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Introduction: The burden of non-communicable diseases (NCDs) is a major challenge for countries, regardless of their level of development. Social branding is an emerging approach to health promotion for NCD prevention. In this paper, the process of social branding is documented as a case study to help researchers develop similar kinds of interventions in the settings in which they work. Methods: The process of developing a social brand is documented through conversations with the project team, observations in the field, interaction with community local members, and information gathered through photographs, videos and newspaper clippings. Results: The social brand focused upon in this study was named the "Aarogyachi Vaari" (Health Pilgrimage) inspired by the "Pandrapur Wari," a religious pilgrimage undertaken in the state of Maharashtra, India. Various stakeholders from self-help groups, panchayat raj institutions and schools from the local village collaborated successfully to implement the health event in a manner similar to the way in which diverse religious groups come together for the Pandrapur Wari religious pilgrimage. The Aarogyachi Vaari took the form of a strategically planned health event consisting of various health promotion stalls, many developed by local villagers themselves. The organisation of the event was aided by resource mobilisation within the local community. Discussion: Social branding can be an effective tool for health promotion in community settings. Studying people's cultural preferences and what makes them feel connected and excited can lay the foundations for the creation of a social brand that reflects their choices and helps them take up healthy behaviours on their own. It is possible to mobilise a community for health through social branding that is culturally relevant and connected to the interests and priorities of local people.

Objective: Strategic storytelling can be used to reframe dominant cultural narratives and improve community health outcomes. This pilot study assessed the impact of an original, online 3-week e-course, delivered from November to December 2021, in increasing learners' knowledge of and concern for the seriousness of skin-shade discrimination and the use of skin-lightening products in India, increasing learners' understanding of storytelling-based communication techniques for public health promotion, and increasing learners' intentions to use strategic storytelling for social change. Design, Setting and Method: The course used case-method pedagogy to address colourism and cosmetic skin lightening. Learners (N = 25) completed a pre-course baseline survey on their knowledge and concerns regarding colourism and the use of skin-lightening products, as well as their expectations and interests in taking the course. Following course completion, learners completed a post-webinar survey. The Wilcoxon Signed-Rank test was used to assess differences from pre- to post-course surveys on quantitative items. Open-ended responses were also analysed using qualitative content analysis for recurring themes on learner interest and experience. Results: From pre- to post-course surveys, there were significant improvements in learners' knowledge of skin shade discrimination and the use of skin-lightening products (p < 0.05). Learners indicated being more concerned about the seriousness of skin shade discrimination post-course compared to pre-course. Learners also described a positive learning experience and indicated that the e-course enhanced their understanding of strategic storytelling. Conclusion: Findings highlight the importance of an original e-course that uses case-method pedagogy to build knowledge and skills that addresses the impacts of colourism on the health of Indian adolescents and provides new directions for future research on health education interventions that aim to tackle colourism.

Objective: Schools are important settings for health promotion. In schools, children and adolescents can be reached regardless of their social background, which represents a unique opportunity for promoting health. Several studies have demonstrated the importance of school leadership in initiating and sustaining health promotion; however, efforts to systematically review the influence of school leadership on school health promotion are still lacking. Hence, this paper analyses empirical studies published in scientific journals on school leadership and health promotion in schools. Design: Systematic literature review. Method: Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a review was conducted using two main databases: Web of Science and Scopus, which retrieved 51 eligible articles. Results: The review of these articles resulted in the identification of seven main themes -- school leaders' health; attitudes, knowledge and behaviour; accountability; support from school leaders; shared leadership approaches; capacity building and parent engagement. Conclusion: This systematic literature review expands the literature by highlighting the school leadership factors that promote school health promotion in Oceania, Europe, North America, South America, Africa and Asia continents. Future systematic literature reviews could explore studies and different aspects of health promotion by teachers, especially in the Asian context.

