Health Education Research最新文献

To encourage people who inject drugs to vaccinate against COVID-19, our research team collaborated with a harm reduction organization in East Harlem to create a multilevel, technology-based intervention that combined a brief (<6 minute) educational video with pre-post-test items measuring the likelihood of vaccination, attitudes, and vaccine-related heath literacy. A total of 545 participants completed the intervention; 45 vaccinated at the end of their first study visit. The remaining 500 were randomly assigned to two groups that were sent different text message configurations to examine which more effectively encouraged follow-up vaccination. The intervention group received Multimedia Messaging Service text messages featuring combinations of words and images, similar to frames of a graphic novel; the control group received Short Message Service texts consisting solely of words. Among those who did not vaccinate at first visit, 26 (7 intervention group and 19 control) vaccinated at follow-up. Greater vaccine-related knowledge (e.g. the vaccine does not contain a live virus) and positive vaccine attitudes were significantly associated with post intervention vaccination. Misinformation and misconceptions (i.e. vaccines are population control; vaccination is only for people who are already sick) emerged as powerful barriers to vaccination. Further research is warranted to address other forms of vaccine hesitancy among additional high-risk populations.

A nutritious diet is an important protective factor against hypertension and cardiovascular disease. However, there are substantial barriers to healthy eating within American Indian (AI) communities resulting from colonization, the effects of which are still present today in systemic inequities. To address these inequities, many AI communities work toward restoration of access to and knowledge of traditional (i.e. pre-colonial) foods. The Chickasaw Healthy Eating Environments Research Study (CHEERS) was one such approach that provided Chickasaw Nation citizens with heart-healthy foods in line with the Dietary Approaches to Stop Hypertension (DASH) diet, as foods in the DASH diet represent many foods found in traditional AI diets, such as beans and fresh produce. In consultation with Chickasaw Nation community partners, there was interest in exploring lived experiences with traditional food and food practices and any recognized connections with overall health. Therefore, the current study is a qualitative analysis exploring these concepts with a subset of CHEERS participants. Emerging themes suggest participants have rich lived experiences with traditional foods and food practices and recognize many connections between traditional foods and health. These results substantiate the importance of traditional diets on AI health and can be integrated to strengthen culturally tailored nutrition interventions.

Tobacco use has detrimental effects on women's reproductive health and is associated with poor pregnancy outcomes. Antenatal care (ANC) check-ups provide health professionals with a unique opportunity to screen and counsel pregnant tobacco users to quit. Currently, in India, pregnant women are not being screened for tobacco use during antenatal care visits and healthcare providers lack formal training to provide tobacco cessation advice. This article describes the designing and development of a tailored behaviour change intervention (BCI) module for tobacco cessation and its delivery to pregnant women attending antenatal clinics. The BCI module was designed to incorporate the components of the Capability, Opportunity and Motivation Model and the Behaviour Change Wheel guide. The development was done in three steps-understanding the behaviour, developing intervention model, and identifying implementation options along with monitoring and evaluation strategies. The module has three tools-counselling flipbook for healthcare provider, take home pamphlets, and information posters for patient waiting areas. A gender- and culture-specific BCI module was developed and implemented to screen and counsel 105 pregnant tobacco users during antenatal visits, leading to high self-reported tobacco quit rate (69%) which corroborated with urine cotinine levels at baseline and end line.

