Health Education Research最新文献

The VAX-TRUST project addresses vaccine hesitancy in seven European countries with a systematic and evidence-based approach. Interventions, targeting healthcare professionals, draw from behavioural and social theories. A checklist, inspired by the TIDieR (Template for Intervention Description and Replication), ensures a detailed description of actions, transparency and replicability. The intervention development process begins with collaborative meetings and systematic revisions, concluding with external evaluations for replicability in diverse public health contexts. This study aims to provide valuable insights for future complex interventions in public health, based on lessons learnt to reduce the risk of vaccine-preventable diseases. The analysis of educational interventions within the VAX-TRUST project has led to the definition of precise guidelines to ensure their replicability and adaptation to various contexts, attempting to establish a universally applicable approach. Active participant engagement and consideration of local social dynamics, beyond information transmission, have emerged as key factors to improve intervention effectiveness. Various educational tools and collaboration with academic institutions have contributed to strengthening credibility.

Limited data exist on educational programs for people using insulin pump (IP) therapy or those considering its initiation, and the influence of individual characteristics on their educational pathway remains unclear. Our aim was to analyze the characteristics of people with type 1 diabetes (T1D) referred for IP therapy and how these characteristics may influence their educational process. A retrospective descriptive observational study was carried out on people with T1D referred for participation in a structured pre-IP educational program in a hospital setting. Educational, sociodemographic and clinical variables were collected and analyzed. Participants were followed up 5 years after IP placement. Seventy-one people finalized the educational program, of whom 10 experienced major barriers to completing it. People with lower educational level required more sessions and weeks to complete it compared to those with higher educational levels. People referred due to suboptimal metabolic control and hypoglycemia also required more time to complete the process. It is essential for diabetes educators to recognize the diversity of characteristics, needs and challenges among the participants in an educational program. Based on this, they must adapt strategies to provide more effective, person-centered diabetes education and support, fostering positive and sustained outcomes and engagement for participants.

The rapid ageing of our society poses significant challenges, including an increase in chronic diseases and loneliness among older adults, leading to higher demands for care and support. Addressing these needs requires an integral approach, especially among older adults with low socioeconomic status (SES). This article details the development of the Neighbourhood Active & Connected (NAC) intervention, using the Intervention Mapping framework to expand an evidence-based physical activity intervention into a neighbourhood-oriented, holistic and systemic strategy for healthy ageing. NAC focuses on enhancing physical activity, social connectedness, and digital literacy. It was developed through co-creation with local stakeholders and low-SES older adults, ensuring optimal alignment with their needs and capabilities. Performance and change objectives were established based on literature consultation and an extensive need assessment, with intervention materials refined through engagement with the target group. The results of a large-scale cluster randomised controlled trial will be utilised to evaluate NAC's impact on physical activity, loneliness, social cohesion, health-related quality of life, and digital literacy among low-SES community-dwelling older adults. This paper aims to provide a detailed roadmap for researchers and practitioners to adapt, implement and evaluate similar interventions, promoting healthy ageing in low socio-economic contexts.

Physical activity (PA) is recommended in clinical practice guidelines as effective for the management of polycystic ovary syndrome (PCOS). However, adherence to PA interventions is low in this population, and long-term uptake of PA is a challenge. We conducted a feasibility trial of two PA interventions for women with PCOS. This paper reports a qualitative evaluation of the trial in tandem with an evaluation of barriers and facilitators to PA in a sub-group of participants. Eleven participants with PCOS were purposively sampled from the main sample (n = 36) and participated in semi-structured interviews. Interviews were audio-recorded and transcribed verbatim. Data were analysed using reflexive thematic analysis. Five themes were developed relating to experiences of the intervention and factors influencing PA behaviour: (1) The Changing Nature of Priorities, (2) The Push and Pull of PCOS Symptoms, (3) Focusing Beyond the Scale, (4) Knowledge as a Foundation for Change and (5) The Balance of Stigma and Social Support. These findings can be used to design PA interventions that consider the interplay between PCOS and PA behaviour to achieve health benefits beyond short-term interventions.

