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The importance of enhancing social and emotional skills in educational settings has gained prominence, with many countries and organizations embracing the Social and Emotional Learning (SEL) framework to equip individuals with the tools needed for shaping a self-identity, emotional regulation, goal achievement, empathy, nurturing relationships, and responsible decision-making and overall well-being. In this paper, we aim to connect the globally acknowledged Collaborative for Academic, Social, and Emotional Learning SEL framework with international policies that underscore the importance of social and emotional skills in the school context. To accomplish this goal, we first provide a brief overview of the key components of the SEL framework. Subsequently, we explore two significant educational policies within the European context. The first policy is the World Health Organization Health Promoting Schools initiative. We present its objectives, a WHO-affiliated program example, the promoted and assessed competencies of students, and its results, connecting its framework with the CASEL SEL approach. The second focus is the Organisation for Economic Co-operation and Development Study on Social and Emotional Skills, describing its developmental process and the assessment framework. Finally, we describe the alignment of SEL with these European educational policies and illustrate their role in advancing and improving the evaluation of SEL initiatives in educational environments.

This conceptual paper introduces the Mindful Interactions (MI) tool designed to enable university teaching academics to promote student mental health and in so doing, impact positively on academic outcomes. The MI tool is comprised of three elements: "understandings" to provide theoretical guidance which inform pedagogy, "practices" to provide strategies for translating theory into practice, and "guiding principles" which provide a catalyst for critical reflexion, challenge existing beliefs, and create a shared vision from which to work. Relationships are at its core, acknowledging that university students report teacher-student relationships as key to their mental health. Issues related to university student mental health, of which psychological distress is an important component, have been well documented and exacerbated since the onset of COVID-19, increasing demands on universities to meet student mental health needs. It is contended in this paper that understanding the causes of psychological distress, particularly in relation to Adverse Childhood Experiences, offers an alternative lens through which to view student mental health. This lens suggests additional ways of thinking about how university teaching academics and universities might proactively respond to student mental health needs. Cultural Historical Activity Theory informed the theoretical framework for the study, whilst two 'approaches' (the 'Three Pillars of Trauma-informed Care' and 'Trust Based Relational Intervention') along with associated trauma literature underpinned the development of the MI tool.

Background: Whole-school interventions modify the school environment to promote health. A subset of these interventions promotes student commitment to school to prevent substance (tobacco, alcohol, other drugs) use and/or violence. A previous review identified the theory of human functioning and school organisation as a comprehensive theory of such interventions, and found evidence that these interventions reduce substance use and/or violence., Objectives: The objectives were to search for, appraise and synthesise evidence to address the following questions: (1) What whole-school interventions promoting student commitment to school to prevent substance use and/or violence have been evaluated, what intervention subtypes are apparent and how closely do these align with the theory of human functioning and school organisation? (2) What factors relating to setting, population and intervention affect implementation? (3) What are the effects on student substance use, violence and educational attainment? (4) What is the cost-effectiveness of such interventions? (5) Are intervention effects mediated by student commitment to school or moderated by setting or population?, Data Sources: A total of 56 information sources were searched (in January 2020), then an updated search of 48 of these was carried out (in May 2021). Reference lists were also searched and experts were contacted., Review Methods: Eligible studies were process/outcome evaluations of whole-school interventions to reduce student violence or substance use among students aged 5-18 years attending schools, via actions aligning with the theory of human functioning and school organisation: modifying teaching to increase engagement, enhancing student-staff relationships, revising school policies, encouraging volunteering or increasing parental involvement. Data extraction and quality assessments used existing tools. Theory and process reports were synthesised qualitatively. Outcome and economic data were synthesised narratively; outcome data were meta-analysed., Results: Searches retrieved 63 eligible reports on 27 studies of 22 interventions. We identified four intervention subtypes focused on student participation in school-wide decisions, improving staff-student relationships, increasing engagement in learning and involving parents. The theories of change of most intervention subtypes aligned closely with the theory of human functioning and school organisation, and informed refinement of an intervention theory of change. Theories of change for interventions increasing learning engagement did not align with this theory, aiming instead to increase school commitment primarily via social skills curricula. Factors influencing the implementation included whether or not interventions were tailorable, workable and well explained. Interventions with action groups comprising staff/students, etc. and providing local data were well implemented. Implementation was also affected by whether or not schools accepted the need for change and staff had the resources for delivery. Meta-analyses suggest small, but significant, intervention effects in preventing violence victimisation and perpetration, and substance use. There was sparse and inconsistent evidence of moderation and some evidence of mediation by student commitment to school. Two economic evaluations suggested that there is the potential for the interventions to be cost-effective., Limitations: The quality of the studies was variable and the economic synthesis was limited to two studies., Conclusions: Whole-school interventions aiming to promote student commitment to school share similar theories of change and factors affecting implementation. They have the potential to contribute to preventing violence and substance use among young people. Future trials should aim to optimise intervention effectiveness by better theorisation, and assess implementation and effect moderators and mediators., Study Registration: This study is registered as PROSPERO CRD42019154334., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/151/05) and is published in full in Public Health Research ; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

Background: Physical inactivity is a significant public health issue affecting working adults because it can increase the risk of noncommunicable diseases., Objectives: The objective is to determine the outcomes of a multi-component workplace environmental intervention that incorporated physical activity self-regulation (PASR) to promote physical activity (PA) among employees., Materials and Methods: This was a 6-month intervention with a two-group, parallel, quasi-experimental study. A total of 11 workplaces were randomly assigned to intervention group (IG) or control group (CG) using a 1:1 allocation ratio. In each group, 84 eligible participants were recruited. The IG was exposed to the organizational support and the PA support components throughout the study. The PASR Scale, International PA Questionnaire, and pedometer were used to measure the outcome at the baseline, 3rd-month, and 6th-month follow-ups, respectively. The repeated measures-analysis of variance analysis was used to determine the changes in the PASR skills, MET-min/week, and step/week over time., Results: The IG had 75 participants (51 females and 24 males) and the CG had 73 participants (52 females and 21 males) at the 6th-month follow-up. Despite there was no statistically significant difference in the outcomes between groups over time, the IG showed significant improvements in total PASR (ηp2 = 0.021), goal setting (ηp2 = 0.024), total MET-min/week (ηp2 = 0.031), housework-related PA (ηp2 = 0.101), and step/week (ηp2 = 0.827) throughout this intervention., Conclusion: This intervention was found to be effective in improving the PASR skills, MET-min/week, and step/week of IG participants. Meanwhile, because some effect sizes were small, these findings should be interpreted with caution., (Copyright © 2024 Copyright: © 2024 Indian Journal of Public Health.)