Several school-based physical activity interventions have been developed to address the critical public health concern that children are not meeting the recommended daily moderate-to-vigorous physical activity (MVPA). However, less is known about implementation fidelity and its impact on programme efficacy. This study examined process evaluation findings of a school-based physical education (PE) intervention and its impact on MVPA among 3rd and 4th-grade children. Four fidelity components (adherence, dose, quality of delivery, and participant responsiveness) were assessed through weekly, unannounced direct observations of intervention classrooms. MVPA was assessed using accelerometry at baseline and post-intervention. Multilevel modelling was used to assess the effect of implementation fidelity on child MVPA. Overall fidelity score of our intervention was high (76.4%), although participant responsiveness (82.4%) and quality of delivery (77.8%) were implemented more successfully than dose (65.8%) and adherence (52%). Participant responsiveness was a statistically significant predictor of change in student MVPA (β = 26.14, 95% CI: 2.68, 49.60). Adherence, dose, quality of delivery, and overall fidelity were not significant predictors of student outcomes. Participant responsiveness is an important aspect of fidelity. School-based PE interventions should focus on enhancing student engagement for successful impact. Further investigation is needed to identify factors that enhance child responsiveness.

Children's perception of health is shaped by various socio-economic and family contexts. Schools represent a key setting for health promotion, and peer health education is increasingly recognised as an effective strategy. This study aimed to examine peer health education programmes in elementary schools, focusing on implementation, facilitating factors, barriers, and effects. A scoping review was conducted in accordance with The Joanna Briggs Institute recommendations. Five databases were searched. Studies involving children aged 6-12 as recipients and peer educators aged 6-15 were included. Although the literature specifically targeting this age group is limited, 10 studies could be analysed. Out of 149 articles were identified, 10 studies were retained. Peer education took two forms: same-age education and inter-age education. Topics included nutrition, hygiene, and physical activity. The included studies reported positive trends in participants' knowledge, attitudes, and behaviours. The involvement of the pupils and the integration of the interventions into the school curriculum were facilitating factors. Time constraints and the need for ongoing support were obstacles. Understanding the mechanisms of peer education is essential. Further research may inform the design and evaluation of future interventions and guide public policy.

This study investigated how fear, disgust, anger, and sympathy relate to the effectiveness of pictorial warning labels (PWLs) designed to communicate alcohol-related cancer risks. We recruited two samples: (1) an online panel of moderate and heavy drinkers (aged 21-84), and (2) college student drinkers (aged 18-28). Participants were randomly assigned to view either three narrative PWLs depicting lived experiences or three non-narrative PWLs showing diseased organs. Across both samples, narrative PWLs elicited lower levels of anger and disgust and higher levels of sympathy than non-narrative PWLs. Narrative PWLs also generated less fear than non-narrative PWLs among the online panel participants, but not among college student drinkers. Moreover, in the online panel sample, narrative PWLs decreased intentions to reduce and stop drinking due to lower fear, but simultaneously increased intentions to reduce drinking due to a decrease in anger and an increase in sympathy. Among college students, narrative PWLs promoted intentions to reduce and stop drinking only through greater sympathy. These findings highlight sympathy as a key emotional pathway for promoting behavioural change. In designing cancer warning labels for alcohol, communicators should consider avoiding appeals that provoke disgust or anger and instead use narrative approaches to evoke sympathetic responses in consumers.

Digital behaviour change interventions delivered through web-adaptive platforms offer novel pathways for tobacco control in youth. However, the longitudinal efficacy of tailored online cessation tools remains underexplored. This meta-analysis evaluates the comparative effectiveness of dynamically tailored web interventions versus passive controls in youth smokers. Following PRISMA guidelines, we systematically searched six databases (PubMed, Cochrane, Web of Science, Embase, SCOPUS, and CINAHL) through January 2024. Seven randomized controlled trials (n = 5660) assessing adaptive web platforms for smokers aged 10-30 years were included, with methodological rigour assessed via Joanna Briggs Institute criteria. Adaptive interventions significantly improved self-reported abstinence versus controls [risk ratio (RR) = 2.19, 95% CI 1.48-3.24]. Efficacy varied by follow-up stage: 1-2-month RR = 1.56 (1.28-1.90), 2-3-month RR = 2.24 (1.64-3.07), 4-6-month RR = 1.62 (0.96-2.74), and 7-24-month RR = 1.54 (1.12-2.11). Biochemical validation data from three trials showed null effects (RR = 0.05, -0.09 to 0.18), revealing measurement discordance. Web-based adaptive tools demonstrate short-term efficacy in youth smoking cessation, yet require integration with objective verification protocols. Future implementations should prioritize real-world engagement metrics and standardized outcome reporting.

