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Objective: To provide healthcare professionals guidance on youth at risk for prolonged recovery and post‐traumatic headache (PTH), and on pharmacologic and non‐pharmacologic management of PTH due to concussion and mild traumatic brain injury. Background: Headache is the most common persistent post‐concussive symptom affecting 8% of youth for >3 months after concussion. Over the past decade, many studies have explored the treatment of PTH in youth, but there are no established guidelines. Methods: This white paper is based on a synthesis of an updated systematic review of the literature on treatment of PTH and a narrative review of the literature on risk factors for prolonged recovery and health disparities. Results were interpreted by a group of expert providers in PTH in children and adolescents through collaboration of the PTH and pediatric special interest groups of the American Headache Society. Results: Factors that consistently were associated with prolonged recovery from concussion and persistent PTH included female sex, a high number of acute symptoms, and adolescent age. Social determinants of health also likely play an important role in PTH and deserve consideration in the clinical and research settings. A total of 33 studies met the criteria for inclusion in the systematic review of PTH treatment in youth, although most were retrospective and of fair‐to‐poor quality. Treatment strategies included acute and preventive pharmacologic management, procedures, neuro‐modulatory devices, physical therapy, physical activity, and behavioral health support. A collaborative care approach that includes a thoughtful combination of these management strategies is likely most effective. Conclusions: This white paper provides a roadmap for tailoring the treatment of PTH based on factors influencing prolonged headache, the timing of therapies, and therapies with the most evidence for treating PTH in youth. We also highlight research needed for developing more definitive guidelines on PTH management in youth. Plain Language Summary: Post‐traumatic headache (PTH) following concussion is a common and potentially disabling condition impacting youth, yet there are no standards for treatment. This article reviews current evidence and identifies knowledge gaps to guide future research. Based on the limited available evidence and expert opinion, we offer a roadmap for the treatment of PTH in children. [ABSTRACT FROM AUTHOR]

A multiple baseline across 8 nationally syndicated cartoonists evaluated the effects of personal advocacy letters encouraging presentations of a specific prevention message--the depiction of safety belt use in comic strips showing motor vehicle occupants. During baseline these cartoonists depicted safety belt use in only 15% (6 of 41) of their strips with occupied vehicles, but following receipt of a personal letter requesting safety belt use 41% (42 of 102) of their strips depicted safety belt use. Four cartoonists showed clear and immediate increases in depiction of safety belt use, 2 demonstrated delayed and somewhat less consistent belt use, and 2 cartoonists showed no change. The approach and results are discussed with regard to advocacy efforts intended to influence presentation of prevention messages in the media.

Objectives: The United Nations recognize the importance of balancing the needs of people and the planetary systems on which human health relies. This paper investigates the role that climate change has on human health via its influence on climate anxiety., Design: We conducted an intensive longitudinal study., Methods: Participants reported levels of climate anxiety, generalized anxiety and an array of health behaviours at 20 consecutive time points, 2 weeks apart., Results: A network analysis shows climate anxiety and generalized anxiety not to covary, and higher levels of climate anxiety not to covary with health behaviours, except for higher levels of alcohol consumption at the within-participant level. Generalized anxiety showed completely distinct patterns of covariation with health behaviours compared with climate anxiety., Conclusions: Our findings imply that climate anxiety, as conceptualized and measured in the current study, is not in itself functionally impairing in terms of associations with unhealthy behaviours, and is distinct from generalized anxiety. The results also imply that interventions to induce anxiety about the climate might not always have significant impacts on health and well-being., (© 2024 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

The Internet has become an inevitable tool for collecting health and health behavior questionnaires. This study compared the feasibility, presence of score differences, and subjective evaluations by children between Internet and identical paper (asthma/fruit) questionnaires in elementary schools. A randomized crossover design was applied, with children starting with one administration mode before completing (5 minutes later) the other mode. Ten Dutch elementary schools with 270 school children (fifth grade, 10-12 years) were approached to participate. Response was 92%. The Internet mode had significantly less missing/nonunique answers than the paper mode (p < .01). The completion times did not differ significantly between the Internet and the paper mode. Except for perceived self-efficacy to eat sufficient fruit (p < .05), no differences in the asthma and fruit scores were found when comparing between the 2 modes. All variables showed strong intraclass correlation coefficients (166 ≥ 0.64) between modes. Most items had good to very good agreement (kappa 0.61-0.95). The percentages for global and exact agreement ranged per item from 61.3 to 100. Most children preferred the Internet mode on “general preference” and “ease of use” aspects but rated no preference on “understandability.” The majority rated the evaluation aspects of the Internet mode positively. Thus, Internet administration of a health and health behavior questionnaire is feasible at elementary schools, gives comparable responses, and is well accepted and preferred by children compared to the paper version. Therefore, it is recommended to use Internet as a tool in health and health behavior research among children. (J Sch Health. 2006;76(2):80-86) [ABSTRACT FROM AUTHOR]

The Health Belief Model (HBM; Rosenstock, 1966) is the most widely used psychological theory of health- related behaviours but its applicability to non-Western, especially Asian, populations has not been systematically studied. The main objective of the current study was to examine the effects of components of the HBM and dispositional optimism on preventive intention in two separate samples of 220 Hong Kong Chinese adults and 340 Hong Kong Chinese adolescents. Two HBM variables, benefits and barriers, were experimentally manipulated for an imaginary flu outbreak and a hypothetical vaccine. Optimism in the two samples was assessed using the Chinese revised Life Orientation Test (Lai et al., 1998). Participants indicated their intention to take the hypothetical vaccine after reading information for each of the treatment combinations defined by the two HBM variables. The order of the presentation of each of the six treatment conditions was counterbalanced. Results of ANOVA showed that the effects of the two HBM variables were similar in the two groups. Higher benefits and lower barriers were associated with stronger behavioural intention to take the vaccine. The two HBM variables interacted significantly in the adolescent but not the adult sample. Among the adolescents, the difference in intention scores between low and high barriers became larger when the benefits of taking the vaccine increased. In addition, optimism had significant effect on preventive intention only among the adolescents. These findings suggest that age may be an important factor moderating the effects of HBM components as well as optimism on preventive intention in Hong Kong Chinese. Implications of these findings to future research among Chinese were discussed. [ABSTRACT FROM AUTHOR]

Further exploitation of the NOURISHING database is described in the third paper of this trio, from Fismen et al., using the benchmarking tools to create a composite policy index that is capable of evaluating national policies and identifying policy gaps. CO-CREATE: An unusual project to bring young people into obesity policy formation At its launch in 2018, the CO-CREATE project was clearly going to be one of the most remarkable pieces of research undertaken in the field of public health and obesity. [Extracted from the article]

