International Journal of Behavioral Medicine最新文献

{"title":"Correction: \"Better Sleep Means I'm Better Able to Provide Care\": Caregivers' Perceived Impacts of an Internet-Delivered Insomnia Intervention.","authors":"Kate Perepezko, Virginia Gallagher, Jillian Glazer, Heidi Donovan, Meghan Mattos, Julie Klinger, Daniel Buysse, Lee Ritterband, Kelly Shaffer","doi":"10.1007/s12529-026-10450-w","DOIUrl":"10.1007/s12529-026-10450-w","url":null,"abstract":"","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mediating Roles of Self-efficacy, Self-regulation, and Preference on the Effect and Maintenance of a Physical Activity Intervention Among Older Adults in China.","authors":"Qin Ye, Qianqian Liu, Xianlan Li, Jie Peng, Nanyan Li, Qian Deng, Julinling Hu, Chan Yong, Shiyi Li, Yufei Wang, Xing Zhao, Junmin Zhou","doi":"10.1007/s12529-026-10461-7","DOIUrl":"https://doi.org/10.1007/s12529-026-10461-7","url":null,"abstract":"<p><strong>Background: </strong>Current randomized trial evidence for the mediators of physical activity (PA) intervention mainly focused on short-term outcomes, with little reliable evidence about how to promote longer-term maintenance of PA. Furthermore, whether the mediation effects were consistent across socio-economic status (SES) populations remains unknown. The aim of this study was to examine whether changes in self-efficacy, self-regulation, and preference mediated the intervention effect on PA level using cluster-randomized trial data with follow-up measures at 6 months (short term), 12 months (intermediate term), and 24 months (longer term) in Chinese older adults, and whether such effects were heterogeneous across different SES populations.</p><p><strong>Method: </strong>Eight villages were randomly assigned to the intervention (4 villages, n = 238) or the control group (4 villages, n = 267). The intervention group received PA intervention, while the control did not. The hypothesized mediators including self-efficacy, self-regulation, and preference were assessed by valid and reliable scales. The approach used for the mediation analysis was similar to the method described by Baron and Kenny but made use of linear mixed models at each step to account for repeated measurements.</p><p><strong>Results: </strong>Among the 505 participants, the mean age was 70.87 (SD, 5.70) years, and 55.2% were female. Changes in preference at 8 weeks mediated the intervention effect on PA level in the short term (mediated, 19.4%) and intermediate term (mediated, 13.9%), while changes in self-efficacy and self-regulation at 4 weeks, 8 weeks, 6 months, and 12 months, as well as changes in preference at 4 weeks and 8 weeks mediated the intervention effect on PA level in the longer term (range mediated, 7.2-27.4%). The mediation effects were more pronounced among those with low SES (range mediated, 9.5-39.6%).</p><p><strong>Conclusion: </strong>Preference appeared to be a potential mediator of changes in PA level at the early stages, while self-efficacy, self-regulation, and preference were identified as mediators of maintenance in the longer term in rural older Chinese. Such effects were more pronounced among those with low SES. Future interventions and programs could consider building and strengthening components that target these constructs to make a lasting impact on PA. When developing PA intervention studies, it seems necessary to include strategies tailored according to SES.</p><p><strong>Trial registration: </strong>The study was registered at the Chinese Clinical Trial Registry, number ChiCTR2100045653. https://www.chictr.org.cn/showprojEN.html?proj=123704 .</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive Health Behaviours Among Elderly in India: Does Social Capital Matter?","authors":"Jaya Prasad Tripathy","doi":"10.1007/s12529-026-10462-6","DOIUrl":"https://doi.org/10.1007/s12529-026-10462-6","url":null,"abstract":"<p><strong>Background: </strong>India's rapidly ageing population faces growing risks of non-communicable diseases, frailty, and functional decline. Engaging in preventive health behaviours such as physical activity, yoga, preventive checkups, cancer screening, and immunisation is key to promoting healthy ageing. However, the influence of social capital on such behaviours among older Indians remains poorly understood. Thus, we aimed at examining the association between domains of social capital and the uptake of preventive health behaviours among older adults (≥ 60 years) in India.</p><p><strong>Method: </strong>A total of 31,063 respondents in the Longitudinal Ageing Study in India (LASI, 2017-2018) were analysed. Four measures of social capital: social participation, friends and networks, instrumental support provision, and perceived neighbourhood safety were the key exposures. Preventive health behaviours included regular physical activity, yoga, adult vaccination, preventive health checkup, and cancer screening. Survey-weighted binary logistic regression models were fitted, adjusting for socio-demographic and psychosocial covariates.