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Think-aloud test of online education for patients with cardiac diseases: do they meet the needs of women? 心脏病患者在线教育的有声思考测试:它们满足女性的需求吗?
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-21 DOI: 10.1093/her/cyaf006
Emily A Gunning, Rachael P Carson, Emma Schotanus, Sydney Benn, Jordan Henderson, Amy Eccles, Sherry L Grace, Gabriela L M Ghisi

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.

患者教育是心血管康复(CR)的核心组成部分。最近的指导方针呼吁根据女性的独特需求和偏好,为她们量身定制材料。本研究调查了女性患者对在线CR教材的看法(多伦多心脏学院)。通过横断面设计,采用一种“大声思考”方案,然后采用半结构化的定性访谈,收集关于妇女对综合教育网页在内容、格式、视觉效果、长度/数量、难度、适用性、可执行性和改进建议方面的看法的数据。38名现任和前任企业社会责任项目参与者完成了1-h Zoom访谈。转录本由两名研究人员独立使用NVivo的最佳实践进行主题编码。出现了四个主题:(I)材料满足他们的需求(内容,演示和授权),(II)改进演示的建议(网站设计,文本和视觉效果),(III)内容(数量,添加和难度),以及(IV)优化范围和可实施性(包容性,障碍和传播)。总的来说,教育内容满足了妇女的需要,并且是相关的,但应该更新货币,视觉吸引力和可搜索性。女子心脏学院可以满足这些需求和偏好。
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引用次数: 0
Comparison of eco-directed and health-focused brief awareness-raising interventions for enhancing active participation of community residents in drug take-back program. 促进社区居民积极参与药物回收方案的生态导向和以健康为重点的简短提高认识干预措施的比较
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-21 DOI: 10.1093/her/cyaf002
Shuzhe Wu, Qinghua Liu, Qin Li, Jun Wang

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.

药物回收系统为适当处置不需要的药物提供了合法、安全和环保的途径,有助于环境可持续性和减少药物滥用。本研究设计并实施了一个简短的教育干预
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引用次数: 0
Randomized experimental test of a reduced-exposure message for an e-cigarette: comprehension and related misperceptions. 电子烟减少接触信息的随机实验测试:理解和相关误解。
IF 2 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-21 DOI: 10.1093/her/cyae022
Stacey McCaffrey, Saul Shiffman, Mark A Sembower, Ryan A Black

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.

完全从吸烟转向电子尼古丁传递系统(ENDS)可以减少接触有毒物质。然而,许多吸烟者认为,电子烟至少和吸烟一样有害,这使他们不太可能从香烟转向电子烟。有效地传达减少暴露的信息是至关重要的,但必须正确理解这些信息。这项在线研究评估了对事实信息的理解,表明吸烟者完全放弃吸烟转向juul品牌的ENDS可以减少他们接触香烟烟雾中的有害化学物质。参与者是12557名18岁以上的成年人(吸烟者、双重使用者、曾经和从未使用过烟草),随机分为减少接触信息组和对照组。在接触到这条信息后,大多数吸烟者(89%)明白有必要完全从香烟转向JUUL,以减少接触。大多数吸烟者和非使用者(75%)没有误解JUUL完全消除了有害化学物质的接触,85%的人知道使用JUUL有风险。对消息的暴露提高了对JUUL目标受众的理解。健康素养有限的个体在任何情况下都表现出较低的理解力。确保充分理解关于减少ENDS暴露的信息对于确保此类信息有利于公共卫生非常重要。
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引用次数: 0
A scoping review of visual communication of written patient health information preferences including a Māori perspective. 包括Māori观点在内的书面患者健康信息偏好的视觉传达的范围审查。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-21 DOI: 10.1093/her/cyaf005
A Caisip, L Kremer, L Edmonds, A Young

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.