The escalating burden of lifestyle‐related diseases stands as a critical global public health challenge, contributing substantially to the prevalence of chronic conditions and a large portion of premature mortality. Despite this, concise evidence‐based lifestyle interventions targeting physical inactivity, nutrition, alcohol and smoking continue to be underutilised. Although good evidence exists for addressing the four lifestyle‐related risk factors independently, rarely do these present in isolation. Evidence is lacking regarding how to integrate interventions targeting multiple risk factors. Consequently, this paper aims to provide an overview of the evidence for delivering multiple interventions in primary healthcare settings. Different lifestyle factors are inter‐related, with decisions around ordering of the delivery of multiple lifestyle interventions an important consideration. There is evidence supporting the effectiveness of addressing some lifestyle factors simultaneously (e.g., physical activity and nutrition), although smoking cessation may be delivered best in a sequential approach. While the World Health Organisation highlights four key lifestyle factors (nutrition, physical activity, alcohol and smoking), incorporating additional elements such as sleep, mental well‐being and social connectedness offers a holistic framework for promoting well‐being. Despite the presentation of multiple behaviour risk factors being commonplace in healthcare settings, the evidence (outlined in the paper) for how best to deliver interventions to address this is limited, with further research and subsequent clinical guidance required. In order to address the barriers to delivering lifestyle interventions in primary care, innovation will be required. The use of non‐medical personnel, social prescribers and health coaches has the potential to alleviate time constraints, whilst mounting evidence exists for group consultations for addressing lifestyle‐related non‐communicable diseases (NCDs). If the challenges to implementation can be addressed, and if healthcare systems can adapt for the promotion of healthy lifestyles, the impact of NCDs can be mitigated. [ABSTRACT FROM AUTHOR]

This paper is an empirical study of what solidarity in a Western European healthcare system means today. Drawing upon empirical research on the 2015 refugee cohort's health needs and their health‐seeking behaviour, it unites claims from the literature on solidarity in the fields of migration and healthcare. I argue that the Austrian healthcare system not only is an example of 'civic solidarity' in the form of institutionalised obligations to citizens but that it also enacts political forms of solidarity and produces political inclusion for marginalised groups such as refugees. My findings show that being entitled to and accessing services in the healthcare system holds meaning beyond the provision of care: It enables to act autonomously, to build familiar relationships with Austrian institutions, inclusion via the personal electronic health card and to support others in the same solidaristic system. These insights can be used to raise awareness about the inclusional function of healthcare services among practitioners. They also show how solidarity‐based healthcare systems can be a motor for shaping positive relationships between immigrants and the host country, and point to additional modes of solidarity in the context of forced migration next to civil society and nonstate support structures. This paper builds upon ethnographic data that were collected between 2018 and 2020 in Vienna, Austria (observational notes before, during and after medical consultations with refugees; interviews with them; interviews with healthcare practitioners and other care providers). [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. One commonly recommended measure to limit risk of infection is face covering. It is important to identify those factors that can predict the uptake and maintenance of face covering. Objectives: We aimed to identify and synthesise the evidence on malleable psychological and psychosocial factors that determine uptake and adherence to face covering aimed at reducing the risk of infection or transmission of COVID‐19. Search Methods: We searched various literature sources including electronic databases (Medline ALL, Child Development & Adolescent Studies, ERIC, PsycInfo, CINAHL & Web of Science), web searches, conference proceedings, government reports, other repositories of literature and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID19), (2) behaviour of interest and (3) terms related to psychological and psychosocial determinants of COVID Health‐Related Behaviours and adherence or compliance with face covering, to capture malleable determines. Searches capture studies up until October 2021. Selection Criteria: Eligibility criteria included observational studies (both retrospective and prospective) and experimental studies that measure and report malleable psychological and psychosocial determinants and handwashing at an individual level, amongst the general public. Screening was supported by the Cochrane Crowd. Studies titles and abstracts were screened against the eligibility criteria by three independent screeners. Following this, all potentially relevant studies were screened at full‐text level by the research team. All conflicts between screeners were resolved by discussion between the core research team. Data Collection and Analysis: All data extraction was managed in EPPI‐Reviewer software. All eligible studies, identified through full‐text screening were extracted by one author. We extracted data on study information, population, determinant, behaviour and effects. A second author checked data extraction on 20% of all included papers. All conflicts were discussed by the two authors until consensus was reached. We assessed methodological quality of all included studies using an adapted version of the Joanna Briggs Institute Quality appraisal tool for cross‐sectional studies. Main Results: Our initial searches yielded 23,587 results, of which 23 were included in this review. The included studies were cross‐sectional in design, came from nine countries and had a combined sample of 54,401 participants. The vast majority of studies had samples from the general public, with five of the studies focusing on specific samples. All included studies considered people over the age of 18. The quality of 10 of the studies was rated as unclear, 10 were rated as low, and 3 rated high risk of bias, predominately due to lack of reporting of recruitment, sample characteristics and methodology. Ten studies were included in the meta‐analysis and 16 in the narrative synthesis. Findings from the meta‐analysis indicated that knowledge of COVID‐19 (0.341, 95% confidence interval [CI] = 0.06, 0.530, I2 = 100%) was the malleable determinant most associated with face covering behaviour. Perceived susceptibility of COVID‐19 (r = 0.088, 95% CI = −0.004, 0.180, I2 = 80%) and COVID‐related worry and anxiety (r = 0.064, 95% CI = −0.066, 0.191, I2 = 93% had little to no effect on face covering behaviour. In the narrative synthesis, the strongest association was found between perceived benefits and effectiveness of behaviours and mask wearing behaviour. Authors' Conclusions: Understanding the effects of various malleable determinants on COVID‐related face covering can aid in the development and implementation of interventions and public health campaigns to promote face covering behaviour in potential new waves of COVID‐19 or other respiratory infections. Knowledge of COVID and perceived benefits of face coverings warrant further consideration in future research and policy. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. One commonly recommended measure to limit risk of infection is frequent handwashing. It is important to identify those factors that can predict the uptake and maintenance of handwashing. Objectives: We aimed to identify and synthesise the evidence on malleable psychological and psychosocial factors that determine uptake and adherence to handwashing aimed at reducing the risk of infection or transmission of COVID‐19. Search Methods: We searched various literature sources including electronic databases (Medline ALL, Child Development & Adolescent Studies, ERIC, PsycInfo, CINAHL and Web of Science), web searches, conference proceedings, government reports, other repositories of literature and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID‐19), (2) behaviour of interest and (3) terms related to psychological and psychosocial determinants of COVID Health‐Related Behaviours and adherence or compliance with handwashing, to capture malleable determines. Searches capture studies up until October 2021. Selection Criteria: Eligibility criteria included observational studies (both retrospective and prospective) and experimental studies that measure and report malleable psychological and psychosocial determinants and handwashing at an individual level, amongst the general public. Screening was supported by the Cochrane Crowd. Titles and abstracts were screened against the eligibility criteria by three independent screeners. Following this, all potentially relevant studies were screened at full‐text level by the research team. All conflicts between screeners were resolved by discussion between the core research team. Data Collection and Analysis: All data extraction was managed in EPPI‐Reviewer software. All eligible studies, identified through full‐text screening were extracted by one author. We extracted data on study information, population, determinant, behaviour and effects. A second author checked data extraction on 20% of all included papers. All conflicts were discussed by the two authors until consensus was reached. We assessed methodological quality of all included studies using an adapted version of the Joanna Briggs Institute Quality appraisal tool for cross‐sectional studies. Main Results: Our initial searches yielded 23,587 results, of which 56 studies were included in this review. The included studies were cross sectional in design, came from 22 countries and had a combined sample of 199,376 participants. The vast majority of studies had samples from the general public, with eight of the studies focusing on specific samples. All included studies considered people over the age of 18. The quality of the majority of the studies was good (n = 30 rated low risk of bias), with 8 rated high risk of bias, predominately due to lack of reporting of recruitment, sample characteristics and methodology. Thirty‐four studies were included in the narrative synthesis and 28 in the meta‐analysis. Findings indicated that emotions about COVID‐19 (worry [0.381, confidence interval [CI] = 0.270–0.482, I2 = 92%) and anxiety (0.308, CI = 0.154–0.448, I2 = 91%]), knowledge of COVID‐19 (0.323, CI = 0.223–0.417, I2 = 94%), and perceived social norms (0.303, CI = 0.184–0.413, I2 = 92%) were among the malleable determinants most associated with handwashing. Perceived severity (0.006, CI = ‐0.011–0.023) and susceptibility of COVID‐19 (0.041, CI = −0.034 to 0.115) had little to no effect on handwashing behaviour. Authors' Conclusions: Understanding the effects of various malleable determinants on COVID‐related handwashing can aid in the development and implementation of interventions and public health campaigns to promote handwashing behaviour in potential new waves of COVID‐19 or other respiratory infections. Emotions about COVID, knowledge of COVID and perceived social norms warrant further consideration in future research and policy. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability have diverse needs and experience higher rates of diet‐related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet‐related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild‐to‐moderate intellectual disability. Methods: The project was initiated by a disability service provider and was guided by the Cook‐Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co‐designed pre‐program consultation and pilot studies, and draft program resources. Pre‐program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co‐researchers with lived experience of intellectual disability who attended a pre‐pilot and then pilot study sessions as remunerated co‐facilitators. Results: Key characteristics of the FLIP intervention arising from pre‐program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper‐based resources. Conclusions: FLIP intervention co‐design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet‐related health is underway. Highlights: An academic research team, disability service provider and people with lived experience of intellectual disability co‐designed a culinary nutrition intervention for adults with mild‐to‐moderate intellectual disabilityKey considerations for culinary nutrition programs for people with intellectual disability include providing small group practical instruction, paper‐based Easy Read recipes, providing choice and creating a social and inclusive atmosphere [ABSTRACT FROM AUTHOR]

Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. Methods: A public consultation was undertaken with people of any gender aged 18–50 years living in the United Kingdom who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors' knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Results: Fifty‐four people joined the initial discussion round (66% women, 21% men, 13% nonbinary or transgender; 55% aged 18–30 years, 30% 31–40 years, 15% 41–50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term 'preconception health', understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g., preconception health, medical terms), using language that is positive, encouraging and gender‐sensitive where possible, and using messages that are specific, nonjudgmental and realistic. The phrases 'health and well‐being during the childbearing years', 'health and well‐being before pregnancy and parenthood' and 'planning for parenthood' resonated with most public contributors. School‐based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. Conclusion: This public consultation produced recommendations from a diverse group of people of reproductive age in the United Kingdom to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co‐development of public awareness campaigns and guidance for healthcare professionals. Patient or Public Contribution: This public consultation included a diverse group of members of the public. They were not involved in the original design of the project, but following the initial round of online group discussions, they contributed to the interpretation and refinement of the emerging concepts in a subsequent round of group meetings. After the consultation activity, public contributors formed a Public Advisory Group and have subsequently been involved in other studies on the same topic. Two public contributors (E.R. and F.F.) provided critical input in the preparation and revision of this manuscript and are co‐authors of the paper. [ABSTRACT FROM AUTHOR]

In the 30+ years since House, Landis, and Umberson (1988) published one of the first papers establishing links between close relationships and physical health, this subfield has blossomed substantially. Theoretical models of relationships and physical health suggest that the mechanisms underlying relationship-health pathways fall into three categories: psychological (e.g., cognitive, affective), biological, and behavioral (for a review, see Farrell & Stanton, 2019). Interestingly, some mechanisms may branch into both protective and deleterious health pathways; Crowley et al. (2020), for example, showed that support marshaling is associated with better or poorer health depending on whether the support is perceived by recipients as effective. Even within positive and negative relationship processes, further narrowing to more specific relationship processes that promote better health may be useful for finding "active ingredients" that can be targeted in future interventions. [Extracted from the article]

Although green training has been shown in past research to promote environmentally responsible behaviors at work, scholars have paid less attention to its influence on employees' eco‐friendly behaviors outside of work. This omission is critical because confining green training research to the work domain obscures its benefits in promoting employees' pro‐environmental behaviors beyond the workplace, and thus its role in supporting organizational efforts to conserve the natural environment. To address this gap, we examine the direct and indirect (via connectedness to nature) relationships between green training and employees' eco‐friendly behaviors outside of work, including consumption of eco‐friendly products, reuse of items and materials, and reduced consumption of resources such as water, electricity, and paper. We also examine the moderating influence of intrinsic spirituality on the direct link between green training and connectedness to nature, as well as the indirect link between green training and eco‐friendly behaviors beyond the workplace. Using time‐lagged, multisource data, we find support for our hypotheses. Our findings advance knowledge on the important yet largely overlooked role of green training in shaping employees' environmentally responsible behaviors outside of the workplace. [ABSTRACT FROM AUTHOR]