</p><p><strong>Results: </strong>Nearly one-fourth of older adults engaged in regular physical activity (26.2%), 12.3% practised yoga regularly, 6.1% received any adult vaccine, and 9.3% had a preventive health checkup. High social participation (4.2%) and > 3 close friends (3.7%) were uncommon. Older adults with high social participation were significantly associated with adult vaccination (aOR, 3.1; 95% CI, 2.2-4.3), physical activity (aOR, 1.9; 95% CI, 1.4-2.5), yoga (aOR, 4.2; 95% CI, 3.3-5.2), preventive health checkup (aOR, 1.8; 95% CI, 1.4-2.3), and mammogram examination (aOR, 1.8; 1.0-3.4). Networking with friends and instrumental support provision were significantly associated with physical activity and yoga, and receipt of adult vaccination.</p><p><strong>Conclusion: </strong>Higher social capital, particularly social participation and networks, and instrumental support provision were positively associated with preventive health behaviours among older Indians, underscoring its potential role in promoting healthy ageing.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplementing Disease Risk Information for Type 2 Diabetes and Coronary Heart Disease with Polygenic Risk Scores: Testing a Health Action Process Approach-Inspired Path Model to Predict Health Behavior.","authors":"Otto Halmesvaara, Marleena Lonna, Helena Kääriäinen, Markus Perola, Kati Kristiansson, Hanna Konttinen","doi":"10.1007/s12529-026-10465-3","DOIUrl":"https://doi.org/10.1007/s12529-026-10465-3","url":null,"abstract":"<p><strong>Background: </strong>Advances in genotyping have heightened interest in using polygenic risk scores (PRS) to predict complex diseases such as type 2 diabetes (T2D) and coronary heart disease (CHD). However, the psychological effects of receiving a PRS have been examined only to a limited extent, with a notable absence of studies grounded in health psychology theory. The present study investigated whether incorporating PRS into risk communication influences health behaviors, drawing on a model inspired by the Health Action Process Approach (HAPA).</p><p><strong>Method: </strong>The sample was collected in a randomized experimental design (N = 1494), in which 751 participants received a PRS result and 743 did not. Multigroup structural equation modeling was used to estimate HAPA-inspired path models and test whether the path coefficients differed between the study groups. The models examined how perceived risk, self-efficacy, and outcome expectancies were related to intentions to increase physical activity (PA) and fruit and vegetable intake (FVI), and how these intentions, in turn, were related to subsequent behavior.</p><p><strong>Results: </strong>Multigroup analysis revealed small, non-significant differences between groups, suggesting that the inclusion of PRS did not substantially alter the functioning of the motivational pathways proposed by HAPA or the resulting health behaviors.</p><p><strong>Conclusion: </strong>Supplementing traditional disease risk information with PRS does not appear to significantly disrupt the motivational processes typically associated with health behavior change. These findings align with prior research on the HAPA model as well as with studies examining the psychological impact of receiving PRS.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress, Resilience and Social Support as Predictors of Change in Quality of Life Over One Year in Paramedic Trainees.","authors":"Jani Nöthling, Fairuz Pansari, Erine Bröcker, Soraya Seedat","doi":"10.1007/s12529-026-10458-2","DOIUrl":"https://doi.org/10.1007/s12529-026-10458-2","url":null,"abstract":"<p><strong>Background: </strong>Adjusting to the physical and psychological demands of emergency care may be particularly challenging for first-year paramedic trainees and may increase the risk for stress-related disorders, with adverse effects on quality of life (QoL). This longitudinal cohort study aimed to investigate whether psychological distress, resilience, and social support predict changes in QoL among first-year paramedic trainees over a 12-month period.</p><p><strong>Methods: </strong>First-year paramedic trainees (N = 103), recruited from a local university, completed the Kessler Psychological Distress Scale (K10), the Connor-Davidson Resilience Scale (CD-RISC), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), at enrolment, 6 months and 12 months. Psychological distress, resilience and social support were analysed as predictors of change in QoL in relation to general activities, such as work, household and leisure time activities, over time, using a mixed linear regression model, adjusting for baseline non-work-related trauma exposure.</p><p><strong>Results: </strong>Higher levels of psychological distress and lower levels of resilience were significant predictors of a decrease in QoL over time. Social support was not a significant predictor of QoL. Higher non-work-related baseline trauma exposure was associated with decreased QoL at 6 months only. Women trainees reported decreased general QoL at 6 months and 12 months, compared to male trainees.</p><p><strong>Conclusion: </strong>Interventions aimed at strengthening resilience may reduce psychological distress and enhance QoL in paramedic trainees. This could form part of existing wellness- and self-care-related psychoeducational components in paramedic training.