives of HIV pre-exposure prophylaxis service delivery in Central Uganda","volume":"10","author":"Muwonge","year":"2022","journal-title":"Front Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"qxae066","DOI":"10.1093\/haschl\/qxae066","article-title":"The medical competence of health care providers in sub-Saharan Africa: evidence from 16 127 providers across 11 countries","volume":"2","author":"Daniels","year":"2024","journal-title":"Health Affairs Scholar"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1224461","DOI":"10.3389\/fpubh.2023.1224461","article-title":"The experience of healthcare workers to HIV pre-exposure prophylaxis (PrEP) implementation in low- and middle-income countries: a systematic review and qualitative meta-synthesis","volume":"11","author":"Zhang","year":"2023","journal-title":"Front Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"830","DOI":"10.3390\/ijerph22060830","article-title":"Perspectives of primary healthcare workers on HIV injectable pre-exposure prophylaxis (PrEP): a scoping review protocol","volume":"22","author":"Mbatha","year":"2025","journal-title":"Int J Environ Res Public Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/COH.0000000000000895","article-title":"Transforming HIV prevention: the promise of long-acting preexposure prophylaxis in high HIV burden settings","volume":"20","author":"Joseph Davey","year":"2025","journal-title":"Curr Opin HIV AIDS"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2517","DOI":"10.1007\/s10461-021-03213-z","article-title":"\u201cWe\u2019ve got our own beliefs, attitudes, myths\u201d: a mixed methods assessment of rural south African health care workers' knowledge of and attitudes towards PrEP implementation","volume":"25","author":"Asabor","year":"2021","journal-title":"AIDS Behav"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"23259582221111068","DOI":"10.1177\/23259582221111068","article-title":"\u201cPrEP gives the woman the control\u201d: healthcare worker perspectives on using pre-exposure prophylaxis (PrEP) during pregnancy and postpartum in Kenya","volume":"21","author":"Mwongeli","year":"2022","journal-title":"JIAPAC"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1186\/s12879-022-07376-5","article-title":"Improving access to pre-exposure prophylaxis for adolescent girls and young women: recommendations from healthcare providers in eastern Zimbabwe","volume":"22","author":"Skovdal","year":"2022","journal-title":"BMC Infect Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/1478-4491-11-51","article-title":"Effective in-service training design and delivery: evidence from an integrative literature review","volume":"11","author":"Bluestone","year":"2013","journal-title":"Hum Resour Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-7-50","article-title":"Knowledge translation of research findings","volume":"7","author":"Grimshaw","year":"2012","journal-title":"Implement Sci"},{"key":"ref31","volume-title":"Sexual and Reproductive Health and Rights: Measuring Values and Norms to Guide Swedish Development Cooperation","author":"K\u00e5gesten","year":"2021"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.ajog.2016.08.033","article-title":"Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial","volume":"216","author":"Hubacher","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2307\/2673804","article-title":"Why do family planning providers restrict access to services? An examination in Ghana","volume":"22","author":"Stanback","year":"2001","journal-title":"Int Fam Plan Perspect"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e1001608","DOI":"10.1371\/journal.pmed.1001608","article-title":"Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis","volume":"11","author":"Drake","year":"2014","journal-title":"PLoS Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/infdis\/jiy113","article-title":"Increased risk of HIV acquisition among women throughout pregnancy and during the postpartum period: a prospective per-coital-act analysis among women with HIV-infected partners","volume":"218","author":"Thomson","year":"2018","journal-title":"J Infect Dis"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1097\/QAI.0000000000001129","article-title":"Preexposure prophylaxis for HIV prevention in a large integrated health care system: adherence, renal safety, and discontinuation","volume":"73","author":"Marcus","year":"2016","journal-title":"JAIDS"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin Infect Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/s10461-022-03816-0","article-title":"The long-acting cabotegravir tail as an implementation challenge: planning for safe discontinuation","volume":"27","author":"Meyers","year":"2023","journal-title":"AIDS Behav"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement Sci"},{"key":"ref40","first-page":"215","volume-title":"Handbook on Implementation Science","author":"Weiner","year":"2020"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1086558","DOI":"10.3389\/frph.2022.1086558","article-title":"Introduction and integration of PrEP and sexual and reproductive health services for young people: health provider perspectives from South Africa","volume":"4","author":"Pleaner","year":"2023","journal-title":"Front Reprod Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1478-4491-8-8","article-title":"A systematic review of task-shifting for HIV treatment and care in Africa","volume":"8","author":"Callaghan","year":"2010","journal-title":"Hum Resour Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1080\/09540121.2013.793278","article-title":"Task shifting of HIV management from doctors to nurses in Africa: clinical outcomes and evidence on nurse self-efficacy and job satisfaction","volume":"26","author":"Iwu","year":"2014","journal-title":"AIDS Care"},{"key":"ref44","first-page":"54","article-title":"Human resource challenges to integrating HIV pre-exposure prophylaxis (PrEP) into the public health system in Kenya: a