Health Education Research最新文献

Informing adults who smoke (AWS) that completely switching to electronic nicotine delivery systems (ENDS) reduces their exposure to harmful chemicals could prompt them to switch. However, it would be problematic if such reduced-exposure messages prompted ENDS use by adults not currently using tobacco (Former Users and Never Users of tobacco). This study assessed the effect of a reduced-exposure message for JUUL ENDS, presented in a video ad, on behavioral intentions among 3485 AWS, 1756 Dual Users (of cigarettes and ENDS), 1857 Former Users and 5459 Never Users. In a randomized experiment, participants viewed an ad for JUUL with or without a reduced-exposure message. Exposure to the reduced-exposure message significantly increased AWS' Openness to Try ENDS, while significantly decreasing it among Nonusers, resulting in a significant message × user group interaction. Responses of young adults (18-24 years) did not differ from those of older adults (30+), and message exposure did not increase Young Adult Nonusers' Openness to Try. The message's effect on AWS' Openness to Try was completely mediated by its effects on AWS' perception of the risk of ENDS use compared to smoking cigarettes. The reduced-exposure message resulted in a pattern of behavioral intentions consistent with a favorable impact on population health.

Adults who smoke (AWS) who switch completely to e-cigarettes reduce their exposures to many harmful chemicals in cigarette smoke. Those who believe e-cigarettes are less harmful than cigarettes are more likely to use e-cigarettes to switch away from smoking, yet most believe e-cigarettes are at least as harmful as cigarettes. This study assessed the effect on risk perceptions of communicating that switching can reduce exposure to harmful chemicals from cigarette smoke. In a randomized experiment, AWS (n = 3485), dual users (DU) of cigarettes and e-cigarettes (n = 1756), and nonusers (n = 7316) viewed an ad for JUUL with or without a reduced-exposure message, and completed assessments of perceived risk. Message exposure decreased perceived risk of JUUL among adults who smoke, while increasing perceived risk of smoking, thus increasing the perceived risk differential (PRD). Among DU, the message increased perceived risk of smoking, but did not change perceived risk of JUUL. Among nonusers, who rated the perceived risk of all assessed tobacco products higher than did AWS and DU, the message decreased perceived risk of JUUL, and did not affect perceived risk of smoking. Accurate modified exposure communications have potential public health benefit by shifting the PRD of smoking and e-cigarettes.

Patient education is a core component of cardiovascular rehabilitation (CR). Recent guidelines call for tailored materials to support women, given their unique needs and preferences. This study investigated women patient's perspectives of online CR educational materials (Cardiac College, Toronto). Through a cross-sectional design, a think-aloud protocol followed by semistructured qualitative interviews was used to collect data on women's perceptions of the comprehensive educational webpages with regard to content, format, visuals, length/volume, difficulty, applicability, implementability and suggestions for improvement. Thirty-eight current and previous CR program participants completed 1-h Zoom interviews. Transcripts were coded thematically using best practices in NVivo by two researchers independently. Four themes emerged: (I) materials met their needs (content, presentation, and empowerment), (II) suggestions for improvement in presentation (website design, text, and visuals), (III) content (volume, additions, and difficulty), and (IV) optimizing reach and implementability (inclusiveness, barriers, and dissemination). Overall, the education content met women's needs and was relatable, but should be updated for currency, visual appeal, and searchability. Cardiac College for Women may meet these needs and preferences.

Drug take-back system provides a legal, safe and eco-friendly avenue to appropriately dispose of unwanted medicines, contributing to both environmental sustainability and reducing medication misuse. This study designed and implemented a brief educational intervention, which took <1 min on average, to enhance awareness of community residents regarding the dangers of hoarding and improperly disposing of expired and unused medication at home. In a Chinese urban community, 104 eligible households were evenly assigned into 2 groups receiving leaflet-based awareness-raising interventions. Messages about risks of unwanted medicines delivered to the two groups focused on either environmental concerns of pharmaceutical emerging contaminants (eco-directed) or health hazards associated with misuse or overuse (health-focused). Compared with those in a health-focused intervention, significantly more households participating in an eco-directed awareness-raising activity returned unwanted medicines, supported community-level drug take-back program and agreed that drug take-back program should be mandatory and paid for by consumers. Data suggested that the eco-directed awareness-raising intervention might be an attractive approach to enhance the public's active participation in drug take-back program.

Completely switching from cigarette smoking to electronic nicotine delivery systems (ENDS) reduces exposure to toxic substances. Yet, many smokers believe that ENDS are at least as harmful as smoking, making them less likely to switch from cigarettes to ENDS. Effectively communicating reduced-exposure information is critical, but such messages must be properly understood. This online study evaluated comprehension of a factual message, indicating that smokers who switch completely away from smoking to JUUL-brand ENDS can reduce their exposure to harmful chemicals in cigarette smoke. Participants were 12 557 adults 18+ years (smokers, dual users and former and never users of tobacco) randomized to see the reduced-exposure message or to a Control condition. After exposure to the message, the majority of smokers (89%) understood the need to switch completely from cigarettes to JUUL to achieve reduced exposure. Most smokers and nonusers (>75%) did not misperceive JUUL as completely eliminating exposure to harmful chemicals, and >85% understood that using JUUL has risk. Exposure to the message improved understanding of the intended audience for JUUL. Individuals with limited health literacy showed modestly lower comprehension, regardless of condition. Ensuring adequate comprehension of messages about reduced exposure from ENDS is important to ensuring that such messaging can benefit public health.

