Health Promotion International最新文献

Housing is a fundamental determinant of health, yet many housing systems fail to promote well-being or address growing challenges such as climate change, inequality, and urbanization. It is increasingly treated as an investment vehicle and as a commercial product supporting the construction industry, with substantial interactions with climate change, rather than its fundamental role providing shelter. This perspective addresses this gap by proposing an integrated framework for health-promoting housing policy that combines affordability, security, and quality, paying particular attention to their interdependence and the growing influence of climate, adopting a systems-thinking approach. The framework was developed through an iterative literature synthesis and interdisciplinary dialogue, designed to overcome the disciplinary fragmentation of existing evidence. We conducted structured searches in PubMed, Scopus, and Web of Science, supplemented by grey literature, concentrating on materials published since 2010, reflecting the increasing relevance of climate resilience and equity. Inclusion criteria focused on sources examining housing-health interactions, policy interventions, and systemic challenges; purely technical engineering studies were excluded. Themes were mapped against four policy levers, legal, financial, planning, and community-based measures. The resulting framework offers policymakers a flexible menu of options to strengthen housing systems and advance health equity. By integrating climate resilience and social inclusion into housing policy, this approach provides a foundation for coordinated action across sectors. Aligning housing policy with public health goals is essential for building equitable, sustainable, and resilient communities.

A novel school-based mental health literacy (MHL) programme titled 'Do You M.I.N.D.?' was implemented in Singapore to improve knowledge, attitudes, and help-seeking among secondary school students. The present study examined its implementation barriers, facilitators, and preliminary impact on students' MHL. A mixed-methods design was used. Qualitative data were collected through semi-structured interviews with 22 key informants and six session observations guided by the Consolidated Framework for Implementation Research. Quantitative data were collected through a 21-item pre- and post-intervention questionnaire with 841 Secondary One students. Pre-post differences were analysed using Wilcoxon signed-rank tests and difference-in-difference (DiD) analyses, with a significance level set at 0.05. Findings revealed that key facilitators included the relative advantage of the interactive sessions that incorporated Virtual Reality, understanding students' mental health needs and resources, engaging school administrators, and executing with implementation fidelity and fit. However, this relative advantage was lost when the programme shifted to Zoom video conferencing during the COVID-19 pandemic, which served as a salient barrier alongside implementation complexity, insufficient available resources, and challenges in engaging students and teachers. Pre-post data showed overall improvements in MHL, with face-to-face delivery yielding significantly better scores for two items. The programme shows promise in enhancing students' MHL, with the study providing insights for refining content and implementation strategies. The reduced effectiveness during online delivery underscores the importance of maintaining interactive elements in future adaptations. These results highlight the need for sustained resources, stakeholder engagement and support, and delivery models that preserve programme interactivity to optimize outcomes.

Despite growing research on school food interventions aimed at promoting sustainable and healthy diets, the perspectives of adolescents regarding those interventions remain underexplored. This study explores adolescents' understanding, perceived importance, and proposed strategies for (facilitating) healthy and sustainable food choices. A mixed-methods study was conducted among 296 adolescents (aged 12-16) at four Dutch secondary schools. Data was gathered through four consecutive methods: a questionnaire, focus group discussions, classroom discussions, and a group poster assignment. Quantitative data were analysed using descriptive statistics and ordinal logistic regression analyses. Qualitative data were analysed inductively through thematic analysis. Adolescents primarily associated healthy and sustainable food with vegetables, fruit, and organic products. Two-thirds of the sample perceived eating healthy food as (very) important, compared to 21% for sustainable food, while 12% indicated not knowing what sustainable food entails. Proposed strategies to facilitate healthy and sustainable food were grouped in four main categories: 'strategies to change the food environment' (e.g. price), 'strategies to change the food system' (e.g. sustainable food production), 'strategies for communication and social support' (e.g. advertisements), and 'individual behaviour change strategies' (e.g. grocery planning). Most strategies targeted the food environment and/or the food system. While health aspects of food were well understood and perceived as important by adolescents, future approaches should emphasize the relevance of sustainable food for adolescents by addressing values they care about. Adolescents call for structural changes, particularly requiring governmental and organizational actions to improve the offer of healthy, sustainable, and affordable food, requiring collaboration of diverse stakeholders.

