Health Education Research最新文献

{"title":"Dataset development and performance analysis of a specialized conversational artificial intelligence model for targeted smoking cessation dialogues.","authors":"Ebrahim Mellatdoust Pordel, David Akopian, Patricia Chalela, Luis F Velez","doi":"10.1093/her/cyag019","DOIUrl":"10.1093/her/cyag019","url":null,"abstract":"<p><p>Conversational artificial intelligence (AI) is increasingly being used in healthcare to encourage behavioral modification, information dissemination, and patient engagement. However, its effectiveness depends on high-quality, domain-specific training data. General-purpose datasets are often inadequate in terms of clinical specificity and dialog coherence, particularly in sensitive domains like smoking cessation. This study introduces a curated question-and-answer dataset comprising 3000 Q&A pairs from reputable health resources, including expert-authored guidelines and cessation programs. Each entry is annotated with metadata reflecting informational intent, action-oriented content, and user engagement signals, supporting both single-turn and multi-turn conversational modeling. A compact generative language model, Chat Generative Pre-trained Transformer 4o-mini (ChatGPT-4o-mini), was fine-tuned using this dataset and compared against the pretrained base model using BLEU, ROUGE-L, and BERTScore metrics, assessing syntactic accuracy, lexical coverage, and semantic alignment. The fine-tuned model demonstrated improved response clarity, conversational coherence, and adherence to evidence-based content. This study emphasizes methodological benchmarking and model performance rather than behavioral or clinical outcomes, isolating the model-optimization layer to assess how curated, domain-specific training data influence response quality under controlled conditions. By contributing a reproducible pipeline for dataset construction and evaluation, this work supports safe and effective conversational agents in healthcare contexts and promotes responsible AI practices in digital health applications. Statement of significance The success of large language model (LLM)-based conversational agents depends on access to high-quality, domain-specific training data. However, such data is typically absent from models trained on general web corpora. Smoking cessation, as a behavior-change domain with substantial clinical burden and health disparities, requires emotionally attuned and evidence-based messaging to be effective. Rather than introducing a new smoking cessation intervention, this study contributes a reproducible methodological framework for evaluating how curated, evidence-based datasets influence LLM behavior in health education contexts. By isolating the dataset-to-model performance relationship, this work provides a technical foundation that complements prior user-centered intervention studies and supports responsible development of conversational AI systems prior to behavioral deployment. This study contributes a rigorously curated dataset drawn from evidence-based sources, annotated with metadata for motivational framing, tone, and dialogue intent. In parallel, we present a methodology for fine-tuning LLMs and evaluating performance in both single-turn and multi-turn conversational settings.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254147","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":"Improving health literacy on betel nut and oral cancer: a qualitative exploration of resource adaptation for diverse Victorian communities.","authors":"Tejashree Kangutkar, Nidhi Saraswat, Kishita Patel, Bhairavi Khismatrao","doi":"10.1093/her/cyag020","DOIUrl":"https://doi.org/10.1093/her/cyag020","url":null,"abstract":"<p><p>To adapt an existing educational resource highlighting the link between betel nut use and oral cancer to improve its relevance for culturally and linguistically diverse (CALD) communities in Victoria, Australia. This study employed a qualitative design, involving semi-structured interviews with 14 individuals from CALD communities residing in Victoria. A review of an existing resource (developed in New South Wales) was facilitated to seek feedback about content, language, relevance, appearance, and dissemination strategies. The collected data was analysed thematically via content analysis. The data analysis highlighted suggestions to refine the resource around simplified language, culturally relevant visuals, prioritization of oral cancer symptoms, and the inclusion of guidance on reducing betel nut use. Community centres and culturally significant venues were identified as effective dissemination channels. These study findings informed the adaptation process and led to a tailored resource for Victorian CALD populations. Cultural adaptation and community engagement are essential for enhancing the impact of public health materials. This study underscores the importance of culturally tailored public health interventions in multicultural nations like Australia. The traditional approach may fail to resonate with CALD populations; however, well-adapted educational materials can improve understanding and encourage effective risk communication in multicultural settings.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254198","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":"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":1.6,"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":"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":"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":1.6,"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":"Quality of online heatstroke information across four countries: a quantitative content analysis.","authors":"Shinya Ito, Emi Furukawa","doi":"10.1093/her/cyag015","DOIUrl":"10.1093/her/cyag015","url":null,"abstract":"<p><p>Effective heatstroke prevention depends not only on access to information but also on whether online health materials support understanding and actionable decision-making. However, evidence comparing the quality and presentation of online heatstroke information across countries remains limited. We conducted a quantitative content analysis of 120 publicly available heatstroke-related webpages from Japan, the United States, the United Kingdom, and Australia (30 per country), with one World Health Organization webpage included as a reference. Readability, information volume, credibility, and information presentation were assessed using established metrics, including the Patient Education Materials Assessment Tool for Print Materials. Cross-country comparisons and sensitivity analyses focusing on webpages targeting the general public were performed. UK webpages showed higher readability, whereas Japanese webpages more frequently incorporated visual aids and tools that facilitate preventive actions, resulting in higher understandability and actionability scores. However, actionability did not reach adequate levels in any country. Online heatstroke information differs substantially across countries. While readability improves accessibility, greater integration of visual and action-supporting design elements is needed to better promote preventive action.