Health Education Research最新文献

{"title":"The effect of a digital gamified breastfeeding counselling program on breastfeeding self-efficacy, breastfeeding success, and breast-related problems: a randomized controlled trial in Turkiye.","authors":"Ozlem Ulku Bulut, Zehra Golbasi","doi":"10.1093/her/cyag014","DOIUrl":"10.1093/her/cyag014","url":null,"abstract":"<p><p>This single-site, pilot-scale randomized controlled study intended to evaluate the effects of a self-determination theory-informed (D6 gamification model-based) gamified breastfeeding counselling program on breastfeeding self-efficacy, breastfeeding success, and breast-related problems in postpartum participants. A pretest-posttest randomized controlled trial was conducted with 60 pregnant individuals recruited from a single university-affiliated private hospital in Türkiye, using a pilot-scale parallel group design. Participants were assigned to experimental (n = 30) and control (n = 30) groups by block randomization that was performed by an independent statistician. Due to the behavioural nature of the intervention, participant blinding was not feasible; however, outcome analyses were conducted by a blinded biostatistician. The intervention group received a digitally delivered gamified breastfeeding counselling program from gestational week 35 until week 2 postpartum, while the control group received routine prenatal and postnatal care. Data were obtained for validated measures of breastfeeding self-efficacy, breastfeeding success, and breast-related problems. Descriptive and inferential statistical analyses were conducted with SPSS 28.0 software. At week 2 postpartum, the mean breastfeeding self-efficacy scale-short form scores were significantly higher in the gamified counselling group than the control group (63.6 ± 6.2 versus 54.3 ± 8.4, P < .001, Cohen's d = 1.26). Breastfeeding performance also favoured the intervention group, with higher infant breastfeeding assessment tool scores (8.6 ± 1.1 versus 7.3 ± 1.4, P < .001) and LATCH breastfeeding assessment scores (9.3 ± 0.7 versus 8.4 ± 1.1, P = .002). Furthermore, breast fullness severity that was assessed using a dichotomous self-reported outcome (present/absent) checklist in which higher scores indicate more severe fullness, was lower in the intervention group than the control group (2.5 ± 1.1 versus 4.0 ± 1.2, P < .001). Gamified breastfeeding counselling was effective in enhancing breastfeeding self-efficacy and breastfeeding success and reduced common breast-related problems. These findings provide preliminary evidence supporting the feasibility and short-term benefits of integrating gamification-based strategies into breastfeeding education, warranting larger multicenter studies with extended follow-up.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers' perspectives on the healthy change early childhood obesity prevention programme.","authors":"Yolanda Flores-Peña, Erica T Sosa, Perla M Trejo-Ortiz, Hermelinda Ávila-Alpirez, Meizi He","doi":"10.1093/her/cyag009","DOIUrl":"https://doi.org/10.1093/her/cyag009","url":null,"abstract":"<p><p>Childhood obesity remains a critical public health concern among Hispanic families in Mexico and the United States. Healthy Change, a brief peer-led programme delivered in childcare centres, was designed to increase mothers' awareness of child weight status and support healthier feeding practices. Embedded within a cluster randomized trial, this qualitative study examined experiences of Mexican and Mexican American mothers in the intervention arm. Four post-intervention focus groups were conducted at intervention sites (n = 25), and transcripts were analysed using inductive content analysis. Mothers reported favourable impressions, emphasizing practical advice, relatable peer facilitators, and a supportive group atmosphere. Many described initial shock or discomfort on learning that their child was overweight, followed by greater recognition of risk and intentional changes in family diet, routines, and opportunities for physical activity. Participants also identified needs for broader content, clearer communication, and some professional involvement to complement peer support. Family encouragement and involvement facilitated change, whereas competing schedules and communication gaps hindered participation. Findings suggest that peer-led programmes in childcare settings are feasible, acceptable, and capable of supporting healthier family lifestyles. Such interventions may offer a resource-efficient approach to strengthening maternal awareness and advancing early childhood obesity prevention in diverse communities.