这一范围审查审查了书面患者信息(WPI)的视觉设计元素,特别关注图像、颜色、布局和内容呈现,以及它们对患者健康信息沟通、理解、行为和偏好的影响。了解患者的偏好有助于患者知情的WPI设计,这对于生活在殖民社会中的Māori(新西兰奥特罗阿的土著人民)非常重要。对9项研究进行了分析,主要调查了视觉插图在WPI中的整合。与会者普遍赞成在文字旁边加上图片,认为它们有助于增进理解,使健康信息更容易接近。虽然根据文化水平和文化背景的不同,人们更喜欢简单和不那么详细的视觉效果,例如漫画。使用颜色、布局特征(如字体和空白)和内容框架(如风险信息的积极和消极框架)对信息接收和行为结果的影响进行了探讨。目前,关于Māori偏好的文献较少,需要进一步研究。总的来说,这一范围综述强调了设计具有视觉元素的wpi的重要性,以满足不同文化水平和文化偏好,以优化沟通效果和患者参与。
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引用次数: 0
Implementation of a complex eHealth intervention by a public-private partnership in clinical practice: a qualitative multicentre analysis using CFIR. 在临床实践中通过公私合作实施复杂的电子健康干预:利用 CFIR 进行多中心定性分析。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-21 DOI: 10.1093/her/cyaf001
R V H IJzerman, R van der Vaart, L D Breeman, R A Kraaijenhagen, A W M Evers, W J M Scholte Op Reimer, V R Janssen

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.

复杂的电子卫生干预措施-在动态系统中具有多个组件-用于改善医疗保健。在这种情况下,结合资源、专业知识和技术的公私伙伴关系(ppp)至关重要。然而,将这些干预措施纳入实践仍然具有挑战性。本研究确定了通过PPP在实践中实施BENEFIT计划(一项针对心血管疾病患者的复杂电子卫生干预措施)的障碍和促进因素。采用定性研究设计。来自4个心脏康复(CR)站点的10个关键利益相关者(他们都是参与制定和实施BENEFIT项目的PPP合作伙伴)接受了半结构化访谈。使用实施研究综合框架对转录本进行分析。促进因素包括项目适应性、团队内部的沟通和规划、数字医疗保健需求、专门的PPP领导、PPP会议结构以及PPP快速修改实施策略的能力。障碍包括具体的PPP挑战(频繁变化的角色、不明确的角色和职责以及有限的人员配备)、工作场所中断、信息技术(IT)集成不良以及企业责任站点之间实施目标不明确。本案例研究强调了ppp在实践中实施复杂电子卫生干预的挑战。研究结果强调了综合实施方法的必要性,考虑到具体的PPP动态,包括专业知识和资源的结合、透明的角色定义、充足的人员配备、明确的目标沟通和可持续实施的适应性战略。
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引用次数: 0
The outcome of diabetic retinopathy health education program in patients with type 2 diabetes mellitus: a quasi-experimental study. 2型糖尿病患者糖尿病视网膜病变健康教育项目的效果:一项准实验研究。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-19 DOI: 10.1093/her/cyae045
Mat Isa Rif'atunnailah, Chong Mei-Chan, Lee Wan Ling, Iqbal Tajunisah, Saiful Suhardi Mohd Iman, Jamaludin Thandar Soe Sumaiyah, Roslim Nurul Afieda

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.

如果不进行早期干预,糖尿病视网膜病变(DR)可能发展为威胁视力的DR和视力丧失。本研究旨在评估DR健康教育计划对2型糖尿病(T2DM)患者的效果。采用准实验研究设计。干预组接受基于网络的DR健康教育计划,对照组在眼科诊所进行常规随访1年。数据分析采用描述性统计、重复测量方差分析和一般线性模型评估组间平均差异。共有180例T2DM患者入组,对照组和干预组人数相等,退组率为28%。对照组与干预组在知识评分[F (1178) = 116.57, P = 0.001]、糖尿病自我护理[F (1178) = 116.57, P = 0.001]、视觉相关生活质量[F (1178) = 12.70, P = 0.001]方面的平均差异均有统计学意义。干预组在所有三个类别中得分最高。本研究显示,教育干预对2型糖尿病患者的自我护理依从性和视觉相关生活质量有积极影响。DRHEP应该被认为是T2DM管理的一个额外的好处,从综合护理登记开始。
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引用次数: 0
Challenges in implementing school-based drug prevention programs led by law enforcement officers. 在执行由执法人员领导的以学校为基础的毒品预防方案方面面临的挑战。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-19 DOI: 10.1093/her/cyae039
Juliana Y Valente, Julia D Gusmões, Rodrigo Garcia-Cerde, Tania Pietrobon, Zila M Sanchez

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.

