Kerryn Drysdale, Nicola S Creagh, Claire Nightingale, Lisa J Whop, Angela Kelly-Hanku
{"title":"Beyond words: operationalizing inclusive language in Australian cervical screening health promotion policy.","authors":"Kerryn Drysdale, Nicola S Creagh, Claire Nightingale, Lisa J Whop, Angela Kelly-Hanku","doi":"10.1093/heapro/daaf058","DOIUrl":"10.1093/heapro/daaf058","url":null,"abstract":"<p><p>Health equity is a fundamental concern within the broader health promotion aim of creating equal opportunities for health and bringing health differentials down to the lowest level possible. Cervical screening is just one example of a preventative health program where a health promotion lens is required to address entrenched health inequities. We draw on theorizations of policy ecologies to provide a framework for better understanding the processes involved in operationalizing policy with greater inclusivity in language in health promotion. Twenty-eight semi-structured interviews were conducted with 29 key informants between April and October 2022 to explore the operationalization of inclusive language in health promotion in the context of a national program to promote cervical screening to currently underscreening communities in Australia. Four thematic categories emphasize the balance required between demands and domains: (i) the need for clinical guidelines and flexibility in their translation and interpretation; (ii) organizational mandates, clinical practice, and patient-centred care; (iii) socio-cultural norms, behaviours, and attitudes amid politicized/ing milieus; and (iv) community preferences and the need for medical accuracy. As such, we identified how the operationalization of inclusive language in policy is influenced by and influences other domains where cervical screening is promoted. These findings hold wider implications for how the historical legacies of and contemporary need for 'women's health' can be maintained and respected amid demands for greater gender inclusion. At the same time, the failure to trace diverse and diffuse modes and contexts of operationalization may (re)produce health inequities in practice if left unexamined.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112758","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}
Minh X Nguyen, Ingrid Mast, Sarah E Rutstein, Irving Hoffman, Ha V Tran, Le M Giang, Vivian F Go
{"title":"Preferences for eHealth interventions to improve sexual health and prevent HIV for Vietnamese young men who have sex with men.","authors":"Minh X Nguyen, Ingrid Mast, Sarah E Rutstein, Irving Hoffman, Ha V Tran, Le M Giang, Vivian F Go","doi":"10.1093/heapro/daaf060","DOIUrl":"10.1093/heapro/daaf060","url":null,"abstract":"<p><p>There is a lack of effective electronic health (eHealth) interventions focusing on sexual health among adolescent and young men who have sex with men (AYMSM), especially those in low-resource settings. We conducted a qualitative study with AYMSM in Vietnam and explored their perceptions and preferences on eHealth interventions to improve their sexual health and prevent HIV. From December 2022 to March 2023, we invited AYMSM in Hanoi and Ho Chi Minh City, Vietnam, to participate in in-depth interviews and focus group discussions. Qualitative data were thematically analyzed following a combination of deductive and inductive analytic approaches. Overall, 21 participants were enrolled in the study. Overall perceptions regarding eHealth interventions were positive. Perceived usefulness of eHealth interventions included improved knowledge of HIV and other sexually transmitted infections, facilitators of pre-exposure prophylaxis (PrEP) use, convenience, discreetness, affordability, and suitability for young people. Some concerns for eHealth interventions included confidentiality and trustworthiness. Mobile apps were the preferred format of eHealth interventions. Desirable features included connection with their peers and healthcare providers, tracking of behaviors and test results, support for PrEP use, delivery of test kits and condoms, and support for persons living with HIV. Participants suggested a variety of strategies to improve reach, credibility, and user interface of these interventions. To conclude, eHealth interventions have great potential to meet the diverse sexual health needs of AYMSM. Our findings suggest a need to address concerns on trustworthiness and confidentiality as well as employ creative strategies to make the interventions more appealing and accessible to AYMSM.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121495","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}
Benjamin Miranda Tabak, Rubiane Daniele Cardoso de Almeida, Matheus Britto Froner, Débora Helena Rosa Cardoso, Laís Almeida da Conceição