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustaining health interventions in urban schools to construct educational possibilities.","authors":"Christine M Pedder, Erin Centeio, Jeanne Barcelona","doi":"10.1093/her/cyag010","DOIUrl":"https://doi.org/10.1093/her/cyag010","url":null,"abstract":"<p><p>School-based health and wellness initiatives have evolved from isolated efforts into comprehensive, multi-level programs designed to improve and sustain children's overall health and well-being. When focused on building knowledge and changing behavior, these interventions can positively influence the development of lifelong healthy habits in youth. While facilitators and barriers to initial implementation are well documented, less is known about the long-term sustainability of such programs after external support and funding end. This qualitative study examined how inputs, activities, and resources provided during implementation affect the ongoing sustainability of comprehensive health interventions in schools. Semi-structured interviews were conducted with teachers and administrators from low-income, urban elementary schools to explore their experiences and perspectives. Data were analyzed using theory-driven methods guided by the Social Ecological Model and Whole School, Whole Community, Whole Child frameworks. Open coding identified critical themes and variables related to sustaining programming post-intervention. Findings revealed that alignment and continuity across levels of implementation, strong teacher and administrator buy-in, and the availability of ongoing resources, especially time, funding, and professional development, were essential to sustaining program benefits. These results offer practical insights for supporting the long-term success of school-based health and wellness programs.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of post-discharge education provided via telenursing on the quality of life and functional independence levels of elderly patients undergoing hip fracture surgery: a randomized controlled trial.","authors":"Esra Üçpunar, Hasret Yalçınöz Baysal","doi":"10.1093/her/cyag012","DOIUrl":"10.1093/her/cyag012","url":null,"abstract":"<p><p>The aim of this study is to evaluate the effect of post-discharge education provided via tele-nursing on the quality of life and functional independence levels of elderly patients who have undergone surgery due to a hip fracture. This randomized controlled, pre-test/post-test, single-center experimental study included 30 patients in the intervention group and 30 in the control group, conducted between August and April 2023. The intervention consisted of three online video consultations, three telephone calls, and an educational booklet, while no intervention was applied to the control group. Data were collected using a Patient Identification Form, QoL scale, and FIM. Ethical approval, institutional permissions, and informed consent were obtained. In the intervention group, 56.7% of the patients were female, while 53.3% of the patients in the control group were female (P = .79). The average age in the intervention group was 75.80, compared to 75.87 in the control group (P = .97). After the education, the post-test scores of the vitality and mental health subscales of the QoL scale were higher in the intervention group than in the control group (P < .05). After the education, the intervention group had a higher total FIM score than the control group, mainly driven by improvements in self-care and transfer subscales (P < .05). Post-discharge education provided via tele-nursing to elderly patients undergoing surgery for hip fractures improves their quality of life and functional independence levels. Trial Registration: ClinicalTrials.gov, NCT06257615.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of textual warnings and warning symbols on cannabis advertisements on product perceptions among US young adults.","authors":"Yuxian Cui, Shriya Thakkar, Rishika Chakraborty, Morgan B Speer, Cassidy R LoParco, Hermela Amdeta, Darby Mihelich, Diane Mukundwa Ndisebuye, Patricia A Cavazos-Rehg, Carla J Berg","doi":"10.1093/her/cyag013","DOIUrl":"https://doi.org/10.1093/her/cyag013","url":null,"abstract":"<p><p>States with legalized non-medical cannabis require different warnings on packages and advertisements; yet, studies examining effects of textual warnings and different warning symbols on young adults' perceptions are limited. In 2024, US young adults ages 18-34 (n = 3 579) completed an online survey-based experiment using a 2 × 4 factorial design (textual warning: no, yes; warning symbol: none, leaf, THC, leaf + THC), then reported on 5 perception outcomes: addictiveness, harm, cautiousness, appeal, and interest. Multivariable regressions assessed these conditions and their interactions in relation to outcomes, overall and by past-month cannabis use status. Among participants without past-month use, the THC symbol (versus none) was associated with higher perceived addictiveness (B = 0.32, SE = 0.12), harm (B = 0.23, SE = 0.12), and cautiousness (B = 0.31, SE = 0.13); the textual warning was associated with greater appeal (B = 0.18, SE = 0.09). No effects were found among participants reporting cannabis use. An interaction between textual warning × leaf symbol on perceived harm (B = 0.35, SE = 0.18) indicated that exposure to both the textual warning and leaf symbol decreased perceived harm; exposure to only one (i.e. not together) increased perceived harm. Regulatory bodies must understand effects of different warning requirements, consider requiring the THC symbol, assess potential confusion of the leaf symbol, and explore warnings targeting different subgroups.