Health Education & Behavior最新文献

Rural gay, bisexual, and other sexual minority men's (SMM) comfort levels answering sensitive health topics are unknown. This online survey explored comfort levels of 399 rural SMM in the Southern United States when responding to five sensitive health topics (sexual behavior, alcohol use, drug use, sexualized drug use, and mental health), as well as examined demographic and behavioral differences in these comfort levels. Multiple linear regression models were analyzed. More than 70% of participants reported being very or somewhat comfortable answering all five health topics. More politically liberal SMM reported higher levels of comfort with sexual behavior and drug use questions. SMM who had condomless anal sex reported more comfortability answering sexual behavior questions, whereas SMM who used alcohol reported lower comfortability levels answering alcohol use questions. Findings have implications for the conduct and approval of health behavior survey research.

Stigma prevents societal acceptance, reinforces social inequities, and greatly complicates the management of diabetes for those dealing with homelessness. Various forms of media, such as film, can educate audiences and play a role in reducing stigma, but the effectiveness of such interventions in changing individuals' knowledge, attitudes, and beliefs (KAB) requires further exploration. This study assessed the impact of a film on diabetes and homelessness through pre- and post-surveys of audience members (n = 202) at 12 screening events. The surveys measured changes in KAB through Likert scale questions, with scores ranging from 1 to 5. Statistical analyses, including Wilcoxon signed-rank and Kruskal-Wallis tests, were used to assess differences in KAB before and after viewing the film, as well as variations based on prior familiarity with diabetes and homelessness. Respondents' knowledge increased significantly across all topics related to both diabetes and homelessness. There were significant differences in all questions that assessed respondents' attitudes. Notably, respondents' beliefs changed significantly to be more positive, except for a single question where the pre-scores already demonstrated reasonably high baseline knowledge. In several domains, respondents familiar with diabetes did not have as significant of a change compared with individuals who were less familiar with diabetes at baseline. These findings suggest that narrative films can positively influence audience members' KAB about stigmatized conditions like diabetes and homelessness. Future research will examine the lasting impact of such interventions on audience members' KAB.

Obesity is linked to high morbidity and mortality and is particularly prevalent in the southeastern United States. The Supplemental Nutrition Assistance Program-Education (SNAP-Ed), funded by the U.S. Department of Agriculture, provides nutrition education and obesity-prevention programs for individuals who qualify for nutrition assistance programs. This evaluation examines the effect of a statewide SNAP-Ed multimedia social marketing campaign in the southeastern United States on campaign awareness, message recall, and behavioral outcomes. The evaluation employed a cross-sectional design using a survey of the priority population. Participants included SNAP-eligible individuals (n = 671) meeting an income threshold and reporting children under 18 years of age living in the household. Compared to participants who were not aware of the campaign, participants who were aware of the campaign reported more frequent fruit and vegetable consumption and more physical activity, and Mann-Whitney tests of these differences were statistically significant. Mann-Whitney tests also demonstrated that recall of nutrition-related campaign messages (such as "cook healthy meals at home") was significantly and positively associated with frequency of fruit and vegetable consumption. These results provide additional evidence that multimedia statewide SNAP-Ed social marketing campaigns are associated with changes in nutrition and physical activity. These findings have implications for others planning health education campaigns related to nutrition and physical activity; this multimedia social marketing campaign shows promise for shaping behavioral outcomes.

Despite advancements in screening technologies, gynecologic cancers remain among the deadliest and most overlooked cancers. Early detection is crucial, but many women are reluctant to undergo screening due to various barriers and misconceptions. This study explores the motivations and barriers influencing women's decisions regarding early gynecologic cancer screening in Malaysia. In-depth interviews were conducted with 20 professional women from diverse backgrounds using a qualitative approach. Data were analyzed through open and axial coding to identify key themes. An empathy map and user journey map captured the psychological and behavioral aspects of decision-making. The study identified themes such as lack of knowledge, reliance on social media and health care professionals, financial and time constraints, fear of results, and cultural stigmas. Participants with higher awareness were more likely to undergo screening, while those with personal or family cancer experiences showed greater vigilance. The findings emphasize the importance of culturally sensitive communication and health care professionals' role in reducing stigma and promoting early screening. The study's insights contribute to developing strategies to encourage early detection and improve health outcomes for women. These strategies align with the United Nations' Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality), promoting health equity and empowering women. As emphasized by SDG 17 (Partnerships for the Goals), achieving these goals requires strong partnerships and collaborative efforts to create a supportive environment for early cancer screening initiatives. Policymakers can use these insights to foster health equity and empower women through supportive screening environments.

Child drowning is a significant public health issue in Indonesia; however, there remains a lack of understanding within communities of the risks and how to prevent it. This qualitative study aimed to explore existing and suggested actions undertaken by parents and communities to prevent child drowning. Seven focus group discussions were conducted, comprising 62 participants, with parents of children below 5 years and village community leaders from seven villages on Lombok Island, West Nusa Tenggara, Indonesia. Participants were recruited with purposive and snowball sampling methods. The thematic analysis used both deductive, applying the Health Belief Model and the Health Promotion Framework, and inductive approaches. The results highlighted the focus that participants placed on individual-focused, behavioral drowning interventions, particularly through swimming lessons for school-age children and educational programs on life-saving skills for parents and community members. While participants acknowledged the importance of midstream interventions, such as safety measures around water bodies and community-based safe places for children, alongside population-based upstream interventions such as advocating for policies, regulations, and intergovernmental agency collaboration, there was limited understanding on the roles of the education and health departments in preventing child drowning. Participants reported inconsistent and insufficient implementation of swimming lessons in schools. Further research into formal integration of swimming training into school curricula and its impact on reducing child drowning rates, development of contextually relevant water safety promotion approaches, and alignment of cross-sector partnerships is imperative to ensure effective and sustainable drowning prevention efforts in Indonesia.

