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Background: Multidimensional strategies can promote preventive behaviors to prevent cutaneous leishmaniosis. WhatsApp, the popular messenger of Iranians, can be used as a platform to provide health education interventions. This study aimed to investigate the effect of using an educational intervention in WhatsApp based on social cognitive theory (SCT) on the preventive behaviors of health ambassadors., Methods: A randomized clinical trial was conducted from September 2020 to April 2021 on 220 people living in endemic areas of leishmaniosis in Mashhad Province, Iran. By the cluster method sampling, the samples were randomly divided into two intervention and control groups. The intervention was performed for the intervention group over two weeks. Data were collected using a researcher-made questionnaire based on the constructs of SCT before and after the intervention. SPSS 16 was implemented to test multiple statistical analyses., Results: Findings from the intervention group compared with the control group showed that the scores of SCT constructs and preventive behaviors were significantly changed (P < 0.001) across time during baseline through follow-up. These changes were not significant in the control group., Conclusions: The educational intervention based on the SCT model to promote leishmaniosis preventive behaviors is effective. This intervention module can be tested in other targeted populations in endemic areas to prevent and control leishmaniosis., Trial Registration: Iranian Registry of Clinical Trials Registry IRCT20200615047784N1, registered 02/09/2020., (© 2024. The Author(s).)

Introduction: High mortality rates for pregnant women and their new-borns are one of Africa's most intractable public health issues today, and Ethiopia is one of the countries most afflicted. Behavioral interventions are needed to increase maternal health service utilizations to improve outcomes. Hence, this trial aimed to evaluate effectiveness of trained religious leaders' engagement in maternal health education on maternal health service utilization., Methods: The study employed a cluster-randomized controlled community trial that included baseline and end-line measurements. Data on end points were gathered from 593 pregnant mothers, comprising 292 and 301 individuals in the intervention and control groups, respectively. In the intervention group, the trained religious leaders delivered the behavioral change education on maternal health based on intervention protocol. Unlike the other group, the control group only received regular maternal health information and no additional training from religious leaders. Binary generalized estimating equation regression analysis adjusted for baseline factors were used to test effects of the intervention on maternal health service utilization., Results: Following the trial's implementation, the proportion of optimal antenatal care in the intervention arm increased by 21.4% from the baseline (50.90 vs. 72.3, p  ≤ 0.001) and the proportion of institutional delivery in the intervention group increased by 20% from the baseline (46.1% vs. 66.1%, p  ≤ 0.001). Pregnant mothers in the intervention group significantly showed an increase of proportion of PNC by 22.3% from baseline (26% vs. 48.3%, p  ≤ 0.001). A statistically significant difference was observed between in ANC4 (AOR = 2.09, 95% CI: 1.69, 2.57), institutional delivery (AOR = 2.36, 95% CI: 1.94, 2.87) and postnatal care service utilization (AOR = 2.26, 95% CI: 1.79, 2.85) between the intervention and control groups., Conclusion: This research indicated that involving religious leaders who have received training in maternal health education led to positive outcomes in enhancing the utilization of maternal health services. Leveraging the influential position of these religious leaders could be an effective strategy for improving maternal health service utilization. Consequently, promoting maternal health education through religious leaders is advisable to enhance maternal health service utilization. Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT05716178]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sadore, Kebede and Birhanu.)

Background: To date, there is no consensus on indicators for the evaluation of integrated community-based interventions for health promotion and prevention targeting children and adolescents. This study aims at consenting on a scoped set of indicators to evaluate integrated community-based interventions., Methods: Out of 738 indicators derived from a literature search, we preselected 94 indicators allotted to 20 domains based on an internal quality appraisal and consensus process and conducted an eDelphi procedure to assess their relevance in view of experts. Experts were recruited in the field of public health, health sciences and communal health promotion in practice and were invited as participants in this eDelphi. During the eDelphi, 47 experts rated the relevance of 94 indicators in two rounds. Consensus was defined as agreement of 75% (or above)., Results: After round 1, 27 indicators among 11 consented subdomains reached a consensus on relevance. After round 2, a total of 36 indicators reached consensus on relevance in 9 subdomains (such as socioeconomic factors, health education, nutrition and physical activity, oral health, overall health status, specific health conditions, drug related behavior, exposure to drugs and violence, family factors)., Conclusions: These identified indicators may provide a basis for evaluation concepts of integrated community-based interventions for children and adolescents to inform stakeholders about intervention impacts., (© 2024. The Author(s).)

Background: Public health education aims at producing a competent workforce. The WHO-ASPHER framework proposes a set of relevant public health competencies organised in 10 sections (e.g. science practice, leadership, law policies and ethics etc). As part of the Europubhealth (EPH) consortium, eight universities collaborate for the delivery of a 2-year international public health master course. The training pathway includes a first "foundation" year, with a choice of four options (components), and a second "specialisation" year with a choice of seven components. In 2020, EPH consortium decided to use the WHO-ASPHER framework in order to map the competencies addressed and the level of proficiency targeted by each component of its master course., Methods: An 84-item questionnaire covering the whole WHO-ASPHER framework was sent to the 11 EPH component coordinators, asking them to rate the proficiency levels targeted at the end of their courses. Answers from each coordinator were summarised by calculating mean proficiency levels for each of the 10 competency sections. We used Bland & Altman plots to explore heterogeneity of answers and then calculated transformed scores to account for rating heterogeneity. We use tabulation and a heat map to explore patterns of proficiency levels across components., Results: There were differences in overall proficiency levels between years with, as expected, higher scores in year two. Year one components reached medium to high proficiency scores for the sections "science practice", "health promotion" and "communication" with scores ranging from 2.6 to 3 (on a 1-low to 4-high scale). When compared with year one on a heat-map, year two components displayed more contrasted profiles, typically aiming for high proficiency level (i.e. scores above 3.5) on 3 out of the 10 sections of competencies. Except for the "collaborations and partnership" section, the training pathways offered by the EPH master course seem to offer opportunities for a high proficiency level in all domains of competencies., Conclusions: The mapping proved a useful exercise to identify strengths and complementarities among the EPH consortium. The results suggest that the EPH master course is coherent and offers students opportunities to gain proficiency in most competencies relevant to public health practice., (© 2024. The Author(s).)