This study identified barriers to and facilitators of human papillomavirus (HPV) vaccination for adolescent boys and their parents in high-income countries using a social-ecological model (SEM) to inform future health education strategies. A scoping review was conducted in accordance with Joanna Briggs Institute guidelines, Arksey and O'Malley's framework, and Levac's recommendations. Six databases were searched in March and December 2024, with Covidence used for screening. The identified factors were categorized into four levels: intrapersonal, interpersonal, community, and policy. A total of 78 studies were included. Amongst these, 54 facilitators and 120 barriers were identified. Common facilitators included health protection for individuals and their future partners, whilst key barriers were concerns regarding vaccine safety and side effects. Perceptions of risks and benefits emerged as central themes in both categories. Most reported factors were at the intrapersonal (n = 75, 96.2%) and interpersonal (n = 52, 66.7%) levels, with found at the community (n = 27, 38.5%) and policy (n = 28, 35.9%) levels. It is important to emphasize the safety and significance of the HPV vaccine, which should be provided through tailored health education programmes in schools or clinics. This review suggests that future education studies should comprise each domain of the SEM to successfully implement HPV vaccination in adolescent boys. Registration: Open Science Framework (https://doi.org/10.17605/OSF.IO/AWRX6).

The COVID-19 pandemic has been a period of uncertainty, inevitably affecting people's mental health, with a disproportionate impact on vulnerable populations, such as migrants and refugees. To understand what could either mitigate or protect these outcomes, this study explored strategies that refugees and migrants used to cope with the pandemic and its mental health impact. The responses of N = 16 910 refugees and migrants from the worldwide ApartTogether survey were analysed using descriptive analysis and structural equation modelling. Findings indicate that most coping strategies were, either positively or negatively, associated with refugees' and migrants' mental health during the COVID-19 pandemic. Coping strategies such as 'activating myself' and 'thinking something good will come from this' were associated with better mental health outcomes. Important differences between subgroups were found in the number and type of coping strategies, including displaying a higher number of coping strategies by older and female participants, while refugees and migrants living in precarious situations (e.g. being undocumented or living on street) identified less. This increased understanding of refugees' and migrants' differentiated coping behaviours creates avenues for more targeted interventions to support these groups in dealing with future stressful, widespread situations.

Women on the US-Mexico border have a higher cervical cancer incidence rate, are diagnosed at later stages, and have higher mortality compared to non-Border women in the US. We identified key barriers to screening through various qualitative methods and have designed a program that addresses the needs of our community and creates a coordinated program of education, outreach, service delivery, navigation, and capacity building for the future. A multicomponent, culturally tailored, bilingual, evidence-based cervical cancer screening program was developed at Texas Tech University Health Sciences Center El Paso (TTUHSC El Paso). The program was implemented in El Paso and Hudspeth counties. Key program components were (i) theory-based and culturally tailored education delivered by bilingual community health workers; (ii) no-cost Pap and HPV screening; (iii) diagnostic and treatment colposcopy; and (iv) patient navigation and tracking. A total of 2318 women were recruited into the program and offered services. 2206 women were eligible for screening: mean age of the population was 44.8 years, 4.7% (N = 108) had never had a Pap smear, and 40.9% (N = 945) last received a Pap over 5 years previously. Screening uptake was 71.6% (N = 1 569); 7.8% (N = 114) of those tested were positive for high-risk HPV. 101 colposcopies were indicated and 98.0% (N = 99) were completed. Two cancers were diagnosed. A comprehensive cervical cancer screening program can achieve significant screening uptake rates in a high-risk population with historically low screening uptake and has the potential to significantly impact cervical cancer incidence and mortality in this border region.