Health Education Research最新文献

Mobile device use has become ubiquitous with daily life, thus providing opportunities to reach parents to promote healthy eating and physical activity in children. Using a socioecological framework and user-centred design approach, the objective of this study was to understand the context in which parents use their devices and their preferences for a digital programme. The formative research phase of the electronic healthy environments (eHEROs) study used a multiple-methods design, consisting of a quantitative survey (n = 116) and a semi-structured qualitative interview (n = 16). Individual- (i.e. digital literacy) and environment-level (i.e. home internet connection) factors were associated with likelihood to participate and preferences for intervention format. Participants outlined key preferences for mobile app content, including modality (audio and video with text), flow (access), and duration (5-15-min lessons). Motivation for participation related to the relevance of the content, feelings of accomplishment, and creative and engaging packaging. Lastly, participants desired opportunities to build community and connect with other parents, preferably through group meetings. Identifying and incorporating the population's preferences and requirements into the digital design are needed to optimize adoption, engagement, and retention of intervention use.

The Health-Promoting Higher Educational Institute concept integrates health and wellness into institutional culture, policies, and activities. The Health-Promoting Institute (HPI) model in India is relatively new, with limited research on its implementation and impact. This study examines the potential of the HPI model within the Indian educational context, ensuring alignment with the Okanagan Charter principles. To assess the impact of a university-wide health promotion programme on student and staff well-being over 5 years (2015-19) using cross-sectional and longitudinal methods, a study was conducted at a university with 13 500 students and 1431 staff. Key measures included: body mass index (BMI) normalization: increased from 67.95% to 76.89% in students; blood pressure reduction: declined from 10.55% to 6.4% in staff and from 2.69% to 1.03% in students; wellness engagement: increased recreational facility use and annual wellness check-up participation; mental health services: stable among students, increased among staff; and healthcare affordability: lower out-of-pocket expenses. Institutional health promotion programmes promote health indicators of BMI, blood pressure, and access to health care effectively. The HPI model improves students' and personnel's well-being, which can be aligned with Sustainable Development Goal III (Good Health and Well-being). Scalability, policy mainstreaming, and long-term sustainability of the health-promoting university initiatives in India should be assessed in future studies.

Participatory systems approaches are suggested to address the complex drivers of adolescent health but have not been applied or evaluated in a vocational school setting. This study investigated the implementation of a participatory systems approach to health promotion and its potential for driving system-level changes in vocational schools. We used quantitative data to assess implementation fidelity (reach, recruitment, and dose) and outputs in terms of the potential for system-level changes (engagement, knowledge, and leverage points). Qualitative data examined contextual factors (participant responsiveness, and school and municipal contexts) as potential influences on implementation fidelity and outputs. The results showed that school, municipal, and community actors actively participated in systems mapping and in identifying actions targeting leverage points at various system levels. Engaged and knowledgeable community actors were found to be key in generating ideas targeting the deeper layers of the system, enhancing the potential for successful implementation and system-level change. Implementation fidelity and outputs varied across sites due to varying responsiveness and school and municipal contextual factors. In conclusion, participatory systems approaches in vocational schools are feasible, leading to action ideas with promising leverage points for health promotion. However, a flexible approach tailored to specific school and municipal contexts is needed.

School-based health interventions can help prevent adolescent substance use, but their success depends on various factors affecting planning and evaluation. This study examines the factors that facilitate or hinder the success of school-based digital health interventions. A systematic review was conducted in September-October 2024, following PRISMA guidelines, using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO databases. From a total of 2530 studies, after removing duplicates and screening titles and abstracts, 51 full-text articles were assessed and 12 met the inclusion criteria. Data were extracted using an adapted tool for systematic reviews applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The methodological quality was assessed with Joanna Briggs Institute tools. The studies included cluster-randomized controlled trials, quasi-experimental designs, and one cross-sectional study, primarily targeting adolescents aged 11.9-17.4 years, with sample sizes ranging from 90 to nearly 5000 participants. Most interventions were implemented in schools in the USA, Europe, and Taiwan, with balanced gender distribution. Many studies reported on reach and effectiveness in reducing substance use, particularly alcohol. However, adoption and implementation factors influencing school participation were less frequently addressed, and maintenance was not mentioned. To maximize impact, future efforts should focus on enhancing sustainment and participation by leveraging emerging technologies for personalization.

Nicotine vaping is common among Canadian youth. However, there is a lack of evidence for effective school-based prevention approaches targeting nicotine vaping, particularly for high school students. This study explored Canadian student and presenter perceptions of the CATCH My Breath (CMB) curriculum's appeal, appropriateness, and comprehensiveness. A convenience sample of 10 high schools across Ontario, Canada, implemented the CMB curriculum between October 2022 and April 2023. A group of 40 students between 13 and 15 years old participated in six focus groups and 12 curriculum presenters [i.e. teachers and public health unit staff (PHU)] completed interviews to provide feedback about the appeal, appropriateness, and comprehensiveness of the curriculum for Canadian high school students. Qualitative thematic analysis identified major themes from both groups. Presenters and students highlighted key aspects of the curriculum, including the negative health risks of vaping, refusal skills development, and use of engaging activities. Presenters and students offered suggestions for improvement, including extending the session length, using up-to-date relevant statistics, and adding content (e.g. personal testimonies). Presenters and students generally thought that the curriculum was comprehensive, appealing, and appropriate for Canadian high school students. Future studies should evaluate the impacts of the curriculum on student vaping behaviours.