在美国和巴西,以学校为基础的预防毒品项目通常由执法人员实施。然而,有限的研究探索了在提供这些干预措施方面所涉及的挑战,特别是与leo实施这些干预措施有关的挑战。我们的目的是描述影响执行由LEOs提供的以学校为基础的毒品预防方案的挑战。我们进行了一项定性研究,使用了31个半结构化访谈,访谈对象是负责巴西版DARE-Keepin' it REAL项目(五年级和七年级课程)的学习主管,以及8个焦点小组,包括80名参与该项目的学生。对所有数据进行主题分析。低领导者认为警察公司的贬值,导致资源限制和指挥官抵制调整时间表。与学校社区的关系带来了额外的挑战。五年级学生似乎普遍对狮子座的存在持积极态度,而七年级学生则表现出更多的消极反应。LEOs的街头警务经验影响了他们澄清吸毒后果的方法,并愿意分享相关经验,尽管这些内容不是项目的一部分。因此,至关重要的是要考虑在学校提供预防项目的替代方法,同时加强对已经参与项目实施的基层领导的培训,以确保与循证实践保持一致。
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引用次数: 0
The effect of health education on symptom severity in patients with fibromyalgia: a systematic review and meta-analysis. 健康教育对纤维肌痛患者症状严重程度的影响:系统回顾与荟萃分析。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-19 DOI: 10.1093/her/cyae035
Huan-Xi Huang, Renny Wulan Apriliyasari, Pei-Shan Tsai

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.

纤维肌痛(FM)是一种以广泛性疼痛为主要症状的复杂慢性疾病。为了评估健康教育对 FM 患者各种症状严重程度的影响,我们检索了从开始到 2024 年 8 月的七个数据库,以确定评估健康教育对 FM 影响的随机对照试验。主要结果为总体症状严重程度,次要结果为疼痛、抑郁、焦虑、睡眠质量、疲劳、身体功能和自我效能。科克伦随机试验偏倚风险工具和推荐、评估、发展和评价分级法分别用于评估纳入研究的质量和证据的确定性。通过计算赫奇斯 g 和相应的 95% 置信区间来估计治疗效果。元分析共纳入了 13 项试验。结果显示,健康教育能明显减轻 FM 患者的整体症状严重程度、抑郁和焦虑,提高睡眠质量和身体功能(所有 P 值均为 0.05)。
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引用次数: 0
How are pro- and anti-cannabis messaging exposures related to US young adult cannabis use-related factors? 支持和反对大麻的信息暴露与美国年轻人大麻使用相关因素有何关系?
IF 2 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-19 DOI: 10.1093/her/cyae038
Yuxian Cui, Cassidy R LoParco, Katelyn F Romm, Patricia A Cavazos-Rehg, Y Tony Yang, Darcey M McCready, Erin Kasson, Yan Wang, Carla J Berg

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.

考虑到大麻信息的不同来源和潜在的不同影响,本研究通过与大麻相关的认知(社会可接受性和危害)和行为(使用状况、意图和频率;过去一年的戒烟尝试)。对来自4031名美国年轻人(男性= 26.29,女性59.4%,西班牙裔19.0%,黑人13.5%,亚洲13.6%)的2023项调查数据进行多变量回归分析,分别使用代表总体曝光率和特定来源(商店、在线、广告牌/海报/传单、电视/电影/广播、印刷和直接传播)的自变量。更多的支持大麻的信息暴露与更高的感知社会可接受性、更低的感知危害、过去一个月的使用、报告过去一个月未使用的更大的使用意图、报告使用的更长的使用天数和更少的戒烟尝试相关。除意图外,较少的反大麻信息暴露与这些结果相关。特别是,支持大麻的有影响力的信息来源是在线(与看法、使用状况、意图和频率有关)和直接沟通(与看法、使用、使用频率和戒烟企图有关),而反对大麻的信息来源是在线(伤害和使用意图)、直接沟通(可接受性、戒烟企图)和商店(看法、使用和戒烟企图)。暴露程度因社会人口统计学(如性别、种族/民族和教育程度)而异。数字媒体和有针对性的通信的整体影响以及传播大麻相关风险的商店表明需要进行监管和监测。
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引用次数: 0
Correction to: Examining the impact of a leisure time intervention on participation in organized out-of-school activities among adolescents: a quasi-experimental study in Franklin County, KY, USA. 修正:检查休闲时间干预对青少年参与有组织的校外活动的影响:美国肯塔基州富兰克林县的一项准实验研究。
IF 2.1 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2025-02-19 DOI: 10.1093/her/cyae044
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引用次数: 0
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