This scoping review examines the visual design elements of written patient information (WPI), specifically focusing on imagery, colour, layout and content presentation, and their impact on health information communication, understanding, behaviour and preferences among patients. Understanding patient preferences allows for patient-informed WPI design, which is important for Māori (Indigenous peoples of Aotearoa New Zealand) living in a colonial society. Nine studies were analysed, primarily investigating the integration of visual illustrations within WPI. Participants generally favoured the inclusion of images alongside text, finding them instrumental in enhancing comprehension and making health information more approachable. The preference for simpler and less detailed visuals, such as cartoons, was highlighted, although there was variability depending on literacy levels and cultural backgrounds. The use of colour, layout features (e.g. font type and white space) and content framing (e.g. positive versus negative framing of risk information) were explored for their effects on information reception and behavioural outcomes. Currently, there is a paucity of literature on Māori preferences and requires further research. Overall, this scoping review highlights the importance of designing WPIs with visual elements that cater to diverse literacy levels and cultural preferences to optimize communication effectiveness and patient engagement.

Complex eHealth interventions-featuring multiple components within dynamic systems-are used for healthcare improvement. Public-private partnerships (PPPs), combining resources, expertise, and technology, are crucial in this context. Yet, integrating these interventions into practice remains challenging. This study identifies barriers and facilitators affecting implementation of the BENEFIT programme, a complex eHealth intervention targeting cardiovascular disease patients, by PPP within practice. A qualitative study design was employed. Ten key stakeholders from four cardiac rehabilitation (CR) sites, who were all PPP partners involved in developing and implementing the BENEFIT programme, were interviewed semistructured. Transcripts were analysed using Consolidated Framework for Implementation Research. Facilitators included programme adaptability, communication and planning within teams, digital healthcare needs, dedicated PPP leadership, PPP meeting structure and PPP's ability to quickly modify the implementation strategy. Barriers involved specific PPP challenges (frequently changing roles, unclear roles and responsibilities and limited staffing), workplace disruptions, poor information technology (IT) integration, and ambiguous implementation goals amongst CR sites. This case study highlights challenges in implementing complex eHealth interventions by PPPs within practice. The findings underscore the need for a comprehensive implementation approach considering specific PPP dynamics, including combined expertise and resources, transparent role definition, sufficient staffing, clear goal communication and adaptable strategies for sustainable implementation.

School-based prevention drug programs in the United States and Brazil are most commonly delivered by law enforcement officers (LEOs). However, limited research has explored challenges involved in the delivery of these interventions specifically related to their implementation by LEOs. We aim to describe the challenges affecting the implementation of school-based drug prevention programs delivered by LEOs. We conducted a qualitative study using 31 semi-structured interviews with LEOs who delivered the Brazilian version of the DARE-Keepin' it REAL program (fifth- and seventh-grade curriculum) and 8 focus groups with 80 students who participated in the program. All data were thematically analyzed. LEOs perceived devaluation from the police corporation, resulting in resource limitations and commanders' resistance to adapting schedules. Relationships with the school community posed additional challenges. Fifth graders seemed generally positive about LEOs' presence while seventh graders showed more negative responses. LEOs' street-level policing experiences influenced their approach to clarifying the consequences of drug use and willingness to share related experiences, even though this content is not part of the program. Therefore, it is crucial to consider alternative approaches to delivering preventive programs in schools, while simultaneously improving the training of LEOs already involved in program implementation to ensure alignment with evidence-based practices.

Fibromyalgia (FM) is a complex chronic disorder characterized by widespread pain as the primary symptom. To evaluate the effect of health education on the severity of various symptoms in patients with FM, seven databases were searched from inception to August 2024 to identify randomized controlled trials evaluating the effects of health education for FM. The primary outcome was overall symptom severity, and the secondary outcomes were pain, depression, anxiety, sleep quality, fatigue, physical function and self-efficacy. The Cochrane Risk-of-Bias tool for randomized trials and the Grading of Recommendations, Assessment, Development, and Evaluations were used to assess the quality of the included studies and the certainty of evidence, respectively. Treatment effects were estimated by calculating Hedges' g and the corresponding 95% confidence intervals. Meta-analysis included a total of 13 trials. The results revealed that health education significantly reduced overall symptom severity, depression and anxiety and increased sleep quality and physical function among patients with FM (all P values < 0.05). However, no significant effects were observed on pain, fatigue and self-efficacy. Health education may be a beneficial intervention for FM patients, particularly for mitigating symptom severity. Health-care providers should implement health education interventions to empower patients to effectively manage their symptoms.

Diabetic retinopathy (DR) may develop into sight-threatening DR and vision loss if early intervention is not carried out. This study was aimed to assess the effectiveness of DR health education program for patients with type 2 diabetes mellitus (T2DM). The quasi-experimental research design was applied. The intervention group underwent a web-based DR health education program while the control group was followed up the usual way at an ophthalmology clinic for 1 year. Data were analysed using descriptive statistics, repeated measures ANOVA and general linear model to evaluate the mean difference between groups. A total of 180 patients with T2DM were enrolled in the study, with equal number in the control and intervention groups, respectively, with 28% of dropout rate. There was a significant mean difference in knowledge score [F (1178)  = 116.57, P = 0.001], diabetes self-care [F (1178)  = 116.57, P = 0.001] and visual-related quality of life [F (1178)  = 12.70), P = 0.001] between the control and the intervention groups. The intervention group scored the highest in all three categories. Educational interventions positively affected adherence to self-care and visual-related quality of life in type 2 diabetic patients as shown in this study. DRHEP should be considered an added benefit in T2DM management, starting with comprehensive care enrollment.