Background: Involving men and boys as both users and supporters of Family Planning (FP) is now considered essential for optimising maternal and child health outcomes. Evidence on how to engage men and boys to meet FP needs is therefore important. Objectives: The main objective of this review was to assess the strength of evidence in the area and uncover the effective components and critical process‐ and system‐level characteristics of successful interventions. Search Methods: We searched nine electronic databases, seven grey literature databases, organisational websites, and the reference lists of systematic reviews relating to FP. To identify process evaluations and qualitative papers associated with the included experimental studies, we used Connected Papers and hand searches of reference lists. Selection Criteria: Experimental and quasi‐experimental studies of behavioural and service‐level interventions involving males aged 10 years or over in low‐ and middle‐income countries to increase uptake of FP methods were included in this review. Data Collection and Analysis: Methodology was a causal chain analysis involving the development and testing of a logic model of intervention components based on stakeholder consultation and prior research. Qualitative and quantitative data relating to the evaluation studies and interventions were extracted based on the principles of 'effectiveness‐plus' reviews. Quantitative analysis was undertaken using r with robust variance estimation (RVE), meta‐analysis and meta‐regression. Qualitative analysis involved 'best fit' framework synthesis. Results: We identified 8885 potentially relevant records and included 127 in the review. Fifty‐nine (46%) of these were randomised trials, the remainder were quasi‐experimental studies with a comparison group. Fifty‐four percent of the included studies were assessed as having a high risk of bias. A meta‐analysis of 72 studies (k = 265) showed that the included group of interventions had statistically significantly higher odds of improving contraceptive use when compared to comparison groups (odds ratio = 1.38, confidence interval = 1.21 to 1.57, prediction interval = 0.36 to 5.31, p < 0.0001), but there were substantial variations in the effect sizes of the studies (Q = 40,647, df = 264, p < 0.0001; I2 = 98%) and 73% was within cluster/study. Multi‐variate meta‐regression revealed several significant intervention delivery characteristics that moderate contraceptive use. These included community‐based educational FP interventions, interventions delivered to women as well as men and interventions delivered by trained facilitators, professionals, or peers in community, home and community, or school settings. None of the eight identified intervention components or 33 combinations of components were significant moderators of effects on contraceptive use. Qualitative analysis highlighted some of the barriers and facilitators of effective models of FP that should be considered in future practice and research. Authors' Conclusions: FP interventions that involve men and boys alongside women and girls are effective in improving uptake and use of contraceptives. The evidence suggests that policy should continue to promote the involvement of men and boys in FP in ways that also promote gender equality. Recommendations for research include the need for evaluations during conflict and disease outbreaks, and evaluation of gender transformative interventions which engage men and boys as contraceptive users and supporters in helping to achieve desired family size, fertility promotion, safe conception, as well as promoting equitable family planning decision‐making for women and girls. [ABSTRACT FROM AUTHOR]

Purpose: Healthy cancer survivorship involves patients' active engagement with preventative health behaviors and follow‐up care. While clinicians and patients have typically held dual responsibility for activating these behaviors, transitioning some clinician effort to technology and health coaches may enhance guideline implementation. This paper reports on the acceptability of the Shared Healthcare Actions & Reflections Electronic systems in survivorship (SHARE‐S) program, an entirely virtual multicomponent intervention incorporating e‐referrals, remotely‐delivered health coaching, and automated text messages to enhance patient self‐management and promote healthy survivorship. Methods: SHARE‐S was evaluated in single group hybrid implementation‐effectiveness pilot study. Patients were e‐referred from the clinical team to health coaches for three health self‐management coaching calls and received text messages to enhance coaching. Semi‐structured qualitative interviews were conducted with 21 patient participants, 2 referring clinicians, and 2 health coaches to determine intervention acceptability (attitudes, appropriateness, suitability, convenience, and perceived effectiveness) and to identify important elements of the program and potential mechanisms of action to guide future implementation. Results: SHARE‐S was described as impactful and convenient. The nondirective, patient‐centered health coaching and mindfulness exercises were deemed most acceptable; text messages were less acceptable. Stakeholders suggested increased flexibility in format, frequency, timing, and length of participation, and additional tailored educational materials. Patients reported tangible health behavior changes, improved mood, and increased accountability and self‐efficacy. Conclusions: SHARE‐S is overall an acceptable and potentially effective intervention that may enhance survivors' self‐management and well‐being. Alterations to tailored content, timing, and dose should be tested to determine impact on acceptability and outcomes. [ABSTRACT FROM AUTHOR]

This paper examines how objective and subjective heterogeneity in life expectancy affects savings behavior of healthy and unhealthy people. Using data from the Health and Retirement Study, we first document systematic biases in survival beliefs across self‐reported health: those in poor health not only have a shorter actual lifespan but also underestimate their remaining life time. To gauge the effect on savings behavior and wealth accumulation, we use an overlapping‐generations model where survival probabilities and beliefs evolve according to a health and survival process estimated from data. We conclude that differences in life expectancy are important to understand savings behavior, and that the belief biases, especially among the unhealthy, can explain up to a fifth of the observed health‐wealth gap. [ABSTRACT FROM AUTHOR]

To effectively manage a crisis, most decisions made by governments, organizations, communities, and individuals are based on "shared situational awareness" (SSA) derived from multiple information sources. Developing SSA depends on the alignment of mental models, which "represent our shared version of truth and reality on which we can act." Social media has facilitated public sensemaking during a crisis; however, it has also encouraged mental model dissonance, resulting in the digital destruction of mental models and undermining adequate SSA. The study is concerned with the challenges of creating SSA during the COVID‐19 pandemic in Australia. This paper documents a netnography of Australian public health agencies' Facebook communication, exploring the initial impact of COVID‐19 on SSA creation. Chaos theory is used as a theoretical lens to examine information perception, meaning, and assumptions relating to SSA from pre to post‐pandemic periods. Our study highlights how the initial COVID‐19 "butterfly effect" swamped the public health communication channel, leaving little space for other important health issues. This research contributes to information systems, information science, and communications by illustrating how the emergence of a crisis impacts social media communication, the creation of SSA, and what this means for social media adoption for crisis communication purposes. [ABSTRACT FROM AUTHOR]

Summary: The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co‐creating policy with youth (CO‐CREATE) and the Health Behaviour in School‐aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross‐National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged. [ABSTRACT FROM AUTHOR]

Background: Eating, drinking and swallowing (EDS) difficulties are important to identify early. Awareness of EDS changes starts with those living with dementia or their family carers. However, little is known about early identification from the perspective of people with dementia. Aim: The aim of this study was to understand the experience of EDS by people living with dementia in their own home. Methods: Published evidence pertaining to EDS difficulties in dementia was used to inform an online semi‐structured interview guide. Four people living with dementia and a third‐sector Empowerment Lead were invited to become co‐researchers. People living with dementia and their carers were invited to be interviewed. We enquired about their past and present experiences, and future expected changes in EDS, information needs, opinions on early problem identification, and lifestyle modifications following onset of EDS difficulty. Narrative concepts of heroes and villains in their 'stories' were identified. Responses were subjected to framework analysis informed by narrative enquiry. Results: Seven people living with dementia and five family carers were interviewed. The overarching theme was a 'missed connection' between EDS difficulty and dementia. Where EDS difficulties were identified, 'compensatory changes' and a need for 'access to information' were noted. Conclusions: The connection between potential EDS difficulties and a dementia diagnosis may not be made, even though EDS changes were recognised by people living with dementia and their family carers. This may be explained by behaviours that mask problems or allow individuals to cope or compensate. Reduced awareness may also be due to inadequate access to information and lack of specialist services. If the connection between dementia and EDS difficulty is missed it could further delay access to support services. WHAT THIS PAPER ADDS: What is already known on the subject: The prevalence of dementia is increasing and is expected to affect 9% of the population by 2040. EDS difficulties are common in people living with dementia and predispose to poorer outcomes. Better awareness of EDS changes early in the disease process of dementia or at preclinical stages can identify individuals at risk and allow for intervention prior to advanced EDS difficulties developing. What this paper adds to existing knowledge: This paper reports the perspective of people living with dementia and family carers and provides insights into experiences of EDS and the challenges faced and identifies commonalities. The connection between potential EDS difficulties and dementia is missed despite various changes reported by both people living with dementia and their family carers, who tend to make compensatory lifestyle changes without support. What are the potential or actual clinical implications of this work?: Lack of awareness of the connection between potential EDS difficulties and dementia may arise due to inadequate access to information to support people living with dementia and their family carers. Access to such information is needed and the quality assurance of information from reputable sources is important to people living with dementia. There is a need for greater service user awareness of signs of EDS difficulty and how to access specialist services. [ABSTRACT FROM AUTHOR]