{"title":"Predicting health literacy in Brazil: a machine learning approach.","authors":"Benjamin Miranda Tabak, Rubiane Daniele Cardoso de Almeida, Matheus Britto Froner, Débora Helena Rosa Cardoso, Laís Almeida da Conceição","doi":"10.1093/heapro/daaf046","DOIUrl":"https://doi.org/10.1093/heapro/daaf046","url":null,"abstract":"<p><p>Health literacy is essential for promoting well-being and the ability to make informed decisions. We investigated the level of health literacy in Brazil and identified the predictive factors that influence it. Our data contribute to the international context, with a focus on countries in the Global South and, in particular, Latin America. By analyzing health literacy in Brazil, this study sheds light on the challenges faced by populations with similar socioeconomic backgrounds in low- and middle-income countries, where disparities in access to education and health services are widespread. In addition to descriptive analysis, we used the Random Forest machine learning algorithm, which uses bootstrap aggregation (bagging). To make the results interpretable, we implemented Shapley's Additive exPlanation values. The results show a predominance of problematic levels of health literacy among the population. The analysis reveals that factors such as medication use, dependence on the Unified Health System (Sistema Único de Saúde), and educational level are significant predictors of health literacy. The findings highlight the need for public policies aimed at reducing socioeconomic disparities and improving the public health system in order to promote better access to and understanding of health information.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052162","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}
Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski
{"title":"Ending nuclear weapons, before they end us†.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski","doi":"10.1093/heapro/daaf064","DOIUrl":"10.1093/heapro/daaf064","url":null,"abstract":"","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095764","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}
Emily Rickard, Christina Heris, Eden M Barrett, Abigail de Waard, Katherine A Thurber, Makayla-May Brinckley, Rubijayne Cohen, Michelle Kennedy, Louise Lyons, Margaret O'Brien, Tom Calma, Raglan Maddox
{"title":"Footprints in time: individual, social, and environmental factors and never-use of e-cigarettes among Indigenous adolescents.","authors":"Emily Rickard, Christina Heris, Eden M Barrett, Abigail de Waard, Katherine A Thurber, Makayla-May Brinckley, Rubijayne Cohen, Michelle Kennedy, Louise Lyons, Margaret O'Brien, Tom Calma, Raglan Maddox","doi":"10.1093/heapro/daaf024","DOIUrl":"10.1093/heapro/daaf024","url":null,"abstract":"<p><p>Electronic cigarette (e-cigarettes or vapes) use is becoming increasingly common, including among adolescents aged 12-15 years, who are often targeted through marketing and flavoured products. We aimed to investigate associations between individual, social, and environmental factors and e-cigarette never-use (hereafter referred to as never-use) among Aboriginal and Torres Strait Islander adolescents in 2018. This was a cross-sectional analysis of Wave 11 data from the Longitudinal Study of Indigenous Children (N = 440). Poisson regression was used to calculate prevalence ratios of never-use in relation to individual, social, and environmental factors. Never-use was reported by 89.3% of adolescents; 2.5% reported e-cigarette use with nicotine in the last 12 months. Never-use was associated with not using other substances (cigarettes, alcohol, or marijuana), positive social relationships as well as supportive home and education environments. We did not identify significant associations between e-cigarette use and (1) individual factors: suicidal ideation and physical activity; or e-cigarette use and (2) family factors: caregivers' perception of the child's friends and schooling. Never-use was common within a cohort of Aboriginal and Torres Strait Islander adolescents aged 12-15 years and was associated with supportive peer groups, school, and community environments. The factors identified as protective against e-cigarette use largely mirror those protective against cigarette use in this population.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121463","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}
Jan Arvidsen, Jonas Vestergaard Nielsen, Charlotte Skau Pawlowski, Søren Andkjær
