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It has been suggested that the new public health is but nannyism in a different guise and that its advocates are the equivalents of health fascists. It will be argued that a form of paternalism (or maternalism) has always been inherent in public health and that to treat illness as if it was wholly a personal possession is to abdicate the government's responsibility for ensuring a healthy environment.

Intervention research is of significance because the failure or success of particular interventions may have influence on policy and practice. Poorly designed interventions may impede progress in health and safety. Frequently, interventions are based on scientific/ technical definitions of occupational health and safety problems but involve intrusion into complex sociotechnical work environments. Intervention research must be built on a solid foundation of social science research. An example of research useful to health and safety intervention is the Gray Institute study of management practices in the chemical industry that was commissioned by OSHA a few years ago. It focused on safety management in chemical manufacturing firms and their contractors, including a survey of managers and contractors and nine intensive case studies of particular plants. The study describes safety management practices in the best firms in the industry. Such research can provide the groundwork for effective safety interventions in the industry, including training and training requirements, experimentation with redefined managerial responsibilities, regulation of contractors, and others. It also suggests the kinds of useful data that might be collected by NIOSH in the normal course of health and safety studies. Finally, it suggests that the interdisciplinary teams currently investigating occupational health and safety should be expanded to include social scientists.

This paper addresses some issues related to the hypothesis that the risk for premature death is a J-shaped function of alcohol intake. The first part of the paper contains a discussion of the individual level epidemiological evidence. It is argued that the evidence is not yet good enough to allow precise statements about "safe limits", nor does it allow a precise location of the "optimum" consumption level. Measurement errors and confounding variables not yet controlled for remain substantial problems. In particular, future studies need to control for social integration, as this factor may affect both health status and alcohol consumption. The second part of the paper discusses the population level relationship. It is argued that, typically, what is optimum for an individual is too much for a population. Unintended side effects of major public health importance should be expected in this area. In the last section, a plea is made for aggregate level studies as a way of addressing the public health side of the issue.

Background: Infographics facilitate rapid information dissemination with enriched eye‐catching content on social media, but it is unclear what factors affect the adoption of information presented in this way. Objectives: We tested whether the Information Acceptance Model applies to infographics on healthy lifestyle and fitness topics. Methods: Two hundred and four university students were invited to participate in an online survey on their acceptance after reading some healthy lifestyle and fitness topics infographics shared on social media. The data collected were analysed using Partial Least Square path modelling. Results: The results confirmed information usefulness as a predictor of information adoption; attitude towards information and information adoption were the predictors of behavioural intention. Information credibility and attitude towards information, but not information quality and needs, were significantly related to information usefulness. Social media usage and education level were factors affecting infographics impressions. Discussion: Results support most hypotheses. It confirms information usefulness as a predictor of infographics adoption. Attitudes towards information and information adoption are predictors of behavioural intentions of following healthy lifestyle and fitness suggestions through social media infographics. Conclusion: Social media facilitates interpersonal communication, information exchange and knowledge sharing, and infographics may draw people into healthy lifestyle and fitness information items relevant to them. [ABSTRACT FROM AUTHOR]

Objectives: To map the current evidence about the health concerns and the potential solutions related to the Islamic pilgrimage to Mecca. Design: A scoping review was applied. Papers published in English between 2012 and 2023 were included but non‐human research and sources without any related data were excluded. Data charting and extraction were used to map the current evidence. Results: The total of 36 papers were included with the total number of pilgrims of 17,075,887. The majority of studies were published in the Asia Pacific region (36.11%) as original articles (88.89%). The health concerns were grouped into five main aspects. There were 7603 deaths recorded or about 44 incidences of deaths per 100,000 pilgrims during the pilgrimage. There were recorded 11,018; 6178; 3393; and 17,810 cases for communicable diseases; non‐communicable diseases; injuries and trauma; and health services (i.e., cardiac catheterization) and vaccination, respectively. Conclusion: Relating to the five health concerns, this study identified the top seven issues in each category (i.e., hypertension, influenza vaccination), except for the death record. Moreover, there were three solutions (for general health, non‐ and communicable‐diseases) presented. Stakeholders could use this evidence to improve healthcare quality particularly related to the annual Islamic pilgrimage to Mecca. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effectiveness of a school‐based multiple health behaviour change e‐health intervention for modifying risk factors for chronic disease (secondary outcomes). Study design: Cluster randomised controlled trial. Setting, participants: Students (at baseline [2019]: year 7, 11–14 years old) at 71 Australian public, independent, and Catholic schools. Intervention: Health4Life: an e‐health school‐based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. Main outcome measures: Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol‐related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). Results: A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow‐up survey, 5698 (85.8%) two or more follow‐up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57–2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64–1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72–1.38); tobacco use frequency: relative difference, 0.03 (95% CI, –0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, –0.34 (95% CI, –1.16 to 0.49) days per 30 days; device use time: relative difference, –0.07 (95% CI, –0.29 to 0.16) hours per day. Conclusions: Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e‐health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective). [ABSTRACT FROM AUTHOR]

