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Health and Social Problems of Refugee Women and Their Children: A Qualitative Case Study. 难民妇女及其子女的健康和社会问题:定性案例研究。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-08 DOI: 10.1111/phn.13520
Derya Adibelli, Özlem Şahan

Objective: We intend to examine the health and social problems of refugee women and their children in this research.

Design: A qualitative case study.

Sample: We conducted this study between December 2022 and January 2023 with 19 refugee women aged 18-49 years.

Measurements: We used the snowball sampling method for data collection, and individual in-depth interviews were conducted. We completely transcribed the interviews and then main themes and sub-themes were created. To ensure reliability, two independent external coders were asked to code the themes and sub-themes, and Kappa analysis was performed according to the results. We found the Kappa analysis value as 0.87. After the analysis of the study data, we conducted the thematic content analysis on the Nvivo 10 software.

Results: We emerged the main themes following the qualitative data analysis were (1) experiences during migration, (2) communication while receiving health services, (3) childhood immunization status, (4) deciding to have a child, (5) deciding on the number of children, (6) use of family planning methods, and (7) the person with priority in the family.

Conclusion: This research indicated that childhood immunization in refugee children was inadequate, refugee women did not know about family planning methods, and even if they did, they did not use these methods because they wanted to have many children.

目的:我们打算在本研究中探讨难民妇女及其子女的健康和社会问题。设计:定性案例研究。样本:我们在2022年12月至2023年1月期间对19名年龄在18-49岁之间的难民妇女进行了这项研究。测量方法:采用滚雪球抽样法进行数据收集,并进行个人深度访谈。我们完整地记录了采访内容,然后创建了主要主题和次要主题。为确保信度,请两名独立的外部编码器对主题和子主题进行编码,并根据结果进行Kappa分析。Kappa分析值为0.87。在对研究数据进行分析后,我们对Nvivo 10软件进行了专题内容分析。结果:在定性数据分析之后,我们得出了以下主题:(1)迁移期间的经历,(2)接受卫生服务时的沟通,(3)儿童免疫状况,(4)决定要孩子,(5)决定孩子的数量,(6)计划生育方法的使用,以及(7)家庭中优先考虑的人。结论:本研究表明,难民儿童的儿童免疫接种不足,难民妇女不了解计划生育方法,即使了解计划生育方法,也不会使用这些方法,因为她们想要多生孩子。
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引用次数: 0
Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases: A Systemic Review and Meta-Analysis. 揭示维生素D与非传染性疾病之间的关系:一项系统回顾和荟萃分析。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-07 DOI: 10.1111/phn.13521
Dipali Dumbre, Sheela Upendra, Betsy Sara Zacharias

Background: Subclinical vitamin D insufficiency is frequent in both developing and developed countries. Even after rickets was eliminated in the 1930s by fortifying milk, up to 1 billion people worldwide suffer from subclinical vitamin D deficiency (VDD). Numerous noncommunicable diseases (NCDs), including depression, autoimmune illnesses, diabetes, osteoporosis, and cardiovascular disease, are linked to this deficiency.

Methodology: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was applied when conducting a systematic review. Relevant studies published between 2010 and 2023 were found by searching databases such as Web of Science, Scopus, and PubMed. To find correlations between deficiency of vitamin D and NCDs, data was extracted from the studies and analyzed using the Mixed Method Appraisal Tools (MMAT). In meta-analysis data combined from multiple observational Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases-A Systemic Review and Meta-Analysis studies to evaluate the relationship between vitamin D insufficiency and health outcomes. Statistical techniques, such as calculating effect sizes and constructing confidence ranges, are employed to determine combined outcomes and investigate possible causal connections.