Health promotion and education are collaborative efforts involving patients, healthcare providers, and society, crucial for preventing and managing disease outbreaks. However, in Saudi Arabia, the actual or perceived endeavors of physicians and nurses in health education and promotion are not widely understood, which holds significant implications for those working in the field. This study aimed to evaluate the level of awareness and attitude toward health education and promotion among physicians and nurses in primary healthcare centers in Najran, Saudi Arabia. A descriptive cross-sectional study design was employed, and 187 participants were incorporated into the analysis. Questionnaires were distributed to physicians and nurses at the primary health care centers. Participants completed a face-to-face survey questionnaire about their awareness and attitude toward health education and promotion. One of the authors was physically present at the primary health care centers to assist the participants with answering the questionnaire questions. Saudis and physicians had higher awareness than non-Saudis and nurses, respectively. Work experience and institutional factors did not significantly influence awareness. A positive correlation between awareness and attitude was observed. However, perceived shortcomings in current approaches were identified, including a lack of skills and training, poor communication, and inadequate leadership support. Despite these challenges, healthcare professionals held positive attitudes toward health education, recognizing its importance in behavior change, reducing disparities, and influencing community policies. The study highlights the need for targeted interventions, including research on effective models, training programs, and improved communication and leadership support, to address identified gaps and optimize health education implementation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Kenyan Ministry of Health (MOH) and a consortium of nutritionists, researchers and communication, and design specialists developed a novel approach to create an evidence-based recipe book promoting complementary feeding (CF) in Kenya. The ADAPT approach includes five steps: applied research (A), dialogue with stakeholders (D), adapted behaviour change communication (BCC) theories (A), purpose-driven visual communication (P), and tailoring to priority audiences (T). Through this approach, the recipe book addresses key knowledge gaps using behaviour change theories and visual communication best practice to increase accessibility, acceptability, retention and motivation for behaviour change. The book addresses barriers to CF identified through formative applied research. Dialogue with stakeholders helped ensure cultural appropriateness and the book's alignment with MOH recommendations and key messages. The book uses behaviour change theories to approach the reader in a respectful way that motivates behaviour change. The use of consistent, purpose-driven visuals helps ensure key messages are easily understood and accessible to all caregivers regardless of literacy level. The book's tone and content are tailored to its audiences' attributes, needs and preferences. This five-step process inspired the development of ADAPT, a novel approach that integrates behaviour change and visual communication for greater impact. This paper outlines how the consortium used the ADAPT approach to develop an evidence-based book that thoughtfully and holistically addresses a wide range of barriers, provides practical solutions and increases self-efficacy around CF. It offers a blueprint for public health practitioners from any field who are interested in using visual behaviour change communication to promote healthy behaviour., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Risky alcohol use is a major public health problem globally and in Sri Lanka. While a reduction in alcohol consumption can result in physical, mental, and social benefits, behaviour change is difficult to achieve. Effective, context-adapted interventions are required to minimise alcohol-related harm at a community level. THEATRE is a complex, community-based intervention evaluating whether a promising Sri Lankan pilot study that utilised arts-based research to moderate alcohol use can be scaled up. While the scaled-up pilot study protocol is presented elsewhere, the aim of this protocol paper is to describe the intervention programme theory and evaluation design, and modifications made to the study resulting from COVID-19 and the financial crisis. Drawing on the Behaviour Change Wheel (BCW) and Theoretical Domains Framework, behaviour change theories are presented with potential pathways to guide implementation and evaluation. Alcohol consumption patterns and context of drinking is detailed. The multifaceted intervention targets individuals and communities using arts-based interventions. Four of nine BCW functions are employed in the design of the intervention: education, persuasion, modelling and enablement, and training. Modifications made to the study due to COVID-19 and the financial crisis are described. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka (ERC/2018/21-July 2018 and Feb 2022) and the University of Sydney (2019/006). Findings will be disseminated locally to community members and key stakeholders and via international peer-reviewed publications.

Background: Hospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers., Methods: In this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach's alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software., Results: Before the intervention, there was no significant difference between the two groups in terms of demographics and the study's main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001)., Conclusions: The research results show that Health Action Model educational intervention can change workers' awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance., Trial Registration: IRCTID: IRCT20160619028529N7., (© 2023. The Author(s).)

Objectives: to construct and validate an educational video storyboard about care for premature newborns at home., Methods: a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index., Results: the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard's final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9., Conclusions: the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.

Objective: This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes., Design: Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5-14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Setting: International school-based nutrition programmes., Subjects: Individuals involved with the implementation of school-based nutrition programmes., Results: From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment., Conclusions: These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the 'outer contextual factors' of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.