Vaccination hesitancy remains a prominent global health concern, as recognized by the World Health Organization (WHO). This quantitative study, conducted on a representative sample of the Belgian population (n = 1,030), explores consumer segmentation concerning vaccination attitudes during the COVID-19 pandemic in 2021, identifying five distinct clusters. While 39.6% of the surveyed consumers broadly accepted the COVID-19 vaccine (Convinced Pro-Vaxxers), our analysis revealed that 17.1% were skeptical (Skeptics), 12.7% were fearful of the inoculation procedure (Fearful Doubters), and 7.1% were fully opposed to vaccination (Anti-Vaxxers). Nearly one in four participants (Indifferent Pro-Vaxxers) showed little interest in the pandemic yet remained largely favorable toward vaccination. The variation in cluster size, attitudes, beliefs, and sociodemographic traits highlights the complexity of vaccine hesitancy, indicating it is not a binary issue. These findings underscore the importance of tailored health communication and vaccination campaigns to address hesitancy and improve vaccine uptake.

There is a persistent misunderstanding in the interdisciplinary field of public health, particularly regarding the roles and titles associated with health education specialists. The confusion necessitates a focus on collaboration, professional development, and standardizing terms within the realm of public health, health education, and health education specialists. To contribute to clarifying these roles, a qualitative exploratory case study was conducted, specifically examining the challenges and skills of health education specialists in clinical care or hospital settings. During three virtual focus group discussions, 13 participants who were selected through convenience sampling from the National Commission for Health Education Credentialing expressed their perspectives. Thematic analysis revealed key themes associated with challenges that included respect, buy-in, and prioritization. Concerning skills, the data indicated an overlap when assessing the most and least utilized skills of health education specialists. The application of skills correlated to size of the health care system or clinical care setting as well as the title and function of the health education specialist. Those working in larger health care systems primarily utilized fewer skills as their tasks and efforts were more concentrated. The implications for practice suggest that health care organizations can fully utilize and integrate health education specialists with concerted efforts on buy-in from executive leadership, professional growth, and clear communication to promote awareness of the role. These efforts will empower health education specialists to elevate their expertise, bring awareness to the profession, and enhance the quality of patient education.

Minoritized communities often experience worse health outcomes on the cancer continuum. Mainstream strategies may have limited reach and utility to populations experiencing inequities in real-world settings. Through the combined use of community-based participatory research (CBPR) and social marketing strategies, which highlight community-centered and culturally adapted processes, we provide an approach to inform future intervention research across various health topics that has been successful in engaging minoritized and understudied communities. We present two case studies that used participatory social marketing principles to culturally adapt evidence-based cancer screening programs for two communities in New York City. The first program is a campaign to increase screening and vaccination for hepatitis B among Korean and Chinese American immigrants. The second is a culturally adapted program to increase breast and cervical cancer screening among a multiracial and ethnic population of Muslim women. These case studies illustrate the benefits of integrating social marketing and CBPR approaches as a key strategy when developing public health campaigns to effectively reach and influence health behaviors in partnership with communities that have been socially marginalized and historically underserved.

Health and behavior change programs play a crucial role in improving health behaviors at individual and family levels. However, these programs face challenges with engagement and retention and typically show modest efficacy. Cognitive load theory is an established and highly used educational theory that proposes individuals have a finite capacity to process new information ("working memory"). Learning, engagement, and performance are negatively impacted when working memory is exceeded. Cognitive load theory is grounded in an understanding of human cognition and conceptualizes different types of cognitive loads imposed on individuals by a learning experience. Cognitive load theory aims to guide the design of learning experiences, considering how the human mind works, leading to more meaningful and effective learning. Cognitive load theory is increasingly applied to domains outside the classroom, such as designing patient and clinical education. Applying cognitive load theory to the design of health programs, their materials, and interfaces can provide insights. By considering the cognitive demands placed on individuals when interacting with health programs, design can be optimized to reduce cognitive load and better facilitate learning and behavior adoption. This may enhance engagement, retention, and effectiveness of programs. Cognitive load theory may be particularly valuable for individuals with diminished working memory due to high levels of mental load and stress. Design principles are presented to consolidate knowledge from cognitive load theory and existing approaches to guide researchers, policymakers, and health programmers. Further research and interdisciplinary collaboration are needed to realize the potential of cognitive load theory in health.

Physical activity (PA) helps prevent several diseases; however, individuals residing in low-income neighborhoods have lower PA participation rates due to social disparities, as outlined in the social-ecological model. The purpose of this pilot study was to apply the social-ecological framework to test the effectiveness of a six-month, community-based PA program in a low-income neighborhood. Participants (n = 45) lived in a low-income neighborhood near a community fitness center. Those randomized to the experimental arm (n = 23) received gym access and attended monthly on-site workshops (Months 1-3) designed to enhance PA determinants such as planning and habit formation. The remaining participants (n = 22) were assigned to a wait-listed control group. PA, body composition, and fitness data were collected using accelerometers, BODPOD, and on-site fitness assessments at baseline, Month 3, and Month 6. Compared to the control group, participants in the experimental arm engaged in more moderate-to-vigorous PA (d = .48, d = .74), total PA (d = .41, d = .99), and steps (d = .48, d = .92) at Months 3 and 6, respectively. The experimental group also showed improvements in fitness tests, including the 30-s chair test (d = .29, d = .23) and the 8-foot up-and-go test at Month 3 (d = -.23), though these gains were not sustained at Month 6. Overall, this pilot study supports the feasibility of promoting PA and improving fitness outcomes in a low-income neighborhood. Notes for improvement and future directions are provided such as tracking PA exclusively performed at the community center to better assess program impact.