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989484","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":"Health education interventions to reduce cannabis and tobacco smoking-related harms among people who use cannabis: a systematic review.","authors":"M K Nottage, K East, D Robson, T P Freeman, L Hines, R Stanbridge, H Walsh, L Brose","doi":"10.1093/her/cyag016","DOIUrl":"10.1093/her/cyag016","url":null,"abstract":"<p><p>Cannabis is commonly smoked and often co-used with tobacco, yet evidence on interventions to reduce smoking harms for people who use cannabis is limited. We systematically reviewed evidence on the efficacy and effectiveness of health education interventions (aiming to increase health literacy, knowledge, or motivation) in reducing cannabis smoking and tobacco smoking among people using cannabis. We searched five databases (inception-February 2025) for quantitative evaluations of health education interventions targeting cannabis use and reporting cannabis and/or tobacco smoking among people who use cannabis. Evidence from 32 studies was synthesized narratively, with risk of bias assessed using design-appropriate tools. Samples ranged from 15 to 10 781 participants, predominantly adolescents and young adults. Half evaluated interventions to prevent uptake, mostly school-based programmes, which showed mixed impact in reducing cannabis smoking. Half promoted quitting/reduction and provided some evidence that motivational interventions reduced cannabis smoking. Tobacco outcomes were rarely assessed (k = 7) and largely null; risk of bias was high throughout. Overall, school-based preventive programmes showed mixed effects, while motivational interventions more consistently reduced cannabis but not tobacco smoking. Even modest effects may benefit public health, highlighting the need to clarify effective components, delivery settings, and to standardize measures for routes of administration and co-use.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13192474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989504","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":"Effectiveness of support-based interventions on self-efficacy in patients with diabetes: a systematic review and meta-analysis.","authors":"Jihyon Pahn, Youngran Yang, Junhee Ahn, Ji Young Kim, Yura Jang","doi":"10.1093/her/cyag022","DOIUrl":"10.1093/her/cyag022","url":null,"abstract":"<p><p>This study conducted a systematic review and meta-analysis to examine the effect of social support interventions on improving self-efficacy in patients with diabetes. A literature search was performed using Medline, CINAHL, Cochrane Library, and Embase for studies published between January 2014 and December 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software. This systematic review and meta-analysis followed the PRISMA guidelines. From 5543 records, this research included six randomized controlled trials involving 1030 adult patients with diabetes. Social support interventions were effective in improving self-efficacy (Standardized Mean Difference = 1.33, 95% CI: 0.48-2.18) with high heterogeneity (I2 = 95%), demonstrating that social support can significantly enhance self-efficacy. This study demonstrates the impact of social support interventions on self-efficacy among diabetes patients. The findings of this systematic review strongly advocate for the prioritization and expansion of social support interventions in diabetes care, underscoring the urgent need for continued and enhanced research in this critical area (PROSPERO registration number: CRD42024566185).</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388172","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":"Examining fear appeals and information seeking in tuberculosis health education campaigns: an experimental test of the extended parallel processing model with perceived barriers as a moderator.","authors":"Lunrui Fu, Huaizhi Han, Liang Chen","doi":"10.1093/her/cyag017","DOIUrl":"10.1093/her/cyag017","url":null,"abstract":"<p><p>Tuberculosis (TB) health education campaigns often struggle to motivate at-risk populations by employing one-size-fits-all fear appeals without considering how structural barriers shape audiences' ability to respond. Drawing on the Extended Parallel Processing Model (EPPM), this study tested how varying levels of threat and efficacy in TB messages influence information-seeking intentions, with perceived barriers as a moderator. In a 2 (threat: low versus high) × 2 (efficacy: low versus high) between-subject experiment with 225 Chinese participants, results revealed that high-threat messages increased participants' TB information-seeking intentions compared with low-threat messages. In addition, low-barrier individuals responded best to high-threat, high-efficacy messages; moderate-barrier individuals were motivated by high-threat messages even with low efficacy messages. These findings demonstrate that accounting for structural barriers extends the EPPM framework and provide health educators with a practical framework for audience segmentation and message tailoring.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989536","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":1.6,"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":"Supporting responsive feeding in early childhood education centres: a process evaluation of the CELEBRATE feeding intervention using the RE-AIM framework.","authors":"Julie E Campbell, Jessie-Lee D McIsaac, Olga Levin, Sarah Caldwell, Margaret Young, Linda Mann, Stephanie Ward Chiasson, Elizabeth Dickson, Melissa D Rossiter","doi":"10.1093/her/cyag021","DOIUrl":"10.1093/her/cyag021","url":null,"abstract":"<p><p>Early childhood education centres are key settings for fostering self-regulation skills related to food through responsive feeding environments. The CELEBRATE Feeding coaching intervention aimed to support early childhood educators in implementing these practices across eight centres in two Canadian provinces. Using the RE-AIM framework, quantitative and qualitative data from coaching logs, pre- and post-intervention surveys, observations, interviews, and a 6-month post-intervention survey were analysed as part of the process evaluation. The intervention reached a diverse range of educators and children, resulting in improvements in responsive feeding behaviours, with observation scores significantly increasing (38.2-45.8 on a 63-point scale, P < .001) from baseline to post-intervention. Interviewed centre staff (n = 37) reported engaging more frequently in responsive feeding practices and observed positive changes in children's food intake and independence. Most surveyed educators (>90%) found the 6-month duration and monthly visits appropriate, with strong support from their coach. Educators valued expert guidance and practical resources and felt motivated and capable in adopting responsive feeding practices. Challenges included communication, scheduling barriers, and educator turnover. Follow-up data indicated that all centres continued key practices, though some barriers remained. Overall, the intervention had a positive impact, though addressing logistical barriers is crucial for long-term sustainability.</p>","PeriodicalId":48236,"journal":{"name":"Health Education Research","volume":"41 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273535","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}