Background: Wellness is a holistic, multidimensional, and process‐oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well‐being without an in‐depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer‐reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty‐six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well‐being without an in‐depth clarification of its theoretical foundation. [ABSTRACT FROM AUTHOR]

Time is often an important ingredient of a healthy lifestyle. Starting from this observation, this paper studies optimal public policy concerned with promoting healthy choices taking into account both monetary and time investments in health. Individuals tend to underestimate the importance of their health while making decisions, which makes their investments too low compared to the first‐best. While the decentralization of the first‐best requires personalized subsidies on both time and monetary investments, this may be problematic due to informational issues. In a second‐best world where individual productivities and time investments are publicly unobservable, whereas monetary investments are observable in an anonymous way, the paper considers a policy with a non‐linear income tax and a linear subsidy on monetary health investments. If there are no incentive concerns, all other things equal, monetary investments complementary (substitutable) to time investments should be subsidized more (less) than those independent of time use. The addition of incentive concerns demonstrates that optimal subsidization of monetary health investments is less straightforward than one might think. Overall, the time ingredient in the production of health does play a role in the optimal policy design, affecting not only the subsidy on monetary health investments but also the income taxation. [ABSTRACT FROM AUTHOR]

In this paper we use the concept of the person to examine person‐centred dialogue and show how person‐centred dialogue is different from and significantly more than transfer of information, which is the dominant notion in health care. A further motivation for the study is that although person‐centredness as an idea has a strong heritage in nursing and the broader healthcare discourse, person‐centred conversation is usually discussed as a distinct and unitary approach to communication, primarily related to the philosophy of dialogue—the philosophy of Martin Buber. In this paper we start with the concept of person to critically reflect on theoretical perspectives on communication to understand person‐centred conversations in the context of nursing and health. We position the concept of the person through the use of Paul Ricoeur's philosophy and follow by distinguishing four theoretical perspectives on communication before reflecting on the relevance of each of these for person‐centred communication. These perspectives are: a linear view of communication as transfer of information, communication as a relation in the sense of philosophy of dialogue, practice‐based communication on constructionist grounds, and communication as a practice to create social community. In relation to the concept of the person, we do not find transfer of information relevant as a theoretical underpinning for person‐centred conversations. From the other three perspectives that are relevant we distinguish five types of person‐centred conversations pertinent to nursing and health: problem identifying conversations, instructive conversations, guiding and supportive conversations, caring and existential conversations, and therapeutic conversations. Through this analysis it is argued that person‐centred communication and conversations are substantially different to transfer of information. We also discuss the significance of communication adjusted to specific situations, including emphasis on how we speak in relation to the aim or topic of a conversation. [ABSTRACT FROM AUTHOR]

Background: Obesity is higher in people with intellectual disabilities. Aims: There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond 'what works' and examine the 'context, mechanisms and outcomes' (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. Method: We explored six‐review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. Results: There were few theoretically underpinned, multi‐component programmes that were effective in the short to long‐term and many failed to explore the 'context and mechanisms'. We developed a logic model and engaged in two co‐production workshops to refine this model. Discussion: Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi‐component, have a closer understanding of the interplay of the 'context and mechanisms', and co‐designed using a logic model framework. [ABSTRACT FROM AUTHOR]

Background: To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice. Methods: As part of a multi‐phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients' attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019). Results: This review included 35 papers about "Patient Attitudes" and 125 papers about "Patient Behaviours"—indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients' opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different. Conclusion: This review, given its multi‐focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international "mapping" of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain. [ABSTRACT FROM AUTHOR]

Introduction: Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high‐risk, medicalised pregnancy, birth, and post‐natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way. Objective: This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood. Method: The review follows the nine‐stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated. Findings: A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full‐text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness‐related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance. Conclusion: Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population. [ABSTRACT FROM AUTHOR]

This paper explores the use of Fisher and Tronto's four phases of ethics of care (caring about, taking care of, caregiving, and care receiving) to three personal information management (PIM) frameworks, with a focus on PIM maintaining. The author argues that ethics of care can provide a theoretical foundation for PIM by using the four phases of caring to develop a perspective of PIM as a caring process using the categories of PIM as self‐care and PIM as caring for others. The paper begins by reviewing Fisher and Tronto's ethics of care, cites research in related fields that have applied ethics of care, and then describes how ethics of care could be applied to PIM research. To conclude, the author offers suggestions for how ethics of care can be applied to future PIM research in the following areas: better understand the motivations for PIM; the ways in which PIM can contribute to the social concepts of equality, justice, and trust and how social institutions can facilitate "good" PIM. [ABSTRACT FROM AUTHOR]

Sugar‐sweetened beverage taxes have become an increasingly popular policy to combat the worldwide obesity epidemic, but relatively little is known about their impact on health outcomes, particularly among high school aged students. In this paper, I use public‐use data from the Youth Risk Behavioral Surveillance System to determine whether high school students living in three of the American cities which have implemented Sugar‐sweetened beverage taxes have experienced public health improvements. Using an event‐study design that compares outcomes in treated districts to a group of similar control districts, I find reductions in soda consumption in Philadelphia and average body mass index in Philadelphia, San Francisco and Oakland, with suggestive evidence that the improvements are concentrated among female and non‐white respondents in both cases. [ABSTRACT FROM AUTHOR]

Aim: Health literacy is the ability to understand and interpret health information and navigate the health‐care system. Low health literacy is associated with poorer health knowledge and disease management, increased chronic illness, underutilisation of preventative health services and increased hospitalisations. The aim of the study is to review the available literature on the relationship between parental health literacy and health outcomes for children with chronic disease in high‐income countries (HIC) and low‐ and middle‐income countries (LMIC). Methods: We systematically searched Medline, EMBASE and Web of Science, and assessed study quality using the Newcastle Ottawa Scale. We reviewed all relevant studies, and identified themes using thematic analysis. Results: Of 1167 studies assessed, 49 were included in the review. All studies were of adequate quality. Twenty‐two were from LMIC and 27 from HIC. Six themes were identified: Parental health literacy, parental education, socio‐economic conditions, identity and culture, family factors, and health behaviours. In both HIC and LMIC, lower parental health literacy was associated with poorer child health outcomes. Disease‐specific knowledge was found in a number of papers to directly impact parent health behaviour and child health outcomes, and may mitigate the effects of low parental health literacy. Conclusion: There is a clear link between parental health literacy, health behaviour and health outcomes for children with chronic disease. Disease‐specific knowledge as a target for health‐care interventions holds promise for application in low‐resourced settings with parents (particularly mothers) who have lower health literacy, where disease‐specific education may improve child health outcomes, although more research is required to determine how we can best facilitate these programmes. [ABSTRACT FROM AUTHOR]