Results: Fourteen studies-including cross-sectional studies, prospective cohorts, randomized controlled trials, and longitudinal studies-met the inclusion criteria. Significant correlations among deficiency of vitamin D and a number of NCDs, including anemia, diabetes, hypertension, rheumatoid arthritis (RA), mental health issues, and autoimmune hypothyroidism, were found in the review. The results highlight the prevalence of deficiency of vitamin D worldwide and its detrimental impact on health. In order to lower the risk of numerous NCDs, this review emphasizes the need for greater awareness and possible interventions to maintain appropriate vitamin D levels. A meta-analysis was conducted to investigate the potential causal connections between vitamin D insufficiency and different health disorders. It elucidates the connections between deficient levels of vitamin D and conditions such as mental health disorders, anemia, diabetes, hypertension, and autoimmune diseases. The study prioritizes the examination of temporal correlations, biological plausibility, and the removal of confounding factors to provide support for these associations. While the text acknowledges that experimental data, such as randomized controlled trials, would enhance the argument for causation, it mostly depends on observational studies.

背景:亚临床维生素D不足在发展中国家和发达国家都很常见。即使在20世纪30年代通过强化牛奶消除了佝偻病之后,全世界仍有多达10亿人患有亚临床维生素D缺乏症(VDD)。许多非传染性疾病(ncd),包括抑郁症、自身免疫性疾病、糖尿病、骨质疏松症和心血管疾病,都与这种缺乏有关。方法学:在进行系统评价时,采用系统评价和荟萃分析首选报告项目(PRISMA)协议。通过搜索Web of Science、Scopus和PubMed等数据库,找到了2010年至2023年间发表的相关研究。为了发现维生素D缺乏与非传染性疾病之间的相关性,从研究中提取数据并使用混合方法评估工具(MMAT)进行分析。在综合了多个观察数据的荟萃分析中,揭示了维生素D与非传染性疾病之间的关系——一项评估维生素D不足与健康结果之间关系的系统综述和荟萃分析研究。统计技术,如计算效应大小和构建置信范围,被用来确定综合结果和调查可能的因果关系。结果:14项研究——包括横断面研究、前瞻性队列研究、随机对照试验和纵向研究——符合纳入标准。该综述发现,维生素D缺乏与许多非传染性疾病(包括贫血、糖尿病、高血压、类风湿性关节炎(RA)、精神健康问题和自身免疫性甲状腺功能减退)之间存在显著相关性。研究结果强调了全球范围内维生素D缺乏的普遍性及其对健康的有害影响。为了降低许多非传染性疾病的风险,本综述强调需要提高认识并采取可能的干预措施来维持适当的维生素D水平。进行了一项荟萃分析,以调查维生素D不足与不同健康疾病之间的潜在因果关系。它阐明了维生素D缺乏水平与精神健康障碍、贫血、糖尿病、高血压和自身免疫性疾病等疾病之间的联系。该研究优先考察了时间相关性、生物学合理性和消除混杂因素,为这些关联提供支持。虽然文章承认,实验数据,如随机对照试验,将加强因果关系的论点,但它主要取决于观察性研究。
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引用次数: 0
Effect of Brochure and Audio Recordings of Testicular Cancer Stories on Testicular Self-Examination: Randomized Controlled Study. 睾丸癌宣传册及录音资料对睾丸自我检查的影响:随机对照研究。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-07 DOI: 10.1111/phn.13512
Ayse Kılıc Ucar, Irem Aykac, Sevinc Tastan

Objectives: The aim of this study was to determine the effects of a training program based on educational brochures and audio recordings of testicular cancer (TC) stories on testicular self-examination (TSE) and health beliefs among university students.

Design: The study had a pretest-posttest, control group experimental design.

Sample: This study was conducted with 106 students in Turkey.

Method: Data were collected using a personal information form, the Health Beliefs Model (HBM) Scale for TC and TSE, and a form for determining TSE and sharing information.

Results: There was a statistically significant difference between the posttest scores obtained by the intervention group, who received the training and the control group on the susceptibility, benefits and health motivation, barriers, self-efficacy, and health motivation dimensions of the HBM Scale (p < 0.05). The percentage of TSE in the intervention group increased from 14.8% to 90.7% after receiving training on TC and TSE, which was significantly different from the pretest and posttest scores of the control group.

Conclusions: Training using educational brochures and audio recordings of TC stories had a positive effect on TSE and health beliefs. The results suggest that both training methods can be used to increase social awareness of TC.