Attitudes towards older adults can affect their health and quality of life. Evidence shows that the most negative attitudes have been observed among adolescents and young adults. Therefore, this study aimed to investigate the effect of a multi-intervention based on the Positive Education about Aging and Contact Experiences (PEACE) model on the students' attitudes towards older adults. This interventional study involved 100 male and female students from Naein City, Isfahan Province, Iran, selected through a multi-stage random sampling method. The participants were randomly divided into two groups (control group, n = 50 and intervention group, n = 50). The intervention employed a variety of methods based on the PEACE model. This study's assessment comprised three stages: pre-intervention, immediate post-intervention, and a 4-month post-intervention (follow-up). After the intervention, the attitude, appreciation, and prejudice dimensions scores in the intervention group were significantly higher than in the control group (P < 0.001). In follow-up, no significant difference was observed in the attitude scores between the control and intervention groups (P = 0.974). Applying various strategies derived from the PEACE model has significantly shaped students' attitudes towards older adults.

This study aimed to determine the levels of birth perception and maternal blues among postpartum women who received and did not receive prenatal education programmes. This study, which had a cross-sectional descriptive design, included women who had received prenatal education (n = 64) and women who had not (n = 64). Research data were collected using a Descriptive Information Form, Perception of Birth Scale, and Suryani Maternal Blues Scale. Data were collected twice on the second and fifth postpartum days. Significant differences were found between groups in terms of perception of birth scale scores on both the second day postpartum and the fifth day postpartum for childbirth perception, childbirth experience, pain experience, partner involvement, awareness, and postpartum experience. Regarding maternal blues scale scores, a significant difference was found between groups in terms of responsibility on the fifth day postpartum. This study provides insights into the effects of prenatal education on childbirth perception and maternal blues levels, offering implications for future maternal care practices. Based on our knowledge, this is the first study that investigates the association between prenatal education and birth perception and maternal blues in a middle-income country.

Previous evaluations of the pain care-related Extension for Community Healthcare Outcomes (ECHO) telementoring programmes found that long-term programmes (16-52 weeks) improve clinician knowledge, self-efficacy, and prescribing practices. We evaluated a 6- to 7-week Pain Management ECHO in Nevada Medicaid clinician networks. We collected pre- and post-knowledge and self-efficacy scores from 15 of 18 unique ECHO participants (83% response rate). We derived opioid prescribing outcomes from 44 894 Medicaid pharmacy claims records from 11 ECHO participants and 10 comparison clinicians. The three outcomes included any opioid (binary), non-opioid pain medication (binary), and opioid dose (continuous). Logistic regressions using difference-in-difference (DID) estimated the ECHO treatment effects. Knowledge scores (75% to 82%) and self-efficacy scores (3.4-4.1) increased after ECHO participation. After ECHO participation, opioid prescribing decreased, and non-opioid prescribing increased; changes in both outcomes were above and beyond changes in the comparison group (any opioid DID treatment effect: -0.6 percentage points; non-opioid pharmacologic: 1.1 percentage points). Incremental changes across three domains of Moore's Framework for continuing medical education provide evidence supporting a short-duration ECHO intervention in partnership with Medicaid managed care. Promulgation of this less resource-intensive approach can sustainably aid clinicians in managing pain experienced by Medicaid beneficiaries.

Mexican-heritage families on the Texas-Mexico border report less physical activity (PA) and are at greater risk for chronic disease than the US population. According to social cognitive and family systems theories, family-centred PA programmes engaging Mexican-heritage fathers can improve psychosocial outcomes related to PA. The study assesses changes in child's PA self-efficacy, skill competency, father's social support for child PA, and parenting strategies after a culturally tailored, father-focused, and family-centred lifestyle programme (¡Haz Espacio para Papi!; Make Room for Daddy). Using a stepped-wedge cluster randomized design, participating families (n = 42), consisting of children (mean age: 9.8 ± 1.0) and fathers (mean age: 38.9 ± 7.9]), were from four randomized geographic clusters. Child's PA self-efficacy, skill competency, father's social support for child PA, and parenting strategies were evaluated pre- and post-programme. Linear mixed models assessed programme effects on child and father psychosocial outcomes. The programme was associated with a significant increase in father's social support for child PA (β = 0.08; SE = 0.03; P = .01). However, the programme had no statistically significant associations with child self-efficacy (P = .66), skill competency (P = .96), or parenting strategies (P = .08). This culturally tailored programme resulted in significantly increased fathers' social support for child PA. Programmatic components related to child psychosocial outcomes may need to be strengthened to adequately demonstrate effectiveness.

Narrative persuasion has been widely used in health communication campaigns and persuasive message design. However, several meta-analyses showed that the relative effectiveness of narratives in promoting behavior change was not consistently observed in the existing literature. With the goal of exploring boundary conditions of narrative effects, this study investigates the interaction effects of narrative persuasion and stages of change on promoting behavior change in the context of encouraging parents to vaccinate their children against human papillomavirus (HPV). Findings from an online experiment (N = 593) showed that non-narrative messages were more effective in bolstering behavioral intention than narrative messages among people who were not ready to engage in behavior change (i.e. in the precontemplation stage). In addition, among people who were thinking about changing their behavior (i.e. in the contemplation stage) or motivated to take action (i.e. in the preparation stage), both narratives and non-narratives were effective in increasing behavioral intention. This study contributes important theoretical insights to the role of narratives in health communication. Public health professionals may consider tailoring message design strategies to audience characteristics to enhance message effectiveness.