Background: Recent advances in the psychological understanding of health‐related behaviour have focused on producing a comprehensive framework to model such behaviour. The Capability‐Opportunity‐Motivation‐Behaviour (COM‐B) and its associated Theoretical Domains Framework (TDF) allow researchers to classify psychological and behavioural constructs in a consistent and transferable manner across studies. Aim: To identify oral and dental health‐related studies that have used the TDF and/or COM‐B as frameworks to guide research and examine the ways in which these concepts have been practically used in such research. Method: Narrative review of published literature. To be included, the paper had to (1) state that the TDF or COM‐B had been used and to have targeted at least one construct identified in either framework, (2) include primary empirical data, (3) focus on a behaviour directly related to oral or dental‐related health (eg brushing, applying fluoride varnish, flossing) and/or attitudes, intentions and beliefs related to the behaviour. Studies could include any research design, and participants of any age or gender and include patients, parents or dental health professionals. Findings: Nine studies were identified that had drawn on the COM‐B and/or TDF as the framework for their research. Seven of the studies were based on the TDF only, with one employing both the COM‐B and Health Belief Model, and one using the TDF with COM‐B. The nine studies covered a broad range of oral health‐related behaviours including child tooth brushing, fluoride varnish application and non‐ or micro‐invasive management of proximal caries lesions. The populations in the studies included dentists, dental teams and parents of children. All studies adopted only a subset of the constructs within the TDF, often without justification. Conclusions: It is encouraging that oral health researchers are adopting standardized psychological frameworks to develop their research and oral health interventions. Future work should build on the small number of studies identified in this review and consider using standardized tools to do so. [ABSTRACT FROM AUTHOR]

BACKGROUND Health literacy impacts children's health and educational attainment. Therefore, determining the most appropriate pedagogical design is critical. The long‐term health benefits of health literacy for each child's life course further justify this imperative. School‐based health literacy programs are of interest internationally. METHODS: We brainstormed the search terms and established inclusion/exclusion criteria for this systematic review. We searched 2 databases (CINAHL, ERIC) following PRISMA guidelines. Three authors screened and sorted the findings. RESULTS: We identified 21 relevant studies from 629 retrieved. Few (6/21) studies were situated in the primary school setting. CONCLUSIONS: This review found a variety of project designs, evaluation methods, and conceptual models. Descriptive analysis of the final 21 papers highlighted the importance of multicomponent design (whole‐of‐school and curriculum), cross‐curricula integration, professional development for teachers, age of children, role of parents, and role of community. The results of this analysis may inform primary school program design in the future. Schools provide a logical setting for health literacy development. Despite the evidence that adolescence is too late, few studies have been situated in primary schools. Teachers lack confidence to teach health and need ongoing professional development. Parent, child, and community voices are essential for sustained engagement and program success. [ABSTRACT FROM AUTHOR]

Objectives: This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory. Methods: A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0–5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study. Results: Eleven articles were included in this meta‐synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance. Conclusions: The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children. [ABSTRACT FROM AUTHOR]

Sense of coherence (SoC) refers to how individuals cope with stress and maintain health, yet its concept remains no consensus about how it is defined and applied in the context of stroke care. This study aims to clarify the concept of SoC by reviewing its applications in various stroke populations and its changes across different stages of stroke. The adapted steps of Rodger's evolutionary approach of concept analysis were used to explore the attributes, surrogate or related terms, antecedents, and consequences of SoC in stroke. Twenty‐five articles were included after evaluating 1065 records and 80 full‐text articles. The SoC's attributes, characterized with dynamicity of comprehensibility, manageability, and meaningfulness in stroke, lie within the different stroke phases (acute, sub‐acute and chronic). There is no surrogate term to SoC. Related terms included coping, resistance resources, resilience, hardiness, and readiness. Antecedents related to stroke survivors and informal caregivers included sociodemographic factors, body functioning factors, social factors, stroke‐related factors, and caring factors. Consequences for stroke survivors, informal caregivers, and dyads included psychological status, health behavior, marital satisfaction, care provision, and perception of rehabilitation needs. The findings of the concept analysis of SoC in stroke reveal that this concept extends beyond survivors experienced stroke, and its comprehensive understanding needs considering various aspects including the SoC of informal caregivers, dyads, and family. This paper serves as a novel perspective for future stroke care, focusing on the needs for dynamic monitoring and adaptations to changes of SoC at different stages of stroke care. A proper understanding of SoC can also contribute to developing assessment tools and theoretical models in stroke care with some emphasis on the phases of strokes (attributes), demographic and functional characteristics (antecedents), and both stroke survivor–caregiver‐related outcomes sensitive to SoC. [ABSTRACT FROM AUTHOR]

Limited information is available regarding the knowledge of Cardiovascular Disease (CVD) risk factors and the actual risk behaviors among African American (AA) older women living in rural areas of Alabama. A pilot study of needs assessment for CVD prevention behaviors was conducted to collect such data from rural AA women. This paper reports the quantitative part of the needs assessment of this pilot study. We recruited participants (N = 30) using convenience sampling. Data collection measures included: i) American Heart Association's CVD‐related knowledge questionnaire, ii) Five Times Sit to Stand Test to measure dynamic balance and iii) Six minute walk test (6MWT) to assess exercise endurance iv) standard weighing scale to measure body weight and v) standard measurements scale to measure height. Descriptive and inferential statistics were used to analyze the data. The majority (76%) of participants had hypertension (70%), diabetes (60%), poor balance (70%), and low exercise endurance (100%). Most of the participants had low knowledge related to CVD risk factors. This study demonstrated the need to conduct a large‐scale study to assess knowledge related to heart health and the actual needs and preferences of these individuals. Conducting such a study would lay the foundation for developing a need‐based program for these underserved individuals while incorporating their preferences and the strategies that would help engage them in a heart health intervention. [ABSTRACT FROM AUTHOR]

Objectives: As part of a wider study describing the impact of a breast cancer diagnosis on lifestyle behaviours, this paper describes the impact of a breast cancer diagnosis on alcohol consumption and factors influencing consumption. Methods: Cross‐sectional online survey of 140 people (138 women) and interviews with 21 women diagnosed with breast cancer in the last 10 years. Results: Of the 100 survey participants who drank alcohol 25% were drinking at increasing or higher risk levels and 17% strongly wanted to change their drinking behaviour. The habitual aspects of alcohol consumption were the strongest predictor of current alcohol consumption behaviours. Social norms and perceptions about conflicting information were substantial barriers to change. Conclusions: Breast cancer survivors need accurate information about the risks of alcohol consumption and guidelines in order to make informed decisions about making changes to their behaviour. Interventions to support breast cancer survivors to reduce alcohol consumption need to focus on the development of healthy habits and may benefit from a focus which includes partners and friends. [ABSTRACT FROM AUTHOR]