Purpose: The present study has attempted to examine the connection between health literacy (HL) and subjective well-being (SWB) amongst university students in North India. In addition, the present research also sought to establish the role of "gender" and "absence/presence of health professional in the family" as a socio-demographic variable in the relationship between HL and SWB. Design/methodology/approach: This study used a descriptive and quantitative research design. Students were asked to respond to an online questionnaire as part of a survey strategy. Out of 550 respondents who completed the survey, only 511 responses were usable after data cleaning. Findings: The structural equation modelling regression analysis revealed a positive association between HL and SWB. In addition, the moderating role of gender and the "presence/absence of health professionals in the family" between HL and SWB was also established. Research limitations/implications: Although a sizable sample of university students responded to this poll, it was a convenience sample. The study cannot be generalised to the general population; thus, future scholars can include other socio-demographic sections. Theoretically, it has tested a research framework concerning multiple dimensions of students' SWB and HL. In addition, the moderating role of gender and the "presence/absence of health professionals in the family" is another unique research contribution of this study. Practical implications: The results of the current study provided evidence that HL promotion efforts are needed amongst the student population in India to enhance their well-being. The objective of practitioners and relevant stakeholders (parents, government agencies and universities) should be to build capacities concerning HL at both personal and institutional levels. Based on the findings, more educational programmes should be created for the students to promote HL and raise awareness of healthy lifestyles. Originality/value: The degree to which people can locate, comprehend and use information and services to support health-related decisions and actions for themselves and others is known as "health literacy." HL is closely associated with SWB, which means how people perceive and assess their lives and particular spheres and activities within them. The current research on the relationship between the two domains is limited. This study looked into the effects of HL on SWB amongst university students in North India.

Wellness is an important asset of every human being. The wellness of health encourages a person to move towards awareness, education and individual progress. Teachers are the superheroes of the educational system and tend to be underrepresented and overworked. The promotion of teacher wellness and health is revealed student health and wellness and may lead to a more effective and positive environment for learning on the whole. According to the National Wellness Institute, "a conscious, self-directed and evolving process of achieving full potential". This study aims to find the level of wellness among school teachers. Survey method was adopted to collect data through questionnaire from 60 school teachers of Kendriya Vidyalaya, Government and Government Aided School. The finding of the study reveals that the Kendriya Vidyalaya School Teachers scores higher on the dimension of "Meaning" (28.6) and lower on the aspect of "Body and Sexuality" (15) among the ten dimensions, the Government school scores higher on the proportion of "Self-Responsibility" (21.4) and lower on the aspect of "Body and Sexuality" (12) among the ten dimensions and the Government Aided School teachers scores higher on size of "Meaning" (24.5) and lower on the aspect "Body and sexuality" (13.4) among the ten dimensions. The study also reveals that every school scores lowest in one particular point (i.e. Body and Sexuality). Hence, Kendriya Vidyalaya School Teachers have good wellness than the Government and Government Aided School.

Background: Dental neglect results in dental caries, gum disease, and contributes to chronic diseases such as heart disease, stroke, diabetes, and cancers. Poor oral health habits developed in childhood persist into adulthood and can contribute to chronic diseases. School settings are a practical platform for teaching oral health skills. Purpose: The purpose was to assess the effectiveness of school-based, primary prevention oral health interventions for children and adolescents and to examine these programs for health behavior theory applications. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement and Checklist was used in reporting systematic review data. EBSCOhost database was utilized to search interventions by applying inclusion criteria. Data extraction occurred in four distinct phases to ensure all examined interventions met acceptable standards. Results: Eight interventions satisfied the inclusion criteria. Each study utilized oral health knowledge as an outcome variable. Two of the eight interventions stated that they utilized a specific health behavior theoretical framework. Each study applied health behavior concepts. Interventions were efficacious for improving oral health knowledge. Translation to Health Education Practice: Oral health education interventions in schools appear to be effective in providing dental skills and oral health knowledge.

