Health Promotion International最新文献

Tobacco use remains the leading cause of preventable deaths worldwide. Despite efforts by many countries to reduce the impact of tobacco products and lower smoking rates, smoking prevalence is higher among people experiencing homelessness. The reasons are complex and go beyond individual choices, including limited awareness about quitting, restricted access to services, and previous negative experiences. This study is a secondary data analysis of qualitative interviews with women experiencing homelessness. The original data were collected in 2021 as part of a study aimed at understanding tobacco behaviours, attitudes towards quitting, and factors influencing engagement for a subsequent randomized controlled trial. This secondary qualitative analysis, conducted in 2025, examines how policy and environmental contexts influence smoking behaviours among women experiencing homelessness using a social ecological model (SEM) framework. Data were categorized and mapped using the five specified categories within the SEM: policy and environment, community contexts, organizations and systems, interpersonal connections, and individual power and resource distribution. The participants show remarkable resilience in overcoming early-life and adolescent environmental and contextual hardships. Gaps in health services emphasize the need for aligned policy and service improvements. Using the SEM framework, which emphasizes the policy and environmental contexts, offers a deeper understanding of the context of women's lives. The evidence from this study supports the implementation of gender- and age-appropriate holistic approaches to healthcare and tobacco interventions tailored to this community.

Indoor tanning (IT) is a modifiable risk factor for skin cancer, including melanoma. Social media provides a large potential audience for messaging to address IT, and incorporating elements of evidence and theory-based message design may be an effective way to impact knowledge, attitudes, and behaviours within these audiences. However, few studies have investigated whether these elements are used in practice. This content analysis explored whether Canadian health and cancer organizations incorporate theory- and evidence-supported message design strategies and provides suggestions for how these messages could be strengthened. We identified 36 Facebook pages operated by Canadian government and nonprofit health and cancer organizations and searched these pages using predefined keywords to collect 246 posts. We analysed the text and audiovisuals using a codebook based on the study objectives, evidence from the literature, and constructs from the health belief model. Posts were shared between 2009 and 2020, with the highest frequency between 2011 and 2017, corresponding to several Canadian IT policy developments. Of the posts, 156 (63.4%) mentioned at least one specific consequence of IT; of these, 132 (84.6%) mentioned skin cancer. However, there were few references to other consequences of IT, such as eye and appearance damage. Additionally, only three posts recommended alternative behaviours to IT. Some evidence-based message design features, including narratives (5.3%), myth correction (26%), and normative appeals (30.5%), were less frequent. These results may help message designers leverage the large potential audience on social media to effectively address the excess cancer risk posed by IT.

Policy makers lack guidance on effective ways to introduce alcohol warnings, making it important to document the experiences of early adopter countries. Aims of this study were to (i) assess uptake of a mandated pregnancy warning label in Australia, (ii) identify the placement of the warning on products (i.e. front, back, side, top, or bottom), and (iii) compare the results for (i) and (ii) between 2023 and 2024 to provide insights into industry willingness to engage with the policy. In-store visits and web-scraping were used to capture product images that were coded for presence and location of the mandatory pregnancy warning (2023: n = 5923; 2024: n = 6666). Four years after the initial introduction of the policy, corresponding to 1 year after the end of the implementation transition period, 22% of assessed products did not display the mandatory pregnancy warning. In both 2023 and 2024, prevalence was lowest in the spirits category and among single unit and imported products. In most instances, warnings were located on the back of products, although a substantial proportion of multi-packs displayed the warning on the underneath panel of the packaging. The Australian experience offers important insights for other jurisdictions introducing health warnings on alcohol products. Clearly specified compliance deadlines and requirements for warning location could overcome the identified implementation issues.

The complexity of research translation is well recognized. Efforts to accelerate the process have emerged through implementation science, scale-up, scalability, and sustainability. This area of research is now inundated with a plethora of new concepts, creating overlap and confusion for those working in public health, implementation science, and scale-up as well as those seeking to understand it. This perspective examines the commonly used processes (scale-up, scalability, transferability, sustainability) and articulates their current definitions found in the literature. An explanation of the similarities and differences is also provided along with an illustration of where they may be applied in the public health programs: stages of research and evaluation framework. This perspective aims to clarify these processes, in order to provide guidance for seeking to engage in this area, how and when those processes might apply for those new to the field as well as those working within it.

The Health Service by Health Students (HSHS) is a French interprofessional education program implemented in 2018 across all French regions by Health Universities. It aims to train health students (HS) in prevention through primary health prevention actions (PHPA) targeting young populations. This study evaluated the impact of the HSHS program in Franche-Comté (HSHS-FC) on HS's representations of their target public during the 2022-23 academic year. A longitudinal, observational, prospective multicenter survey was conducted using a self-administered questionnaire before (T1) and after (T2) PHPA. The variation in responses between T1 and T2 (Δ) was analyzed for each target public. Among 755 HS included, 468 (62.0%) worked with young children, 240 (32.7%) with teenagers, and 40 (5.3%) with young adults. No significant differences in representations were found at T1 and T2 between groups regarding social background or health behavior factors. However, students working with young children and teenagers showed a statistically significant change in all items between T1 and T2. At T1, HS working with young children reported lower perceptions of their ability to receive, understand, and integrate information. Students focusing on young children reported the greatest shift in representations. HSHS-FC plays a role in reshaping HS's representations of young publics, especially children. The greater evolution in perception among HS working with young children highlights the value of initiating primary prevention early in life.

