Sakthi Senthilvelan, Joanne E Mantell, Lobsang Palmo, Andrea A Howard, Debrah Vambe, Ntombifuthi Ginindza, Nonhlanhla Dlamini, Yael Hirsch-Moverman
{"title":"Exploring diabetes self-management practices among people with TB in Eswatini: a qualitative analysis.","authors":"Sakthi Senthilvelan, Joanne E Mantell, Lobsang Palmo, Andrea A Howard, Debrah Vambe, Ntombifuthi Ginindza, Nonhlanhla Dlamini, Yael Hirsch-Moverman","doi":"10.1093/her/cyaf028","DOIUrl":"https://doi.org/10.1093/her/cyaf028","url":null,"abstract":"<p><p>Diabetes mellitus (DM), prevalent globally among individuals with tuberculosis (TB) and associated with suboptimal TB treatment outcomes, is a major concern in Eswatini, where high TB incidence and care gaps in screening for and managing pre-DM and DM exist. Understanding the feasibility and acceptability of DM self-management practices among individuals with TB and pre-DM/DM is key to improving both TB treatment success and glycaemic control in Eswatini and other resource-limited settings. To explore barriers and facilitators to adopting DM self-management practices, we conducted 26 in-depth interviews with individuals diagnosed with both TB and pre-DM/DM in Manzini, Eswatini. Our analyses were guided by the situated Information Motivation and Behavioural Skills model. While participants demonstrated substantial knowledge about the dietary and exercise changes needed to manage pre-DM/DM, many were unaware of the link between TB and DM. Some attributed their pre-DM/DM diagnosis to dietary habits or family history. Despite being well-informed and motivated to engage in self-management practices, structural barriers, especially financial constraints, frequently hindered their efforts. Participants suggested addressing these challenges by enhancing community education on DM, promoting home gardening initiatives, and offering financial assistance for transportation to clinics.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565409","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":"Integrating behavioural theories to advance cervical cancer prevention: insights from Chinese young women.","authors":"Xizhu Xiao, Yi Zhu","doi":"10.1093/her/cyaf026","DOIUrl":"https://doi.org/10.1093/her/cyaf026","url":null,"abstract":"<p><p>Cervical cancer remains a major threat to women's health. While the Theory of Planned Behaviour (TPB) has been widely used to predict prevention behaviours, gaps in prior research highlight the need for integrated models that explore underlying mechanisms. This study examines cervical cancer prevention intentions among 1027 Chinese young women, the primary audience for such efforts, using a framework that combines TPB, the Extended Parallel Process Model (EPPM), and Protection Motivation Theory (PMT). Structural equation modelling reveals that affective attitude (β = 0.51) is a stronger predictor of human papillomavirus (HPV) vaccination intention than cognitive attitude (β = 0.43) and perceived behavioural control (β = 0.39). For cervical cancer screening, perceived behavioural control (β = 0.42) surpasses injunctive norms (β = 0.28) and descriptive norms (β = 0.17). Additionally, perceived severity negatively impacts affective attitudes towards vaccination (β = -0.26), and response efficacy shows unexpected negative effects on behavioural intentions (βHPV vaccination = -1.34; βcervical cancer screening = -0.36). These findings underscore the importance of addressing emotional distress, enhancing susceptibility perceptions, and correcting misconceptions about response efficacy in health campaigns. This integrated approach offers critical insights for improving cervical cancer prevention strategies in China.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565411","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":"An enhanced educational intervention for improving confidence in the eye health benefits of appropriate care for age-related macular degeneration: a randomized controlled trial.","authors":"Elisa Wang, Gordon S Doig, Angelica Ly","doi":"10.1093/her/cyaf029","DOIUrl":"10.1093/her/cyaf029","url":null,"abstract":"<p><p>Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss worldwide. Appropriate care is available for patients, reducing the risk of AMD progression. Unfortunately, patients do not always receive appropriate eye care. Our study aimed to develop and evaluate an enhanced educational intervention focused on the health benefits expected from receiving appropriate eye care for AMD. We conducted a randomized, single-blind, controlled trial between May 2022 and October 2023 at an intermediate-tier not-for-profit clinic, the Centre for Eye Health. We recruited 137 patients previously diagnosed with intermediate or advanced (neovascular, geographic atrophy) AMD. Patients were enrolled and randomized (68 enhanced education, 69 standard care). On the intention-to-treat analysis, there was no significant difference between groups with regards to the primary outcome, confidence in the eye health benefits of AMD-related care at 6 months (P = .25). On a priori-defined subgroup analysis, enhanced education resulted in a clinically meaningful and statistically significant differential improvement in confidence in the eye health benefits of AMD-related care for patients who were diagnosed with AMD less than 5 years ago (Pinteraction = .036). Further study is needed to confirm whether enhanced education can improve confidence in eye health care benefits for newly diagnosed AMD patients. Trial registration: anzctr.org.au Identifier: ACTRN12622000984796.