Objectives: The purpose of this study was to assess the experience and satisfaction of teachers and parents of children with and without diabetes, with the Kids and Diabetes in School (KiDS) intervention. Project KiDS aimed to foster a safe and supportive school environment to encourage the management of type 1 diabetes and prevention of type 2 diabetes. Design: This qualitative evaluation involved semi-structured, face-to-face, in-depth interviews with a purposive sample of 35 respondents, including teachers and parents of children with and without diabetes attending the selected schools at 1 and 3months post-intervention implementation. In total, n = 5 schools (3 government and 2 private) were selected out of 15 schools in which the KiDS project was implemented. Methods: In total, 65 interviews were conducted in two rounds. The sample comprised teachers (n = 20 in round 1; n = 18 in round 2), parents of children with diabetes (n = 3 in both the rounds) and parents of children without diabetes (n = 15 in round 1; n = 6 in round 2) attending five schools. Data were analysed using the thematic framework method. Results: Teachers reported gaining new knowledge as a result of the KiDS intervention. They felt more confident in assisting children with diabetes. Suggestions to strengthen the KiDS resource pack were the inclusion of case studies and audio-visual aids. Parents of children with diabetes reported that the project reinforced information and improved diabetes management skills. Their suggestions for strengthening KiDS materials included the provision of additional technical information. The parents of children without diabetes reported that the resource pack aided a better understanding of diabetes and clarified myths and misconceptions. Suggestions for strengthening the pack included the regular reinforcement of information on diabetes among children. Conclusion: Findings support the upscaling of KiDS work elsewhere in India through the engagement of multiple stakeholders to promote the management and prevention of diabetes in school.

Objective: Anaemia is a health problem for adolescents in India. This paper examines the nuanced transformations triggered by a multi-pronged, community-based anaemia intervention with adolescents and their families, seeking meaningful insights for future nutrition and anaemia programmes. Design: Qualitative study rooted in critical theory. Setting: Three slum communities -- Dharavi and Kandivali (in Mumbai) and Kalwa (in Thane) in Maharashtra, India. Methods: Data were collected through focus-group discussions and in-depth interviews with young people, parents and other stakeholders. Content analysis of drawings of a nutritious food plate by participants supplemented discussion and interview data. Thematic analysis was undertaken manually using a grounded theory approach. Findings: Nutrition education with adolescents and parents led to reduced junk food consumption although reinforcement of the information provided was necessary to sustain the change. Parental support was a crucial factor in ensuring anaemia treatment compliance but was affected by a lack of awareness regarding the consequences of anaemia and the nutritional requirements of anaemic adolescents. Other factors, including the pampering of boys, the neglect of girls and the heavy workload of mothers influenced treatment compliance. Awareness and agency among adolescents contributed to a supportive environment in terms of raised consciousness and better sanitation within families and the community. Conclusion: Findings highlight the need for a holistic approach to address anaemia among young people. While nutrition and health education are important to address treatment noncompliance, this approach should also focus on factors such as socioeconomic status, gender equity, health prioritisation, family involvement and engaging young people as agents of change to promote an enabling environment.

Introduction: Inadequate caregiving conditions interfere with successful health and development outcomes. Access to appropriate information can result in improved health and development outcomes in children. Health promotion text messaging, a primary mHealth strategy, has been implemented in various countries to reach communities where the majority of the population may be living in poverty and lacks access to information and health services. This systematic review investigated what effect the provision of information regarding health and development in young children, using text messages, has on caregiver behaviour and child outcomes. Method: The review was conducted according to the PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) guidelines. Studies were retrieved from Scopus, MEDLINE, PubMed, Web of Science Core Collection and Cochrane library using primary search phrases. The search was not limited to a specific period. Thematic analysis was used to organise and synthesise the information extracted from selected studies into main and sub-themes. Results: In total, 19 studies were identified, including randomised controlled trials (RCTs) (n = 13, 68.42%), observational studies (n = 3, 15.79%) and non-RCTs (n = 3, 15.79%). Message content included educational information regarding health and development (89.47%), reminders (36.84%) and caregiver support (52.63%). The majority of studies (n = 17; 89.47%) found statistically significant positive effects of text message intervention on caregiver behaviour. Text messages also affected child outcomes, with 15.79% (n = 3) of studies reporting a positive effect. Conclusion: Text messaging is an effective tool to influence caregiver behaviour and child outcomes in health. There is however limited evidence regarding text message intervention effectiveness on child development, both in quality and in quantity. More research, especially in low- and middle-income countries, is necessary.