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivating Women with Gestational Diabetes: Are Healthcare Professionals Saying the Right Words?","authors":"Helena Perić, Ana Munda, Draženka Pongrac Barlovič","doi":"10.1007/s12529-026-10460-8","DOIUrl":"https://doi.org/10.1007/s12529-026-10460-8","url":null,"abstract":"<p><strong>Background: </strong>Effective communication plays a crucial role in gestational diabetes mellitus (GDM) management, yet little research has examined whether healthcare professionals (HCPs) use motivational statements that align with patient preferences. This study investigates the alignment between the motivational statements used by HCPs and those preferred by women with GDM, applying self-determination theory (SDT) as a framework and using qualitative as well as quantitative techniques for analysing results.</p><p><strong>Method: </strong>One hundred twenty-six pregnant women with GDM and 21 HCPs rated 27 motivational statements categorized into autonomy, competence, and relatedness components of SDT. Differences in statement ratings between groups were analysed using Mann-Whitney U tests with Bonferroni correction. A chi-square test was used to assess discrepancies between statements used by HCPs and statements written by patients. Spearman's correlations, Kruskal-Wallis tests, and Mann-Whitney U tests were used for associations between statement ratings and demographic characteristics (BMI, age, education level, history of GDM, obstetric history).</p><p><strong>Results: </strong>The chi-square test revealed a significant misalignment. Women with GDM preferred competence-focused statements, whereas HCPs emphasized autonomy (χ²(2) = 6.228, p = 0.044). No significant associations were found between statement ratings and demographic variables.</p><p><strong>Conclusion: </strong>The study highlights the need for better alignment between HCPs' communication and patients' needs to enhance their sense of competence, which could improve adherence to treatment recommendations.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Clinical Trial of a Group Coping Intervention for English and Spanish Speakers with Chronic Graft-Versus-Host Disease.","authors":"Joely A Centracchio, Johan Euceda, Sasha Boyers, Anna Barata, Jacqueline Montano, Christopher Michelini, Hanna Culang, Elisabeth Henley, Andrea Pineda, Adriana Alvarez, Meilin Diaz-Paez, Trent P Wang, Ashley M Nelson, Areej El-Jawahri, Lara Traeger","doi":"10.1007/s12529-026-10459-1","DOIUrl":"10.1007/s12529-026-10459-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic graft-versus-host disease (cGVHD) affects up to 40% of allogeneic hematopoietic cell transplant (HCT) survivors, producing lasting physical and psychosocial sequelae. Despite their high symptom burden, survivors with cGVHD are rarely included in survivorship intervention research. This pilot study evaluated the feasibility and acceptability of a group-based coping intervention for patients with cGVHD (Horizons program), delivered in English and Spanish to patients in South Florida, USA, to inform larger-scale testing.</p><p><strong>Methods: </strong>We conducted a single-arm trial of the Horizons program, enrolling adults with moderate or severe cGVHD from an academic medical center. Enrollment and group assignment were stratified by language. Participants engaged in eight weekly 90-min videoconference sessions co-led by a transplant clinician and behavioral health expert (5-6 participants per group). Feasibility benchmarks included ≥ 50% enrollment, ≥ 80% attendance, and ≥ 80% retention. Exit interviews were analyzed using content analysis to assess acceptability.</p><p><strong>Results: </strong>From December 2023 to August 2024, 21 of 40 approached patients enrolled (52.5%). The sample (median age 60) was 71% male and 71% Hispanic/Latino; 11 participated in English and 10 in Spanish. Nineteen participants (90.5%) attended ≥ 4 sessions, and 95.2% completed follow-up. Treatment fidelity averaged 96.7%. Qualitative feedback underscored increased support, self-efficacy, and connection. Participants emphasized peer validation, the development of coping skills, and comfort in discussing their experiences.</p><p><strong>Conclusion: </strong>Horizons demonstrated high feasibility, excellent fidelity, and acceptability among diverse, English- and Spanish-speaking cGVHD survivors, supporting further evaluation in larger, multisite trials.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Note.","authors":"Konstadina Griva","doi":"10.1007/s12529-026-10456-4","DOIUrl":"https://doi.org/10.1007/s12529-026-10456-4","url":null,"abstract":"","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-Informed Care Adapted for Indian LGBTQ+ Community: A Narrative Review.","authors":"Vasudha Sharma, Ravleen Kaur Suri, Gurnoor Kaur Suri, Eeshan Ralhan, Rajeev Sharma, Sasidhar Gunturu","doi":"10.1007/s12529-026-10457-3","DOIUrl":"https://doi.org/10.1007/s12529-026-10457-3","url":null,"abstract":"<p><strong>Background: </strong>India has a complex relation with concepts of gender and sexuality. Existing stigma in Indian society results in complex trauma and high psychiatric morbidity. We suggest adaptations to trauma and dissociation-informed therapy to ideally support the Indian queer community.