Background: One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people., Methods: Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP)., Results: In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality., Conclusion: This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Pregnant women are vulnerable to oral disease due to physiological, hormonal, and dietary alterations. The aim of the present study was to evaluate the impact of the educational program according to the Health Promotion Model (HPM) on the oral health prevention behavior of pregnant women., Study Design: A randomized controlled trial., Methods: This study was performed on 105 pregnant women visiting health centers located in Arak from February to November 2022. The subjects were randomly assigned to intervention (n=54) and control (n=51) groups. A reliable and valid questionnaire according to HPM constructs was used to collect the data. The pre-test was conducted in the groups. The intervention group received the educational program in 9 educational sessions (from 12 to 24 weeks of pregnancy). Then, the post-test was conducted in the 36th week of pregnancy in the groups. Finally, the data were analyzed by SPSS software (version 18) and using independent t-test, paired t-test, and Chi-square test., Results: There were statistically significant differences between the intervention and control groups regarding perceived benefits (24.68±3.63 vs. 26.57±3.67, P =0.009), perceived barriers (7.31±3.14 vs. 5.81±3.59, P =0.025), positive affect (10.50±1.66 vs. 11.29±1.34, P =0.009), negative affect (1.59±0.223 vs. 1.40±1.51, P =0.006), commitment to the action plan (4.05±1.92 vs. 4.77±1.50, P =0.034), and tooth brushing time (2.29±0.72 vs. 2.74±0.48, P <0.001). However, no significant difference was observed regarding the tooth brushing frequency (2.05±0.58 vs. 2.07±0.66, P =0.901) after the intervention. The brushing time for 2-3 minutes in the intervention group increased from 51.85% to 75.92% after the intervention., Conclusion: HPM-based education was effective in promoting the duration of tooth brushing in pregnant women. However, it had no effect on the tooth brushing frequency., (© 2023 The Author(s); Published by Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Objective: To measure the impact of the community health programme "Education for health in adolescence" carried out in the Parquesol neighborhood, Valladolid (Spain), during the years 2015-2019., Method: Community-based quasi-experimental pre- and post-test analytical intervention trial with control group. A total of 407 adolescent surveys were collected. The CHIP-AE test validated for Spain was used. Pre- and post-test results were analyzed and compared with the control group., Results: Improvements were found in the female intervention group compared to the control group in the variables resilience (3.68 vs. 3.41; p <0.01), health and safety at home (4.30 vs. 4.00; p <0.01), physical activities (3.16 vs. 2.60; p <0.01) and self-esteem (3.17 vs. 2.79; p <0.05)., Conclusions: The community intervention carried out improves the health profile of adolescents. The baseline perception of health presents differences by gender, with higher scores in males. Post-intervention improvement is substantial in females in resilience, physical activities and health and safety at home. In addition, the worsening due to the passage of time described in previous studies is corrected in the variables self-esteem, satisfaction and well-being., (Copyright © 2023 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The sanitary service is a mandatory prevention training programme for all French healthcare students. Students receive training and then have to design and carry out a prevention intervention with various populations. The aim of this study was to analyse the type of health education interventions carried out in schools by healthcare students from one university in order to describe the topics covered and the methods used., Method: The 2021-2022 sanitary service of University Grenoble Alpes involved students in maieutic, medicine, nursing, pharmacy and physiotherapy. The study focused on students who intervened in school contexts. The intervention reports written by the students were read doubly by independent evaluators. Information of interest was collected in a standardised form., Results: Out of the 752 students involved in the prevention training program, 616 (82%) were assigned to 86 schools, mostly primary schools (58%), and wrote 123 reports on their interventions. Each school hosted a median of 6 students from 3 different fields of study. The interventions involved 6853 pupils aged between 3 and 18 years. The students delivered a median of 5 health prevention sessions to each pupil group and spent a median of 25 h (IQR: 19-32) working on the intervention. The themes most frequently addressed were screen use (48%), nutrition (36%), sleep (25%), harassment (20%) and personal hygiene (15%). All students used interactive teaching methods such as workshops, group games or debates that was addressed to pupils' psychosocial (mainly cognitive and social) competences. The themes and tools used differed according to the pupils' grade levels., Conclusion: This study showed the feasibility of conducting health education and prevention activities in schools by healthcare students from five professional fields who had received appropriate training. The students were involved and creative, and they were focused on developing pupils' psychosocial competences., (© 2023. The Author(s).)

4-H academics responded to the COVID pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

This study investigates the patterns of promoting physical activity among residents in Mueang District, Mahasarakham Province, Thailand. It explores the impact of contemporary societal shifts, such as increased reliance on technology and decreased physical labor, on public health. The research identifies the rise of chronic diseases due to lifestyle changes and the need for preventive strategies emphasizing physical activity. Utilizing a questionnaire, the study analyzes residents' knowledge, awareness, motivation, and practices regarding health promotion through physical exercise. The findings reveal high general knowledge and awareness of health benefits but low levels of physical activity practice, influenced by lifestyle and societal changes. The study emphasizes the importance of tailored health promotion strategies and the role of digital platforms in enhancing physical activity awareness and participation. This research contributes to understanding effective methods to promote physical activity and addresses the health challenges faced by the local population, promoting sustainable physical and mental health.

Background: Health education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations., Methods: We pre-registered the study on Open Science Framework https://osf.io/ek5yg/ . We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting., Results: We identified 8618 unique records, 96 met our criteria for inclusion - involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09-0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05-0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers., Conclusions: Evidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health., (© 2023. The Author(s).)

Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a "non-traditional" setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated "supersetting approach," where multiple settings work in synergy with each other., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jenkins, Wills and Sykes.)