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565408","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":"What constitutes pro-human papillomavirus vaccination videos on social media? Message characteristics, strategies, and theoretical constructs.","authors":"Qian Huang, Tyler R Harrison, Susan E Morgan","doi":"10.1093/her/cyaf025","DOIUrl":"https://doi.org/10.1093/her/cyaf025","url":null,"abstract":"<p><p>Videos are essential for promoting human papillomavirus (HPV) vaccinations across populations because videos encompass multiple message characteristics. To understand the patterns of message characteristics, strategies, and theoretical constructs embedded in videos of different types, we coded and analysed 38 variables from 56 videos across five types of pro-HPV vaccination videos (talking head, animation, produced-story, velfie, and mixed-type). We discovered that message characteristics such as redundancy, use of statistics, vividness, video quality, accuracy, authenticity, obtrusiveness, and doctor's recommendations varied across video types. A number of arguments, argument strength, and use of inoculation or forewarning varied by video type, whereas emotional appeals and use of social norms did not. Talking head videos were the lowest in vividness, whereas animation videos were the highest. Animation videos were highly redundant in visual and vocal information and used inoculation strategies to debunk misinformation. Produced-story videos conveyed most information about the susceptibility and severity of HPV-related diseases. Velfie videos had the highest believability and authenticity. Mixed-type videos included various features from the four single-type videos. Findings from this study underscore that because of the differences in the use of theoretical constructs across video types, the potential of different types of videos to affect HPV vaccine uptake may vary.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545529","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}
Ligia I Reyes, Susan L Johnson, Shariwa Oke, Beatriz A Carmona, Laura L Bellows
{"title":"Understanding parents' digital use and preferences for an mHealth intervention in low-income, rural settings.","authors":"Ligia I Reyes, Susan L Johnson, Shariwa Oke, Beatriz A Carmona, Laura L Bellows","doi":"10.1093/her/cyaf024","DOIUrl":"https://doi.org/10.1093/her/cyaf024","url":null,"abstract":"<p><p>Mobile device use has become ubiquitous with daily life, thus providing opportunities to reach parents to promote healthy eating and physical activity in children. Using a socioecological framework and user-centred design approach, the objective of this study was to understand the context in which parents use their devices and their preferences for a digital programme. The formative research phase of the electronic healthy environments (eHEROs) study used a multiple-methods design, consisting of a quantitative survey (n = 116) and a semi-structured qualitative interview (n = 16). Individual- (i.e. digital literacy) and environment-level (i.e. home internet connection) factors were associated with likelihood to participate and preferences for intervention format. Participants outlined key preferences for mobile app content, including modality (audio and video with text), flow (access), and duration (5-15-min lessons). Motivation for participation related to the relevance of the content, feelings of accomplishment, and creative and engaging packaging. Lastly, participants desired opportunities to build community and connect with other parents, preferably through group meetings. Identifying and incorporating the population's preferences and requirements into the digital design are needed to optimize adoption, engagement, and retention of intervention use.