Partisanship is a factor behind COVID-19 vaccine hesitancy in USA. A growing body of research indicates that conservative Republicans demonstrate greater vaccine hesitancy than their liberal Democratic counterparts. Importantly, older adults tend to be more conservative yet exhibit less vaccine hesitancy overall. Accordingly, this study investigates age as a moderating factor in early vaccine attitudes, addressing a gap in the current literature. Leveraging protection motivation theory and data from the Collaborative Multiracial Post-Election Survey (N = 15 000), our analysis suggests that the relationship between partisanship and COVID-19 vaccine hesitancy is conditioned by age, as measured both continuously and categorically through generational cohorts. Our primary contribution is the finding of no partisanship effect on the oldest cohort of Americans in the earliest days of COVID-19 vaccine implementation. For adults from the Silent Generation, partisanship has no systematic effect on COVID-19 vaccine hesitancy. Furthermore, for younger partisans, vaccination attitudes are more closely tied to political identity than previously known. Our findings uncover generational diversity and provide novel insight into vaccine hesitancy across age and partisanship. Examining age interactions is crucial since age is a major risk factor for many infectious diseases worldwide. Understanding this relationship is essential to ensure that vaccine campaigns are targeted in the most effective way. We present an important contribution that is intersectional in nature, furthering research in both health behavior and politics.

Nutritionists and dietitians are the leading nutrition experts, increasingly leveraging social media to share nutrition and health information. While nutritionists and dietitians share role similarities, differences in qualifications, regulatory frameworks, and scope of practice remain. This study aimed to assess and analyse the professional and ethical use of Instagram by Australian nutritionists and dietitians. Using a cross-sectional approach, 500 Instagram posts by nutritionists and dietitians were assessed using a modified Social Media Evaluation Checklist. The criteria included categories of financial disclosure, cultural awareness, evidence-based information, transparency, privacy/confidentiality, professionalism, and justifiability. Descriptive data analysis was conducted, and scores were reported in both frequencies (n) and percentages (%). Both nutritionists and dietitians primarily shared content related to diet information and service promotion on Instagram. Scores suggest good professional and ethical demonstration in areas such as cultural awareness, balanced and accurate information, adherence to scope of practice, and transparent imagery. However, inconsistencies were noted with financial disclosure, transparent advertising, referencing sources, accessible language, and safeguarding patient identity. While nutritionists and dietitians demonstrated adherence to professional and ethical practices in certain areas, not all standards were fully met. With the growing usage of social media by nutritionists and dietitians for service promotion, there is a need for clear regulations and updated guidelines tailored to these professionals, with an emphasis on transparent financial disclosure and ensuring accessibility of content. Such guidance would ensure nutritionists and dietitians uphold high ethical and professional standards, fostering public trust and enhancing credibility of information shared by these nutrition experts.

Asthma is a common non-communicable disease in children and adolescents. In the Global South, many children are either undiagnosed or under-treated. Health education through theatre has emerged as an innovative and effective method for disseminating health-related information in Africa for conditions such as HIV/AIDS. In this study, we therefore aimed to assess the impact of an asthma awareness theatre, which was adapted from a UK-based play by local theatre groups in six sub-Saharan African countries. This theatre aimed to improve asthma knowledge, and attitudes, dispel myths, and reduce stigma around asthma among adolescents. The study employed a pre-post design, using questionnaires to assess changes in asthma knowledge before and after the theatre, testing for statistically significant changes using Wilcoxon Signed Rank Tests. Adolescents (11-17 years) in Ghana, Malawi, Nigeria, South Africa, Uganda, and Zimbabwe were recruited (n = 3534) through local schools. Nearly all participants stated that the performance was fun (90.7%) and informative (98.1%). Asthma knowledge significantly improved (P < 0.01), including the belief that asthma is not contagious, which rose from 59.7% before to 78.3% after the theatre. To improve health-seeking behaviour and address under-diagnosis and undertreatment of asthma in sub-Saharan African societies, educating young people about asthma and reducing stigma around the condition is of particular importance. We conclude that theatre is an effective way to educate adolescents about asthma at scale across societies in Africa.