Background: The present study was conducted with the aim of designing and validating questionnaires for evaluating the public health students' knowledge, performance, and satisfaction (KPS) in the course of educational technology. Methods: The present study was conducted with qualitative‐quantitative approach. Qualitative stage was done based on experts' opinion and related articles and questionnaires for developing, designing, and validating the tools. For validating the tools, face validity and content validity was done based on the opinion of the 10 expert panel. In quantitative stage, all initial validated tools were implemented on 50 students of public health for determining the reliability. The reliability of the tools was calculated using the internal consistency method of the items with Cronbach's ⍺ coefficient, and Kuder–Richardson. All analyses were conducted using SPSS‐19 software. Results: In the field of qualitative research, an assessment tool consisting of 20 four‐option questions was designed. The content validity of this tool was confirmed based on the opinions of 10 educational experts, with CVI Total = 0.862 and CVR = 0.885. Additionally, the reliability of the tool was validated through testing on 50 public health students, resulting in a reliability coefficient of r = 0.780. Furthermore, for performance evaluation, four assessment tools each comprising 20 questions (totaling 80 questions) were designed. The validity values for these tools in the areas of PowerPoint (CVI = 0.981, CVR = 0.960), pamphlet (CVI = 0.866, CVR = 0.877), poster (CVI = 0.871, CVR = 0.906), role‐playing (CVI = 0.871, CVR = 0.980), and the reliability of the tools with Cronbach's ⍺ r > 0.80 were confirmed. In the satisfaction assessment section, a researcher‐made questionnaire consisting of 18 questions across seven domains was designed, with confirmed content validity (CVI = 0.949, CVR = 0.861) and reliability (r = 0.928). Conclusions: It seems that this tool can be used to measure the KPS of students from the educational technology course of the health field and similar fields. [ABSTRACT FROM AUTHOR]

Background: In underdeveloped nations like Ethiopia, severe acute malnutrition (SAM) is one of the most pressing public health issues. Despite efforts to pinpoint the causes of SAM, the impact of parents' drug usage on their children's nutritional status remains unclear and unresolved. Objective: The purpose of this research was to determine the risk factors for SAM in children under five who were attending medical facilities in the Leqa Dulacha district. Materials and Methods: A health facility‐based case‐control study was carried out from March 1 to July 30, 2022, with 256 children under the age of five. Random sampling was used to identify study participants in a methodical manner. Mothers and other child caretakers were interviewed using a structured questionnaire and anthropometric measurements were performed using standardized, calibrated equipment. Epi‐data version 3.1 was used to code and enter the data, and it was then exported to IBM SPSS for analysis. An analysis of multivariable binary logistic regression was conducted, and the measure of association employed was the adjusted odds ratio (AOR), with a 95% confidence interval (CI). Results: A total of 96.5% of respondents responded. SAM in children was significantly correlated with the following factors: parent alcohol consumption [AOR = 3.142; 95% CI = (1.104, 8.945)]; child illness in the previous 15 days [AOR = 4.122; 95% CI = (1.686, 10.07)]; poor dietary diversity [AOR = 3.044; 95% CI = (1.189, 7.788)]; household food insecurity [AOR = 4.024; 95% CI = (1.544, 10.490)]; and parent chewing chat [AOR = 3.484; 95% CI = (1.329, 9.134)]. Conclusions: A number of factors have been linked to SAM in children, including the use of health services, the child's illness within the previous 15 days, food security, child feeding practices, and parent substance use. Therefore, it is important to emphasize the value of health education programs on child feeding habits, particularly the significance of dietary diversity, and to work together to modify the way that parents raise their children. [ABSTRACT FROM AUTHOR]

Objective: In community health, there is great demand but limited time for the delivery of staff and patient education. During the COVID‐19 pandemic, evolving needs necessitated that health education be provided in an accurate and timely manner. This paper describes the development, implementation, and evaluation of a YouTube channel designed to disseminate health education to a wide audience of public health workers and patient populations. Methods: This project, divided into three phases, originated within shelter‐based care, providing education to shelter staff (Phase 1) and overtime has evolved to provide education within the Community Health Worker Hub at a major teaching hospital for community health workers (Phase 2) and the populations they serve (Phase 3). Further, during phase 3, the project developer used an artificial intelligence (AI) platform to increase the reach of the YouTube channel. Results: Over a span of 21 months, 18 unique videos have garnered 489 views. Conclusions: Clinicians and educators can leverage technology platforms for health education delivery, increasing the reach of their work while meeting the demands of the profession. While the quality of some information on YouTube may be poor, patients and students turn to this platform for health education. It is imperative that public health nurses embrace this medium, rather than push against it. By creating high‐quality content, educating students and patients about DISCERN and PEMAT tools, and guiding patients to credible sources, public health nurses may ameliorate the standards of health education on YouTube. [ABSTRACT FROM AUTHOR]