qualitative study","volume":"19","author":"Mack","year":"2015","journal-title":"Afr J Reprod Health"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1002\/chp.1340240506","article-title":"Implementing clinical guidelines: current evidence and future implications","volume":"24","author":"Grimshaw","year":"2004","journal-title":"J Contin Educ Health Prof"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12916-018-1244-y","article-title":"A systematic review of multi-level stigma interventions: state of the science and future directions","volume":"17","author":"Rao","year":"2019","journal-title":"BMC Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e014709","DOI":"10.1136\/bmjgh-2023-014709","article-title":"Lessons learnt from daily oral PrEP delivery to inform national planning for PrEP ring introduction for women in low-income and middle-income countries: a qualitative inquiry of international stakeholders","volume":"9","author":"Heck","year":"2024","journal-title":"BMJ Glob Health"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/j.0887-378X.2004.00325.x","article-title":"Diffusion of innovations in service organizations: systematic review and recommendations","volume":"82","author":"Greenhalgh","year":"2004","journal-title":"Milbank Q"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e857","DOI":"10.1016\/S2352-3018(22)00251-X","article-title":"Relative cost-effectiveness of long-acting injectable cabotegravir versus oral pre-exposure prophylaxis in South Africa based on the HPTN 083 and HPTN 084 trials: a modelled economic evaluation and threshold analysis","volume":"9","author":"Jamieson","year":"2022","journal-title":"Lancet HIV"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2475","DOI":"10.1080\/21645515.2016.1178433","article-title":"The value of demonstration projects for new interventions: the case of human papillomavirus vaccine introduction in low-and middle-income countries","volume":"12","author":"Howard","year":"2016","journal-title":"Hum Vaccin Immunother"},{"key":"ref51","volume-title":"Lenacapavir for PrEP","year":"2025"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"197","DOI":"10.24141\/1\/5\/2\/5","article-title":"The urgent need for the use of pre-exposure prophylaxis (PrEP) in the prevention of HIV\/AIDS in sub-Saharan Africa","volume":"5","author":"Ayenigbara","year":"2019","journal-title":"J Appl Health Sci"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e25319","DOI":"10.1002\/jia2.25319","article-title":"Maximizing the impact of HIV prevention technologies in sub-Saharan Africa","volume":"22","author":"Ward","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"iv13","DOI":"10.1093\/heapol\/czw149","article-title":"Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review","volume":"32","author":"Watt","year":"2017","journal-title":"Health Policy Plan"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"e0228620","DOI":"10.1371\/journal.pone.0228620","article-title":"Factors influencing uptake, continuation, and discontinuation of oral PrEP among clients at sex worker and MSM facilities in South Africa","volume":"15","author":"Pillay","year":"2020","journal-title":"PLoS One."},{"key":"ref56","volume-title":"Guideline on when to start antiretroviral therapy and on preexposure prophylaxis for HIV","year":"2015"},{"key":"ref57","article-title":"The Urgency of Now: AIDS at a Crossroads","volume-title":"Global AIDS Update 2024","year":"2024"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1056\/NEJMoa2407001","article-title":"Twice-Yearly Lenacapavir or Daily F\/TAF for HIV Prevention in Cisgender Women","volume":"391","author":"Bekker","year":"2024","journal-title":"N Engl J Med."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1056\/NEJMoa2411858","article-title":"Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons","volume":"392","author":"Kelley","year":"2025","journal-title":"N Engl J Med."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"11","DOI":"10.11604\/pamj.2023.46.11.40984","article-title":"Task shifting and task sharing in the health sector in sub-Saharan Africa: evidence, success indicators, challenges, and opportunities","volume":"46","author":"Mbouamba Yankam","year":"2023","journal-title":"Pan Afr Med J."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1186\/s12913-023-09848-z","article-title":"Optimizing the roles of health workers to improve access to health services in Africa: an implementation framework for task shifting and sharing for policy and practice","volume":"23","author":"Okoroafor","year":"2023","journal-title":"BMC Health Serv Res."},{"key":"ref62","article-title":"Nurses in advanced roles in primary care: Policy levers for implementation","volume-title":"OECD Health Working Papers","author":"Maier","year":"2017"},{"key":"ref63","article-title":"HIV Prevention 2030 Global Access Framework","author":"UNAIDS","year":"2026"},{"key":"ref64","volume-title":"Children and Young People Living with HIV: Global Overview 2024","year":"2024"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/S0140-6736(18)31070-5","article-title":"Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: the International AIDS Society\u2013 Lancet Commission","volume":"392","author":"Bekker","year":"2018","journal-title":"Lancet."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"2228112","DOI":"10.1080\/16549716.2023.2228112","article-title":"Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis","volume":"16","author":"Coales","year":"2023","journal-title":"Glob Health Action"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1818059\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:38:41Z","timestamp":1782106721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1818059\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":66,"alternative-id":["10.3389\/fpubh.2026.1818059"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1818059","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"article-number":"1818059"}}