Experiencing cancer impinges life in several ways. Research on the biographical implications of cancer has focused on its disruptive nature. Biographical renewal is not given full attention despite existing literature on positive transformations after cancer. This conceptual paper presents an account of biographical renewal in the milieu of cancer survivorship. Further, we discussed some crucial facilitators that promote the biographical renewal. Caregivers may consider biographical renewal as a substantially new goal in the survivorship care plan to improve patients' quality of life. The discussion is designed to foster an understanding of biographical renewal for the psychosocial practice by professionals with cancer patients, survivors, and their caregivers – formal and informal, to provide comprehensive care during cancer survivorship. Implications for palliative care are also discussed. [ABSTRACT FROM AUTHOR]

Reading nutrition facts labels is a competency for which training is given in several nutrition education programs, especially in obesity outreach workshops. The Top Trumps-style card game is commonly used in obesity prevention educational programs to engage participants in reading nutrition facts labels; however, the success of TV cooking shows among children and teenagers has not been explored for educational purposes. This paper is a descriptive study of developing a gamified activity as part of the one-time outreach workshop facilitated by the Obesity and Comorbidities Research Center (OCRC) in Brazil. By playing the MestreChef Nutritional (MCN) game, participants followed similar rules as the corresponding TV cooking show. They were challenged to decide to select food items, calculate dietary food intake, and prepare a recipe to visualize the proportion of macronutrients contained in daily diets. The analysis of the nutritional dietary table completed by participants revealed to be a rich source of information, and we identified in our cohort that selecting an adequate number of food items and making healthy food choices was not concerning. However, their lack of competency in performing mathematical reasoning, particularly in calculating serving sizes and converting grams of macronutrients into calories, was evident. Moreover, facilitators of the workshops agreed that the MCN game presents definitively more didactic effectiveness and playability than the Foods Top Trumps, a former game used in the outreach workshops. The MCN game nourishes the engagement of the participants in learning nutrition-related concepts and may be an efficient didactic resource to improve nutrition knowledge in outreach activities when an alternative method is required to stimulate reading nutrition facts labels.

Social media plays a significant role in adolescents' lives, with both positive and negative effects. Implementing interventions to mitigate the negative aspects and enhance the positive ones could improve adolescents' well-being. Unfortunately, there is a scarcity of evidence-based interventions available. To fill this gap, we have developed a school-based program based on combining evidence-based and consensus-based approaches, incorporating input from adolescents, school personnel, researchers, and municipal advisers. This paper describes the program's content and principles, and presents the results from a pilot evaluation, which assesses feedback from pupils and teachers, thereby informing potential enhancements and the program's overall significance. The intervention description encompasses theoretical perspectives, behavior change techniques, and procedural details. Pupils (n = 266; 16+ years) evaluated the program concerning satisfaction, relevance, importance, and usefulness through a questionnaire. Additionally, exploratory focus group interviews were conducted with seven teachers and eleven pupils to gather their perspectives on the program's relevance, impact, and potential changes to the theme-based teaching. Results from the pilot showed an average score of 7.3/10 for overall satisfaction with the program. Sub-questions assessing perceived relevance, engagement, and usefulness averaged between 6.7 and 7.5. Gender differences were observed, with boys tending to rate the program lower than girls. In focus group interviews, the pupils expressed increasing awareness of their own and others' social media use, that the topic was important and exciting, and that the program generally worked well. The pupils' evaluation indicates the need for this kind of program described in this study.

In the last two years, a growing number of studies have focused on the promotion of students' mental health to address the negative effects of the COVID-19 pandemic. However, less studies have been conducted on sustaining teachers' mental health which has been affected by the sudden changes in online teaching and the difficulties in keeping and building relationship with students. Even before the pandemic, teaching has long been recognised as one of the most challenging occupations characterized by high levels of stress. Although the research highlighted the key role of mental health promotion among teachers, there is still a lack of programs enhancing teachers' wellbeing. This study examined the impact of the PROMEHS program, a school-based curriculum, on teachers' mental health. A total of 687 teachers participated in the study. Applying a pre- and post-training study design with experimental and waiting list groups, teachers were evaluated in social and emotional learning, resilience, and self-efficacy. The results showed that there was a significant improvement in all competences of the teachers in the experimental group compared to those in the waiting list group. The paper discusses the implications of the findings with recommendations for further studies in the area.

Diabetes is a leading cause of morbidity, mortality and cost of illness 1,2 . Health behaviours, particularly those related to nutrition and physical activity, play a key role in the development of type 2 diabetes mellitus 3 . Whereas behaviour change programmes (also known as lifestyle interventions or similar) have been found efficacious in controlled clinical trials 4,5 , there remains controversy about whether targeting health behaviours at the individual level is an effective preventive strategy for type 2 diabetes mellitus 6 and doubt among clinicians that lifestyle advice and counselling provided in the routine health system can achieve improvements in health 7-9 . Here we show that being referred to the largest behaviour change programme for prediabetes globally (the English Diabetes Prevention Programme) is effective in improving key cardiovascular risk factors, including glycated haemoglobin (HbA1c), excess body weight and serum lipid levels. We do so by using a regression discontinuity design 10 , which uses the eligibility threshold in HbA1c for referral to the behaviour change programme, in electronic health data from about one-fifth of all primary care practices in England. We confirm our main finding, the improvement of HbA1c, using two other quasi-experimental approaches: difference-in-differences analysis exploiting the phased roll-out of the programme and instrumental variable estimation exploiting regional variation in programme coverage. This analysis provides causal, rather than associational, evidence that lifestyle advice and counselling implemented at scale in a national health system can achieve important health improvements., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

The transition from primary school to secondary school is an important milestone for young people and the challenges that students face at this time have been widely researched. However, there seems to be a gap in how schools proactively support students to prepare for the transition to ensure that their mental health and wellbeing is at the forefront of decision-making. With one in seven young people diagnosed with mental health problems, and puberty occurring around the time of transition, it is critical that schools consider the impact of this period of change on their students. Through a comprehensive literature review and desktop-based research, this current paper explores how schools can impact this time of heightened vulnerability by considering the importance of sense of belonging, relationships between students, staff and parents, and positive school climate. The results will reflect these areas and show that a proactive approach to mental health teacher training and whole-school programmes that develop students' social and emotional skills, resilience and relationships are key to students thriving during this transition from primary school to secondary school. This paper concludes with recommendations for schools to implement to better support the transition period to enhance the wellbeing of its students as well as suggestions for future research.

