Health Promotion International最新文献

A large number of adolescents, particularly adolescents from underserved neighborhoods, often fail to meet physical activity (PA) guidelines, increasing their risk of developing noncommunicable diseases. Physical inactivity among adolescents is considered a complex problem driven by multiple, interrelated factors, and participatory action research is a valuable approach for exploring and improving the systems that influence adolescents' PA behaviors from the perspective of adolescents themselves. By using the Youth-Centered Participatory Action Denmark project, conducted in two youth clubs in underserved neighborhoods, as a case example, the aim of this paper was to demonstrate how participatory action research and systems thinking can be applied in practice to co-create a systems map on adolescents' outdoor PA. The adolescents participated as co-researchers, actively using their lived experiences and priorities to shape the research. Five key drivers of outdoor PA were identified from the system map: sense of belonging, maintenance of outdoor space, peer influence, accessible and attractive spaces, and the role of youth club staff. These drivers highlight the complexity of promoting outdoor PA and underscore the need for interventions that address multiple aspects and levels of the system. By combining participatory action research and systems thinking, this study provides insights into the mechanisms that shape adolescents' outdoor PA, from the perspective of adolescents themselves. The developed system map will serve as a starting point for co-developing interventions to increase outdoor PA among adolescents, in close collaboration with the adolescents themselves.

Health literacy (HL) is a fundamental factor in raising health awareness and self-management, especially in contexts with increasingly complicated health systems. Its accurate and culturally appropriate measurement is necessary to support effective medical interventions. Accordingly, we translated the Health Literacy Questionnaire (HLQ) into Vietnamese and analysed its psychometric properties on the basis of data derived from respondents who completed the translated instrument. A cross-sectional study was performed with 585 residents (average age = 40.9 (SD = 14.7; youngest = 19 years old, oldest = 81 years old) of Ho Chi Minh City in December 2024. A reliability analysis showed that the Vietnamese HLQ had good reliability (Cronbach's alpha = 0.75 to 0.86). A nine-factor model was constructed using 44 items from the questionnaire, after which it was subjected to confirmatory factor analysis to determine its fit under the assumption that no correlated residuals or cross-loadings exist. The fit indices satisfied the cut-offs [χ2 (weighted least squares mean and variance) (866) = 2545.77, P < 0.001, CFI = 0.931, TLI = 0.924, RMSEA = 0.058, SRMR = 0.053], but the effects are less distinctive with regard to scales 6-9 (e.g. engagement with healthcare providers, understanding of health information). The results provide a solid scientific basis for using the questionnaire in research and practice. Its application is key to improving understanding of and access to community health information.

Older men seek help for mental health concerns at almost half the rate of older females. Efforts to motivate older men to seek help through health promotion messaging are an important public health initiative that can complement healthcare system changes. Guided by the reasoned action approach, this study aimed to identify the most salient beliefs that shape help-seeking intention among older men by region (i.e. city or rural area) to primarily inform campaign messaging and improve mental health help-seeking among older men. A mixed-methods enquiry was conducted across two samples of older men, comprising open-ended belief elicitation interviews (N1 = 23, M1 age = 74.91) and an online closed-question survey (N2 = 306 participants, M2 age = 75.28). Interviews identified 52 behavioural, normative, and control beliefs. Survey results showed salient beliefs influencing help-seeking intention (range β = 0.42 to β = 0.44), including encouragement from others, gaining new solutions, improved self-understanding, and being listened to and supported when seeking help, representing suitable messaging design candidates. The influence of salient beliefs on intention did not differ by region. The results suggest that health promotion efforts grounded in reasoned action approaches can support the development of tailored interventions to promote help-seeking for poor mental health. However, research is needed to evaluate how to effectively translate salient beliefs into carefully framed mental health messages, aligned with broader healthcare system-level reforms to promote help-seeking among older men.

Food insecurity is increasingly recognized as a public health issue with social and psychological dimensions. However, evidence on its association with mental health and social isolation in regional Australia remains limited. A cross-sectional online survey among adults (≥18 years) living in the Illawarra and Shoalhaven regions of Australia assessed food insecurity using the 18-item USDA Household Food Security Survey Module, categorized into 'food secure' (score = 0) or 'food insecure' (score = 1+). Self-rated mental health and physical health (excellent/good vs. fair/poor) and reported diagnosis of a mental health condition was determined. Social isolation was assessed using six individual indicators and a composite social isolation score dichotomized participants into high versus low isolation. Multivariate logistic regression models examined associations between mental health, social isolation, and food insecurity, adjusting for relevant sociodemographic characteristics. Of participants (n = 666; 80% female; 57.1% university education), 38.3% experienced food insecurity. Poor self-rated mental health (22%) was associated with increased odds of food insecurity (AOR = 2.41, 95% CI: 1.47-3.96), as was diagnosed mental illness (AOR = 2.33, 95% CI: 1.46-3.71) and poor self-rated physical health (AOR = 2.06, 95% CI: 1.23-3.44). Participants with high social isolation on the composite score (15.5%) had two times higher odds of food insecurity compared with those with low isolation (AOR = 2.16, 95% CI: 1.09-4.26). Strong associations were also observed for individual indicators. Findings demonstrate strong links between food insecurity, mental health, and social isolation in regional Australia. Addressing food insecurity requires integrated strategies that combine material assistance with initiatives to strengthen social connectedness.