目的:本研究的目的是确定基于教育手册和睾丸癌(TC)故事录音的培训计划对大学生睾丸自我检查(TSE)和健康信念的影响。设计:采用前测后测、对照组实验设计。样本:本研究在土耳其对106名学生进行。方法:采用个人信息表、健康信念模型(HBM) TC和TSE量表、确定TSE和信息共享表进行数据收集。结果:干预组与对照组在HBM量表的易感性、获益与健康动机、障碍、自我效能感、健康动机维度上的后测得分差异有统计学意义(p)。结论:使用教育手册和TC故事录音进行培训对TSE和健康信念有积极影响。结果表明,这两种训练方法都可以提高社会对TC的认识。
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引用次数: 0
Middle-Range Theory of Disaster Cognitive Readiness in Nursing Practice Through Theory Derivation and Sentence Synthesis. 从理论推导和句子综合看护理实践中灾害认知准备的中程理论。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-06 DOI: 10.1111/phn.13528
Sinwoo Hwang, Seoyoung Baek

Introduction: Disaster nursing is a complex, dynamic, and resource-limited working environment, like military operations. As the COVID-19 outbreak has shown, not only hospitals, but all communities need nurses who can systematically respond to disasters. It is important for nurses to possess the necessary readiness to respond to disasters with confidence and autonomy. However, there is a lack of evidence for a theoretical framework for nurses' cognitive readiness for disaster nursing.

Objective: The purpose of this study was to describe the development of a middle-range theory about nurse's cognitive readiness in disaster response.

Methods: Fletcher and Wind's model was modified to develop a theoretical framework for disaster cognitive readiness by using theory derivation and sentence synthesis.

Results: In the developed theory, "Disaster cognitive readiness" refers to the cognitive preparedness of nurses for effectively responding to and managing disaster situations which are in high-stakes, complex environments, achieved through a combination of education, training, and practice in essential skills such as problem-solving, communication, resilience, and ethics. The theory for disaster cognitive readiness described the competencies: knowledge, problem-solving, metacognition, decision-making, adaptability, risk-communication, resilience, and ethics. The outcomes of disaster cognitive readiness are personal (job satisfaction, professional growth) and organizational (disaster management, disaster resilience) outcomes.

Conclusion: The results of this study are expected to be useful in developing educational and training programs that emphasize the characteristics of disaster nursing competencies and in verifying their effectiveness in enhancing disaster cognitive readiness as well as individual and organizational outcomes.

灾难护理与军事行动一样,是一个复杂、动态、资源有限的工作环境。正如COVID-19疫情所表明的那样,不仅医院,而且所有社区都需要能够系统地应对灾害的护士。对护士来说,拥有必要的准备能力,以自信和自主的态度应对灾难是很重要的。然而,缺乏证据的理论框架,护士的认知准备灾害护理。目的:本研究的目的是描述一个关于护士在灾难应对中的认知准备的中程理论的发展。方法:采用理论推导和句子合成的方法,对Fletcher和Wind的模型进行修正,构建灾害认知准备的理论框架。结果:在发达的理论中,“灾难认知准备”是指护士在高风险、复杂的环境中有效应对和管理灾害情况的认知准备,通过教育、培训和实践相结合,在解决问题、沟通、恢复力和道德等基本技能方面实现。灾难认知准备理论描述了能力:知识、解决问题、元认知、决策、适应性、风险沟通、恢复力和道德。灾难认知准备的结果是个人(工作满意度、专业成长)和组织(灾害管理、灾害复原力)的结果。结论:本研究的结果有望有助于制定强调灾害护理能力特征的教育和培训计划,并验证其在提高灾害认知准备以及个人和组织成果方面的有效性。
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引用次数: 0
Public Health Education Service for HealthStudents: Feedback From Experience in France. 面向健康学生的公共卫生教育服务:法国的经验反馈。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-06 DOI: 10.1111/phn.13514
Anne-Laure Lejot, Stéphanie Bouget Mohammedi
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引用次数: 0
Nursing Partnerships Are Crucial for Bridging Education and Public Health. 护理伙伴关系对于衔接教育和公共卫生至关重要。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-02 DOI: 10.1111/phn.13527
Ellen M McCabe, Beth E Jameson, Erin D Maughan