Background: Limited evidence exists on the effectiveness of using an entertainment-education methodology to address multiple public health issues and of using participatory street theatre to improve public understanding related to public health. Objective: To assess the feasibility, acceptability and impact of the Actor-Doctor project, an intervention involving theatre professionals and medical specialists to jointly deliver street-theatre-based public health education. Design: A real-world, mixed-methods post-intervention study evaluated the Actor-Doctor project among 486 participants in Ahmedabad, India, in 2017. Setting and method: Focus group discussions with actors and semi-structured interviews with doctors and implementers assessed project feasibility, acceptability and perceived impact. Post-intervention surveys among actors, audience and a control group assessed impact on knowledge and attitudes related to select public health issues. Quantitative data were analysed using multivariable regression, and qualitative data were analysed using an inductive thematic analysis. Results: The Actor-Doctor project was feasible to implement, as 20 street theatre performances on five public health themes were developed and staged. Members of the audience showed higher knowledge of environmental health, anaemia and openness to discussing sexual health issues, compared to a control group (omega squared 0.03-0.24; p < 0.001). Actors and doctors collaborating to create theatre-based public health education derived satisfaction from the project. Balancing scientific accuracy and entertainment, especially humour was challenging. Conclusion: The Actor-Doctor project was instrumental in improving public-health-related engagement between actors, doctors and the public.

Objectives: The purpose of this study was to develop and research an interactive health education programme on NCDs in a rural subpopulation of Bengaluru and to build 'health champions' among young people to contribute to the prevention of NCDs in India. Design: A descriptive qualitative approach was used to develop and evaluate an interactive educational programme. Students, aged 12-16, from a rural secondary school took part in the study. Method: Participants were separated into five focus groups covering different NCDs including hypertension, diabetes mellitus, otitis media, oral cancer and malnutrition. Each focus group was interviewed face-to-face before, during and after all activities. Content analysis was conducted using a directed approach. Results: Findings were organised into themes that described aspects of learning that enhanced or detracted from student understanding about NCDs. Conclusion: Findings from this study show that creative methods have a positive impact on educating students, aged 12-16, on NCDs.

Objective: Using a participatory action research (PAR) model, this paper reports on findings from a mixed-methods study which aimed to discover whether specifically developed health education resources (A Germ's Journey) aid children's understanding of health-hygiene principles, and how these findings can inform the future development of culturally relevant resources to teach children in low- and middle-income countries about the association between bacteria, handwashing and disease. Design: Educational health-hygiene workshops were conducted at 13 case study sites (n = 651) in collaboration with local organisations in Ahmedabad, India. During Phase 1 of the study, children's and teacher--trainer workshops were conducted using UK resources. Following suggestions from local teachers, a Gujarati book was co-created and in Phase 2, workshops (using the Gujarati book) were delivered. Methods: Data were collected from children using quasi-experimental methods, using pre-workshop questions, follow-up questions, observations and baseline and post-workshop assessments. Data were collected from teachers using questionnaires. Results: Following teacher-trainer workshops during Phase 1 of the study, 100% of teachers stated that they would use the resources with their pupils in the future. Two months after participating in the workshops, 60%-73% of children knew how germs can cause illness, and 76%-80% knew how to remove germs from hands. When assessed during Phase 2 of the study, 54% of children scored higher after the intervention, showing an increased understanding of microbiology after using the resources. Conclusion: The results indicate that children had an improved understanding of the causes of bacterial disease and the health implications of not using adequate health-hygiene practices. Recommendations for the future development of resources include the use of a PAR model of research, co-creation with end users, and working alongside local organisations and participants in order to access 'hard-to-reach' areas.