Purpose. To provide a bibliographical-historical perspective and main interest in the field of myopia. Methods. In this bibliographic study, the Web of Science Database was searched from 1999 to 2018. Recorded parameters included journal name, impact factor, year and language, number of authors, type and origin, methodology, number of subjects, funding, and topics. Results. Epidemiological assessments were the leading type of article (28%), and half of the papers were prospective studies. The number of citations for multicenter studies was significantly higher (P = 0.034). The articles were published in 27 journals, with the majority in Investigative Ophthalmology, Vision Sciences (28%), and Ophthalmology (26%). Etiology, signs and symptoms, and treatment equally encompassed the topics. Papers addressing etiology, specifically genetic and environmental factors (P = 0.029), signs and symptoms (P = 0.001), and prevention, specifically public awareness (47%, P = 0.005), received significantly more citations. Treatment to decrease myopia progression was a much more common topic (68%) than refractive surgery (32%). Optical treatment was the most popular modality (39%). Half of the publications came from 3 countries: the United States (US), Australia, and Singapore. The highest ranked and cited papers came from the US (P = 0.028) and Singapore (P = 0.028). Conclusions. To our knowledge, this is the first report of the top-cited articles on myopia. There is a predominance of epidemiological assessments and multicenter studies originating from the US, Australia, and Singapore, assessing etiology, signs and symptoms, and prevention. These are more frequently cited, emphasizing the great interest in mapping the increase in the incidence of myopia in different countries, public health awareness, and myopia control. [ABSTRACT FROM AUTHOR]

This paper presents a historical account of conceptual development at the intersection of American education and health. Beginning with early advancements from the Association for Supervision and Curriculum Development and the World Health Organization, the authors show the movement from early considerations of the codependency of health and education. The authors suggest that more than fifty years of theoretical innovations at the nexus of health and education culminated in the 2014 introduction of "Whole School, Whole Community, Whole Child" (WSCC). At the same time, the authors show that the trajectory of this movement was far from linear. In addition to explaining why WSCC is in many ways a critical revision of the social determinants model that serves today as a promising foundation of American school-based health, the authors examine opportunities and challenges that the pivot towards WSCC presents. Three particular areas are explored: assessment, funding, and collaboration.

Globally, Indigenous populations have been impacted by colonization. Populations who have endured colonization are at higher risk of developing chronic diseases. Canada's Truth and Reconciliation Commission emphasizes reducing barriers to participation in physical activity and recommends the creation of culturally relevant and supportive policies and programing. Physical activity is a cornerstone in health promotion and public health to combat chronic diseases; however, in Canada, Indigenous developed physical activity programing is sparse, and those targeting women are non-existent in some regions. Makoyoh'sokoi (The Wolf Trail Program) is an 18-week long, holistic wellness program that was created by and for Indigenous women. Makoyoh'sokoi was developed by communities following extensive consultation and cultural oversight. Makoyoh'sokoi's core program consists of 12 weeks of weekly physical activity programing and health education, followed by another 6 weeks of weekly health education. Notably, communities have control over the program to modify based on individual needs and challenges. Programs commence and conclude with a ceremony with Elders giving a blessing and opening each other to connection. The goals of Makoyoh'sokoi are to empower women, improve health outcomes, and to implement a sustainable program by training a network of community members in their respective communities to facilitate delivery., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Rural Latino children have higher rates of obesity compared to non-Latino Whites. Schools are in a unique position to address rural childhood obesity through policies. While evidence exists on factors that promote or impede school-based physical activity (PA) and nutrition policies, only a fraction has been in rural communities. This study seeks to understand 1) the knowledge and perceptions of school nutrition and PA policies and 2) barriers and facilitators to their implementation among rural school stakeholders from Washington State., Methods: We conducted 20 semi-structured, in-depth interviews with school stakeholders (e.g., principals and school nutrition directors) from four K-12 school districts in the Lower Yakima Valley of Eastern Washington State. Thematic analysis was conducted using inductive, constant comparison approach to identify themes around knowledge and perceptions of policies and barriers and facilitators of policy implementation., Results: Three main themes were identified: perceptions and knowledge of school PA and nutrition policies, barriers to policy implementation, and facilitators of policy implementation. The majority of stakeholders were supportive of school-based policies promoting PA and a healthy diet, even when lacking a specific understanding of these policies. Four subthemes were identified as barriers to policy implementation: viewing PA as a low priority, misuse of recess time, funding constraints, and lack of strong leadership. Facilitators of implementation included strong leadership at the district level, creating healthy norms through school-community linkages and pooling community resources to improve nutrition and PA among children., Conclusions: Schools provide a unique setting to promote healthy diet and PA behaviors among children and their families. Study findings show that while knowledge of specific nutrition and PA policies may vary, support for such policies were high among rural stakeholders. Study findings can inform policy development and support strategies for policy implementation in rural settings. Future studies may want to examine whether implementation of strategies addressing the barriers and enhancing facilitators lead to success in rural school settings., (© 2023. The Author(s).)