Essential life skills related to food and meals have a potential triple dividend for children and adolescents, that is, short-term, medium-term and possible generational effects with regard to public health, sustainability and well-being of future citizens in local communities. While parents and childhood environments are a basis for learning about food and meals, systematic food education in the setting of primary and lower secondary schools may have a significant role that should be utilized more strongly, reaching and benefitting all pupils from a life course perspective. Through this article, we explore the current state of the art of the mandatory school subject Food and Health (FH) from the Nordic perspective. Our leading questions are: (1) What potential is currently utilized and which future potential does FH education have in primary and secondary schools in terms of food education for essential life skills and competencies, and (2) How can this untapped potential be better harnessed with a goal of facilitating better learning in FH? Drawing on data from Norway as a case study, supported by Swedish and Finnish data, we discuss the status, challenges and potential reformation of food education, focusing on FH. This includes perspectives on the prioritization of the FH subject and the organization of more systematic food education in schools, which might improve FH's status and significance. Combining theory-practice, creating room for discussion and focusing less on cooking-related activities may better facilitate learning in FH. Without proper FH, food education might be nonsystematic, thereby generating unequal outcomes for children and adolescents. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dental caries (cavities) experience is prevalent in US children, and national data show rates to be increasing among young children. Disparities are found for those in the low‐income and non‐Hispanic Black and Hispanic/Latinx groups. Use of caries prevention, specifically dental sealants, is low, even among school‐based programs. CONTRIBUTIONS TO THEORY: A population health management (PHM) framework may support targeted school‐based case management to reduce oral health disparities. PHM‐oriented tools were applied to a school‐based oral health intervention and developed into a conceptual model. From 2014 to 2019, Chicago‐based Oral Health Forum (OHF) developed a case management intervention in schools, utilizing PHM tools. Through programmatic and school‐based partnerships, the PHM tools informed intervention to incorporate community‐based organizations, case management staffing, oral health education, targeted community outreach, and Community Dental Health Coordinators' training. CONCLUSIONS: Through a PHM framework, school‐based oral health partnerships targeting high‐need children was implemented. Use of PHM tools in school‐based health programs should be considered in other high caries schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescents are more susceptible than originally thought to COVID‐19, and they could play a significant role in community transmission. We aim to evaluate a health education program on students' declarative knowledge and risk awareness concerning COVID‐19‐related public health recommendations. METHODS: A quasi‐experimental pre‐post pilot study was conducted. A number of 487 students aged between 12 and 17 years old participated in an educational program. Following Socratic Method, preventive actions were simulated in order to encourage students to seek answers about the correct application of measures. The program covered 3 prevention areas: (1) practice hygienic handwashing; (2) instruction on the appropriate use of masks; and (3) promotion of physical distancing, and was implemented in class by 3 registered nurses. RESULTS: Following the educational program, declarative knowledge regarding handwashing and mask use improved along with the students' total score. In the pre‐test, students 16 years and older as well as female students obtained higher scores in declarative knowledge. Age‐dependent differences between groups vanished in the post‐test, but girls still achieved better scores. CONCLUSION: This nurse‐led health education program proved to be effective to enhance declarative knowledge about COVID‐19‐related public health recommendations. [ABSTRACT FROM AUTHOR]

Objectives: Health literacy (HL) about healthy cognitive aging is essential in preventing cognitive decline and promoting cognitive well‐being. It is important that one such HL module should be scientifically designed, delivered in a technically sound manner to the audience, and specific to the context. The present study thus aimed at developing and validating educational multimedia about cognitive health. Methods: The study followed a methodological framework and was carried out across three phases, that is, identification of themes, development and validation of educational script and design, and validation of educational multimedia. The module was scripted based on the Integrated HL framework and the recommendations made during the modified nominal group technique among the research team. Seven speech‐language pathologists (SLPs), with expertise in the field of cognitive sciences, and 15 representatives of the general public validated the module using the Educational Content Validation Instrument in Health and the Patient Education Materials Assessment Tool for Audiovisual Materials questionnaire. Results: The scientific content of the educational script received satisfactory agreements among the experts (content validity index [CVI]: 0.93) and representatives of the general public (CVI: 0.86). The technical aspects of the educational multimedia were rated to have high understandability (experts: 92.8%; representatives of general public: 98.8%) and actionability (experts and representatives of general public 100%). Conclusion: Overall, the developed educational multimedia scored optimally with respect to the objective, structure, relevance of the content, actionability and understandability of the multimedia. The developed module holds the potential to be used at community and national level health educational programs or awareness campaigns to enhance public knowledge and beliefs pertaining to cognitive health. Patient or Public Contribution: SLPs with expertise in the field of cognitive science and representatives from the general public were included to validate and obtain feedback on the developed educational multimedia. [ABSTRACT FROM AUTHOR]

A number of authors criticise opt‐out (or 'deemed consent') systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt‐out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt‐out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt‐out system without one. While it may be that some countries with opt‐out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt‐out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this scoping review was to identify recommendations and gaps in knowledge surrounding the prevention of disordered weight control behaviors (DWCBs) through policy. Method: A search was conducted in several databases to identify English language articles that described an active policy, recommendation, guideline, or educational curriculum that could be implemented by governments or regulatory bodies to prevent DWCBs or related constructs (e.g., weight stigma, body dissatisfaction). Two researchers independently screened articles with oversight from a third researcher. Data were extracted from the final sample (n = 65) and analyzed qualitatively across all articles and within the domains of education, public policy, public health, industry regulation, and media. Results: Only a single empirical evaluation of an implemented policy to reduce DWCBs was identified. Over one‐third of articles proposed recommendations relating to industry regulation and media (n = 24, 36.9%), followed by education (n = 21, 32.3%), public policy (n = 19, 29.2%), and public health (n = 10, 15.4%). Recommendations included school‐based changes to curricula, staff training, and anti‐bullying policies; legislation to ban weight discrimination; policies informed by strategic science; collaboration with researchers from other fields; de‐emphasizing weight in health communications; diversifying body sizes and limiting modified images in media; and restricting the sale of weight‐loss supplements. Discussion: The findings of this review highlight gaps in empirically evaluated policies to reduce DWCBs but also promising policy recommendations across several domains. Although some policy recommendations were supported by empirical evidence, others were primarily based on experts' knowledge, highlighting the need for greater research on population‐level DWCBs prevention through policy. Public significance: Our scoping review of the evidence on policies for the prevention of disordered weight control behaviors identified several recommendations across the domains of education, public policy, public health, and industry regulation and media. Although few empirical investigations of implemented policies have been conducted, expert recommendations for policies to prevent disordered weight control behaviors among populations are plentiful and warrant future consideration by researchers and policymakers alike. [ABSTRACT FROM AUTHOR]