Public health nurses (PHNs) and school nurses are integral in addressing health disparities, managing chronic illnesses, preventing and controlling communicable diseases, and promoting wellness within communities. Schools serve as pivotal platforms for implementing health initiatives and providing opportunities for disease prevention and health promotion. School nurses identify and address health risks, including chronic conditions, communicable diseases, substance abuse, and mental health concerns, and often act as knowledgeable authorities to access community resources. PHNs perform a vital role in communicating the health experiences of diverse and sometimes vulnerable individuals and families to health planners and policymakers. They also empower community members to articulate concerns and goals, promoting a collaborative approach to public health development. Collaboration between PHNs and school nurses enhances community health through joint efforts in screenings, health education, and community-wide interventions. However, barriers, such as isolated strategic planning, siloed funding, and inadequate information systems, hinder effective collaboration. The authors advocate for joint strategic planning, integrated funding, and interoperable health information systems that may now be fragmented to strengthen these partnerships in order to improve population health. Enhancing these collaborations is vital for creating supportive environments where students can thrive academically and health-wise, ensuring a sustainable impact on community health.

公共卫生护士和学校护士在解决健康差距、管理慢性病、预防和控制传染病以及促进社区健康方面发挥着不可或缺的作用。学校是实施卫生倡议和提供预防疾病和促进健康机会的关键平台。学校护士识别和处理健康风险,包括慢性病、传染病、药物滥用和精神健康问题,并经常作为获得社区资源的知识权威。初级保健护士在向卫生规划人员和决策者传达不同的、有时是脆弱的个人和家庭的卫生经验方面发挥着至关重要的作用。它们还使社区成员能够阐明关注的问题和目标,促进对公共卫生发展采取协作方式。初级保健医生和学校护士之间的合作,通过在筛查、健康教育和全社区干预方面的共同努力,加强了社区卫生。然而,诸如孤立的战略规划、孤立的资金和不充分的信息系统等障碍阻碍了有效的合作。作者提倡联合战略规划、综合供资和可互操作的卫生信息系统,这些系统现在可能分散,以加强这些伙伴关系,以改善人口健康。加强这些合作对于创造支持性环境至关重要,使学生能够在学业和健康方面茁壮成长,确保对社区健康产生可持续影响。
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引用次数: 0
From Micro to Macro: Understanding the Far-Reaching Consequences of B12 Deficiency on Women's Health. 从微观到宏观:了解B12缺乏对女性健康的深远影响。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-02 DOI: 10.1111/phn.13525
Betsy Sara Zacharias, Sheela Upendra, Dipali Dumbre

Background: Vitamin B12 (B12), playing the role of a coenzyme in one-carbon metabolism, is an important vitamin necessary for human health.

Objectives: To systematically review evidence to identify the complications of B12 deficiency among women.

Methods: We conducted a systematic search of quantitative studies on disorders associated with B12 deficiency among women, published in English in the last 25 years (1999-2024), using electronic databases such as Scopus, Web of science, CINAHL, PubMed, and Medline.

Conclusion: The search produced 28 full-text articles. B12 deficiency prevalence among women identified by the selected studies ranges from 0.6% to 45.5%. The deficiency of B12 is connected with the risk for depression/post-partum depression, breast cancer, recurrent pregnancy loss, gestational diabetes mellitus, insulin resistance, and obesity among women. It is necessary to monitor and correct the B12 deficiency among women in order to prevent complications.

背景:维生素B12 (B12)是人体必需的重要维生素,在单碳代谢中起辅酶的作用。目的:系统地回顾证据,以确定妇女B12缺乏的并发症。方法:我们对过去25年(1999-2024)发表的与女性B12缺乏症相关的定量研究进行了系统检索,使用电子数据库,如Scopus、Web of science、CINAHL、PubMed和Medline。结论:检索得到28篇全文文章。所选研究确定的妇女B12缺乏症患病率从0.6%到45.5%不等。缺乏B12与女性患抑郁症/产后抑郁症、乳腺癌、复发性流产、妊娠期糖尿病、胰岛素抵抗和肥胖的风险有关。有必要监测和纠正妇女B12缺乏症,以防止并发症。
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引用次数: 0
The Effect of Motivational Interview-Based Education on Nutrition Exercise Behavior, Sedentary Activity Duration, and Anthropometric Outcomes in Obese Adolescents. 动机性访谈教育对肥胖青少年营养运动行为、久坐活动持续时间和人体测量结果的影响。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-02 DOI: 10.1111/phn.13530
Hasan Evcimen, Sonay Bilgin

Purpose: The aim of this study was to examine the effect of motivational interview-based training on nutrition exercise behavior, sedentary behavior duration, and anthropometric outcomes in adolescents.