Purpose: The purpose of this study is to understand the association between health behaviours of diet, physical activity, smoking cigarettes, alcohol consumption, safe sex and sleep quality with demographic (e.g. age, gender) and psychological (i.e. stress, self-esteem and sense of coherence) factors in Indian residential college students. Design/methodology/approach: Students studying for Bachelor of Technology at residential colleges in India were invited to complete an online questionnaire regarding their health behaviours, demographics and psychological variables. Each health behaviour was regressed onto demographic and psychological factors to determine which of them were associated with performing each behaviour. Findings: There was no clear pattern of predictors for the health behaviours overall. Self-esteem was related to healthy diet, being single was related to adequate sleep, higher parental income was related to safer sex and being older was related to more alcohol use and safer sex. Research limitations/implications: This study revealed that health education efforts may need to be designed for specific behaviours and correlates among Indian college students. Interventions regarding (1) healthy eating should target students with lower self-esteem, (2) sleep should target students in a relationship and (3) safer sex should target younger students and those from less affluent backgrounds. Originality/value: This research is one of the first attempts to study the predictors of health behaviours among Indian college students. The study highlighted that psychological factors (e.g. self-esteem) and demographic factors (e.g. relationship status, parental income, age) affect different health behaviours. These findings can help health educators to design tailored interventions and aid in health education and promotion among Indian college students.

Rates of pediatric human immunodeficiency virus (HIV) as well as mortality and morbidity related to HIV and Acquired Immune Deficiency Syndrome (AIDS) depend, in part, on the resources available in the child's country. HIV prevention and intervention efforts also are influenced by cultural factors. The purpose of this article is to summarize key findings from this special issue on international perspectives of HIV/AIDS in schools with a focus on neuropsychological and psychoeducational implications. After providing a brief summary of each article, we outline a call to action for school psychologists and educators.

Lymphatic filariasis (LF), a neglected tropical disease is targeted for elimination globally by 2020. National Health Policy of India set the goal by 2017 and annual single-dose mass drug administration (MDA) with anti-filarial drugs is in operation in endemic districts since 2004. Performance and effectiveness of MDA was diverse across the nation and prevalence of infection continues above threshold level in 50% of endemic districts which requires alternative strategies. National programme aims at achieving >65% consumption for transmission control. Post 10 rounds of MDA in an endemic district of Kerala state, a three-arm study identified determinants in gap in outreach and consumption, based on which context-dependent intervention using social group work and networking (SGWN) was implemented and impact assessed. A spill over effect with overall increase in coverage and consumption rates irrespective of arms apparently is due to inclusive improvement in MDA programme whereas, significant relative improvement in intervention arm reflects effectiveness of SGWN strategy. Though reduction in microfilaria prevalence in all arms was observed, it was significant between intervention and comparison arm. This study highlights need for context-dependent communication strategy to improve MDA for accelerating LF elimination by the targeted 2020.

Objective: Low socioeconomic status young people in low- and middle-income countries use tobacco at higher rates than their wealthier peers. School-based tobacco use prevention interventions that employ a life skills approach are effective at preventing tobacco use. In India, the Salaam Bombay Foundation (SBF) has implemented a multiyear, multicomponent life skills education programme in Mumbai schools to prevent tobacco use. A quantitative evaluation found that SBF programme exposure was associated with not only reduced tobacco use but also improved life skills, self-esteem and self-efficacy. To illuminate how programme exposure engendered these effects, we compared the experiences and perceptions of eighth and ninth grade students (ages 13-15) between SBF and non-SBF schools. Methods: We divided Mumbai into four quadrants or regions and randomly selected one SBF and non-SBF school from each quadrant; 10 participants were then randomly selected from one class per school. A total of eight group discussions (N = 80 participants) were conducted using mind-mapping with a focus on students' daily life, future aspirations and non-academic school programming. Researchers analysed the data thematically. Results: Despite similar home lives, SBF students were profoundly more optimistic about their future than non-SBF students. SBF students attributed this increased optimism and agency to opportunities to actively advocate against tobacco, formal recognition in a published newsletter, a sense of belonging to a 'Super Army' and supportive mentorship provided by their Super Army and peer leaders. The SBF programme created a safe space in which to build resilience. Conclusion: These findings can guide development of programmes for vulnerable populations with broader goals than tobacco prevention.