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545528","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":"Institutionalizing wellness: the health-promoting university in India and its impact on public health.","authors":"Alaka Chandak, Rajiv Yeravdekar","doi":"10.1093/her/cyaf027","DOIUrl":"https://doi.org/10.1093/her/cyaf027","url":null,"abstract":"<p><p>The Health-Promoting Higher Educational Institute concept integrates health and wellness into institutional culture, policies, and activities. The Health-Promoting Institute (HPI) model in India is relatively new, with limited research on its implementation and impact. This study examines the potential of the HPI model within the Indian educational context, ensuring alignment with the Okanagan Charter principles. To assess the impact of a university-wide health promotion programme on student and staff well-being over 5 years (2015-19) using cross-sectional and longitudinal methods, a study was conducted at a university with 13 500 students and 1431 staff. Key measures included: body mass index (BMI) normalization: increased from 67.95% to 76.89% in students; blood pressure reduction: declined from 10.55% to 6.4% in staff and from 2.69% to 1.03% in students; wellness engagement: increased recreational facility use and annual wellness check-up participation; mental health services: stable among students, increased among staff; and healthcare affordability: lower out-of-pocket expenses. Institutional health promotion programmes promote health indicators of BMI, blood pressure, and access to health care effectively. The HPI model improves students' and personnel's well-being, which can be aligned with Sustainable Development Goal III (Good Health and Well-being). Scalability, policy mainstreaming, and long-term sustainability of the health-promoting university initiatives in India should be assessed in future studies.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565410","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}
Clara Heinze, Charlotte Demant Klinker, Anne Sidenius, Rikke Fredenslund Krølner
{"title":"Process evaluation of a participatory systems approach to promote health and well-being among students at vocational schools.","authors":"Clara Heinze, Charlotte Demant Klinker, Anne Sidenius, Rikke Fredenslund Krølner","doi":"10.1093/her/cyaf022","DOIUrl":"10.1093/her/cyaf022","url":null,"abstract":"<p><p>Participatory systems approaches are suggested to address the complex drivers of adolescent health but have not been applied or evaluated in a vocational school setting. This study investigated the implementation of a participatory systems approach to health promotion and its potential for driving system-level changes in vocational schools. We used quantitative data to assess implementation fidelity (reach, recruitment, and dose) and outputs in terms of the potential for system-level changes (engagement, knowledge, and leverage points). Qualitative data examined contextual factors (participant responsiveness, and school and municipal contexts) as potential influences on implementation fidelity and outputs. The results showed that school, municipal, and community actors actively participated in systems mapping and in identifying actions targeting leverage points at various system levels. Engaged and knowledgeable community actors were found to be key in generating ideas targeting the deeper layers of the system, enhancing the potential for successful implementation and system-level change. Implementation fidelity and outputs varied across sites due to varying responsiveness and school and municipal contextual factors. In conclusion, participatory systems approaches in vocational schools are feasible, leading to action ideas with promising leverage points for health promotion. However, a flexible approach tailored to specific school and municipal contexts is needed.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192387","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}
Pablo Fernández-León, Marta Lima-Serrano, Javier Fagundo-Rivera, José Manuel Martínez-Montilla
{"title":"Planning, implementation, evaluation, and sustainment of digital health interventions for adolescent substance use prevention: a systematic review of influencing factors based on the RE-AIM framework.","authors":"Pablo Fernández-León, Marta Lima-Serrano, Javier Fagundo-Rivera, José Manuel Martínez-Montilla","doi":"10.1093/her/cyaf021","DOIUrl":"10.1093/her/cyaf021","url":null,"abstract":"<p><p>School-based health interventions can help prevent adolescent substance use, but their success depends on various factors affecting planning and evaluation. This study examines the factors that facilitate or hinder the success of school-based digital health interventions. A systematic review was conducted in September-October 2024, following PRISMA guidelines, using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO databases. From a total of 2530 studies, after removing duplicates and screening titles and abstracts, 51 full-text articles were assessed and 12 met the inclusion criteria. Data were extracted using an adapted tool for systematic reviews applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The