(1) Background: Pakistani women are among one of Catalonia's most affected groups by obesity and cardiovascular disease. The design of health education strategies for them has become a compelling need. This paper aims to enlighten the elaboration and evaluation procedure of culturally and linguistically tailored nutrition education materials for Pakistani women participating in the PakCat Program, which aims to evaluate the efficacy of a nutrition education strategy allowing the participants to become ambassadors of healthy eating habits for their community. (2) Methods: In this Randomised Control Trial (RCT), 137 Pakistani women (70 from the intervention and 67 from the control group) took part. We conducted 10 sessions for the intervention group and 3 sessions for the control group in the form of small groups. The sessions were conducted in Urdu and Punjabi, and the material was translated into Urdu, Catalan, Spanish and English. For some sessions, we elaborated on new materials and for others, we adapted them from the existing nutrition material in aspects of language and culture. We evaluated the nutritional material from the observation carried out by the dietician who developed the sessions, participants' feedback at the end of the sessions and a satisfaction questionnaire. (3) Results: We summarised the elaborated material in form of two multilingual nutritional guidelines about portion size and heart-healthy foods. We also registered several materials generated for the PakCat program such as an infographic about myths and beliefs related to food, a booklet to read and interpret the food labels, a recipe book for healthy snacks, and an infographic of 10 tips for healthy eating. We also organised a PhotoVoice exhibition of 70 healthy plates elaborated by the intervention group participants. The participants highly appreciated the material in terms of visualization, cultural and linguistic adequacy, and level of comprehension through all three evaluation methods. (4) Conclusions: The design of culturally and linguistically tailored nutrition education material for Pakistani women living in Catalonia is attainable and effective to meet their specific needs. The healthy dietary recommendation can be adapted to them preserving their traditional dietary pattern, and they acquire the confidence to start following a healthy diet., Competing Interests: The authors declare no conflicts of interest.

Background: Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0-3., Methods: We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for dissemination of reliable medical information. The control group received only the WeChat group., Results: Between the intervention and control groups, changes in unintentional injuries (OR = 1.71, 95% CI: 1.02-2.87, P = .04), preventability (β = 0.344, 95% CI: 0.152-0.537, P &lt; .001), daily supervision behavior (β = 0.503, 95% CI: 0.036-0.970, P = .04), and behaviors for preventing specific injuries (β = 2.198, 95% CI: 1.530-2.865, P &lt; .001) were significantly different, and change in first-aid skills for treating a tracheal foreign body were nearly significant (P = .06)., Conclusions: The WeChat-group-based parental health education can reduce the occurrence of unintentional child injuries by improving parents' skills, beliefs, and behaviors. Online social communities promote health education and reduce unintentional injuries among children., Trial Registration: ChiCTR1900020753. Registered on January 17, 2019., (© 2022. The Author(s).)

Background: Health promotion behaviors are key determinant of health and well-being, and also play an important role in promoting successful aging. This study investigated levels of engagement in health promotion behaviors among Chinese rural older adults, and explored effects of perceived health competence, health education activities experience and sociodemographic variables on health promotion behavior in this population., Methods: A multicenter cross-sectional survey was performed. Participants were recruited by a multistage, stratified, cluster-sampling procedure from Nanbu County, Sichuan Province, China. All participants completed four paper questionnaires: sociodemographic characteristics and health care status survey, the Chinese version of the health promoting lifestyle profile-II (HPLP-II), perceived health competence scale and Lubben social network scale. Data were collected from July to August 2021. Stepwise multiple linear regression analysis was performed to analyze the effects of different factors on health promotion behaviors., Results: A total of 425 rural older adults with an average age of 72.7 years were included in analysis. The overall average score of HPLP-II was 101.6. The stepwise multiple linear regression analysis results showed that those who had higher perceived health competence (β = 0.66, P < 0.001), experienced health education activities (β = 0.254, P < 0.001), had physical examination (β = 0.107, P < 0.001), was married (β = 0.189, P < 0.001), had primary school education or above (β = 0.189, P < 0.001), and had a per capita monthly household income of more than 1000¥ (β = 0.085, P = 0.007), have higher levels of engagement in health promotion behaviors; while the level of health promotion behaviors of the older adults living alone was lower than that of living with their spouse or others (β = -0.192, P < 0.001). Combination of the above variables accounted for a total of 69.1% of the variance in health promotion behaviors., Conclusions: The level of health promotion behaviors among Chinese rural older adults is low. Perceived health competence and health education activities experience are two strong determinants of health promotion behaviors. Comprehensive health promotion programs aimed at improving perceived health competences and health literacy through health education activities may be an important part of optimizing the level of health promotion behaviors among rural older adults., (© 2022. The Author(s).)

Background: Falls are common among adults aged 60 years and older because of physiological changes. Most falls in older adults occur most often at home. Coupled with the lack of awareness and knowledge of preventing falls, the proportion of injuries and deaths among older adults due to falls is increasing yearly. Our study developed a WeChat mini-program for urban elderly to implement teach-back health education (TBHE) that a repeated cycle process of health education, assessment, and re-education in preventing falls at home., Objectives: This study aimed to evaluate the application effect of the TBHE-based WeChat mini-program on health education knowledge for fall prevention at home for urban older adults., Design: A single-blinded, two-arm parallel-group, randomized controlled trial was conducted., Setting: Three residential communities, named Hot Spring Apartment, Hualinyuan, and Dongtang Community in Gulou District, Fuzhou, China., Participants: Participants were older adults recruited from communities in Fuzhou from January to March 2021., Methods: Fifty-nine participants agreed to participate and were assigned randomly to the intervention group (n = 29) or the control group receiving traditional health education (n = 30). Each participant in the intervention group received twice a week for a total of 8 weeks of health education interventions performed by the first author that she is intervenor according to specific themes. The trial statistician, recruiters, and participants were blinded to group allocation. The intervenor (first author) was blinded to the study hypotheses. To evaluate the effects of the intervention, we assessed participants' knowledge total score and scores of physiology and disease; drug application; mental, cognitive, and spiritual well-being; lifestyle; and house environment at baseline and 1-week post-intervention and compared scores between two groups. A two-way repeated-measures analysis of variance was conducted to examine the effects of time, group, and their interaction., Results: There was a significant difference in knowledge of house environment (p = 0.003) between the two groups. Within groups, total and five dimensions knowledge scores had a significant difference (p < 0.001). Moreover, interaction effects were significant on drug application (p = 0.012) and mental, cognitive, and spiritual well-being (p = 0.015)., Conclusions: The TBHE can improve knowledge on fall prevention at home among urban older adults. The TBHE based on the WeChat mini-program could enhance the efficiency and effectiveness of being educated among urban older adults., Trial Registration: Chinese Clinical Trial Register: ChiCTR2100052946 ; reg date: 06/11/2021., (© 2022. The Author(s).)