At the rapid rate that language. content, and preferences are changing around topics related to sexual health education, it is no wonder that curriculum in Canada is lagging behind. With a focus on the elementary classroom, this paper analyzes the problems associated with sexual health education in elementary classrooms and also takes a close look at some solutions for these issues. The purpose was to look at how outdated curriculum, heteronormative bias, and the negative messaging or outdated language have adverse consequences for LGBTQ+ students and the school space. Solutions include creating explicit policies within the school division that support inclusivity, continuous professional development opportunities for staff, and having active Gay-Straight Alliances that support safe spaces.

COVID-19 caught the world off-guard, bringing disruption and chaos to all sectors, including education. Within Caribbean Small Island Developing States (SIDS), the experiences were varied, as were the responses of educational stakeholders at all levels to the crisis of the pandemic. Stakeholders' experiences and responses should inform educational planning and policy, and it is against that backdrop that this research was conducted. This research captures the insights from three webinars sponsored by the Caribbean Centre for Educational Planning, which focused on challenges faced by educational institutions at the primary, secondary and tertiary levels of the education system. The transcripts from those webinars were used to construct this paper using a generic qualitative research design. The webinars pulled on the expertise of panelists from across the Caribbean and North America. The findings reveal that most stakeholders were unprepared for the challenges occasioned by COVID-19, which translated into further difficulties adapting to online/blended teaching/learning, psycho-social stresses, heightened economic challenges, and disruptions to examinations. In response to these challenges, among the stakeholders, training was implemented, open communication increased, technical and infrastructural resources were upgraded, health and safety protocols were enforced/reinforced, and domestic and international groups collaborated to bolster access for all students. Lessons learned included the need for collaboration, equity, access, and opportunities, and exercising the courage to radically rethink the region's 'educational futures' by incorporating the shared perspectives of key stakeholders in educational planning and policy making.

This study explores the social determinants of Black Canadians' exposure to everyday racism, its relationship to health system access, and implications for health promotion. We used data from the A/C Study survey on HIV transmission and prevention among Black Canadians. We implemented the survey (N = 1360) in 2018-2019 in Toronto and Ottawa-two large cities that together account for 42% of Canada's Black population-among self-identified Black residents aged 15-64 years, who were born in sub-Sahara Africa or the Caribbean or had a parent who was born in those regions. Participants reported racist encounters in the preceding 12 months using the Everyday Discrimination Scale. We assessed the socio-demographic correlates of racist experiences and the impact of racism on health system access using multivariable generalised linear models. Sixty percent of participants reported experiencing racism in the preceding 12 months. Based on the adjusted odds ratios, participants were more likely to experience racism if they were older, employed, Canadian-born, had higher levels of education, self-identified as LGBTQ + and reported generally moderate access to basic needs and adequate housing; and less likely to experience racism if they lived in Ottawa, self-identified as female or reported higher levels of social capital. Visiting a healthcare provider or facility, and difficulty accessing healthcare were associated with racist experiences. Racist experiences diminished the likelihood of being tested for HIV. Racist experiences were widespread, especially among those with higher levels of social wellbeing or greater exposure to Canadian institutions. Study participants also associated racist experiences with the healthcare system., (© 2022. The New York Academy of Medicine.)

Boarding schools, by definition, house students in residence either on campus or close by in residential facilities - where the sleep environment is likely to differ from their home environment. For boarders, being in the boarding environment occurs alongside a convergence of psychosocial and physiological factors likely to impact adolescent sleep. This paper comprises a review of the literature on sleep and boarding students in the Australian context. We also propose recommendations aligned with the scientific evidence base that can be used to promote healthy sleep in Australian boarding school students, focusing on staff training and sleep knowledge, daily routines, sleeping arrangements, and student mental health and wellbeing. It must be noted that these recommendations should be considered interim recommendations until further research is performed in the area. Further, we suggest the development of standardised practice guidelines, to ensure that student sleep is supported appropriately within the Australian boarding context.

Perinatal health and health behaviors play a crucial role in maternal and neonatal health. Data examining psychosocial factors which predict self-reported health and health behaviors as well as objective indicators downstream of health behaviors among pregnant women are lacking. In this longitudinal study design with 131 pregnant women, perceived social support was examined as a predictor of self-rated health and average levels of sleep quality, health-promoting and health-impairing behaviors, and red blood cell (RBC) polyunsaturated fatty acids across early, mid, and late pregnancy. Participants provided a blood sample and fatty acid methyl esters were analyzed by gas chromatography. Measures included the Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Prenatal Health Behavior Scale. Regression models demonstrated that, after adjustment for income, race/ethnicity, age, relationship status, pre-pregnancy body mass index, greater social support was associated with better self-rated health (p = 0.001), greater sleep quality (p = 0.001), fewer health-impairing behaviors (p = 0.02), and higher RBC omega-3 fatty acids (p = 0.003). Associations among social support with health-promoting behaviors, RBC omega-6 fatty acids, or gestational weight gain were not significant. Findings underscore the benefits of perceived social support in the context of pregnancy. Examination of pathways that link social support with these outcomes will be meaningful in determining the ways in which perinatal psychosocial interventions may promote health., (© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Background: Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited. Methods: A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included. Results: Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Conclusion: This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization. Plain English summary: Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization. [ABSTRACT FROM AUTHOR]

Background and Purpose: Neurologic physical therapy (PT) can assist people with neurologic conditions and injuries to optimize their health and well-being by addressing barriers at the individual, relationship, community, and societal levels. The purpose of this special interest article is to provide consensus-driven strategies to address barriers to implementing health promotion and wellness (HPW)-related neurologic PT practice., Summary of Key Points: Environmental scan, literature review, and expert input were used to determine barriers and develop strategies. Barriers include lack of time; low knowledge, self-efficacy, and awareness; client complexity; and lack of HPW resources; as well as concerns regarding payment and scope of practice. Four key strategies emerged: (1) develop and disseminate a consensus-based scope of practice for HPW in neurologic PT; (2) increase knowledge of resources related to HPW; (3) promote delivery models for HPW-related neurologic PT; and (4) encourage advocacy, community building and partnership along the continuum of care., Recommendations for Clinical Practice: Clinicians should practice to their full scope of HPW-related PT practice. This includes optimizing movement, including physical activity and fitness, as well as reinforcing the importance of healthy sleep, nutrition, stress, and smoking cessation. These activities address primary, secondary, and tertiary prevention. Clinicians are encouraged to report their experiences with HPW-focused delivery models and outcomes. Additional research is needed to understand the full impact of HPW on PT practice (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A364)., Competing Interests: All authors received honoraria and travel support related to this work from the Academy of Neurologic Physical Therapy as members of the Health Promotion and Wellness Task Force. Additionally, A.R. is a member of the World Health Organization Development Group for a Package of Rehabilitation Interventions for Traumatic Brain Injury. M.R.R. received additional concurrent funding from the National Institute of Disability, Independent Living, and Rehabilitation Research; Academy of Neurologic Physical Therapy; Parkinson's Foundation; and Davis Phinney Foundation. S.A.B. has a patent pending (18KU028M-02). E.C.H.B., S.F., K.J.H., and K.M. have no additional potential conflicts of interest to report., (Copyright © 2021 Academy of Neurologic Physical Therapy, APTA.)