Introduction: Children and young people in India have a high prevalence of dental decay. As part of a broader epidemiological study, we interviewed 10 head teachers to understand the status of, and challenges to, inclusion of oral health education in the curricula of public and private schools in Tamil Nadu, India. Objectives: The two main objectives of this study were (1) to describe the views of head teachers about the implementation of oral health education in school curricula and (2) to identify challenges to achieving oral health education in public and private schools in Tamil Nadu. Method: Qualitative descriptive design, with a purposive sample of 10 head teachers who participated in semi-structured interviews. Thematic coding was used to analyse and report on the data. Results: There is a lack of oral health education in public and private schools in Tamil Nadu, India. Four main types of barriers to the initiation and implementation of oral health education were lack of recognition, academic burden, prioritisation of other health needs and policy inequities. Head teachers acknowledged the lack of oral health education in their schools, yet also acknowledged the importance of oral health education in promoting students' health. Conclusion: Health curricula in Tamil Nadu schools lack integration of oral health education. Limited access to the services, cultural factors, policy deficiencies, insufficient awareness among policy-makers, the nature of the education system and lack of research contribute to the current situation. Policy-makers should address these barriers to enable and promote oral health education strategies in both private and public schools of Tamil Nadu.

Life Skills Education (LSE) is a novel promotional program that teaches generic life skills through participatory learning methods of games, debates, role-plays, and group discussion. Conceptual understanding and practicing of the skills occurs through experiential learning in a non-threatening setting. Such initiatives provide the adolescent with a wide range of alternative and creative ways of solving problems. Repeated practice of these skills leads to a certain mastery and application of such skills to real life situation helps in gaining control over the situation. LSE empowers the youth to choose appropriate values and behaviour which are ingredients of positive health. Development of a model school mental health program using the LSE methodology and psychosocial competence of the adolescents as the goal is described. The highlights of model are: (1) Comprehensive health in adolescents is the goal; (2) Using Life Skills as the medium; (3) Providing a structure to the program by activities; and (4) Teachers as facilitators. (Contains 1 table.)

Akshar Forum, an experimental livelihood school in the semi-rural village of Pamohi, Assam, in Northeast India, tests cutting-edge methods in education in the context of underserved communities and rural development programs. Started in 2015, the school links 42 children and their parents to the vast knowledge resources of the Internet to teach them how to earn a living, start a business, initiate development work in their own communities, and act as stewards for their local environment. The school is developing a number of for-profit social enterprises: a shop for handcrafts, a soap-making business, a health clinic, a community bank, an office for legal and financial services, a laundromat business, and an environmental remediation company--all designed to provide vocational training to teenage students while simultaneously working toward the development of the community. The school functions on the belief that all of an individual's basic needs must be met in order to achieve self-actualization and escape cyclic, systemic poverty. Akshar Forum employs a student-centered model to help each individual student find the most fitting career path and maximize their earnings in a competitive labor market. Akshar Forum is an ongoing experiment that has implemented a series of innovative practices, supporting active participation from students and parents, and making modifications as they asses the efficacy of various strategies.

Purpose: The current Indian secondary school curriculum has been criticised for its failure to deliver relevant skills-based food and nutrition education for adolescents. The purpose of this paper is to understand the views of adolescents, their parents, teachers and school principals on the present food and nutrition curriculum and the role of the schools in developing food skills. Design/methodology/approach: Semi-structured interviews were held with 15 students aged 14-15 years, 15 parents, 12 teachers and ten principals in ten private schools in Kolkata, India. The interview questions were primarily based on the content, merits and demerits of the curriculum. The digitally recorded data were transcribed verbatim and analysed thematically. Findings: All the 52 interviewees observed that the food and nutrition curriculum created awareness in students about the importance of healthy eating. However, they also described certain weaknesses of the curriculum. These included lack of practical assignments, an out-dated and a limited curriculum, which failed to initiate critical thinking and was contradicted by sales practices in the school food environment. The interviewees prioritised the inclusion of food skills in the curriculum. Practical implications: The emerging evidence suggests the need for the development of a skills-focussed food and nutrition curriculum to encourage healthy eating behaviours among adolescents. Originality/value: Most of the work on food and nutrition education has come from developed nations--this is the first study in the Indian context of the secondary school food and nutrition curriculum.