Given the diverse sources of cannabis messaging and potential differential effects, this study examined pro- and anti-cannabis messaging exposure overall and via specific channels in relation to cannabis-related perceptions (social acceptability and harm) and behaviors (use status, intentions and frequency; past-year quit attempts). Multivariable regression analyses of 2023 survey data from 4031 US young adults (Mage = 26.29, 59.4% female, 19.0% Hispanic, 13.5% Black and 13.6% Asian) used independent variables representing overall exposure and via specific sources (stores, online, billboards/posters/flyers, TV/movies/radio, print and direct communication), respectively. Greater pro-cannabis messaging exposure correlated with greater perceived social acceptability, lower perceived harm, past-month use, greater use intentions among those reporting past-month nonuse and more days used and fewer quit attempts among those reporting use. Less anti-cannabis messaging exposure correlated with these outcomes, except intentions. Particularly, influential sources of pro-cannabis messaging were online (associated with perceptions, use status, intentions and frequency) and direct communication (perceptions, use, use frequency and quit attempts), and those of anti-cannabis messaging were online (harm and use intentions), direct communication (acceptability, quit attempts) and stores (perceptions, use and quit attempts). Exposure differed by sociodemographics (e.g. sex, race/ethnicity and education). The impact of digital media and targeted communications overall and stores in communicating cannabis-related risks suggest the need for regulation and monitoring.

Understanding prenatal alcohol exposure (PAE) risk perception is important for the communication and prevention of alcohol use during pregnancy. A previous systematic review has explored the dimensions and influencing factors of women's PAE risk perceptions, leading to the construction of Pregnancy Alcohol Use Risk Perception (PARP) conceptual model. This study aims to refine the PARP model using a Delphi process. A total of 37 international experts participated, 17 completed all three online surveys between May 2022 and December 2022. The online survey consisted of Likert-scale and free-text responses on the usefulness and clarity of the components and the design of the PARP model. Likert-scale responses were analysed using descriptive statistics. Free-text responses were analysed using a reflexive thematic analysis approach. The model was amended following participants' responses. Four characteristics underpinned the revised model-relevance-to-self and the negotiations of risks, inter-relatedness of affect with the cognitive processing of risk, contextual influences of individual, sociocultural and institutional/political/organizational rendering a socioecological perspective to PAE risks perception and the dynamic characteristics of PAE risk perception. The acknowledgement of PAE risk perceptions and the contextual influences can support development of targeted and tailored messages and health education materials.

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.

Patients diagnosed with amyotrophic lateral sclerosis (ALS) become dependent on caregivers to meet their daily needs and perform personal care activities. For this reason, ALS is a disease that can challenge both the patient and the caregiver physically, mentally and socially. Supporting the caregiver indirectly affects the patient's quality of care and mental well-being. Therefore, this study aimed to determine the effect of a structured psychoeducation program on coping with stress, psychological resilience and self-compassion in caregivers of ALS patients. This quasi-experimental study with a pre-test-post-test control group was conducted with caregivers of 62 ALS patients in Türkiye. The study was conducted between July 2023 and February 2024. A psychoeducation program was applied to five different groups via zoom application for 6 weeks each. The survey form, Perceived Stress Scale, Brief Resilience Scale and Short Form of Self-Compassion Questionnaire were used as measurement tools. The chi-squared test and paired samples t-test were used to analyze the data. While there was no significant difference between the intervention group and the control group in the pre-test in terms of their mean scores on the coping with stress inventory, short psychological resilience scale and self-compassion scale, at the post-test, psychological resilience and self-compassion scores were significantly higher in the intervention group. This study revealed that psychoeducational programs that support caregivers are effective in increasing psychological resilience and self-compassion.

Evidence-based medicine (EBM) is helpful for laypersons' decision-making. This study aimed to evaluate the effectiveness of e-learning materials on the essential components of EBM for laypersons. We conducted a web-based, open-label, randomized controlled trial with laypersons in Japan aged ≥20 years who used the internet. Participants were randomly assigned to the intervention group with the e-learning material and the control group with only the 'Introduction' section of the same material. The primary and secondary outcomes were the self-created acquirement test scores (responding correctly with confidence) immediately after using the material and after 4 weeks. A multiple linear regression analysis was conducted. Of the 122 participants, 62 were randomly assigned to the intervention group and 59 to the control group; finally, 59 and 58, respectively, were included in the full analysis set. The mean (standard deviation) of the acquirement test score immediately after learning was 14.11 and (3.11) and 11.07 (3.88) in the intervention and control groups, respectively, indicating statistical significance (multivariable P < 0.001). The secondary long-term outcome was also statistically significant. The results showed that the e-learning material was effective for laypersons in acquiring the essential components of EBM. The material may increase laypersons' confidence in appraising health information, which can be used in decision-making.