Shiftworkers are vital to essential industries yet often experience adverse health impacts, including barriers to regular physical activity. Young shiftworkers face additional challenges due to the transitional life stage and the increase of unhealthy behaviours. This study aimed to co-design tailored, evidence-based physical activity resources to support the health and wellbeing of young shiftworkers. A participatory co-design approach was undertaken, involving 48 co-designers, including young, experienced, and former shiftworkers, workplace health and safety professionals, science communicators, and academic experts. Participants attended 1-2 of eight online workshops. Data from the recorded and transcribed workshops informed resource development and included the identification of key physical activity topics and effective communication strategies. A combined inductive and deductive thematic analysis identified 22 unique codes, which were synthesized into five major themes: physical activity basics, impacts of insufficient physical activity, physical activity for shiftworkers, strategies and actions for shiftworkers, and recommendations for workplaces. These themes guided the development of a public-facing website containing evidence-based, context-relevant physical activity resources tailored specifically for young shiftworkers. A motivational and positive framing was consistently endorsed to enhance engagement and support behaviour change. The final resources reflect the diverse perspectives of co-designers and offer a scalable and practical tool to promote physical activity in this priority population. Further research should investigate resource uptake, usability, and behavioural outcomes over time.

Despite notable global progress in tackling water, sanitation, and hygiene (WASH), substantial challenges persist, particularly in low- and middle-income countries (LMICs). While WASH in LMICs is a quintessentially gendered issue, with the burden falling primarily on women, their meaningful participation in WASH management is often questioned. And yet women have important stories to tell. This paper examines the experiences of WASH through the oral histories of older women (n = 32 respondents aged 60+) in three districts in northern Ghana. We situate this work within an eco-social framework that allows us to contextualize resource access related to the determinants of health. Findings reveal substantial perceived improvements in WASH access over the years. This progress was primarily attributed to education and training on appropriate WASH practices. Results also underscore the crucial role of stakeholders, including NGOs, local governments, WASH committees, women's support groups, and individual initiatives, in the advancement of local WASH services. However, the absence of adequate WASH services continues to exacerbate vulnerability to gender-based violence (GBV). Results indicate the need for collaboration and cooperation in achieving Sustainable Development Goal (SDG) 6 (water and sanitation for all), and most importantly, galvanize our thinking around the role of women in this process, by addressing SDG 5 (empowering women and girls) and SDG 3 (health and wellbeing for all).

This study explores how a school wharekai (communal dining hall) implementing the Ka Ora, Ka Ako Healthy School Lunch Programme operates as a multidimensional health promotion setting that fosters student capabilities beyond nutrition. Using a qualitative approach grounded in mātauranga Māori (Māori knowledge) and community-based participatory research, we conducted focus groups with 22 students and semi-structured interviews with 12 staff members to examine how the wharekai promotes wellbeing. Findings show that the wharekai provides a culturally responsive environment where three interrelated capabilities flourish: self-management, interpersonal relationships, and community participation. Through daily routines and authentic roles in food preparation, students practise responsibility, initiative, and cooperation. Shared meals strengthen tuakana-teina (peer) relationships and build trust between students and staff, while collective activities foster belonging, reciprocity, and sustainability. Conceptualizing food spaces through cultural frameworks such as the wharekai demonstrates how school food programmes can simultaneously address food insecurity and create transformative learning environments. This study highlights how culturally grounded, settings-based approaches can integrate nutritional, social, and relational dimensions of health promotion, reimagining school food provision as a holistic, capability-building practice that enhances individual and collective wellbeing.

Dunghutti Country is located within Australia's number one 'stroke hotspot', with incidence almost double the national average. First Nations peoples are disproportionately affected by stroke, with higher incidence and hospitalization rates and a greater risk of dying compared to non-First Nations Australians. Early recognition of stroke symptoms is critical for people to access time-sensitive medical interventions, maximizing recovery potential. Whilst an internationally recognized F.A.S.T (Face, Arm, Speech, Time) message exists to promote rapid recognition of stroke symptoms, community awareness of F.A.S.T is limited. This project aimed to collaboratively design a culturally responsive F.A.S.T health message with and by First Nation's peoples, thus increasing awareness of stroke symptoms, to improve response for seeking time-sensitive medical care. Guided by a qualitative participatory action methodology, and the use of cross-cultural Yarning as the method, this collaborative project involved six Dunghutti stroke survivors, a Dunghutti artist, a knowledge holder of local Dunghutti language, and a local occupational therapist/researcher, who reviewed the mainstream F.A.S.T health message and reimagined that message in a culturally relevant and meaningful way. Yarning allowed exploration of key themes, identifying three elements necessary to maximize the impact of First Nations health and well-being messaging. Elements included ensuring the health message (i) connects to Country, (ii) connects to understandings of health and well-being, and (iii) connects through relevant content, with First Nations peoples centred within the ideation, development, and message delivery processes.

Professional sport club community organizations (CCOs) are regarded as important neighbourhood settings for men's health promotion. However, little is known about how age, and perceptions of ageing and masculinity, shape physically inactive men's engagement in CCO-led health programmes. This study addresses this international knowledge gap by presenting novel insights on the lived experiences of 17 physically inactive men (aged 30-71) involved in the Active Blues programme based in north-west England. Men who engaged in the programme initially regarded it as an important opportunity to return to competitive sport. However, it was the facilitation of traditional masculine values of banter and camaraderie with new like-minded peers which was essential for men's continued engagement, and which helped them manage age-related health conditions. Those who did not engage in Active Blues were more likely to have accepted socially constructed deficit-focused narratives of ageing which, for some, meant 'slowing down'. Fulfilling family commitments and caring responsibilities also prevented some men's engagement. The findings emphasize the need to develop more diverse and culturally nuanced understandings of engaging men in gender-responsive CCO-led health promotion programmes which are underpinned by conceptions of positive, strengths-based, healthy masculinities and which reinforce notions of peer support, camaraderie and openness.