Mask‐wearing, social distancing, and vaccination remain effective ways to mitigate the spread of COVID‐19. Yet, many hesitate to enact some or all these preventive behaviors. We created three persuasive messages—framed to promote benefits to either (1) oneself, (2) close‐others, or (3) distant‐others—to determine whether the effectiveness of these messages varied based on personality differences (specifically independent/interdependent self‐construal and chronic construal level). In two online experiments (N = 862), we measured individual differences and showed participants one of the three messages. Consistent interactions between interdependent self‐construal and message conditions showed that those high in interdependent self‐construal responded most positively to the self‐focused messages promoting mask‐wearing, social distancing, and COVID‐19 vaccination. Those low in interdependent self‐construal responded most negatively to the self‐focused messages. Although no interaction effect was observed for independent self‐construal, and inconsistent evidence emerged for construal level, other‐focused messages performed either better or equally well to the self‐focused messages for most participants and may thus be promising for future public health communication efforts. [ABSTRACT FROM AUTHOR]

Policy PointsPublic health science regarding alcohol consumption and problems, alcohol's role in equity and social justice, and identification of effective policy interventions has grown steadily stronger in the past 30 years.Progress on effective alcohol policies has stalled or gone backward in the United States and much of the world.Because alcohol influences at least 14 of the 17 sustainable development goals, as well as more than 200 disease and injury conditions, reducing alcohol problems should offer a platform for collaboration across public health silos but will require that public health itself respect and follow its own science. [ABSTRACT FROM AUTHOR]

Issue addressed: It is well‐established that health education and promotion programs work best when they have been tailored to meet local contextual needs. In this brief report we describe a health education program and how it identified and incorporated local priorities into its delivery in two remote Aboriginal communities in the "Top End" of the Northern Territory. Methods: During the first visit to each community team members met with local stakeholders and ran an inaugural HealthLAB session. Fieldnotes were taken during or directly after each interaction. At the end of each day team members debriefed regarding their fieldnotes. After both trips had been completed, priority areas were extracted from fieldnotes and synthesised. Results: Although some health priorities were congruent across all groups, Community Members and Childcare staff tended to identify practical solutions while School and Clinic staff were focused on the clinical outcome. Community Members were particularly focused on the wider social and systemic factors impacting health. Conclusion: In response to the need for practical support, HealthLAB modified their health education packages to upskill mothers and sports coaches to provide brief health education sessions to local children and young people. So what?: It is recognised that many health promotion programs focus on individual behaviours without creating supportive environments. While it was out of scope for HealthLAB to address physical environmental factors, by building local capacity and knowledge to deliver health education, the program can contribute to a healthier and supportive social environment. [ABSTRACT FROM AUTHOR]

The author revisits the topic of facemasks for the general public and the advice to give them about its effective use during the Covid-19 pandemic. Topics include the efforts of governments of many countries to mandate the wearing of facemasks to fight the virus, an updated health advice on wearing facemasks issued by the World Health Organization in May 2022 after the emergence of the Omicron variant, and the improvement in facemask supply and clarity about the virus' mode of transmission.

With international health challenges, there are opportunities for collaboration between nations on health issues, including developing and sharing resources for teaching and learning. This article outlines collaboration across Scotland and England to develop a core resource for eLearning on health literacy. It describes the development of the resource with case studies of the implementation in Scotland and England, demonstrating the balance between shared development and tailored implementation. The eLearning was developed to increase awareness of NHS workforce and community partners, supplemented by training for NHS librarians and public health specialists to enable them to provide more tailored training on health literacy techniques. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to examine public health nursing (PHN) students' experiences delivering peer‐to‐peer health education to college students during a health fair. Design: A qualitative, descriptive research design was used. Sample: Senior‐level nursing students (n = 13) completing the clinical portion of a PHN course. Measurements: A semi‐structured focus group guide consisting of 10 questions and follow‐up probes was used to elicit PHN student experiences. Focus groups were recorded, transcribed, and analyzed using a thematic analysis technique. Results: Five main themes were identified: (1) benefits of health fairs in general, (2) benefits of nursing‐student‐led health fairs, (3) negatives of nursing‐student‐let health fairs, (4) importance of interaction, and (5) suggestions for maximizing the potential of nursing student‐led health fairs. Conclusions: Although challenges exist, PHN students experienced several benefits from the provision of peer‐to‐peer health education. College campuses represent a unique clinical site that allows nursing students to utilize their insider status to better assess, understand, and provide tailored health education to the college community. This clinical site has shown to provide positive experiences for nursing students and is critical in developing essential nursing skills and building confidence for future clinical rotations. [ABSTRACT FROM AUTHOR]