Low fruit and vegetable consumption is a major dietary risk factor globally, yet many countries, including the Philippines, under-prioritize this sector compared to staple crops. This study analyses the policy context for fruits and vegetables in the Philippines, focusing on the implementation of two key programs of the Department of Agriculture-the High Value Crops Development Program (HVCDP) and the National Organic Agriculture Program (NOAP)-to identify enabling factors, challenges, and transferable lessons for strengthening fruit and vegetable policy. Guided by policy learning and multiple streams theory, 44 key informant interviews were conducted with stakeholders across government, civil society, academia, and the private sector. The findings reveal that the HVCDP and NOAP offer complementary and mutually reinforcing strengths in supporting the fruit and vegetable sector. Both programs demonstrate effectiveness through multi-level and vertically integrated governance. HVCDP contributes through its emphasis on infrastructure investment and crop-specific planning, while NOAP strengthens the system through an end-to-end value chain approach, including capacity building, peer-to-peer learning, and accessible certification mechanisms tailored to smallholder organic producers. Despite these strengths, both programs face challenges, including policy fragmentation, inconsistent funding, research-farmer disconnects, limited market development, and insufficient technical support. We recommend five areas for enhancement: strengthening policy coordination through integrated frameworks, improving funding allocation, enhancing research-farmer linkages, developing market systems, and strengthening extension services. These insights contribute to knowledge on effective fruit and vegetable policies within food systems frameworks, offering guidance for similar contexts seeking to improve nutrition outcomes through greater policy prioritization of fruits and vegetables.

With the global industry for commercial infant and toddler foods growing, there are concerns that nutrient-poor foods, particularly snacks, are being marketed as suitable for children under 36 months. The current study aimed to document the prevalence of commercial snack foods (CSFs) for infants (<12 months) and toddlers (12 to <36 months) compared to other product categories in Australia, and assess their nutritional composition, taste profile, texture and level of processing. Data were from a 2022 cross-sectional audit of infant and toddler foods conducted across three major Australian supermarkets. Using food categories outlined in WHO Europe's Nutrient and Promotion Profile Model (NPPM), CSFs were defined as 'snacks and finger foods' and 'confectionery' products. Around a quarter (23%) of infant foods and two-thirds (67%) of toddler foods were CSFs, and most (77%) were assessed as being sweet rather than savoury. Only 19% of CSFs met all applicable NPPM compositional requirements, with toddler CSFs performing comparatively worse than infant CSFs, particularly in terms of their energy density (18% of products compliant vs. 72%) and total sugar content (42% vs. 88%). Overall, 71% of CSFs were categorized as dissolvable (either with or without an initial crispy/crunchy texture), while 63% were ultra-processed based on the NOVA classification system. These study findings indicate that a significant portion of the Australian market for infants and toddlers consists of CSFs that are largely sweet, dissolvable and ultra-processed and non-compliant with international recommendations for key nutrients. Comprehensive reforms are needed to improve the nutritional quality of these products.

Research on the Commercial Determinants of Health (CDoH) has primarily focused on high-income countries and large commercial entities, with limited scholarly literature addressing the practices of smaller commercial entities in low- and middle-income countries (LMICs). However, LMICs face the greatest public health challenges resulting from harmful commercial activities, and most commercial entities in these countries are small and medium-sized enterprises (SMEs). This perspective article examines harmful practices commonly adopted by SMEs in LMICs, drawing on a published framework of commercial sector practices and portfolio. By sharing examples of these practices, the paper highlights harmful actions of SMEs in LMICs, illustrates the significant public health burden they create, and calls for more research and policy focus on these issues. There is an urgent need for CDoH research in LMIC contexts, which should include documenting and monitoring the activities of commercial actors, including SMEs. It is essential for researchers from LMICs to be involved in this research, and efforts should focus on building capacity in this area. To minimize the harms associated with these commercial practices, local regulatory action is required, alongside support from intergovernmental organizations such as the World Health Organization.

This article explores the evolving field of Indigenous health promotion, highlighting the use and endorsement of conventional health promotion models despite ongoing efforts toward decolonization. Although some Indigenous-led initiatives exist, such as the Kahnawà:ke Schools Diabetes Prevention Program (KSDPP), deeply entrenched funding models perpetuate dependency on colonial governments, marginalizing traditional knowledge and leadership within Indigenous community health systems. Drawing on community-engaged and participatory research, this study explored the potential of community mobilization to decolonize health promotion in Indigenous communities. The study, conducted during the delivery of KSDPP Community Mobilization Training sessions, explored diverse First Nations community member perspectives on culturally grounded health promotion: what it looks like and how it is implemented. Utilizing talking circles, the study identifies four core knowledge translation processes that illuminate both the nature and practical implementation of culturally grounded health promotion. These processes were grouped as experiential education, social-collaborative, adaptive, and personal cultural healing. The findings underscore the urgent need to recognize and support the ongoing shift toward Indigenous-led health promotion interventions grounded in culture and to challenge the continued reliance on Western health promotion frameworks in Indigenous settings.