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating nurse-led self-regulation in multiple sclerosis management with an interactive web-based program: a randomized controlled trial.","authors":"Ayyüce Tuba Koçak, Selda Arslan","doi":"10.1093/her/cyag011","DOIUrl":"10.1093/her/cyag011","url":null,"abstract":"<p><p>This study aimed to evaluate the effect of the 'I Can Manage' an interactive web-based program that supports self-regulation under the leadership of nurses, application on self-management, fatigue and anxiety levels in individuals with Multiple Sclerosis (MS). This study is a parallel-group randomized controlled trial. Individuals with MS were randomly assigned to an intervention group (N = 38) and a control group (N = 38). The intervention group used 'I Can Manage' for eight weeks, while the control group did not receive any intervention. Data were collected using the Participant Identification Form, Multiple Sclerosis Self-Management Scale, Fatigue Severity Scale, State-Trait Anxiety Inventory, Program Usage Form, and Web Program Evaluation Form. The study was registered at ClinicalTrials database (NCT05393765). The time x group interaction for the self-management scores was significant and had a moderate effect size in favour of the intervention group (P < .01, pη2 = 0.114), whereas no significant changes were observed in the fatigue, state, and trait anxiety scores. A total of 86.8% of the participants used at least one feature of the program, and 93.9% found it easy to use and understand. 'I Can Manage' improved self-management in individuals with MS but did not lead to significant changes in fatigue or anxiety levels.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Codesigning COVID-19 booster promotion materials in online workshops with long-term care staff: a process evaluation.","authors":"Kimberly C Arthur, Kanetha B Wilson, Breana Berry, Brianna Binion, Marla Becker, Alphonse Derus, Sanaa L Diop, Margaret Gachuiri, Beverly B Green, Ahoua Koné, James Licitra, Caroline Liou, Courtney E McCracken, Lauren E Nisotel, Shanise E Owens, Annalisa V Piccorelli, Sophie Ramsey, Lindsay B Schwartz, Kirsten Senturia, Jennifer Svoboda, Jaclyn Volney, Brian D Williamson, Clarissa Hsu","doi":"10.1093/her/cyag004","DOIUrl":"10.1093/her/cyag004","url":null,"abstract":"<p><p>When engaging communities in vaccine promotion efforts, it is critical to understand who has availability and interest in participating, and how participants experience the process. Guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework, we evaluated an online codesign process with long-term care center staff to design coronavirus disease (COVID-19) booster promotion materials for their colleagues. Twenty-six staff joined codesign teams organized by self-identified race to culturally tailor materials during a cluster-randomized controlled trial with 40 centers in two US states. Data sources included surveys; interviews; screening, enrollment, and attendance data; fidelity assessment; codesigned materials; and focus groups. We report summary statistics and thematic analyses. We found that time constraints could impede enrollment. Most codesigners enjoyed collaborating and identified their individual contributions. Many linked having shared characteristics with their teammates (e.g. race, gender, age) to a feeling of connection. A few reported feeling motivated to engage in booster promotion. The process resulted in messages aligned with known psychological antecedents of vaccination. Considering recruitment challenges and limited participation of direct care staff, organizers should consider shorter codesign processes. Organizing teams based on shared characteristics could promote comfort. Community input should inform codesign structure and team composition to achieve optimum enrollment and engagement.