methodological quality was assessed with Joanna Briggs Institute tools. The studies included cluster-randomized controlled trials, quasi-experimental designs, and one cross-sectional study, primarily targeting adolescents aged 11.9-17.4 years, with sample sizes ranging from 90 to nearly 5000 participants. Most interventions were implemented in schools in the USA, Europe, and Taiwan, with balanced gender distribution. Many studies reported on reach and effectiveness in reducing substance use, particularly alcohol. However, adoption and implementation factors influencing school participation were less frequently addressed, and maintenance was not mentioned. To maximize impact, future efforts should focus on enhancing sustainment and participation by leveraging emerging technologies for personalization.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121311","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}
Lucas R W Fairs, Farzana Rahman, Beheshta Momand, Anne Philipneri, Celina Degano, Marcella Bianco, Dale S Mantey, Steven H Kelder, Adam G Cole
{"title":"Canadian student and presenter perceptions of the appeal, appropriateness, and comprehensiveness of the CATCH My Breath vaping prevention curriculum.","authors":"Lucas R W Fairs, Farzana Rahman, Beheshta Momand, Anne Philipneri, Celina Degano, Marcella Bianco, Dale S Mantey, Steven H Kelder, Adam G Cole","doi":"10.1093/her/cyaf018","DOIUrl":"10.1093/her/cyaf018","url":null,"abstract":"<p><p>Nicotine vaping is common among Canadian youth. However, there is a lack of evidence for effective school-based prevention approaches targeting nicotine vaping, particularly for high school students. This study explored Canadian student and presenter perceptions of the CATCH My Breath (CMB) curriculum's appeal, appropriateness, and comprehensiveness. A convenience sample of 10 high schools across Ontario, Canada, implemented the CMB curriculum between October 2022 and April 2023. A group of 40 students between 13 and 15 years old participated in six focus groups and 12 curriculum presenters [i.e. teachers and public health unit staff (PHU)] completed interviews to provide feedback about the appeal, appropriateness, and comprehensiveness of the curriculum for Canadian high school students. Qualitative thematic analysis identified major themes from both groups. Presenters and students highlighted key aspects of the curriculum, including the negative health risks of vaping, refusal skills development, and use of engaging activities. Presenters and students offered suggestions for improvement, including extending the session length, using up-to-date relevant statistics, and adding content (e.g. personal testimonies). Presenters and students generally thought that the curriculum was comprehensive, appealing, and appropriate for Canadian high school students. Future studies should evaluate the impacts of the curriculum on student vaping behaviours.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112480","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}
Hassan Rezaeipandari, Sara Jambarsang, Afsaneh Kakanaeini
{"title":"Effectiveness of multiple interventions based on the Positive Education about Aging and Contact Experiences model on the attitudes towards older adults among students.","authors":"Hassan Rezaeipandari, Sara Jambarsang, Afsaneh Kakanaeini","doi":"10.1093/her/cyaf023","DOIUrl":"10.1093/her/cyaf023","url":null,"abstract":"<p><p>Attitudes towards older adults can affect their health and quality of life. Evidence shows that the most negative attitudes have been observed among adolescents and young adults. Therefore, this study aimed to investigate the effect of a multi-intervention based on the Positive Education about Aging and Contact Experiences (PEACE) model on the students' attitudes towards older adults. This interventional study involved 100 male and female students from Naein City, Isfahan Province, Iran, selected through a multi-stage random sampling method. The participants were randomly divided into two groups (control group, n = 50 and intervention group, n = 50). The intervention employed a variety of methods based on the PEACE model. This study's assessment comprised three stages: pre-intervention, immediate post-intervention, and a 4-month post-intervention (follow-up). After the intervention, the attitude, appreciation, and prejudice dimensions scores in the intervention group were significantly higher than in the control group (P < 0.001). In follow-up, no significant difference was observed in the attitude scores between the control and intervention groups (P = 0.974). Applying various strategies derived from the PEACE model has significantly shaped students' attitudes towards older adults.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102926","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}