Method: This randomized controlled single-blind experimental study was conducted between January 2021 and March 2023. The research sample consisted of 76 adolescents with obesity (intervention: 38 and control: 38) determined by power analysis. The intervention group received a 6-session motivational interview-based training program. No intervention was applied to the control group. Data were collected using a personal information form, nutrition exercise behavior scale, adolescent sedentary activity questionnaire, and body mass ındex measurement form. Data collection tools were administered to both groups before the intervention, at the last session and at the 3rd month follow-up. In the analysis of the data, chi-square test, independent sample t-test and two-way mixed design ANOVA were used.

Results: There was no statistically significant difference between the pretest nutrition exercise behavior scale, sedentary activity questionnaire, and body mass index z-scores of the intervention and control groups (p > 0.05). After the motivational interview-based education program, nutrition exercise behaviors improved (p: 0.00), sedentary behavior duration and BMI decreased (p: 0.00) in the intervention group. No significant difference was observed in the control group. Nutritional exercise behavior, duration of sedentary behavior and BMI values of the intervention group showed a significant difference compared to the control group (p: 0.00).

Conclusion: It was determined that motivational interviewing applied to adolescents with obesity created a positive change on nutritional exercise behavior, sedentary behavior durations, and anthropometric results. It is recommended that nurses should use motivational interviewing in the management of nutrition and exercise behaviors of adolescents with obesity.

Trial registration: Clinical Trials ID: NCT05268653.

目的:本研究旨在探讨基于动机访谈的训练对青少年营养运动行为、久坐行为持续时间和人体测量结果的影响。方法:随机对照单盲实验研究于2021年1月至2023年3月进行。研究样本为76例肥胖青少年(干预组38例,对照组38例)。干预组接受了为期6期的动机性访谈培训计划。对照组未采取干预措施。采用个人信息表、营养运动行为量表、青少年久坐活动问卷和体重ındex测量表收集数据。两组在干预前、最后一次和第3个月随访时均使用数据收集工具。数据分析采用卡方检验、独立样本t检验和双向混合设计方差分析。结果:干预组与对照组的营养运动行为量表、久坐活动问卷、体重指数z-得分比较,差异均无统计学意义(p < 0.05)。动机访谈教育后,干预组营养运动行为改善(p: 0.00),久坐行为持续时间和BMI下降(p: 0.00)。对照组无明显差异。干预组营养运动行为、久坐行为持续时间、BMI值与对照组比较差异有统计学意义(p: 0.00)。结论:对肥胖青少年进行动机性访谈对营养运动行为、久坐行为持续时间和人体测量结果产生了积极的影响。建议护士在管理青少年肥胖患者的营养和运动行为时采用动机性访谈。试验注册:临床试验ID: NCT05268653。
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引用次数: 0
Exploration of Psychological, Social, and Familial Issues of Females Living in the Shelter in Iraqi Kurdistan Through an Art-Based Qualitative Study. 以艺术为基础的质性研究探讨伊拉克库尔德斯坦避难所女性的心理、社会和家庭问题。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-02 DOI: 10.1111/phn.13513
Bayar Mohammed Omar Abdulla, Deldar Morad Abdulah, Zuhair Rushdi Mustafa

Objective: Female young prisoners may not be willing to discuss their familial and social issues through direct interviews. Therefore, other academic techniques, such as art-based techniques, could be used in this context. We aimed to explore female prisoners' psychological, familial, and social issues through an art-based approach.

Methods: In this thematic qualitative study, we conducted a 2-h painting training program for females (21-48 years) who were confined in women's shelters in the Kurdistan Region. To carry out this initiative, we collaborated with the administration of women's prisoners in Duhok, Erbil, and Sulaymaniyah governorates in the Kurdistan Region.