{"title":"A RE-AIM evaluation of a co-designed child-friendly outdoor space in 'the middle of nowhere'.","authors":"Jan Arvidsen, Jonas Vestergaard Nielsen, Charlotte Skau Pawlowski, Søren Andkjær","doi":"10.1093/heapro/daaf056","DOIUrl":"https://doi.org/10.1093/heapro/daaf056","url":null,"abstract":"<p><p>Involving children in the co-design of outdoor spaces has been suggested as a viable approach to engagement and use. However, an in-depth evaluation of such spaces is necessary to establish their full potential. The evaluation framework RE-AIM was used to examine the reach, effectiveness, adoption, implementation, and maintenance of a Danish outdoor space that was co-designed with fifth graders from the local school. Fifth to eighth graders participated in the evaluation via a questionnaire (n = 143) and fifth and eighth graders participated in focus group discussions (n = 23). Questionnaire responses suggested that high levels of reach and adoption do not result in frequent use. Findings from focus groups highlighted seven key constraints of implementation and maintenance: (i) limited perceived accessibility, (ii) lack of possibilities for spontaneous social interactions, (iii) lack of age-appropriate activity opportunities, and (iv) competing outdoor spaces and leisure activities constrain use in the implementation phase. Furthermore, (v) insufficient upkeep, (vi) an unpleasant social atmosphere, and (vii) lack of novelty in activity opportunities limit sustained use in the maintenance phase. In conclusion, the study suggests that although co-design with children seems a viable and valuable strategy in developing child-friendly outdoor spaces, local socio-spatial factors may counteract frequent use.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009646","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":"Harnessing law for global noncommunicable disease control: evaluating a legal training program, 2014-23.","authors":"Clare Slattery, Suzanne Zhou, Hayley Jones, Abbey Malone, Rachel Kitonyo Devotsu, Ma-Anne Rosales-Sto Domingo, Thomas Kehoe","doi":"10.1093/heapro/daaf045","DOIUrl":"https://doi.org/10.1093/heapro/daaf045","url":null,"abstract":"<p><p>In 2014, the McCabe Centre for Law and Cancer launched its flagship International Legal Training Program (ILTP), which aims to raise the capacity of government lawyers from low- and middle-income countries using the law to address noncommunicable diseases (NCDs). The course consisted of in-person/online training followed by practical implementation by participants through a 'priority project'. To evaluate the ILTP, we conducted a mixed-methods study using: (i) pre- and post-course survey data collected from participants over the last 10 years; (ii) an assessment of legal and policy changes made by participants in their home countries following the ILTP; and (iii) assessment of outcomes reported publicly. From 2014 to 2023, the ILTP had 450 participants from 97 countries and territories over its 13 deliveries. Participants rated the ILTP highly and reported large increases in confidence/knowledge in using law for NCD prevention and control. Priority projects developed by participants contributed to NCD law and policy change in a documented 30 countries, the defence of legal challenges to NCD laws in 5 countries, and the initiation of a legal challenge against the tobacco industry to recover health care costs in 1 country. Evaluation of the ILTP reveals that building the capacity of government lawyers can be effective in driving legal and policy change to better prevent and control NCDs globally. Legal capacity building programs such as the ILTP are essential for addressing NCDs and must be continued and expanded.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055567","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}
Mimi Mhlaba, Tsholofelo Mohitshane, Nqobile Mnisi, Elelwani Nevhufumba, Georgia Torres, Florian Zech, Carey Jooste, Bridget Vermeulen, Lisa J Ware
{"title":"The health status of South African youth joining Youth Employment Initiatives: a health promotion opportunity.","authors":"Mimi Mhlaba, Tsholofelo Mohitshane, Nqobile Mnisi, Elelwani Nevhufumba, Georgia Torres, Florian Zech, Carey Jooste, Bridget Vermeulen, Lisa J Ware","doi":"10.1093/heapro/daaf061","DOIUrl":"10.1093/heapro/daaf061","url":null,"abstract":"<p><p>Youth Employment Initiatives (YEIs) support young adults to enhance their employability but infrequently consider their health. This study assessed the physical and mental health of South African youth starting YEIs to understand the need for integrated health service components. Youth (18-35 years, n = 193, 76% female, mean age 24.6 ± 3.6 years) were recruited using a purposive sampling strategy from the YEI programme within South Africa. Sociodemographic and health data were collected by survey, with a subsample (n = 90) undergoing cardiometabolic assessment. One-third of youth reported thoughts of suicide or self-harm in the past 2 weeks, with significantly higher levels of depression and anxiety in youth under 25 years. Obesity levels and blood pressure were significantly higher in youth 25-35 years (68% overweight/obese, 26% hypertensive). Our findings support the urgent need for integrated physical and mental health support within youth programmes to reduce both the future and current burden of non-communicable diseases.