</p><p><strong>Method: </strong>We searched PubMed using the keywords \"LGBT India mental health\", \"LGBT Trauma psychotherapy\", and \"LGBT India\", yielding 174 studies.</p><p><strong>Inclusion criteria: </strong>relevant English original or meta-analytic studies from India.</p><p><strong>Exclusion criteria: </strong>non-English, non-Indian, inaccessible studies. After duplicate removal, abstract screening and full text analysis, a total of 37 studies (6 studies-LGBT statistics, 13 studies-struggles of LGBT Indian community, 11 studies-mental health impact, 9 studies-available resources, and 7 studies-trauma and dissociation-informed therapy) were included for this narrative review.</p><p><strong>Results: </strong>Familial, communal, and police violence against the LGBTQ+ still exists in India. Stigma, microaggressions, homophobia, and re-traumatization in healthcare cause complex PTSD and other psychiatric disorders. Government, non-profit, and community-based interventions are lacking.</p><p><strong>Discussion: </strong>Individually tailored, socially sensitive trauma-informed therapy would be ideal for the Indian queer community. \"Narrative exposure therapy\" creating culturally empowering narratives, \"Mentalization-based therapy\" reducing internalized stigma, \"Prolonged exposure group therapy\" building a support system, \"Milan family therapy\" combating negative stigma, and \"somatic therapy\" reclaiming one's body would help adapt existing Western trauma and dissociation-informed therapy models for the LGBTQ+ population in India.</p><p><strong>Conclusion: </strong>By adapting a model of trauma-informed therapy for the Indian LGBTQ+ community, we provide culturally and ethically sensitive recommendations for mental health professionals through this narrative review.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Multifaceted Enhanced School-located Influenza Vaccination Strategies in China: A Mixed Methods Evaluation Using the RE-AIM Framework and Normalization Process Theory.","authors":"Yiluan Hu, Ruijie Yan, Xuejun Yin, Enying Gong, Yachen Wang, Xin Xin, Xiaoyan Shi, Zundong Yin, Juan Zhang","doi":"10.1007/s12529-026-10452-8","DOIUrl":"https://doi.org/10.1007/s12529-026-10452-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Influenza vaccination rates remain low among primary school students and vary by school, even under the free School-Located Influenza Vaccination (SLIV) in Beijing, China. To improve influenza vaccination coverage, we developed multifaceted, enhanced SLIV (E-SLIV) strategies in response to factors that influenced the SLIV implementation. The E-SLIV strategies were proved with modest effectiveness in improving influenza vaccination uptake via a cluster randomized trial in the 2022-2023 influenza season. This paper reports the implementation outcomes and identifies influencing factors for the implementation of the E-SLIV strategies, which was conducted in the same settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;The E-SLIV intervention study involved 20 primary schools in Beijing, China, which were randomly allocated in a 1:1 ratio to the intervention (i.e., E-SLIV) or control (i.e., usual SLIV practice) groups in the 2022-2023 influenza season. This study applied a convergent mixed methods design to evaluate implementation outcomes specifically for 10 schools in the E-SLIV group. Quantitative data were collected from 39 implementers via a close-ended questionnaire and a project-specific implementation checklist, and from 915 parents via a close-ended questionnaire. Qualitative data were gathered from 18 implementers and 8 parents via semi-structured interviews. Quantitative descriptive and qualitative thematic analysis were applied, with findings integrated via joint display for meta-inference based on an evaluation framework that combines the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework with Normalization Process Theory (NPT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;E-SLIV reached 1,172 of the 1,541 targeted students in 10 intervention schools, representing an intervention coverage rate of 76.1% (95% CI [74.0%, 78.2%]). Qualitative findings indicated that the E-SLIV strategies may have limited success in reaching those with social media information overload and those who were hesitant about influenza vaccination. All 10 schools adopted the overarching E-SLIV strategies, but insufficient priority and endorsement from school administrators may have hindered the consistent adoption of specific program components. Both quantitative and qualitative findings suggested the E-SLIV strategies were flexible with adequate resources, enabling good implementation of most intervention components. However, relationships, skills, contexts, and content integration needed strengthening, and implementation was limited by COVID-19 related workload and vaccination uncertainty, and vaccine shortage, as the qualitative findings indicated. Around 83.3% (95% CI [73.4%, 93.2%]) of school implementers and 70.4% (95% CI [67.4%, 73.4%]) of parents favored maintaining E-SLIV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The multifaceted E-SLIV strategies reached most target populations and were well-implemented with high fidelity by mos","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}