Results: The paintings included in this study explored the social and familial issues faced by girls and women who were imprisoned for various reasons. The paintings of the participants were categorized under the following three main headings: familial issues, social pressure, and women's rights. The artwork expresses that these girls and women suffer from a wide range of familial and social issues. They share that they lack the rights, as men do, to discuss their opinions and feelings within their societies and families. Additionally, these women experience pressure from their families and society for various reasons, as mentioned hereafter.

Conclusions: This study revealed that the lack of meeting females' rights and their inability to practice their wishes and rights could be the main reason for the familial and social issues in Kurdish society. The findings suggest that the restrictions and limitations placed on women's agency and autonomy contribute significantly to the challenges and hardships faced by women within their families and communities. Addressing these issues and promoting gender equality may be essential in fostering a more inclusive and harmonious society in the Kurdistan region.

目的:女性年轻囚犯可能不愿意通过直接访谈来讨论她们的家庭和社会问题。因此,其他学术技术,如基于艺术的技术,可以在这种情况下使用。我们的目的是通过艺术的方式来探讨女囚犯的心理、家庭和社会问题。方法:在这个专题定性研究中,我们对库尔德斯坦地区妇女收容所的女性(21-48岁)进行了2小时的绘画训练计划。为了实施这一倡议,我们与库尔德斯坦地区杜胡克、埃尔比勒和苏莱曼尼亚省的女性囚犯管理部门进行了合作。结果:本研究中的画作探讨了因各种原因被监禁的女孩和妇女所面临的社会和家庭问题。参与者的画作被分为以下三个主要标题:家庭问题、社会压力和妇女权利。艺术作品表达了这些女孩和妇女遭受广泛的家庭和社会问题。她们认为,她们缺乏像男性那样在社会和家庭中讨论自己的观点和感受的权利。此外,由于各种原因,这些妇女受到来自家庭和社会的压力,如下所述。结论:本研究揭示了女性权利得不到满足和无法实现自己的愿望和权利可能是库尔德社会中家庭和社会问题的主要原因。调查结果表明,对妇女能动性和自主权的限制和限制在很大程度上加剧了妇女在家庭和社区中面临的挑战和困难。解决这些问题和促进性别平等对于在库尔德斯坦地区建立一个更加包容和和谐的社会可能至关重要。
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引用次数: 0
Utilizing Health Literacy to Empower Latino Adolescents. 利用健康扫盲增强拉丁裔青少年的能力。
IF 1.7 4区 医学 Q2 NURSING Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1111/phn.13449
Sonique Sailsman, Robyn Johnson

Latinos are a minority population that experience many healthcare disparities that impact their access to health-related services. Improvement of health literacy is one way that healthcare providers can positively influence health outcomes within this population. Changes in educational curriculum have limited student's exposure to health information and created a gap in knowledge. A presentation regarding health literacy and advocacy was created for a group of Latino adolescents at a metro area high school. The presentation was offered in English, providing education on how to obtain health information from reputable sources, best words to describe symptoms of illness, and tips to successfully advocate for family members who may have difficulty communicating in English. The overall experience of the students was positive and impactful based on engagement and anecdotal feedback. The hope is to continue to partner with community organizations and improve health literacy among Latino adolescents and their families.

拉美裔是少数群体,他们在医疗保健方面存在许多差异,影响了他们获得医疗相关服务的机会。提高健康素养是医疗服务提供者对这一人群的健康结果产生积极影响的一种方式。教育课程的变化限制了学生接触健康信息的机会,造成了知识上的差距。我们为都会区一所高中的一群拉丁裔青少年制作了一个关于健康知识普及和宣传的演示文稿。讲座以英语进行,教育学生如何从可靠的渠道获取健康信息、描述疾病症状的最佳词汇,以及如何成功地为英语交流有困难的家庭成员进行宣传。根据参与情况和轶事反馈,学生们的总体体验是积极和有影响力的。我们希望继续与社区组织合作,提高拉丁裔青少年及其家人的健康素养。
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