Objectives: Identifying those with inadequate oral health literacy is difficult because little is known about its various multiple dimensions. Accordingly, the present research investigated dimensions of the concept using a qualitative approach. Method: Participants (n = 15) who met inclusion criteria (Including having expertise in the fields of general dental, social dental, and health education and health promotion and having at least 5 years of relevant working experience) were recruited by purposive sampling via the public health and dentistry faculty in Tehran between December 2018 and October 2019. Thematic analysis was used to assess the data. Results: A total of 15 specialists (ranging in age from 28 to 61, mean 44) were included in the study. Their working experience averaged 15.5 years (SD = 7.7, Min = 6, Max = 30). Independent analysis of qualitative data by three researchers led to identification of seven themes and 18 sub‐categories, including need perception (feeling the need and paying attention to meeting the need), emotional literacy (valuation of oral health, formation of personality and taking care of oral health), planning literacy (planning and goal‐orientation), communicative literacy (choice in decision‐making, interpersonal communication skill and claiming), behavioural literacy (self‐care), cognitive literacy (knowledge, information comprehension, information use, and information analysis) and media literacy (the ability to use up‐to‐date technologies, the ability to search for and acquire the information, and judgment). Conclusions: Our findings provide insights into the dimensions of oral health literacy. It is hoped that these findings can be used to guide the development of interventions on OHL and that aspects of the concept can help to enhance levels of OHL and help to promote health at societal level. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus is a risk factor for developing dementia and a public health concern around the world. Identifying any predictive factors associated with diabetes‐related dementia prevention behaviors are of value in helping to prevent dementia. From six community hospitals in Chiang Mai, Thailand, 182 people aged 30–60 years were enrolled in a cross‐sectional study and completed a written questionnaire on dementia prevention behaviors and perceptions of health beliefs. Multiple linear regression analysis was applied to determine possible associations between dementia prevention behaviors and health belief perceptions. A high level of preventive behavior was associated with high perceptions of the benefits of, and barriers to, dementia prevention and longer duration of patients' diabetes. Findings indicate the predictive role of the two factors in the perception of health beliefs about dementia prevention behaviors among the participants. Although further testing with different samples and in different locations is warranted, education programs for health practitioners that integrate the findings of this study would be beneficial to improvement of dementia prevention behaviors in people with diabetes. [ABSTRACT FROM AUTHOR]

BACKGROUND: School‐based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state‐level content policies. The purpose of this study was to evaluate the associations between state‐level high school HIV education policies and adolescent HIV risk behaviors. METHODS: This was a cross‐sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state‐level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex. RESULTS: Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth. CONCLUSIONS: Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education. [ABSTRACT FROM AUTHOR]

Background: In Brazil, zoonotic sporotrichosis became a national public health problem, with thousands of cases in the last decade in several regions of the country. In this context, health education activities are critical, especially in promoting early diagnosis and access to proper health care in sporotrichosis hyperendemic areas. Therefore, we report the implementation of a public specialised reference service (SRS) for diagnosis and treatment of sporotrichosis in southern Brazil. We evaluated the impact of the SRS on diagnostic confirmation and speed of diagnosis. Methods: The SRS was implemented in Rio Grande City. We implemented a public service to promote the correct diagnosis, treatment and follow‐up of human sporotrichosis cases. To study the impact of implementing SRS, the annual number of cases and the period between the appearance of lesions until diagnosis were compared, using prior data and that post‐implementation. Results: The implementation of the SRS directly benefited almost 50 patients in only four years, with the collaboration of almost 50% of the local health groups, together with an increase of more than 200% in diagnosis confirmation and speed of diagnosis, showing the reach, impact and importance of the SRS. Conclusion: The impact on the individual and collective health of the local population highlights the value of this public health approach in facing the epidemiological threat of zoonotic sporotrichosis. [ABSTRACT FROM AUTHOR]

See related letter by Padovani et al. [ABSTRACT FROM AUTHOR]

In the early 1970s, a World Health Organization‐initiated and United States‐funded project released lab‐reared mosquitoes outside New Delhi in the first large‐scale field trials of the genetic control of mosquitoes. Despite partnering with the Indian Council of Medical Research and investing significantly in outreach to local communities at the release sites, the project was embroiled in controversy and became an object of vehement debate within the Indian parliament and diplomatic contretemps between the United States and India. This early episode of genetic control research demonstrates how a scientific collaboration was entangled in geopolitics and shaped by the legacy of colonialism. This historical case study has implications for public deliberation in the present, pointing to the challenges of shared decision‐making in the context of structural inequality, the way that a backdrop of military interest in a technology can impede trust, and the long‐term consequences of projects that foster mistrust. [ABSTRACT FROM AUTHOR]

Aim: To explore what competencies and skills Malawian nurses gained after participating in an institutional health and training programme in Norway and how they viewed these competencies applicable upon return to Malawi. Furthermore, to examine facilitators and challenges experienced on the exchange programme and opportunities and obstacles to make the competencies usable in own local hospital context. Design: Qualitative study with an explorative design. Methods: Fourteen interviews and one focus group discussion were conducted at Queen Elizabeth Central Hospital, Blantyre, Malawi, from August to September 2018. Results: Competencies gained in Norway included clinical skills, teamwork, coordination and strengthened professionalism. The main finding was that the exchange programme was a transformative experience. Upon return to Malawi, the competencies gained on the exchange were helpful. However, the return was characterized by mixed emotions due to the considerable difference between the two clinical settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: We developed the Tobacco Prevention Toolkit (Toolkit) to enhance the impact of school‐based tobacco education. This study describes the process of developing the Toolkit, its contents, and reach. METHODS: Qualitative community‐based participatory research (CBPR), including focus group discussions (N = 152) and working groups with parents, educators, researchers, and youth (N = 87) were used to develop the Toolkit and design its implementation. Toolkit reach was assessed through number of trained educators using the Toolkit, estimated number of youth recipients of the Toolkit resources, and using Google Analytics for online engagement. RESULTS: The Toolkit is a free, online resource aimed at preventing tobacco use by middle and high school students. Toolkit content addresses varied forms of tobacco including electronic cigarettes, hookah, smokeless tobacco, and cigarettes; addiction; and positive youth development; and is available in multiple interactive formats such as real‐time quizzes, factsheets, activities, and presentations. The Toolkit is mainly delivered by trained educators, who adapt its content and duration to tailor their drug prevention teaching to student needs. As of April 2020, when data for this paper were collected, 4,750 educators have reached an estimated 1.3 million youth. The Toolkit website has 186,116 users and 802,602 page views, growing steadily since 2016. As of August 2021, additional students have been reached, for now a total of 1.85 million students reached. CONCLUSION: The Toolkit resources are evidence‐based, comprehensive, responsive, interactive, easily accessible, and flexible. Applying CBPR was instrumental in developing the Toolkit and expanding its reach. [ABSTRACT FROM AUTHOR]

