Health Education Research最新文献_第2页

Enhancing early childhood health and safety education: the impact of life skills-based teaching strategies. 加强幼儿健康和安全教育：基于生活技能的教学战略的影响。

IF 2 4区医学

Health Education Research Pub Date : 2025-08-12 DOI: 10.1093/her/cyaf038

Hui-Ling Chen, Wei-Hsiang Huang

{"title":"Enhancing early childhood health and safety education: the impact of life skills-based teaching strategies.","authors":"Hui-Ling Chen, Wei-Hsiang Huang","doi":"10.1093/her/cyaf038","DOIUrl":"https://doi.org/10.1093/her/cyaf038","url":null,"abstract":"This study investigated how life skills-based health education influences early childhood educators' cognition, attitudes, and teaching confidence, using a quasi-experimental, parallel mixed-methods design. A total of 65 in-service students were assigned to an experimental (n = 33) or control group (n = 32). Quantitative measures assessed pre- and post-intervention changes, while qualitative data from open-ended reflections were analysed thematically. Statistical results revealed significant improvements in all three dimensions for the experimental group. Generalized Estimating Equation analyses confirmed significant group × time interaction effects for attitudes (B = 4.64, P < .001) and confidence (B = 19.69, P < .001), with no interaction for cognition (P = .078), suggesting knowledge consolidation rather than new learning. Qualitative findings clarified the mechanisms of change: simulations and collaborative tasks enhanced students' critical reflection, situational adaptability, and real-world application of health teaching strategies. By answering both what changed and how it changed, this study supports integrating life skills and simulation into health education curricula to build sustainable teaching capacity. Future studies should extend follow-up duration and expand contextual diversity to evaluate long-term impact and generalizability.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974479","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}

引用次数: 0

Preoperative patient education in vascular surgery. 血管外科术前患者教育。

IF 2 4区医学

Health Education Research Pub Date : 2025-08-12 DOI: 10.1093/her/cyaf031

Isabel C Cohen, Samantha Watson, Patrick Sweeney, Margaret Reilly, Karen J Ho

{"title":"Preoperative patient education in vascular surgery.","authors":"Isabel C Cohen, Samantha Watson, Patrick Sweeney, Margaret Reilly, Karen J Ho","doi":"10.1093/her/cyaf031","DOIUrl":"10.1093/her/cyaf031","url":null,"abstract":"This is a systematic review and meta-analysis of preoperative patient education interventions used in vascular surgery and their impact on patient knowledge. Embase, PubMed, and Ovid were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For inclusion, studies involved an educational intervention for a vascular surgery procedure and patient knowledge was an outcome. Using mean knowledge scores (defined as the percentage of correct responses on knowledge assessments) pre and post education intervention for experimental groups, a forest plot with standardized mean difference (SMD) was generated. Subgroup analyses were performed for abdominal aortic aneurysm (AAA) repair and decision aids. Six studies (654 patients) met inclusion criteria (five randomized controlled trials, one prospective cohort study). Procedures included AAA repair, femoral-popliteal artery bypass, carotid surgery, and endovenous thermal vein ablation. Education interventions included informed consent discussions, decision aids, virtual reality displays, and videos. The pooled SMD was 0.64 (95% confidence interval [CI], 0.48-0.79), suggesting a significant positive effect of education interventions on patient knowledge. For AAA repair and decision aid subgroups (four papers each), the SMD was 0.58 (95% CI, 0.42-0.75) and 0.62 (95% CI, 0.45-0.79), respectively. Preoperative patient education enhances understanding of vascular surgery procedures. Developing procedure-specific and patient-oriented education interventions will help address knowledge gaps among patients with vascular disease.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015243","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}

引用次数: 0

'You want to treat all patients the same. . . But it's important to know where someone is coming from': a qualitative study of U.S. healthcare providers' perspectives on culturally relevant sexual and reproductive healthcare for refugee women. 你想对所有病人一视同仁……“但重要的是要知道某人来自哪里”：一项关于美国医疗保健提供者对难民妇女的文化相关性和生殖保健观点的定性研究。

IF 2 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf032

Milkie Vu, Marian Enders, Dabney P Evans, Heidi Copeland, Aku Dogbe, Diane Zhao, Cindy Khuc, Autumn Curran, Ghenet Besera

