Health Education Research最新文献

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.

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.

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.

Cultural competence is widely recognized as a core component of equity in healthcare. However, little is known about how healthcare professionals in Greece, a frontline country for displaced populations, develop and implement cultural competence in refugee healthcare. This study explores the experiences, training needs, challenges, and strategies of Greek healthcare professionals for delivering culturally competent care to refugees and asylum seekers. Twelve healthcare professionals from various Greek healthcare settings participated in semi-structured interviews. Data were analysed using reflexive thematic analysis within an interpretive description framework, appropriate for applied health research. Three themes were developed: (i) developing cultural competence through cross-cultural engagement; (ii) finding a balance: dilemmas and complexity in refugee healthcare; and (iii) caring in isolation: refugee care in unsupportive environments. Systemic constraints and patient-provider challenges limited participants' efforts, despite their demonstrated adaptability and commitment, which sometimes resulted in emotional exhaustion or disengagement. Findings highlight the need for multilevel interventions, combining structural competence, advocacy, and reflective supervision, to support uninterrupted, culturally responsive care and promote healthcare providers' well-being.

This mixed-methods study describes the development and pilot testing of AccessKCTeen, an intervention to improve sexual and reproductive health (SRH) access for marginalized youth. Community discussions guided development of an intervention featuring SRH outreach events to disseminate information, share resources, and connect teens to care via telemedicine and mobile health clinics. During eight outreach events, we recruited adolescent participants for baseline assessments (demographics, event satisfaction, and trust in the medical profession) and one-month follow-up (trust and SRH utilization). We documented feedback on SRH resources (e.g. condoms), telemedicine, and mobile care with field notes. Among 96 participants (46% Black; 23% Hispanic; 23% gender minority; 50% sexual minority), most were 'very' (76%) or 'somewhat' (9%) satisfied with the event; 15% were 'neutral'. At baseline, trust was moderate (16.4 ± 2.7; scale range 5-25). Many accepted SRH items for future use. Field notes documented adolescent comments regarding telemedicine as safe, private, and convenient, and the mobile clinic as private and trustworthy. At follow-up, 20% obtained healthcare; trust was 17.2 ± 2.8. Our findings indicate that a community-integrated, multi-component intervention is acceptable to adolescents and warrants further evaluation of its impact on SRH outcomes.

This single-blind, randomized controlled experimental study evaluated the effects of Mindfulness-Based Compassionate Living (MBCL) practice on stress, self-efficacy, and quality of life of patients receiving haemodialysis (HD) in an outpatient clinic in Türkiye. A total of 67 HD patients were allocated to the experimental (n = 34) or control group (n = 33). The experimental group received a MBCL training intervention for 30 min twice a week for 8 weeks during their HD sessions. The control group underwent HD as usual. Data were collected before and after the intervention using Perceived Stress Scale, Self-Efficacy Scale, Quality of Life Index-Dialysis III, Self-Compassion Scale-Short Form, and Mindful Attention Awareness Scale. Between the pretest and posttest, the experimental group showed a significant decrease in stress scores and increases in quality of life, self-compassion, and mindful awareness scores (P < .05). There were no intergroup differences in pretest scores, whereas significant differences in stress, quality of life, self-compassion, and mindful awareness scores were observed in the posttest (P < .05). Self-efficacy scores did not differ significantly within or between the groups (P > .05). MBCL practice appears to be effective in reducing stress and increasing quality of life, self-compassion, and mindful awareness in people undergoing HD in outpatient settings.

Social and community service settings are a promising environment to support individuals with lower socioeconomic positions in quitting smoking. However, there remains a notable lack of support from their professionals in these settings. This study provides an overview of facilitators and barriers to smoking cessation support among these professionals. A systematic review was conducted up to April 2024 using five databases. Data were analysed using thematic synthesis, with themes categorized according to the Social Ecological Model. Eleven studies were included. We found twelve factors that could facilitate professionals in providing support. These factors related to the intrapersonal (i.e. knowledge/skills, self-efficacy, and belief), interpersonal (i.e. trustworthy connection with clients, readiness of clients, and clients' supportive social environment), organizational (i.e. expertise improvement in smoking cessation, availability of resources, and organizational support), and societal level (i.e. availability of appropriate cessation programmes, supportive healthcare financing, and public awareness). We found that these factors often were not present, which hindered professionals from providing support. Professionals working in social and community service settings could reach many people who smoke. However, there are numerous obstacles to overcome before their full potential can be realized. To harness this potential, organizational changes are necessary, with governments playing a supportive role.

The present study investigated the effect of the lifestyle-based health promotion intervention on health behaviour, irrational health beliefs, and eating behaviour of patients with type 2 diabetes. For this purpose, 90 patients with type 2 diabetes were selected by convenience sampling and randomly assigned to experimental and control groups, each comprising 45 patients. The experimental group received eight 90-min sessions of lifestyle-based health promotion intervention, while the control group received no treatment. The data were collected by the Health-Promoting Lifestyle Profile, Irrational Health Belief Scale, and the Dutch Eating Behaviour Questionnaire, administered to the participants at the pre-test, post-test, and 3-month follow-up phases and analysed by the analysis of variance. The results indicated that the mean score of health behaviours of the experimental group improved. In contrast, the mean scores of their eating behaviour and irrational health beliefs decreased compared with the control group (P < .01). The findings of this study underscore the significant impact of lifestyle-based health promotion interventions on patients with type 2 diabetes. Consequently, practitioners and healthcare professionals might include lifestyle-based health promotion interventions in the standard treatment programs for patients with type 2 diabetes to promote their health and treatment outcomes.