Background and Objective: Self-medication is considered one of the largest social, economic, and health problems in developing communities, including Iran. The present study aimed to determine the effectiveness of a child to family communication approach to self-medication based on the Health Belief Model [HBM]., Material and Methods: This study is a quasi-experimental study that was conducted on 124 students in the fourth grade and their mothers in the intervention and control groups in Isfahan city, Iran. Using multi-stage simple random sampling, two primary schools were selected from each group, and then one class was selected from each primary school. Students in the intervention group attended the educational sessions. Then, the students were required to transfer their education to their families. The impact of education on mothers was evaluated two months after the last session. Data were collected before and after the intervention with a researcher-created questionnaire based on the HBM and were analysed using the SPSS 17 software package, with chi-square, Mann-Whitney U, and Wilcoxon tests., Results: Before training, there was not a significant difference in the mean scores of the HBM constructs in terms of the demographic characteristics between the two groups. After the educational intervention, the mean of knowledge and HBM constructs were increased significantly, and the mean of perceived barriers decreased significantly in the experimental group [ P < 0.001]., Conclusion: According to the present study, the child-to-family education based on the HBM was effective. It is suggested that educational interventions based on the HBM be designed and implemented to decrease self-medication in Iranian families., (© 2022 Fakhreddin Chaboksavar et al., published by Sciendo.)

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016-2018 in the form of a questionnaire interview among patients-consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities ( N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients' lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients.

To date, little research on healthy lifestyle promotion has focused on older adolescents (16-18-year-olds), yet this is a key time that habitual healthy lifestyles could be developed. Ninety-three participants (thirty-nine males; fifty-four females) (mean age = 16.9, (SD 0.4) years), from three low socio-economic high schools in England, completed an online questionnaire on their self-reported: (i) daily physical activity (PA), (ii) active transportation, (iii) active leisure time, (iv) food intake and (v) experiences of how healthy lifestyles are promoted specifically to them. Overall, 60% reached the daily PA recommended guidelines. Yet, 92% used a bicycle/walked for a least 10 min continuously as active transport and of these, 86% undertook this at least 5 days per week. Almost half undertook MVPA as active leisure, but 66% still spent ≥ 5 h sedentary. Seventeen percent met recommended nutritional guidelines for health and 90% ( n = 80) did not report school as a place that promoted healthy lifestyles. It is recommended as a public health measure and as an educational policy matter that schools implement more targeted PA and healthy eating initiatives for older adolescents that also include the adolescent voice. Further, gaining a deeper insight into male older adolescents' health literacy is needed.

We offered an enrichment program for high school students with the theme, "The Environment, Health, and You" during the Summer of 2022 and the Spring of 2023. We developed several educational modules for high school students that provided them with an opportunity to learn and explore the foundations of physiological systems, nutrient needs to maintain health, and the impact that environmental factors can have on them. The modules included videos, discussion boards, games, readings, and labs. These modules were integrated into the first session: Your Body and Health. On "day 1," the first module explored the basic physiology and anatomy of the body with respect to the organization of cells into organ systems. Additionally, the educational content included information on macro- and micronutrients and their impact on body development, nutrition, and metabolism. The nutrition module explored nutrition concepts and various factors that can impact healthy eating patterns, such as food insecurity issues and the consumption of ultraprocessed foods. A lab activity on label reading was included to help empower students to make healthy choices. A total of 43 high school students participated in the program. Overall, the quality of the educational content in the modules was rated highly by the students, and they indicated that the educational experience inspired them to learn more about the physiology and nutrition concepts associated with human metabolism, and the importance of healthy food choices to maintain health.

Background: The rates of exclusive breastfeeding at 6 months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care., Method: Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads who breastfed exclusively in the first 4 weeks of the children's life and agreed to participate were included. The main outcome was exclusive breastfeeding at 6 months. Secondary variables were type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the effectiveness, the difference in the proportions of dyads with exclusive breastfeeding at 6 months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6 months, a multilevel logistic regression model was fitted. All analyses were performed to intention to treat., Results: The percentage of dyads with exclusive breastfeeding at 6 months was 22.4% in the intervention group and 8.8% in the control group. PROLACT intervention obtained an RR =2.53 (95% CI: 1.54-4.15) and an NNT = 7 (95%CI: 5-14). The factors associated with exclusive breastfeeding at 6 months were the PROLACT intervention, OR = 3.51 (95%CI: 1.55-7.93); age > 39 years, OR = 2.79 (95%CI: 1.02-7.6); previous breastfeeding experience, OR = 2.61 (95%CI: 1.29-5.29); income between 500 and 833.33 €, OR = 3.52 (95%CI 1.47-8.47).); planning to start work before the infant was 6 months old, OR = 0.35 (0.19-0.63) ., Conclusions: The PROLACT intervention in primary care is more effective than the usual practice for maintaining exclusive breastfeeding at 6 months, and can therefore be considered evidence-based practice for implementation in standard practice., Trial Registration: The trial was registered with ClinicalTrials.gov under code number NCT01869920 (03/06/2013)., (© 2022. The Author(s).)