{"title":"'You want to treat all patients the same. . . But it's important to know where someone is coming from': a qualitative study of U.S. healthcare providers' perspectives on culturally relevant sexual and reproductive healthcare for refugee women.","authors":"Milkie Vu, Marian Enders, Dabney P Evans, Heidi Copeland, Aku Dogbe, Diane Zhao, Cindy Khuc, Autumn Curran, Ghenet Besera","doi":"10.1093/her/cyaf032","DOIUrl":"10.1093/her/cyaf032","url":null,"abstract":"Refugee women have poor outcomes and low utilization of sexual and reproductive health services, which may partly arise from a lack of culturally relevant sexual and reproductive healthcare. Little research has explored strategies to provide culturally relevant sexual and reproductive healthcare to this population. Our study seeks to fill this literature gap. We conducted in-depth, semi-structured interviews with 17 providers (e.g. physicians, nurse practitioners, registered nurses) serving refugee women in Metropolitan Atlanta, Georgia. Two coders analysed the data using a qualitative thematic approach. According to providers, perceived cultural barriers to receiving sexual and reproductive healthcare included hesitancy to voice concerns or needs, delayed care seeking, a low emphasis on preventive care, and decision-making that is influenced by gender norms. Many providers reported a lack of or inadequate formal training in providing sexual and reproductive healthcare for refugee women. Regarding strategies to deliver culturally relevant care, providers emphasized: applying principles of patient-centered care, tailoring care to patients' characteristics and cultural backgrounds, recognizing implicit bias and structural racism, accommodating autonomous, informed decision-making while building trust, and partnering with community members. In conclusion, our study identified multiple important strategies that can facilitate the provision of culturally relevant sexual and reproductive healthcare for this population.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838277","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}

引用次数: 0

Integrating behavioural theories to advance cervical cancer prevention: insights from Chinese young women. 整合行为学理论促进宫颈癌预防：来自中国年轻女性的见解。

IF 2 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf026

Xizhu Xiao, Yi Zhu

{"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":"10.1093/her/cyaf026","url":null,"abstract":"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.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.0,"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}

引用次数: 0

An enhanced educational intervention for improving confidence in the eye health benefits of appropriate care for age-related macular degeneration: a randomized controlled trial. 增强教育干预以提高对年龄相关性黄斑变性适当护理对眼睛健康益处的信心：一项随机对照试验

IF 2 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf029

Elisa Wang, Gordon S Doig, Angelica Ly

{"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":"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.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 4","pages":""},"PeriodicalIF":2.0,"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}

引用次数: 0

Exploring diabetes self-management practices among people with TB in Eswatini: a qualitative analysis. 探讨斯威士兰结核病患者糖尿病自我管理实践：一项定性分析。

IF 2.1 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf028

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":"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.","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}

引用次数: 0

What constitutes pro-human papillomavirus vaccination videos on social media? Message characteristics, strategies, and theoretical constructs. 社交媒体上的亲人乳头瘤病毒疫苗接种视频构成什么？信息的特征、策略和理论结构。

IF 2.1 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf025

Qian Huang, Tyler R Harrison, Susan E Morgan

{"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":"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.","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}

引用次数: 0

Understanding parents' digital use and preferences for an mHealth intervention in low-income, rural settings. 了解低收入农村地区家长对移动医疗干预的数字使用和偏好。

IF 2.1 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf024

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":"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.","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}

引用次数: 0

Institutionalizing wellness: the health-promoting university in India and its impact on public health. 健康制度化：印度促进健康的大学及其对公众健康的影响。

IF 2.1 4区医学

Health Education Research Pub Date : 2025-06-26 DOI: 10.1093/her/cyaf027

Alaka Chandak, Rajiv Yeravdekar

{"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":"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.","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}

引用次数: 0

Process evaluation of a participatory systems approach to promote health and well-being among students at vocational schools. 对促进职业学校学生健康和福祉的参与性系统方法进行过程评价。

IF 2 4区医学

Health Education Research Pub Date : 2025-05-31 DOI: 10.1093/her/cyaf022

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":"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.","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"40 3","pages":""},"PeriodicalIF":2.0,"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}

引用次数: 0