BACKGROUND The relationship between health and learning generally goes without question in developed countries, and has a philosophic, economic, and statutory basis. Historically, school health and school health education have evolved in response to addressing the public health needs of the times. Health literacy skills are more important now than ever. Living in an ongoing COVID‐19 global pandemic reminds us of the vital role of being in control of our health, wherein health literacy plays a "life or death" role in our daily lives. METHODS: Considering the evolution of school health education, we examine the significance of health literacy in our society and schools in contemporary times. RESULTS: We must take a critical look at a place for education for health literacy and why it should be an innovative path in adaptive, reimagined, and revitalized schools. CONCLUSIONS: It is time to rebrand school health in general, and school health education specifically. Improved health literacy is an asset leading to greater opportunities for health and life‐long learning. [ABSTRACT FROM AUTHOR]

Key misunderstandings of palliative care exist in the community, with media being reported as a key source underpinning knowledge. This retrospective media analysis of consecutive articles sought to examine the portrayal of palliative care in the Australian print media, focussing on the 2 years (2016–2018) coverage preceding the Voluntary Assisted Dying legislation in Victoria, Australia. Summative content analyses revealed coverage of palliative care was frequently (74%) in the context of a discussion of euthanasia. Only small numbers of articles described the activities of palliative care, and even fewer its potential beneficial impact, while a quarter (26%) described palliative care was inadequate to relieve suffering. These findings suggest that current coverage of palliative care in the media may contribute to negative public views and misconceptions. An opportunity exists to enhance media coverage, and in turn, improve the public understanding of care in serious illness. [ABSTRACT FROM AUTHOR]

Background: Our study aimed to evaluate to what extent Zero2 Expo's 'Birthing a Better Future', a co‐created multimedia exhibition, was effective in raising awareness on the importance of the first 1001 days of life and explore what refinements would help to optimize the impact of future exhibitions. Methods: We conducted a mixed‐methods evaluation of the exhibition delivered in the John Radcliffe Hospital, Oxford. Through convenience sampling, 14 participants were selected to participate in 12 structured interviews and 19 participants completed a questionnaire. Interviews were thematically analysed alongside quantitative analysis of questionnaire responses through Likert scales. Results: The majority (78.6%, n = 11/14) of participants who completed the questionnaire either agreed or strongly agreed that the exhibition raised their awareness about the first 1001 days of life. This was supported by the analysis of interviews. The use of art was found to provoke an emotional engagement from participants. Participants felt that the length of the written pieces and location of the exhibition were important factors for designers to consider in future exhibitions. Conclusion: This study demonstrated that multimedia exhibitions, combining science with art, may be an effective way to raise awareness of public health messages. Engaging with key stakeholders will be an essential step in order to improve future public health exhibitions. Public Contribution: When designing the study, the public reviewed the study tools, which were refined based on their feedback. At every phase of the study, members of the public who are artists co‐created the exhibition content. [ABSTRACT FROM AUTHOR]

Objectives: Tooth brushing with fluoride toothpaste has a major effect on the reduction in dental caries. However, among young children, tooth brushing requires skill and motivation from caregivers and is not widely practised. To find a more effective way to train caregivers, Protection‐Motivation Theory (PMT)‐based educational programmes were compared with the basic one with regard to the incremental caries rate in children, caregiver's motivation and caregiver's awareness. Methods: In a quasi‐experimental study, 9‐ to18‐month‐old children and their caregivers (N = 102) were allocated to PMT or control groups. The PMT group received PMT‐based oral health education programme while the control group received public hospital's current one. Children's caries status and motivation and awareness among caregivers were measured. Mann‐Whitney U test was used to find out the difference between control and test groups. Results: After 12 months, the PMT group showed lower dmft, dmfs and incremental caries rate compared with control. Chi‐square test showed the control group was at more risk of developing additional dental caries (RR 2.23, 95% C.I.: 1.41–3.54, p < 0.001), and when early carious lesions were included (RR 2.40, 95% C.I.: 1.56–3.69, p < 0.001). In terms of motivation and awareness among caregivers, the PMT group rated their perception of disease severity and belief in self‐efficacy significantly higher than the control group. Conclusions: PMT‐based education programmes encourage suitable motivation and awareness that changes oral healthcare behaviour of caregivers, relating to decreased incremental caries rate in infants and toddlers comparing with regular health education methods. [ABSTRACT FROM AUTHOR]

Social media (YouTube) has been used to educate the public on stroke signs and the need to contact emergency hotline. We perform sentiment analysis to explore the emotional response to the 2006 North American and contrast this with the five Australian campaigns (2009–2015). The positive sentiment in the North American campaign provides insights for developing material for public health campaigns. [ABSTRACT FROM AUTHOR]