Latina women report disproportionately high and increasing prevalence of chronic health conditions (obesity, diabetes) related to low physical activity levels. Efforts to date at addressing high rates of physical inactivity in this at-risk population have shown modest success. The original Seamos Saludables (sample size N = 266) was a culturally and linguistically adapted, print-based physical activity intervention that showed significant increases in moderate to vigorous physical activity (MVPA) from baseline to 6 months. However, only 11% of intervention participants reached the national PA guidelines of ≥ 150 min/week of aerobic MVPA. The current study tests the original Seamos Saludables intervention (Original Intervention) against an enhanced iteration Seamos Activas II (Enhanced Intervention). Study aims and intervention refinements focus on increasing the percentage of Latinas meeting national aerobic PA guidelines. For the current study (Seamos Activas II), a randomized controlled trial with (N = 199 participants) of two PA interventions (original intervention, N = 102; vs. enhanced intervention, N = 97) was conducted. Intervention refinements involved further targeting key constructs of the Social Cognitive Theory and incorporating text-message-based strategies for self-monitoring, in response to participant feedback for greater interactivity and accountability. PA assessments were conducted at baseline and 6 months. The sample was predominantly Mexican American (89%) with average age of 43.8 years (SD = 10.11) and mean BMI at baseline was 30.6 (SD = 7.56). There were significant within group increases in MVPA from baseline to 6 months (p < .05) in both Original and Enhanced Intervention arms. However, quantile regression models did not indicate significant differences in 6-month outcomes between conditions controlling for baseline, p = 0.73. There were significant differences between conditions with respect to meeting national guidelines for aerobic MVPA at 6 months, with 57% of Enhanced Intervention participants meeting guidelines compared to 44% of Original Intervention participants, OR = 1.66, 95% CI: 1.09 -2.89. Models suggest trends favoring the enhanced condition for improvements in biomarkers over 6 months. Findings indicate that the intervention enhancements likely helped more Latinas achieve nationally recommended, health enhancing PA levels than the original intervention and showed promise for improving physiological response to exercise.Trial Registration ClinicalTrials.Gov; NCT02630953. Registered 14 December 2015. https://clinicaltrials.gov/ct2/show/NCT02630953 ., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The 45 and Up Study (the Study) is the largest study of healthy ageing in Australia and one of the biggest in the world. This review considered papers on physical activity in the first 15 years since the cohort was launched. Methods: This narrative review extracted papers in the Study inventory of publications and supplemented by searches in Scopus and Medline databases. Results: A total of 114 papers were identified, but after dual assessor extraction, 92 published articles were included that used physical activity as an exposure or outcome measure or reported physical activity prevalence in the sample studied. Results indicated that half of these physical activity studies used a cross sectional design. The 45 and Up survey responders were a highly active group, with three quarters meeting WHO recommended levels of physical activity. Optimal use of the longitudinal nature of this cohort linked physical activity exposures to a range of new health, environmental and wellbeing outcomes, and these papers were the most cited among 45 and Up physical activity papers. Nineteen of these 92 papers have been cited 50+ times, indicating good usage of 45 and Up physical activity data by the field. Discussion & Conclusion: Physical activity-related research has been an important part of the overall output of the 45 and Up Study, but recommendations for future research include greater use of the longitudinal nature of the cohort, more standardisation in the way physical activity estimates are described, and using waves of the 45 and Up Study physical activity data to explore patterns of activity over time as the exposure variable in relation to health outcomes. [ABSTRACT FROM AUTHOR]

Background: Cancer outcomes are poor in socioeconomically deprived communities, with low symptom awareness contributing to prolonged help-seeking and advanced disease. Targeted cancer awareness interventions require evaluation., Methods: This is a randomised controlled trial involving adults aged 40+ years recruited in community and healthcare settings in deprived areas of South Yorkshire and South-East Wales., Intervention: personalised behavioural advice facilitated by a trained lay advisor., Control: usual care. Follow-up at two weeks and six months post-randomisation., Primary Outcome: total cancer symptom recognition score two weeks post-randomisation., Results: Two hundred and thirty-four participants were randomised. The difference in total symptom recognition at two weeks [adjusted mean difference (AMD) 0.6, 95% CI: -0.03, 1.17, p = 0.06] was not statistically significant. Intervention participants reported increased symptom recognition (AMD 0.8, 95% CI: 0.18, 1.37, p = 0.01) and earlier intended presentation (AMD -2.0, 95% CI: -3.02, -0.91, p < 0.001) at six months. "Lesser known" symptom recognition was higher in the intervention arm (2 weeks AMD 0.5, 95% CI: 0.03, 0.97 and six months AMD 0.7, 95% CI: 0.16, 1.17). Implementation cost per participant was £91.34, with no significant between-group differences in healthcare resource use post-intervention., Conclusions: Improved symptom recognition and earlier anticipated presentation occurred at longer-term follow-up. The ABACus Health Check is a viable low-cost intervention to increase cancer awareness in socioeconomically deprived communities., Clinical Trial Registration: ISRCTN16872545., (© 2021. The Author(s).)