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121414","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":"Community music as health promotion: equity-related insights from urban context in Australia.","authors":"Emma Heard, Brydie-Leigh Bartleet","doi":"10.1093/heapro/daaf057","DOIUrl":"10.1093/heapro/daaf057","url":null,"abstract":"<p><p>Health promotion researchers and practitioners the world over are grappling with how to tackle growing health inequity. The Ottawa Charter for Health Promotion (Ottawa Charter) provides a framework for addressing inequity from an intersectoral, strengths-based, and social justice approach; yet this framework continues to be underutilized. Similarly, evidence suggests creative arts can support positive health and well-being but the potential for the arts to contribute to efforts addressing health inequity is underexplored. In this community-embedded, qualitative case study, we investigate the contribution community-centred music making can have across the five health promotion action areas outlined in the Ottawa Charter. Findings from this study highlight the potential for community music to contribute to personal skill development in relation to maintaining a healthy and well life and engaging in equity-focussed change. Community music can create supportive environments through fostering social connections and activating community spaces. Community music can be a powerful means of strengthening community action by bringing communities together around local issues and activism. When integrated into social services, community music can support the re-orienting of health services by connecting people with services and by encouraging people to share health-related knowledge and resources. Finally, our findings demonstrate that community music can shape public opinion and be a conduit to reach people in positions of power in ways that have the potential to influence healthy public policy. This study demonstrates that health promotion researchers and practitioners can and should look to communities' cultural and creative assets in our efforts towards health equity.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060550","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":"Determinants of chronic non-communicable disease screening among adults in Ghana.","authors":"Irenius Konkor, Minal Waqar, Vincent Kuuire","doi":"10.1093/heapro/daaf067","DOIUrl":"10.1093/heapro/daaf067","url":null,"abstract":"<p><p>The pervasiveness and growing concern of non-communicable diseases (NCDs) in developing countries, which were considered not in the distant historical past, as diseases of only the affluent and of developed countries, is no longer in doubt. The proportion of deaths attributable to NCDs today includes figures never witnessed in any previous historical period. Delayed screening is one of the drivers of this worrying trend. The objective of this study, therefore, was to examine the determinants of NCD screening in Ghana. We fitted logistic regression models to a sample of 1342 individuals who successfully completed a cross-sectional survey across three cities in Ghana. Results show that factors such as knowledge on the causes of NCDs, health insurance, high neighbourhood social capital, poor self-rated health, and exposure to NCDs campaign messages significantly predicted an increased likelihood of NCDs screening. However, socio-cultural beliefs such as developing NCDs being the will of God or the enemy being able to spiritually inflict an individual with NCDs were found to be associated with a lower likelihood of screening for NCDs. Beyond the traditional determinants of health, this study expands the analytical gaze and frontiers of the determinants of NCDs in Ghana through the lens of socio-cultural belief systems. While improving access to healthcare, exposure and knowledge through educational programs as well as building community social capital might be important in scaling up NCD screening, dismantling untenable beliefs and misconceptions is similarly crucial.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121384","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}