Early childhood education and care (ECEC) settings are pivotal in shaping children's dietary behaviours. While the importance of centre-based nutrition policies (CBNPs) in shaping early childhood nutrition environments is well established, little is known about how these policies are interpreted and implemented by those working in the sector. In particular, limited research has explored the perspectives of both service-level (ECEC employees) and agency-level (health/government organization) stakeholders, which are two groups central to supporting and enacting these policies in practice. This study used a qualitative exploratory design to understand stakeholder experiences and perspectives regarding the implementation of CBNPs and the broader challenges in fostering supportive ECEC nutrition environments. Semi-structured Zoom interviews were conducted with 9 ECEC employees and 10 agency-level representatives across 8 Australian jurisdictions. Interview data were analysed using reflexive thematic analysis. Three overarching themes were identified, reflecting how stakeholders understood the importance of CBNPs and what factors they believed were necessary for successful implementation: (i) the need for realistic rather than idealistic policy requirements, (ii) adaptation as a prerequisite for implementation, and (iii) the value of a multi-faceted approach in creating optimal nutrition environments. Findings point to the need for a multi-faceted approach that combines adaptable guidelines with targeted, practical support such as training and resources, tailored to the realities of ECEC settings. Strengthening partnerships between policymakers, educators, families, and health professionals is critical to supporting the sector and developing feasible strategies that enhance CBNP implementation and promote healthy eating among young children.

Medical writing is a key element in pharmaceutical companies' efforts to shape the relevant medical science literature. As part of what is called 'publication planning', medical writing can influence the knowledge base on which prescribers make decisions, and can build specific claims in targeted sales efforts. Most publication planning is done by hired medical education and communication companies (MECCs), with the rest done by other commercial entities, such as units of pharmaceutical companies or of contract research organizations, that provide essentially the same services as MECCs. Here we provide an estimate of the number of MECCs and comparable entities contributing to the medical science literature in English. To identify these companies, we collected data from Web of Science (858 named firms from 20 498 papers mentioning medical writing assistance), LinkedIn (410 company profiles), and Google and DuckDuckGo (68 company websites). After removing duplicates and false positives, we found 1148 MECCs and other comparable entities providing medical writing services. More than 50% of Web of Science papers that acknowledged medical writing support are sponsored by only ten pharmaceutical companies. Most of the remaining papers in our database are sponsored by other pharmaceutical, device, and biotechnology companies. This study likely undercounts MECCs, because it depends on some level of transparency in publications or other leakage of information. Our combining multiple sources for the data should limit the undercount of MECCs. The study does not identify MECCs that work exclusively in languages other than English.

Most of our waking hours are spent in the workplace, where mental health significantly impacts workers' quality of life and overall well-being. Mental health can have both positive and negative consequences not only on the working population but also on organizations and society as a whole. In this context, best practices in Workplace Mental Health Promotion (WMHP) are essential for guiding initiatives aimed at fostering mental health in occupational settings. The main objective of this study was to develop and validate best-practice indicators for WMHP. For this purpose, a qualitative empirical design was employed. Drawing on a review of the WMHP literature, a list of potential indicators was generated and subsequently submitted to an expert panel for evaluation. The reliability of the expert judgments was assessed using the intraclass correlation coefficient (ICC). Content validity was evaluated through the content validity ratio (CVR) and the modified kappa statistic (K*). As a result, 27 validated, evidence-based indicators were obtained, which showed consistency with findings from previous research. These results have important theoretical and practical implications and can inform future research as well as guide practitioners and organizations in the implementation of WMHP practices.

The digital determinants of health have recently attracted attention in the medical and public health literature, but the environmental aspects of these determinants have rarely been considered. This Perspectives article calls for applying a planetary health lens to the digital determinants of health, with a focus on the impacts of novel generative AI technologies on the natural world. The argument is founded on the principle that human and planetary health are intertwined and that digital technologies such as generative AI affect the health of both humans and the other living things in ecosystems. The article discusses proposals of how generative AI tools can contribute to action on the climate, loss of biodiversity and pollution crises but also highlights how the expansion of generative AI infrastructure and operation has exacerbated the problems of e-waste, greenhouse gas emissions and major burdens on energy and water resources. It is argued that for progress to be made in improving human and planetary health, those working in health promotion and other public health domains must acknowledge that human and planetary health are interdependent, so that we can refer to the 'digital determinants of human and planetary health'. The article highlights this interdependence and the importance of fighting for multispecies justice and the rights of nature to promote the mutual flourishing of humans and the natural world. Actions are proposed that can be taken at the organization and community level to make visible and counter the impacts of generative AI on human and planetary health.

The active mobility experiences of adolescents intersect with those of younger children and older youth in many ways. However, existing research informing health promotion is limited in its exploration of the distinct features that differentiate adolescent active mobilities and the differences within adolescence. Drawing on interviews and audio-recorded walking tours with 12 adolescents aged between 12 and 15 from urban areas of Australia, this paper examines adolescents' constructions of active mobility and place in their local areas. We adopted a constructionist epistemological approach and conducted a reflexive thematic analysis of adolescents' accounts. Our analysis suggests that adolescents construct mobility as an everyday, utilitarian practice, and understand clean, well-maintained places to constitute a 'good' neighbourhood. Unlike younger children, our analysis illustrates how urban risk was also constructed as an everyday aspect of mobility that adolescents could navigate with little effort. Mobility as offering connection (both socially and to self) was also a key theme generated by our analysis as a potentially distinct aspect of local active mobilities during the adolescencent years. Based on this, we recommend further critical enquiry into opportunities for enhancing connection in mobility among adolescents from diverse population groups.