BACKGROUND: We analyzed data from a study to evaluate the effectiveness of the Relationships Under Construction (RUC) sexual risk avoidance education program promoting positive youth development and healthy relationships. METHODS: Twelve schools in the Midwestern region of the United States randomized to the intervention implemented RUC in health or science classes, while control schools collected study measures and implemented the standard curriculum. RESULTS: Post‐randomization analyses revealed significant differences in grade, race/ethnicity, and prior relationship education at baseline between intervention and control students. Subsequent analyses controlled for these differences. We distributed parental notification letters to 641 students, and no parents requested that their adolescent opt out of data collection. We obtained assent and baseline computer‐assisted survey interviews or paper‐and‐pencil instrument forms from 100% of these students. Findings suggest that RUC significantly reduced sexual activity (odds ratio = 0.56, p =.046) at 3‐month follow‐up, compared to those in the control group. RUC also reduced pornography viewing and improved attitudes about delayed gratification, beliefs, decision making, and negative outcome expectations. CONCLUSIONS: Our findings suggest that RUC improves sexual attitudes, beliefs, and behaviors among this population of adolescents. Additional research is needed to assess RUC impacts among diverse populations. [ABSTRACT FROM AUTHOR]

Aims: To identify barriers and enablers that influence engagement in and acceptability of diabetes prevention programmes for people with pre‐diabetes. The results will provide insights for developing strategies and recommendations to improve design and delivery of diabetes prevention programmes with enhanced engagement and acceptability for people with pre‐diabetes. Methods: This review used a critical realist approach to examine context and mechanisms of diabetes prevention programmes. Medline, Embase, PsycInfo, Cinahl, Web of Science, Scopus and Pre‐Medline were searched for English language studies published between 2000 and 2023. A quality assessment was conducted using Joanna Briggs Institute critical appraisal tools. Results: A total of 90 papers met inclusion criteria. The included studies used a variety of quantitative and qualitative methodologies. Data extracted focused on barriers and enablers to engagement in and acceptability of diabetes prevention programmes, with seven key mechanisms identified. These included financial, environmental, personal, healthcare, social and cultural, demographic and programme mechanisms. Findings highlighted diverse factors that influenced engagement in preventive programmes and the importance of considering these factors when planning, developing and implementing future diabetes prevention programmes. Conclusions: Mechanisms identified in this review can inform design and development of diabetes prevention programmes for people with pre‐diabetes and provide guidance for healthcare professionals and policymakers. This will facilitate increased participation and engagement in preventive programmes, potentially reducing progression and/or incidence of pre‐diabetes to type 2 diabetes and improving health outcomes. [ABSTRACT FROM AUTHOR]

This paper analyses the impact of a healthy food nudge intervention on purchases of 1590 customers of a supermarket chain's loyalty program in Uruguay through a randomized controlled trial. Nudges were presented in the form of messages sent through WhatsApp to customers three times a week for 8 weeks (between July and September 2020). Messages highlighted the benefits of cooking at home and eating mindfully and healthy (vegetables, fruits, healthy snacks, legumes, and fish), and included easy to implement tips. Results show that, on average, customers assigned to the treatment group increased their purchases of healthy food by 8% and substituted sugar‐sweetened for sugar‐free beverages. We find an unintended increase in purchases of unhealthy food of 7%, with no correlative increase in calories, suggesting that customers substituted higher calorie products for lower calorie ones. We find that households with lower educational attainment, lower income, and with children under the age of 12 are more likely to increase purchases of fruits and vegetables, while other households are more likely to improve the diet quality without increasing expenditure. Effects do not persist after the intervention is over, suggesting that salience, rather than information is the main channel triggering the effects. [ABSTRACT FROM AUTHOR]

Issues addressed: Little research has been conducted on the impact of Aboriginal and Torres Strait Islander brief intervention training programs on health staff participants' own health behaviours. Through the Queensland B.strong program (2017‐2020), brief intervention training in smoking cessation, nutrition and physical activity was provided to the Aboriginal and Torres Strait Islander health workforce and other health and community professionals. This study examined the program's impact on participants' own health behaviours. Methods: Data were collected through four surveys (pre‐ and post‐training workshop, and 3‐month and 6‐month follow‐up) of the 1131 participants in B.strong training workshops from June 2017 to August 2019. Surveys included items on participants' own health behaviours. Pre‐ and post‐workshop surveys were paper‐based, and follow‐up surveys were completed online. For the analysis of data reported in this paper, paired‐samples t tests were used to assess changes between pre‐workshop and 3‐month follow‐up. Results: Statistically significant improvements were found between pre‐workshop and 3‐month follow‐up in the number of serves of vegetables or legumes/beans eaten per day, the number of serves of fruit eaten per day, and in time spent in physical activity. However, there was: no statistically significant change in smoking status, with baseline rates being relatively low; a statistically significant increase in consumption of sugary drinks, and of takeaway foods; a nonsignificant increase in consumption of snack foods; and no significant change in sedentary behaviour of participants. Conclusion: While some positive changes in participants' own health behaviours in nutrition and physical activity were associated with the B.strong program, there was no change in their smoking behaviour. So what?: This study found that some improvements in participants' own health behaviours were associated with the B.strong program. This research may inform future Indigenous brief intervention training programs and health services on how to promote healthy behaviours for health staff themselves. [ABSTRACT FROM AUTHOR]

This paper examines the hallmarks of an emergent and distinctive Australian and New Zealand health geography over the last 30 years. Building on an assessment of the early development of the sub‐discipline in the two countries, a review of published work reveals the co‐presence of local themes alongside connections to more global perspectives associated notably with health behaviour. Further common themes are the influence of year‐round exposure to outdoor spaces and the proximity of "blue spaces" to urban centres. However, there are divergences in the evolution of the sub‐discipline. A comparison of attendance at the biennial International Medical Geography Symposia (held since 1985) with publications in the journal Health & Place reveals differentially globalised characters. A steady flow of international visitors and appointments to New Zealand universities as well as more apparent connections to the wider discipline of geography contrast with more applied geospatial and public health connections in Australian health geography. [ABSTRACT FROM AUTHOR]

Introduction: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a cardiac inherited arrhythmogenic disease potentially leading to sudden cardiac death that is determined by electrical instability exacerbated by acute adrenergic tone. Methods and Results: Despite its life‐threatening nature, CPVT remains potentially unnoticed since diagnosis may be difficult especially in apparently healthy athletes. This review summarizes current knowledge and shortcomings of CPVT, focusing on genetics, arrhythmic mechanisms, sport preparticipation screening, and current recommendations. Conclusions: The paper captures the importance of CPVT athletes regarding the necessity of risk stratification, as well as the importance of maintaining a healthy lifestyle. [ABSTRACT FROM AUTHOR]