We assessed human papillomavirus (HPV) prevention practices and HPV literacy of pediatricians, family physicians and medical students in North Carolina. An online survey was distributed to physicians in 2018, and paper surveys were collected among medical students in 2019. Surveys measured HPV literacy, HPV prevention practices and HPV prevention self-efficacy. In terms of comfort, 27% of medical students and 24% of physicians anticipated having an uncomfortable conversion when recommending the vaccine to patients. Most physicians (76%, n = 230) followed the HPV vaccine age recommendation guidelines; however, those with higher HPV vaccine knowledge were more compliant with the guidelines (P < 0.01). Female physicians were more likely to start routinely recommending the HPV vaccine to women (84%, n = 134 versus 72%, n = 92) and men (81%, n = 127 versus 71%, n = 84) between the ages of 9 and 12 years (P < 0.05). Only 27%, n = 73 of physicians and 18%, n = 19 of medical students followed/knew the 'provider-driven' HPV-recommended style. Female physicians were more likely to use this communication style (32%, n = 48 versus 20%, n = 23, P = 0.03). HPV prevention curriculum should be incorporated into medical programs. The gender-related practice patterns found indicate a need for training of male providers specifically. Quality improvement efforts are needed for all physicians to strengthen vaccine communication, recommendation practices and guideline adherence.

Spinal deformities and back pain are growing problems in childhood and adolescence, due to unhealthy habits. This study undertook a scoping review to identify scientific studies with children and adolescents, focusing on the methodologies used, implementation of key factors and gaps, and results of postural education programmes to promote sustainable healthy habits. The methodological tool PRISMA-ScR was used. Five online databases were used to identify papers published since 2013. Eligibility criteria were defined, and the search strategies were drafted. A total of 86 publications were initially identified; after screening and applying eligibility criteria, 11 papers were included in this study for detailed analysis. The postural education programmes in these papers mainly focused on adolescents' postures and postural learning acquisition, using different teaching methodologies; only one study was conducted with children between 5 and 6 years old enrolled in preschool. Follow-up studies revealed inconsistent results. However, developing and measuring the effectiveness of young children's postural education programmes, to enhance experiences of movement variability and strategies for postural control in playful activities, is of great relevance for children's healthy development, and can also have positive impacts on environmental and social sustainability by promoting healthy and conscious lifestyles. [ABSTRACT FROM AUTHOR]

As a super-aging society, health promotion activities in local Japanese communities are increasingly essential. Developing the health-promotion programs must include the perspective of older people residing in these communities and what they believe to be their regional strengths. This study aimed to clarify the elements of regional strengths perceived by older people living in local Japanese communities from the literature review. Using the internet edition of the Japan Medical Abstracts Society (Ichu-shi), the authors examined papers on Japanese regional residents using relevant keywords. Of 342 considered papers, 14 papers were extracted in this study. As a result, the contents related to the regional strengths perceived by the older people living in the local Japanese community were extracted, classified based on the similarity of the meanings and contents, and then summarized into the elements of the strengths. As the regional strengths, three categories were cited for individual elements: "Actions or behaviors underpinned by experience," "Continuing to live with positivity and vigor," and "Extensive support for the subject and their family." Three categories were cited for environmental elements: "A comfortable environment," "Maintaining intimate and friendly interpersonal relations," and "Support that meets the regional characteristics." Along with individual and environmental elements, support from experts in the region was cited. Hence, it was concluded that the active participation of experts is essential for promoting activities in local communities, and that deepening relationship with older people has the potential to improve their quality of life. [ABSTRACT FROM AUTHOR]

The article discusses the call for papers on building a health economy for all in 2023. Topics covered include the existing structural and economic inequalities exposed by the pandemic, and the reorientation of economies for health towards a vision in which every person and people can flourish physically and mentally with dignity and opportunity in a healthy living planet. Also noted are the four themes to build economies for health that the World Health Organization (WHO) Council focuses on.

Background: Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16–25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. Methods: Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. Results: To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. Conclusions: This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement. Keywords: Aboriginal, Torres Strait Islander, Indigenous, Australia, male, cultural adaptation, social media, mental health, masculinities, social support. [ABSTRACT FROM AUTHOR]

Background: Addressing wellbeing at the community level, using a public health approach may build wellbeing and protective factors for all. A collaborative, community-owned approach can bring together experience, networks, local knowledge, and other resources to form a locally-driven, place-based initiative that can address complex issues effectively. Research on community empowerment, coalition functioning, health interventions and the use of local data provide evidence about what can be achieved in communities. There is less understanding about how communities can collaborate to bring about change, especially for mental health and wellbeing. Method: A comprehensive literature search was undertaken to identify community wellbeing initiatives that address mental health. After screening 8,972 titles, 745 abstracts and 188 full-texts, 12 exemplar initiatives were identified (39 related papers). Results: Eight key principles allowed these initiatives to become established and operate successfully. These principles related to implementation and outcome lessons that allowed these initiatives to contribute to the goal of increasing community mental health and wellbeing. A framework for community wellbeing initiatives addressing principles, development, implementation and sustainability was derived from this analysis, with processes mapped therein. Conclusion: This framework provides evidence for communities seeking to address community wellbeing and avoid the pitfalls experienced by many well-meaning but short-lived initiatives. [ABSTRACT FROM AUTHOR]

Background: Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Methods: Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Findings: Twenty‐seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. Conclusions: The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti‐racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence‐based mental health care provisions to tackle mental health inequities. Patient and Public Involvement: This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region. [ABSTRACT FROM AUTHOR]