Background: Health promotion and education (HPE) is a valuable component of initiatives to improve health and prevent disease in the Eastern Mediterranean Region (EMR)., Aims: To assess the type and scope of HPE interventions in the EMR and analyze lessons learned., Methods: A rapid review was conducted using a PICOS (participants, interventions, comparisons, outcomes and study approaches) framework guiding approach., Results: We identified a growin interest in HPE approaches in the EMR, with the majority of studies published within the past five years. Few high-quality studies were identified. Formative research predominated with nearly half of the studies recommending the need toscale up HPE interventions. There was little emphasis on implementation and evaluation of priority HPE interventions., Conclusion: The findings highlight the need to: (1) up-scale resource-efficient HPE interventions; (2) implement HPE programmes addressing noncommunicable disease priorities; and (3) capacity building to operationalize high-quality interventions and evaluations., (Copyright © World Health Organization (WHO) 2022. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Health support pharmacies (HSPs) have been established as a new category of pharmacies in Japan. In addition to prescriptions, HSPs provide several health services, including consultations on diet/nutrition, health foods, and nursing care. Therefore, not only individuals receiving medications but also community residents should have access to HSPs. However, it is unclear whether people are aware of HSPs. Thus, the purpose of this study was to assess the awareness about HSPs and determine the need for their services. To this end, we conducted an online cross-sectional questionnaire survey in 10,000 Japanese adults. Approximately 60.2% of the participants were aware of family pharmacies/pharmacists, and 21.8% of these participants had a family pharmacy/pharmacist. Meanwhile, 2.6% of the participants were aware of HSPs, while 9.2% of the participants had only heard of HSPs. Awareness of HSPs was higher among men and younger individuals than among women and older generations. In addition, only 7.2% of the participants were aware of the location of the HSP in their area of residence. At the time at which this survey was conducted, only 3.5% of the participants were using HSP services, and half of them did not perceive the merits of using these services. However, 44.4% of the participants wished to avail themselves of HSP services in the future, and this desire increased with age. Half of the participants wished to use services that were associated with drugs, and the need for other services, such as consultations on diet/nutrition or health foods, was low. In conclusion, there was low awareness about HSPs among the survey participants. However, from our findings, we gathered that if individuals are aware of HSPs, they will wish to use HSP services. To improve healthy life expectancy, it is important to increase awareness about HSPs and their number.

Background: Adequate sodium intake is important for lowering blood pressure and thus reducing cardiovascular disease risk and other complications. The aim of this review is to identify recent interventions around the world that have been successful in reducing salt intake., Methods: A search in the PubMed, Web of Science and Scopus databases was performed. We include studies published in the last 10 years; randomized trials, pilot intervention without a control arm or experimental study; adult participants; and interventions that successfully reduced salt intake. Study quality was assessed., Results: We included 21 studies, 16 randomized intervention trials and five nonrandomized intervention studies. Eleven interventions described health and nutritional education, seven interventions described nutritional education plus other interventions, and three studies used salt meters to reduce sodium intake., Conclusion: Health and nutritional education, nutritional education plus other interventions and estimates of salt intake showed success in the reduction of salt consumption. There is no evidence that one type of intervention analyzed is more effective than other in reducing salt consumption, so we must analyze each in which individuals or subpopulations will have the intervention performed and use the most suitable approaches to lead to better results.

Background: India achieved elimination of leprosy nationally in 2005, but since then the number of patients with grade 2 disability at diagnosis increased steadily indicating delay in diagnosis. Therefore, there was a need for public health interventions which can increase case finding in their earlier stage. The objective of this study is to compare the effectiveness of three such community-based interventions; 1) Enhancement of community awareness on leprosy; 2) Education and motivation of "Index" leprosy cases; and 3) Involvement of Non-Formal Health Practitioners (NFHPs) to promote early detection of new cases of leprosy., Methodology/principal Findings: Three community-based interventions were implemented between April 2016 and March 2018, embedded within the National Leprosy Eradication Program (NLEP) of India. Interventions were 1) increasing awareness through involvement of Gram Panchayat (local government) in the community regarding early signs of leprosy (Awareness), 2) providing health education and motivating newly diagnosed leprosy patients to bring suspects from their contacts (Index) and 3) training local non-formal health practitioners (NFHP). Each intervention was implemented in a group of ten blocks (sub-division of district) with an additional ten blocks as control (with no intervention). The main outcomes were number of new cases detected and number of grade 2 disability among them. They were obtained from the routine NLEP information system and compared between these interventions. On an average, there was an addition of 1.98 new cases in Awareness blocks, 1.13 in NFHP blocks and 1.16 cases in Index intervention blocks per month per block after adjusting for changes in control blocks during the same period. In terms of ratio, there was a 61%, 40% and 41% increase in case notification in awareness, Index and NFHP intervention, respectively. Overall, the percentage of grade 2 disability across intervention blocks declined., Conclusion: The Awareness intervention appears to be more effective in detection of new cases, compared to Index case motivation and sensitization of NFHPs. However, it is important to stress that while selecting strategies to increase early diagnosis it is important to determine, which is the most appropriate for each context or area and must be decided depending on the local context., Competing Interests: The authors have declared that no competing interests exist.

Background: Health promotion and patient education are crucial to improved population health and are also among the core principles that define naturopathy. Yet, the activities of naturopathic practitioners (NPs) with regards to health promotion and community education have not been widely studied., Methods: A cross-sectional online survey of an international convenience sample of NPs was conducted through disseminating a 15-item questionnaire prepared in five languages. Correlates of most frequently mentioned NP activities were studied., Results: The survey was completed by 813 NPs representing all world regions. Almost all participants (98%) reported at least one health promotion activity. Most reported were information sheets and handouts (92.7%) or social and professional network communications (91.8%) and information talks presented to community members (84.9%). The majority of NPs (79.5%) indicated that the 'health issues individuals in NPs' community have said they need help with' were a 'very important' consideration when they designed health promotion activities. NP characteristics associated with the likelihood of engaging in specific health promotion activities varied between activities but include gender, time since first qualification, factors considered to identify need when designing an activity, and stakeholder involvement in activity design., Conclusions: Health promotion is a key activity of the global naturopathic profession. There are a wide range of patient education tools utilized by NPs., (© 2021. The Author(s).)

