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Purpose
– This paper aims to investigate the relationship between hybrid classes (where a per cent of the class meetings are online) and transportation-related CO2 emissions at a commuter campus similar to San José State University (SJSU).


Design/methodology/approach
– A computer model was developed to calculate the number of trips to campus for a student body similar to SJSU. Different scenarios considered the theoretical effectiveness of implementing a hybrid course system to reduce CO2 emissions.


Findings
– Increases in hybrid courses resulted in decreased student trips to campus and associated CO2 emissions. The utility of such a relationship is demonstrated through a case study where the required increase in online class meetings needed to eliminate the need for an overflow parking lot is studied. Finally, preferential scheduling of online meetings can further reduce trips to campus.


Research limitations/implications
– A limitation of the model is that student schedules are random. Future research could use actual student schedules to better model how online course delivery will affect trips to campus.


Practical implications
– As today's universities struggle with financial pressure, online course delivery is being offered as a way to cope. This analysis provides an additional metric to evaluate online courses and includes other potential financial savings.


Social implications
– Transportation contributes to local air pollution and emissions of heat-trapping gases. As universities move toward more sustainable behaviors, reducing automobile trips to campus can be seen as a priority.


Originality/value
– To the authors' knowledge, this is the first attempt to model the relationship between hybrid courses and CO2 emissions at an urban university. This information will be valuable to the SJSU community, as well as many other institutions.

Type 2 diabetes mellitus is an escalating public health problem in India, associated with genetic susceptibility, dietary shift, and rapid lifestyle changes. Historically a disease of the urban elite, quantitative studies have recently confirmed rising prevalence rates among marginalized populations in rural India. To analyze the role of cultural and sociopolitical factors in diabetes onset and management, we employed in-depth interviews and focus groups within a rural community of Tamil Nadu. The objectives of the study were to understand sources and extent of health knowledge, diabetes explanatory models, and the impact of illness on individual, social, and familial roles. Several cultural, socioeconomic, and political factors appear to contribute to diabetes in rural regions of India, highlighting the need to address structural inequities and empower individuals to pursue health and well-being on their own terms.

Objective To conduct a scoping review to synthesize evidence on food prescription programs. Data Source A systematic search of PubMed, CINAHL, Web of Science, Embase, and the Cochrane Library was conducted using key words related to setting, interventions, and outcomes. Study Inclusion and Exclusion Criteria Publications were eligible if they reported food prescription administered by a health care practitioner (HCP) with the explicit aim of improving healthy food access and consumption, food security (FS), or health. Data Extraction A data charting form was used to extract relevant details on intervention characteristics, study methodology, and key findings. Data Synthesis Study and intervention characteristics were summarized. We undertook a thematic analysis to identify and report on themes. A critical appraisal of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT). Results A total of 6145 abstracts were screened and 23 manuscripts were included in the review. Food prescriptions may improve fruit and vegetable consumption and reduce food insecurity (FI). Evidence for impacts on diet-related health outcomes is limited and mixed. The overall quality of included studies was weak. Addressing barriers such as stigma, transportation, and poor nutrition literacy may increase utilization of food prescriptions. Conclusion Food prescriptions are a promising health care intervention. There is a need for rigorous studies that incorporate larger sample sizes, control groups, and validated assessments of dietary intake, food security, and health.

BACKGROUND: Community health worker (CHW) programs are an important resource in the implementation of universal health coverage (UHC) in many low- and middle-income countries (LMICs). However, in countries with decentralized health systems like the Philippines, the quality and effectiveness of CHW programs may differ across settings due to variations in resource allocation and local politics. In the context of health system decentralization and the push toward UHC in the Philippines, the objective of this study was to explore how the experiences of CHWs across different settings were shaped by the governance and administration of CHW programs. METHODS: We conducted 85 semi-structured interviews with CHWs (n = 74) and CHW administrators (n = 11) in six cities across two provinces (Negros Occidental and Negros Oriental) in the Philippines. Thematic analysis was used to analyze the qualitative data with specific attention to how the experiences of participants differed within and across geographic settings. RESULTS: Health system decentralization contributed to a number of variations across settings including differences in the quality of human resources and the amount of financial resources allocated to CHW programs. In addition, the quality and provider of CHW training differed across settings, with implications for the capacity of CHWs to address specific health needs in their community. Local politics influenced the governance of CHW programs, with CHWs often feeling pressure to align themselves politically with local leaders in order to maintain their employment. CONCLUSIONS: The functioning of CHW programs can be challenged by health system decentralization through the uneven operationalization of national health priorities at the local level. Building capacity within local governments to adequately resource CHWs and CHW programs will enhance the potential of these programs to act as a bridge between the local health needs of communities and the public health system. SUPPLEMENTARY INFORMATION: The online ...

Despite serving as the Philippines' main social protection strategy, debate continues surrounding the ability of the Pantawid Pamilyang Pilipino Program (4Ps) to meet its long-term goal of breaking cycles of intergenerational poverty. To engage with this debate, this study brings together the constructs of entitlement and agency to analyse how different actors associated with 4Ps understand and experience the program. Drawing on forty-three semi-structured interviews with 4Ps beneficiaries, non-beneficiaries, and implementers, we provide a provisional explanation as to why a disconnect exists between the long-term goals of 4Ps and the experiences with the program among these different actors. In addition, this study highlights how challenges associated with the design and implementation of 4Ps, including limited transparency and communication of the program's eligibility requirements, rigid monitoring of beneficiary compliance, and delays in receiving cash transfers, may constrain the transformational potential of this social protection strategy.