The phenomenon of chemsex has emerged as an essential public health issue in recent years. This systematic review aimed to investigate currently available harm reduction strategies and to evaluate the efficacy of the corresponding interventions. Methods: A systematic review of the scientific literature related to harm and risk reduction strategies and the effectiveness of chemsex interventions. Between January 2024 and May 2024, the articles were retrieved from the electronic databases Pubmed, Web of Science, Scopus, PsycInfo, Cochrane, Dialnet, CUIDEN, and SciELO. The review protocol was registered in the PROSPERO database (registration number CRD42024508953). The inclusion criteria were as follows: (I) original studies published in peer-reviewed journals, (II) studies exploring harm reduction interventions for chemsex, and (III) studies reflecting the efficacy of harm reduction interventions for chemsex. Two reviewers independently selected articles by title, abstract, and full paper review and extracted data. Two authors described the selected studies and assessed their methodological quality. Results: The systematic review comprised six scientific papers that met the selection criteria and were obtained from five countries. Although a limited number of studies were included, it was observed that they presented a medium–high methodological quality. Programs evaluated interventions to reduce harm from chemsex, such as a web-based intervention that improved self-efficacy to refuse risky behaviors and accept HIV testing. The studies suggested that peer-led programs can be effective, especially with facilitators who have experienced chemsex dependence. Conclusion: Harm reduction strategies in chemsex are effective and should be promoted by health professionals. Interventions should be accessible, personalized, and non-judgmental to provide appropriate care and support, ensuring a comprehensive and effective public health response. [ABSTRACT FROM AUTHOR]

Background: Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students' main meal choices, meal offer satisfaction and liking. Methods: A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results: Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p < 0.001) during control and intervention periods, respectively. The end-of-study questionnaire (n = 510) revealed that only 6% of students noticed a change the availability of vegetarian main meals. The intervention led to a decrease in the environmental impact of the main meals chosen, a slight decrease in nutritional quality, a slight increase in meal costs and no change in food waste. Conclusions: Doubling availability of vegetarian main meals in a university cafeteria resulted in a twofold increase in their selection, with students reporting being more satisfied and liking the main meals more during the intervention period. These results suggest that serving an equal proportion of vegetarian and nonvegetarian main meals could be considered in French university cafeterias to tackle environmental issues. Trial registration: Study protocol and analysis plan were pre-registered on the Open Science Framework (https://osf.io/pf3x7/). [ABSTRACT FROM AUTHOR]

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]

Primary health care (PHC) has increased in global relevance as it has been demonstrated to be a useful strategy to promote community access to health services. Multilateral organizations and national governments have reached a consensus regarding the basic principles of PHC, but the application of these varies from country to country due to the particularities of local health systems. This article aims to review and summarize PHC strategies and the configuration of health networks in Latin American and Caribbean countries. The review was carried out using keywords in at least 9 databases. Papers in languages other than English, Portuguese, and Spanish were excluded, while non-refereed articles and regional gray literature were incorporated. As a result, 1,146 papers were identified. After three instances of analysis, 142 articles were selected for this investigation. Data were analyzed according to an analysis by theme. The evidence collected on health reforms in the region reflects the need to intensify care strategies supported by PHC and care networks. These must be resilient to changes in the population's needs and must be able to adapt to contexts of epidemiological accumulation. [ABSTRACT FROM AUTHOR]

Infant and young child feeding (IYCF) promotion is a key component in the set of high impact interventions to improve nutrition. The literature provides evidence of the positive impact of IYCF promotion through various platforms, including communities. In 2009, UNICEF and WHO agreed that a global, "generic" IYCF package of resources and tools to plan, implement, and monitor community‐based IYCF programmes and to build skills of community‐based workers was needed. In 2010, the UNICEF Community Infant and Young Child Feeding Counselling Package was finalized and field tested under a strategic collaboration between UNICEF New York and Nutrition Policy and Practice and the Center for Human Services/University Research Company. The Package includes 11 tools to guide adaptation of the materials, the design, planning, and implementation of IYCF programmes and the training, monitoring, supervision, and mentoring of community workers, using an interactive and experiential adult learning approach. The Package was rolled out from 2011 onwards and by 2017 was implemented in 87 countries. In 2013, UNICEF and the United States Agency for International Development‐funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally project started planning the evaluation, and a study site was selected in Nigeria to assess the efficacy and effectiveness of the Package on IYCF practices, knowledge, and worker skills. This article describes the need for and development of the Package, its content and approach to skills building, as well as its current implementation. Finally, it makes the case for the evaluation of the Package, which is covered in the other papers in the Supplement in relation to the Nigeria evaluation. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) promotion in healthcare systems is one of the priority areas highlighted by the World Health Organization, which recognizes that progress has been slow largely due to a lack of awareness and investment while requiring a system-based approach. Community pharmacies are one of the health structures that are more easily accessible to populations, thus constituting an ideal venue for developing health promotion activities. This research aimed to describe PA-enabling interventions developed in community pharmacies by pharmacists. Methods: An electronic search was performed in PubMed, Scopus, Web of Science, Cochrane and reference lists of the different papers until June 2023. Studies were eligible if performed in community pharmacies by pharmacists, focused on interventions aimed at increasing PA levels and if at least one PA-specific outcome was measured at two different time points. Results: We identified 7076 publications in the initial search, plus 31 records identified through backward citation tracking from relevant studies. After an initial screening, 236 were selected for full-text analysis. Of the 29 selected papers, 10 presented a low risk of bias for the measurement of PA levels. PA outcomes were generally self-reported outcomes where the change in terms of the percentage of individuals considered active or who increased PA because of the intervention. Conclusion: Several interventions to improve PA through community pharmacies were found although with a high level of heterogeneity and with only few with a low risk of bias. More targeted research that aims to capture PA levels and support the training of healthcare professionals is needed. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) is the process supporting individuals with life-limiting illness to make informed decisions about their future healthcare. Ethnic disparities in ACP have been widely highlighted, but interpretation is challenging due to methodological heterogeneity. This review aims to examine differences in the presence of documented ACP in individuals' care records for people with advanced disease by ethnic group, and identify patient and clinician related factors contributing to this. Methods: Mixed-methods systematic review. Keyword searches on six electronic databases were conducted (01/2000–04/2022). The primary outcome measure was statistically significant differences in the presence of ACP in patients' care records by ethnicity: quantitative data was summarised and tabulated. The secondary outcome measures were patient and clinician-based factors affecting ACP. Data was analysed qualitatively through thematic analysis; themes were developed and presented in a narrative synthesis. Feedback on themes was gained from Patient and Public Involvement (PPI) representatives. Study quality was assessed through Joanna Briggs Institute Critical Appraisal tools and Gough's Weight of Evidence. Results: N=35 papers were included in total; all had Medium/High Weight of Evidence. Fifteen papers (comparing two or more ethnic groups) addressed the primary outcome measure. Twelve of the fifteen papers reported White patients had statistically higher rates of formally documented ACP in their care records than patients from other ethnic groups. There were no significant differences in the presence of informal ACP between ethnic groups. Nineteen papers addressed the secondary outcome measure; thirteen discussed patient-based factors impacting ACP presence with four key themes: poor awareness and understanding of ACP; financial constraints; faith and religion; and family involvement. Eight papers discussed clinician-based factors with three key themes: poor clinician confidence around cultural values and ideals; exacerbation of institutional constraints; and pre-conceived ideas of patients' wishes. Conclusions: This review found differences in the presence of legal ACP across ethnic groups despite similar presence of informal end of life conversations. Factors including low clinician confidence to deliver culturally sensitive, individualised conversations around ACP, and patients reasons for not wishing to engage in ACP (including, faith, religion or family preferences) may begin to explain some documented differences. Trial registration: PROSPERO-CRD42022315252. [ABSTRACT FROM AUTHOR]