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of health literacy on complication risk perception in patients with type 2 diabetes: the mediating roles of patient-provider communication and perceived social support.","authors":"Linxin Xie, Ting Shu, Zijun Yuan, Mengwei Jiang, Detian Liu, Weiwei Yang, Hongzhen Xie","doi":"10.1093/her/cyag005","DOIUrl":"https://doi.org/10.1093/her/cyag005","url":null,"abstract":"<p><p>Risk perception is a critical psychological factor that motivates patients with type 2 diabetes (T2DM) to adopt preventive behaviours, and the relationship between health literacy and complication risk perception appears to be influenced by social interaction factors. This study aimed to examine the association between health literacy and complication risk perception, with a particular focus on the mediating roles of patient-provider communication and perceived social support. A total of 533 patients with T2DM were recruited from a tertiary hospital in China and completed questionnaires assessing demographic characteristics, health literacy, patient-provider communication, perceived social support, and complication risk perception. The results indicated that patient-provider communication and social support mediated the relationship between health literacy and complication risk perception. These findings suggest that fostering a positive communication environment and enhancing patients' perceived support from family, healthcare providers, and peers may improve their complication risk perception, thereby encouraging proactive preventive behaviours.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pastors' perceptions of faith-based cancer prevention/early detection programs in Virginia: a mixed methods study.","authors":"K R Day, J Sethi, J Zoellner, C E Helms, W Cohn, R A Krukowski","doi":"10.1093/her/cyaf053","DOIUrl":"https://doi.org/10.1093/her/cyaf053","url":null,"abstract":"<p><p>Churches are promising partners for the delivery of cancer prevention and early detection interventions; few studies have examined pastors' views of offering these programs. This mixed methods study occurred in two phases: (i) pastors (n = 213) were surveyed to assess whether their church offered nine different cancer prevention/early detection programs and rated their perceived importance and feasibility of offering programs; (ii) a subsample of pastors (n = 17) participated in interviews. The Consolidated Framework for Implementation Research guided the development of the survey and the interview guide, and convergent parallel analysis was used to triangulate results. Of the nine programs, physical activity and healthy eating programs were most offered (47% and 40%, respectively). Perceived importance was low for most programs (mean = 2.38 out of 4), but perceived feasibility was moderately high (mean = 3.11 out of 4). The interviews identified prominent subthemes such as internal support, church characteristics, and pastor health interest that further described pastors' perceived importance of programs and factors that impeded program offerings. Perceived feasibility subthemes revealed that while pastors perceived programs to be feasible, many lacked the resources to deliver programs. Public health partnerships with churches can help mitigate resource limitations and improve sustainability of cancer screening and early detection programs.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating public health campaigns on health promotion, substance use prevention and physical activity: a systematic review.","authors":"Thomas Zandonai, Giulia Scarpa, Vittoria Barbati, Alessandro Carollo, Andrea Bizzego, Gianluca Esposito, Ornella Corazza","doi":"10.1093/her/cyag008","DOIUrl":"10.1093/her/cyag008","url":null,"abstract":"<p><p>Public health campaigns on substance use and physical activity aid disease prevention. This review examines how process evaluations are conducted in substance use and physical activity campaigns, focusing on methodologies, theoretical frameworks, implementation quality, fidelity, reach, and delivery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was conducted across PubMed, PsycINFO, Web of Science, Scopus, ProQuest, and Google Scholar from 1990 up to April 2025. Eligible studies included randomized controlled trials, quasi-experimental, and observational designs involving adult human participants and reporting process or implementation evaluation components. Twenty-one studies met inclusion criteria. A one-step forward citation analysis was performed using the bibliometrix package in R. Findings revealed that 62% of studies reported process evaluation components, with 52% employing mixed-method approaches. Commonly cited theoretical frameworks included the Transtheoretical Model, Theory of Planned Behaviour, and Social Cognitive Theory. Only 20% of studies explicitly defined process evaluation objectives, and few translated findings into actionable implementation adaptations. Bibliometric analysis indicated influence across 373 publications, primarily from the United States, Australia, and Canada. Overall, process evaluation in public health campaigns remain inconsistent. To enhance the quality and utility of such evaluations, greater theoretical integration, improved methodological transparency, and the use of standardized assessment tools are recommended.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}