It is important for high school female students, to be familiar with their own bodies and regularly examine their own breasts to check for any changes that could potentially be indicative of breast cancer. It is important to educate students about breast self-examination (BSE) as a means of detecting potential breast cancer early. A quasi-experimental pre and post-test design were implemented to evaluate the effectiveness of the educational program on high school female students by comparing the knowledge level obtained before and after the conduction of the educational program. The sociodemographic results of this study found that before conducting the educational program, a large number of participants (76.5%) had poor knowledge about BSE, but after the conduction of the educational program, there was a significant increase in knowledge, with 90.2% showing a positive effect of the program. The test of significance revealed that the increase in BSE knowledge score as a result of the educational program was highly significant (P < 0.000).

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.

This article describes how evaluators and stakeholders could combine their expertise to collaboratively evaluate a program designed to promote mental health in the school environment. The program, called Youth Mental Health First Aid USA (YMHFA), was designed to help young people cope with the early stages of mental health concerns. Specifically, the desired short-term outcomes of this evaluation were to (a) communicate the effectiveness of the program, and (b) determine the effectiveness of the eight-hour training. Data was collected from a survey questionnaire to staff members. Descriptive statistics were used to inform recommendations for the next steps in the development of the program. The Model for Collaborative Evaluations (MCE) was selected in this formative evaluation to actively engage the key stakeholders as collaboration members throughout the evaluation process. Implications for using the MCE in evaluating the mental health program are discussed. Overall, responses showed that the implementation of the mental health program impacted participants' schools positively.

Adolescent smoking is dangerous. This study examined the self-assessment of risk factors to expose student teachers to smoking, compared the scores of health belief model structures in experimental and control groups, and summarized the poster and slogan campaign to prevent smoking. The experimental and control groups (n=30 each) were selected using eligibility criteria and simple random sampling. Three-part questionnaires were used to collect information that was analyzed based on mean, minimum, maximum, percentage, and paired sample t-test data. The key findings were: 1) student teachers in the experimental and control groups had smoked 1-2 cigarettes in the past (20% and 6.67%, respectively). In addition, for both the groups, cigarettes were readily available at convenience stores in residential areas (63.34% and 83.34%, respectively), their fathers smoked (16.67% and 20%, respectively), and their peers persuaded them to smoke (16.67 % and 23.30 %, respectively); 2) the health belief model demonstrated that both the experimental and control groups at 8 weeks had comparable pre-post findings for susceptibility (p=0.000 and p=0.049, respectively), perceived severity (p=0.000 and p=0.063, respectively), perceived benefits (p=0.000 and p=0.065, respectively), perceived barriers (p=0.000 and p=0.703, respectively), and cure to action (p=0.000 and p=0.070, respectively); and 3) The main study "Online Health Education Program to Prevent Tobacco Use for Student Teachers during COVID-19 Pandemic in Thailand: Design, Challenges, and Outcomes" worked on anti-smoking posters and slogans. The 8-week education program with events could enhance experimental group health beliefs. Thus, student teacher smoking prevention efforts should incorporate posters and slogans.

Public health education is a powerful tool for improving communicable disease awareness and prevention protocols. Despite the fact that health education is crucial for the advancement of COVID-19 awareness and vaccination decisions, how a teacher approaches students to learn about health education during COVID-19 vaccination is a challenging issue. This study aimed to assess the preferences for public health education during COVID-19 vaccination intervention and compare the predictors of preferences between science and non-science university students in Bangladesh. A multi-item questionnaire was developed and an online link was conveniently sent to the encounters between 31st May, 2023 and 15th August, 2023. Binary logistic regression analysis was applied to rationalize the research objective. The pooled preference for public health education was 71.3% (95% Confidence Interval [CI] 67.7-74.3) vs. 81.5% (95% CI 79.3-84.7) between science and non-science students. Out of twelve predictors "vaccine agreement", "bio-safety behavior", and "disease awareness" were significantly associated (p < 0.01, p < 0.05) with the preference for public health education in both groups. Varied effects were also observed for some predictors: vaccine "safety" and "side effects" were significant (p < 0.05, p < 0.01) in science and non-science students, respectively. To address the conflict in decisions, non-science students significantly preferred "prevention alliance" whereas science students preferred "environmental health" issues (p < 0.05).Public health education was more preferred by non-science university students than by science students in making COVID-19 vaccine decisions. The focus of transformative public health education should be interdisciplinary, including information on communicable diseases, public health measures, and prevention alliances, as well as information about vaccines' side effects and safety.

The growing popularity of health education on social media indicates the need for its appropriate evaluation. This paper aims to present the potential of the Kirkpatrick Model (KM) with New World Kirkpatrick Model (NWKM) additions to evaluate the nutritional education provided by dieticians via Instagram. Instagram profiles of ten dieticians providing nutritional education for their followers were analyzed in March and April 2021. The study sample included profiles of both macro- and micro-influencers. The analyzed quantitative data included Instagram Engagement Rate and the number of likes and comments per post. The qualitative analysis of the comments was performed following the theoretical framework provided by the KM and NWKM. Collected data showed followers' satisfaction, commitment, and relevance of the presented content, fulfilling the Level 1 of NWKM. Level 2 of NWKM was represented by 4 out of 5 dimensions (knowledge, attitude, confidence, commitment). No comments were found only for skills. Both Levels 3 (Behavior) and 4 (Results) of the KM were met. However, the use of the NWKM for them seems limited. The KM can be used to evaluate nutritional education on social media. The NWKM additions seem applicable mostly for Levels 1 and 2.