Background: Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas., Methods: A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document., Results: Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards., Conclusions: Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S., (© 2024. The Author(s).)

Background: Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems., Methods: This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP., Results: We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation., Conclusions: NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [JA – member of the Steering Group of the Scottish Social Prescribing Network; associate member of the One Health Breakthrough Partnership; and member of the Pharma Pollution Hub. ML – director of Social Prescribing Evidence Hub in Ireland and author of the first social prescribing book. GI − scientific and therapeutic interest in NBSP, its implementation into the German health system to foster nature-based intervention for prevention and therapy. KK − offers nature-based and sustainable interventions in the field of prevention and therapy at VERDE in Leipzig, Germany. SP – co-founder of One Health Breakthrough Partnership in Scotland, and advisor to the Pharma Pollution Hub in England. JR − active and ongoing interest in NBSP, its implementation, and how NBSP can benefit wetland conservation. KW − Clinical Supervisor for the Active Health Link Worker Project, Velocity Cafe & Bicycle Workshop social enterprise, funded by NHS Highland and Transport Scotland.]., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

As Workplace Health Promotion is spreading among several working environments, the university context seems to be one of the best to apply primary prevention activities. Working in this direction, the University of Torino led the Wellness@Work for UniTo Project (W@W), with the aim of promoting employees' health. Internal university professionals assessed body composition and adherence to the Mediterranean diet (MD), giving on-target advice for improving lifestyle. The aim of this paper is to evaluate the effectiveness of the W@W Project after a 4-month intervention period. This project was addressed to university employees, who could participate on a voluntary basis. Researchers assessed (T1) socio-demographic information and collected anthropometric variables. Body composition was evaluated through Classic and Specific Bioelectrical impedance Vector Analysis (BIVA). Adherence to the MD was assessed through the Medi-Lite questionnaire. After the assessments, participants were given 5-min counselling from internal professionals. After about 4 months, participants were supposed to undergo same assessments (T2). Overall, 479 workers joined the project, and of those, 246 came back for the T2 assessment. Globally, either anthropometric, body composition, or MD variables improved significantly after 4 months, both for male and female samples, suggesting how an easy-to-apply WHP intervention could help to improve workers' health.

Human-centred design (HCD) is an approach to problem-solving that prioritises understanding and meeting the needs of the end-users. Researchers and designers practice empathic listening as users share their perspectives, thereby enabling a variety of stakeholders to cocreate effective solutions. While a valuable and, in theory, straightforward process, HCD in practice can be chaotic: Practitioners often struggle to navigate an excess of (often conflicting) ideas and to strike a balance between problem-understanding and problem-solving. In this practice paper, we outline our own experiences with HCD, which ultimately resulted in the development of a successful video-based intervention to bolster vaccine confidence in the Philippines. We highlight the use of 'radical circles' to overcome roadblocks and navigate tensions. Radical circles entail groups of individuals with divergent opinions and identities engaging in critical analysis of a given idea, actively challenging standard ways of thinking, and ultimately, generating solutions. Employing radical circles enabled us to innovate and adapt to new perspectives that emerged along the non-linear HCD pathway. Our incorporation of radical circles into HCD methodology demonstrates its potential as a powerful complementary step in the meaning-making process. In our view, radical circles could enrich HCD processes and provide a solution to design overcrowding, leading to meaningful, transformative and successful interventions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Active outdoor play is important for children's health and development, and playgrounds provide good places for play. However, the importance of playground use for health and well-being is unclear. Our scoping review aims to create an overview of all research on playground use and health benefits for children., Methods: Scopus, Web of Science, SportDiscus, and PsycInfo were searched using two search blocks, focusing on 'playground' and 'children' respectively, for publications from 2000 to November 2023. The primary inclusion criterion was examining the relationship between playground use and positive physical, mental, or social health outcomes. Only papers published in English were reviewed. For each publication, we synthesized and condensed the results, categorizing them by playground setting, reported health outcome, participant age group, study design, methodologies, publication's country, year, and 'stage of evidence'., Results: Data from 247 studies were extracted and nearly 80% of these publications were descriptive or exploratory studies. Fifty-two were intervention studies. Adding playground markings to schoolyards led to increased physical activity. Greening schoolyards had mainly positive effects on social and mental health. In Early Childhood Education and Care, renewing play structures had a positive effect on physical activity in three publications. All Public Open Space interventions we found were different, with mixed effects on health outcomes., Conclusions: The existing evidence provides good arguments for policy makers, city planners and school-leaders to invest in adding playground markings in schoolyards as this will likely result in more physical activity. The evidence for the health benefits of investing in new play structures indicated that tailoring the playground to local needs is important as 'one size does not fit all' and playgrounds need to be designed as engaging and interesting places for children's play if they are to generate health benefits. Investing in 'greening' playgrounds is likely to result in social and mental health benefits for children, but does not always result in more physical activity. The research field needs more efficacy and effectiveness studies, and in particular replication and scale-up studies to demonstrate which type of playground interventions are successful., Protocol: The review protocol was registered at Open Science Framework ( https://doi.org/10.17605/OSF.IO/UYN2V )., (© 2024. The Author(s).)