Race‐based and other demographic information on COVID‐19 patients is not being collected consistently across provinces in Canada. Therefore, whether the burden of COVID‐19 is falling disproportionately on the shoulders of particular demographic groups is relatively unknown. In this article, we first provide an overview of the available geographic and demographic data related to COVID‐19. We then make creative use of these existing data to fill the vacuum and identify key demographic risk factors for COVID‐19 across Canada's health regions. Drawing on COVID‐19 counts and tabular census data, we examine the association between communities' demographic composition and the number of COVID‐19 infections. COVID‐19 infections are higher in communities with larger shares of Black and low‐income residents. Our approach offers a way for researchers and policymakers to use existing data to identify communities nationwide that are vulnerable to the pandemic in the absence of more detailed demographic and more granular geographic data. [ABSTRACT FROM AUTHOR]

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Since the COVID‐19 pandemic took hold in the first quarter of 2020, children and their families across the world have experienced extraordinary changes to the way they live their lives – creating enormous practical and psychological challenges for them at many levels. While some of these effects are directly linked to COVID‐related morbidity and mortality, many are indirect – due rather to governmental public health responses designed to slow the spread of infection and minimise the numbers of deaths. These have often involved aggressive programmes of social distancing and quarantine, including extended periods of national social and economic lockdown, unprecedented in the modern age. Debates about the appropriateness of these measures have often referenced their potentially negative impact on people's mental health and well‐being – impacts which both opponents and advocates appear to accept as being inevitable. [ABSTRACT FROM AUTHOR]

This case study leverages existing library assets and curated educational resources for students, pastors, and health ministers by seeking to increase their understandings of how religion intersects with, and informs, health education and promotion, and public health more broadly, while equipping them with tools to engage in important conversations about health ministry. This article describes and evaluates a library‐based research guide that is a replicable model for collaborative ministerial training about engaging, evaluating, and participating in health education and promotion, which is a vital component of theological education. Much of the pedagogical conversation around religion and health within theological and religious studies has focused on the ways that religion assists in the socio‐cultural construction of health and healing. This case study expands on this conversation by detailing how seminary students, pastors, and health ministers can also use public health knowledge to better provide services to their congregations and communities. This model provides long‐term, publicly‐available, asynchronous access to these materials, making it a valuable resource for theology schools. [ABSTRACT FROM AUTHOR]

Objectives: The WHO World Health Assembly established in 2007 a Resolution (WHA60.17) on oral health, which called upon countries to ensure that public health actions for disease prevention and health promotion are established. The objective of the present survey undertaken 10 years later (2017‐2018) was to measure the application of such programmes for key population age groups in low‐, middle‐ and high‐income countries. Methods: Oral health focal points of ministries of health worldwide (n = 101) answered a structured questionnaire on existing national oral health systems and the actual public health activities. The response rate was 58.4%. The questionnaire was used to collect information about structural factors, country workforce, financial models, provision of preventive services and promotion for oral health, school health programmes, administration of fluoride, national oral health targets and oral health surveillance. The countries were classified by national income for analysis of data. Results: Coverage of population groups by primary oral health care and emergency care varied by national income. The gap between countries in delivery of preventive care was strong since low‐income countries less often reported preventive activities than middle‐income countries and particularly when compared to high‐income countries. School oral health programmes were less frequent in low‐income than other countries. Moreover, population methods of fluoridation and use of fluoridated toothpaste were unusual in low‐income countries. Health education, mass communication and community events were often essential elements in health promotion. In disease prevention, many countries considered the link between oral health and general health conditions and intervention towards shared risk factors of NCDs. The health concern for the consumption of tobacco, unhealthy diet and sugars was particularly emphasized by high‐income countries but less highlighted by low‐income countries. Finally, while national oral health targets for children and surveillance systems were frequently reported by countries, similar systems for adolescents, adults and older people were rare. Conclusions: The inequities between countries in oral disease prevention and health promotion were substantial. Limited financial resources for preventive care and health promotion; inadequate workforce for oral health, and insufficient coverage in primary health care were observed in low‐resource countries. The results of the survey demonstrate the need for building effective oral health systems oriented towards oral disease prevention and health promotion. [ABSTRACT FROM AUTHOR]

This Regular Feature explores the role of health science librarians in the coronavirus pandemic. COVID‐19 has spread rapidly all over the world. All major cities around the globe are in lockdown. In Pakistan, the first case was diagnosed on 26 February 2020, and currently, there are more than 2039 diagnosed cases and 26 deaths as on 31 March 2020. Across the country, there are further 12 000 suspected cases. This will undoubtedly increase if precautionary measures are not taken. Pakistani universities, colleges and schools were in lockdown. The role of university librarians in this emergency included raising awareness through public health education, providing support to medical staff, researchers and providing ongoing traditional services to regular library patrons in Pakistan. The Regular Feature also provides links to useful resources. JM. [ABSTRACT FROM AUTHOR]