This paper investigates the effects of a mandatory, universal prescription drug insurance policy on health behaviors and outcomes within a public health care system providing physician and hospital services free of charge. Using Canadian longitudinal data, we show that the reform improved individuals' general health while reducing body mass index and smoking. However, the program also increased drinking and had no significant impact on mental health, physical activity, or preventive care. We also examine the mechanisms through which these effects can play a role, as well as the heterogeneous effects. Estimates suggest that the policy decreased SES‐based disparities in health. [ABSTRACT FROM AUTHOR]

Background: Engagement of the child, parent and professional may facilitate positive outcomes for young children with communication disorders receiving early intervention (EI) via telepractice. Despite reported positive outcomes of engagement in a family‐centred model of EI, there is limited research exploring the nature engagement in the telepractice environment and guiding professionals on how to best interact with young children and their families. Aim: To identify a set of critical behaviours for building engagement in telepractice EI. Methods & Procedures: A two‐round modified e‐Delphi study was conducted. Participants were international experts in the field of paediatric communication disorders and telepractice EI from diverse allied health and education backgrounds. The experts used a nine‐point Likert scale to rate the importance of a predetermined set of critical behaviours for building engagement in telepractice EI across three different aspects of the telepractice interaction: (1) getting to know each other; (2) family‐centred telepractice; and (3) telepractice specific considerations. Outcomes & Results: A total of 30 experts completed round 1, with 21 participants from round 1 completing round 2 (70% response rate). Across the two rounds, a total of 64 of the 109 items presented (58.71%) achieved consensus as critical behaviours for building engagement in telepractice EI. Conclusions & Implications: The present study identified a set of individual aspects of the telepractice interaction that participants, particularly professionals, may need to intentionally address to engage with families of young children with communication disorders receiving EI via telepractice. The results from this study will contribute to the development of an observational tool to measure engagement in the telepractice EI environment. What this paper adds: What is already known on the subject: A growing body of research suggests telepractice is a feasible alternative for families of young children with communication disorders who lack access to high‐quality EI. The engagement of families through family‐centred care has long been recommended for children enrolled in EI. Although there is growing uptake of telepractice EI, limited research is available guiding professionals on how to engage with families of young children with communication disorders via telepractice. What this paper adds to existing knowledge: This study provides a set of 64 telepractice‐specific behaviours deemed critical to engagement for all participants of the telepractice interaction. The display of these behaviours could assist professionals to better engage with families of young children within the telepractice environment. What are the potential or actual clinical implications of this work?: The findings of this study provide a set of telepractice‐specific behaviours that professionals may need to deliberately display and encourage while interacting with young children with communication disorders and their families. Professionals displaying these behaviours could potentially enhance the engagement of families receiving EI services via telepractice. This set of critical behaviours will be refined with the aim of developing an evidence‐based observational tool to measure engagement in the context of telepractice EI. [ABSTRACT FROM AUTHOR]

Aim: To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of remission of type 2 diabetes, and provide recommendations to researchers and research funders on how best to address them. With the ultimate aim of enabling the remission of type 2 diabetes to become a possibility for more people. Methods: A 1‐day research workshop was conducted, bringing together 31 researchers, people living with diabetes, healthcare professionals and members of staff from Diabetes UK to identify and prioritize recommendations for future research into remission of type 2 diabetes. Results: Workshop attendees identified 10 key themes for further research. Four of these themes were prioritized for further focus: (i) understanding how to personalize lifestyle approaches based on biology, patient choice and subtypes; (ii) understanding the biology of remission; (iii) understanding the most effective approaches to implementation of lifestyle interventions; and (iv) understanding the best approaches to combining therapies (gut hormones, other drugs, lifestyle approaches and bariatric surgery). Conclusions: This paper outlines recommendations to address the current gaps in knowledge related to remission of type 2 diabetes. What's new?: It is known that type 2 diabetes can be put into remission; however, standard clinical treatment of type 2 diabetes does not currently aim to put the condition into remission.This is the first time that researchers and healthcare professionals from a wide range of specialist areas have come together to identify research priorities to increase understanding of remission of type 2 diabetes.The paper sets out key recommendations for further research that is needed in order to make remission an achievable aim for more people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Medical innovations may lessen the perceived risk of disease which can decrease the take‐up of healthy behaviors, a phenomenon known as risk compensation. In contrast, a diagnosis provides updated information about the state of one's health which may motivate positive behavior change. In this paper, I consider how behavior changes in response to a diagnosis of cardiovascular disease (CVD) before and after the FDA approval of new classes of drugs to treat high blood pressure and high cholesterol in 1973. I find that individuals diagnosed with CVD are more likely to follow a diet and decrease body‐mass index in response to the diagnosis, irrespective of medication approvals. Nonsmoking is a notable exception. Prior to medication availability, there is no change in smoking behavior in response to a CVD diagnosis. Conversely, when medication is available, there is a significant decline in smoking. The empirical complementarity of medication and smoking cessation may be driven by increased exposure to medical professionals (who emphasize the harms of smoking) or because medication decreases the risk of CVD death which heightens the importance of investing in future health. [ABSTRACT FROM AUTHOR]

Aim: Position paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life. Methods: A literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>. Results: A total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient. Conclusions: Based on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between education and health behaviours, focusing on potential offsetting responses between calories in (i.e. dietary intakes) and calories out (i.e. physical activity). It exploits the 1972 British compulsory schooling law that raised the minimum school leaving age from 15 to 16 to estimate the effects of education on diet and exercise around middle age. Using a regression discontinuity design, the findings suggest that the reform led to a worsening of the quality of the diet, with increases in total calories, fats and animal proteins. However, I find that these changes are partially offset by a discontinuous increase in physical activity. Back‐of‐the‐envelope calculations suggest little effect on the balance of calories. As such, the findings show that focusing on the two components of energy balance provides additional information that is concealed in analyses that only use a measure of obesity. [ABSTRACT FROM AUTHOR]

Mobile Health (m‐health) technologies, such as wearables, apps, and smartwatches, are increasingly viewed as tools for improving health and well‐being. In particular, such technologies are conceptualized as means for laypersons to master their own health, by becoming "engaged" and "empowered" "managers" of their bodies and minds. One notion that is especially prevalent in the discussions around m‐health technology is that of empowerment. In this paper, I analyze the notion of empowerment at play in the m‐health arena, identifying five elements that are required for empowerment. These are (1) knowledge, (2) control, (3) responsibility, (4) the availability of good choices, and (5) healthy desires. I argue that at least sometimes, these features are not present in the use of these technologies. I then argue that instead of empowerment, it is plausible that m‐health technology merely facilitates a feeling of empowerment. I suggest this may be problematic, as it risks placing the burden of health and behavior change solely on the shoulders of individuals who may not be in a position to affect such change. [ABSTRACT FROM AUTHOR]

Inconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy. [ABSTRACT FROM AUTHOR]