Background: Adequate nutrition is required for growth and development in children. This study tested the effectiveness of nutrition education on knowledge and BMI-for-age (BFA) of school-aged children in the Kumasi Metropolis., Methods: Children, aged 9-13 years old were recruited from ten randomly selected primary schools in the Metropolis. The schools were randomly allocated into 3 groups: nutrition education (3 schools), physical activity (PA) education (3 schools), both interventions (2 schools), or control (2 schools). Following a baseline nutrition and PA knowledge and status assessment in 433 children, twice-monthly nutrition and PA education and demonstrations were carried out for 6 months, followed by a post-intervention assessment., Results: PA and nutrition knowledge improved in all groups (P<0.001); the highest improvement was among those who received both interventions (31.0%), followed by the nutrition education group (29.8%), and the least, the control group (19.1%). Overall, BFA improved by +0.36, from baseline (-0.26) to end of the intervention (+0.10, P<0.001). Within the groups, the nutrition group (+0.65, P<.001) had the highest improvement, then, both the intervention group (+0.27, P<0.001), the PA group (+0.23, P<0.001) and lastly, the control group (+0.18, P=0.001)., Conclusion: Nutrition education could improve knowledge and BMI-for-age in school-aged children in Ghana., (© 2021 Annan RA et al.)

Background: Health promotion is essential to the SAFE strategy for trachoma elimination. Schools are a valuable venue for health promotion. However, there is little literature about the impact of health education and water infrastructure in schools on facial cleanliness and trachoma in the community. Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large., Methodology/findings: A cross-sectional survey was carried out in all 92 villages in Kongwa district, which included 85 primary schools. Data were collected on health messages and water infrastructure in the schools. A random sample of 3084 children aged 0-5 were examined for facial cleanliness in all villages. In 50 villages, a random sample of 50 children aged 1-9 per village were examined for follicular trachoma (TF). Thirty-seven (44.6%) schools had educational materials on face-washing. Fifty (60.2%) schools had a washing station. The presence of a health teacher was correlated with having posters on face washing in classrooms. The presence of face-washing materials was correlated with the availability of washing stations. Neither teachers mentioning face-washing in health curricula nor educational materials in classrooms were associated with clean faces or trachoma in the community. Having a washing station in the school was associated with lower community rates of trachoma., Conclusions: Primary school health messages and materials on trachoma were not associated with clean faces or lower rates of trachoma in the community. The target audience for primary school health promotion is likely the students themselves, without immediate rippling effects in the community. A long-term perspective should be considered during the implementation of health promotion in schools. The goal of school health promotion should be training the next generation of parents and community health leaders in combatting trachoma., Competing Interests: The authors have declared that no competing interests exist.

Timely entries to antenatal care have various benefits for pregnant women and birth outcomes. The aim of antenatal care is to assure that every pregnancy culminates in the delivery of a healthy baby without negative effects on the health of pregnant women through health promotion and disease prevention, early detection, and treatment of complications and existing diseases. Hence, this study assessed the late initiation of antenatal care and associated factors among pregnant women attending antenatal clinics at public health centers of Ilu Ababor Zone, southwest Ethiopia. An Institution-based cross-sectional study was carried out among 389 pregnant women who were attending antenatal care service at twelve randomly selected health centers. A systematic sampling technique was employed to recruit pregnant women. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Those women who started antenatal care follow up after 12 weeks of gestational age were categorized as booked lately. Bivariable and multivariable logistic regression was employed to identify an association between the independent predictors and the outcome variable. In this study, 277 (71.2%) of the participants were booked their first antenatal care visit lately. Having family size of ≥ 4 (AOR: 2.25; 95% CI: 1.07-4.74), maternal age ≥ 25 years (AOR: 2.30; 95%CI: 1.02-5.18) and perceived the right time of booking > 12 weeks of gestation (AOR: 2.39; 95% CI: 1.13-5.04) had higher odds of late antenatal care initiation. Similarly, not being a member of women's health developmental army (AOR: 2.35; 95%CI: 1.09-5.07) and ANC not attended previously (AOR: 3.32; 95% CI: 1.17-9.42) had also a more likelihood of booking antenatal care lately. In this study, the majority of women started antenatal care lately. Thus, the provision of health education on the importance of attending first antenatal care early is recommended., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Introduction: promoting healthy eating habits among childhood is one of the key aspects to improve medium and long-term health outcomes. Objectives: the main aims are to improve eating habits, promote the Mediterranean diet (MD) and prevent and/or reverse overweight and obesity in children from 3 to 12 years old. Methods: the program has a one-year follow-up and includes three to five visits with registered dietitians, one telephone control and one practical workshop. Anthropometric, body composition and eating habits data are collected, and nutritional education is carried out. A total sample of 1,000 children will be included. Results: until now, 622 participants have been included (51.6 % boys; median age 8.5 years). At the beginning, 32.2 % of participants were overweight or obese and 38.9 % had an adequate MD. Although no differences were found in the assessment of the Kidmed questionnaire regarding sex (p = 0.214) or body mass index (BMI) subgroups (p = 0.181), differences were found regarding age (p = 0.023) and BMI Z-score (p = 0.004), showing slightly lower values in those having and adequate MD. At the moment, 362 participants have made the six-month visit, of which 61.6 % presented an adequate MD, with statistically significant differences compared to the baseline visit (p < 0.0001). Conclusions: preliminary results show the need for nutritional education in children and suggest that Programa Nutriplato® can be effective in improving eating habits.