Focusing screening and treatment to those most likely to benefit is the promise of precision medicine but inequitable distribution of precision medicine innovations may exacerbate health disparities. We investigated whether complex genomic concepts can be successfully communicated to diverse populations. Incorporating principles of Community‐based Participatory Research, we created a precision medicine curriculum tailored to the needs of our predominantly Hispanic community. We administered the curriculum over 26 months, assessed pre‐ and post‐test comprehension of 8 genetics‐related terms, and compared comprehension differences based on demography and health literacy. In total, 438 individuals completed pre‐/post‐test assessments. At pre‐test, 45.6% scored ≥75% across eight major constructs; 66.7% at post‐test. Comprehension increased for 7/8 terms with greatest pre/post‐test increases for 'mutation' (55% to 78%) and 'sporadic' (34% to 59%). Mean pre‐test comprehension scores (≥75%) were lower for Spanish versus. English speakers; mean post‐test scores were equivalent. No heterogeneity by demographics or health literacy was observed. We demonstrate that a brief community educational program can improve knowledge of complex genomic concepts. Interventions to increase understanding of genomic concepts underlying precision medicine are key to patients making informed treatment and prevention decisions and may lead to more equitable uptake of precision medicine initiatives. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of death around the world and often is a chronic long term disease. This calls for an expanded workforce to include non‐traditional health care providers. Objective: To determine effectiveness of a cancer information training project with clergy from selected rural Appalachian areas to improve comfort and willingness to work as part of the cancer health care team. Methods: Clergy were trained in the consumer health database of the National Library of Medicine MedlinePlus.gov. Exercises were required that were done using an iPad tablet with an online curriculum. They were also taught how to do a population health assessment of their particular area and develop a health ministry for their church. Results: Three key elements were confirmed that would enable replication of the pilot: access to medlineplus, programmed learning modules using mobile technology such as iPads, and staff support including librarians and medical staff. With these key elements, the cancer project is potentially replicable with other groups beyond clergy. Conclusion: Knowledge about population health, built on new awareness and topical health knowledge, and using new skills to identify relevant information and library resources, could open minds and enhance community support for preventive and medical interventions. [ABSTRACT FROM AUTHOR]

There is limited information about what dental students know about the risks and effects of e-cigarettes, and there is even less information regarding their attitudes about e-cigarettes. The aim of this study was to assess dental students' knowledge, education, and attitudes regarding e-cigarettes and their confidence in discussing e-cigarettes with patients. All fourth- to sixth-year students registered at the King Abdulaziz University Faculty of Dentistry were invited to participate in this cross-sectional study conducted during a three-week period in December 2018. The focus was a comparison of never versus ever e-smokers ("ever" meaning current or former e-smokers). The response rate was 38.7% (193/498). Among the responding students, 43.2% (n=83) had ever used an e-cigarette, and 11 (5.7%) reported being current users. Almost 95% (n=183) of the total participants said they did not feel confident about their e-cigarette education in dental school. Students who had ever used an e-cigarette said they were more confident discussing e-cigarettes with patients than did students who had never used them and also demonstrated greater belief that e-cigarettes lower the risk of cancer for patients who use them as an alternative to smoking traditional cigarettes (p<0.001). This study provides evidence of a gap in dental students' attitudes and knowledge regarding e-cigarettes, making it necessary to integrate e-cigarette education into future curricula. [ABSTRACT FROM AUTHOR]

Background: Knowing that your parent or caregiver will be there for you in times of emotional need and distress is a core aspect of the human experience of feeling loved and being securely attached. In contrast, an insecure attachment pattern is found in many antisocial youth and is related to less sensitive caregiving. Such youth are often distrustful of adults and authority figures, and are at high risk of poor outcomes. As they become adults, they require extensive health, social and economic support, costing society ten times more than their well‐adjusted peers. However, it is not known whether insecure attachment itself is associated with higher costs in at‐risk youth, independently of potential confounders, nor whether cost differences are already beginning to emerge early in adolescence. Methods: Sample: A total of 174 young people followed up aged 9–17 years (mean 12.1, SD 1.8): 85 recruited with moderate antisocial behaviour (80th percentile) from a school screen aged 4–6 years; 89 clinically referred with very high antisocial behaviour (98th percentile) aged 3–7 years. Measures: Costs by detailed health economic and service‐use interview; attachment security to mother and father from interview; diagnostic interviews for oppositional and conduct problems; self‐reported delinquent behaviour. Results: Costs were greater for youth insecurely attached to their mothers (secure £6,743, insecure £10,199, p = .001) and more so to fathers (secure £1,353, insecure £13,978, p < .001). These differences remained significant (mother p = .019, father p < .001) after adjusting for confounders, notably family income and education, intelligence and antisocial behaviour severity. Conclusions: Attachment insecurity is a significant predictor of public cost in at‐risk youth, even after accounting for covariates. Since adolescent attachment security is influenced by caregiving quality earlier in childhood, these findings add support to the public health case for early parenting interventions to improve child outcomes and reduce the financial burden on society. Read the Commentary on this article at doi: 10.1111/jcpp.13111 [ABSTRACT FROM AUTHOR]

Environmental justice (EJ) means socially and economically disadvantaged communities and citizens are entitled to an equally clean environment and resources to enjoy. EJ communities are mostly located close to polluters such as Superfund sites, coal‐fired power plants and landfills and are more likely to be exposed to higher levels of environmental hazards than the U.S. population on average. It is often a difficult task to identify EJ communities and the environmental hazards in the communities without using specific EJ screening tools. Therefore, the goal of this manuscript is to introduce public health nurses to map‐based EJ screening tools. This will help public health nurses to identify EJ communities and take appropriate actions. Public Health Nurses can also use other relevant web sites, such as the U.S. Environmental Protection Agency (EPA), National Institute of Environmental Health Sciences (NIEHS) and Toxicology Data Network (TOXNET) as resources concerning potential health effects of pollutants. Using the provided tools in this paper, nurses should be able to identify EJ communities and be united to recognize barriers of EJ communities and become promoters for EJ advocacy in practice, leadership and education. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school‐level risk and protective factors were examined. METHODS: Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N = 2577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental‐level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race/ethnicity were covariates. RESULTS: LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p ≤ .001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p < .001; 13% LGB vs 7% heterosexual involved in a school fight, p = .001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26–0.73), past 30‐day alcohol use (aOR: 0.71; 95% CI: 0.50–0.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50–1.00). CONCLUSION: Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky. [ABSTRACT FROM AUTHOR]