Numerous studies have been published heralding the benefits of physical education in school education. Sport and physical activities form the major content in learning and the arrangement serves as the major source of development in students. This paper identifies "quality" as an internationally concerned issue and within the concept, the perceptual framework in learning is then placed with focus. To conduct this study, a sample of N = 799 ("11 Asian cities") physical education professionals working in different levels were invited to participate in a questionnaire survey with 37 items designed to forge the conceptualization of quality learning in physical education. Results from statistical analysis showed 24 items grouped in 3 subfactors being retained after EFA, of 37 items that were framed through content analysis to assess the quality physical education learning among the PE professionals. The retained three factors from the EFA were further assessed with robust confirmatory factor analysis (CFA). The 3-factor model demonstrated a good fit with the data (CMIN/DF = 7.367, NFI = 0.888, CFI = 0.901, PCFI = 0.748, RMSEA = 0.089). In this sample, the QPEL demonstrated an acceptable three-factor structure, internal consistency and inter-factor correlation. These items were appropriate to provide the necessary understanding of the diversified practice in the learning of quality physical education.

This article assesses the effectiveness of The Great WASH Yatra handwashing awareness raising campaign in India on changing visitors' intention to wash hands with soap after using the toilet and the underlying behavioural determinants. Interviews based on the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) model of behaviour change were conducted with 687 visitors before and after their visit to the campaign. Data showed that a campaign visit had little effect on the intention to wash hands with soap, even when comparing visitors who had actively participated in handwashing games with those who had not. After a campaign visit, knowledge about the benefits of washing hands had increased by almost half a standard deviation. A multiple linear regression analysis revealed that when considering all behavioural determinants change scores simultaneously, they were able to explain 57% of the variance in the intention change score. These findings suggest that substantively changing behaviour requires more than improving knowledge and emphasizing the importance of washing hands. Identifying the crucial behavioural determinants for handwashing may be an important first step in planning effective large-scale promotion programmes.

This article provides an overview of the recruitment strategies utilized in the Mumbai Worksites Tobacco Control Study, a cluster randomized trial testing the effectiveness of an integrated tobacco control and occupational safety and health program in Indian manufacturing worksites. From June 2012 to June 2013, 20 companies were recruited. Companies were identified using association lists, referrals, internet searches and visits to industrial areas. Four hundred eighty companies were contacted to validate information, introduce the study and seek an in-person meeting with a company representative. Eighty-three company representatives agreed to meet. Of those 83 companies, 55 agreed to a formal "pitch meeting" with key decision makers at the company. Seventy-seven recruitment "pitches" were given, including multiple meetings in the same companies. If the company was interested, we obtained a letter of participation and employee roster. Based on this experience, recommendations are made that can help inform future researchers and practitioners wishing to recruit Indian worksites. When compared with recruitment of US manufacturing worksites, recruitment of Indian worksites lacked current industrial lists of companies to serve as a sampling frame, and required more in-person visits, incentives for control companies and more assurances around confidentiality to allow occupational safety and health experts into their worksite.

The idea of school health is re-imagined with an emphasis on the need for children's health programmes to be rooted in an understanding of the social context. Such programmes must address health, nutrition and education in a comprehensive manner. The article details findings and insights emerging from a qualitative study conducted in municipal schools in Delhi, located in contexts of poverty. The study identifies areas requiring changes in teacher education and health programmes. A creative methodology was utilised to record children's perceptions and teachers' views on health, which found that an approach that privileges the voices of the child and the school in public health planning can be very meaningful.

Project Advancing Cessation of Tobacco in Vulnerable Indian Tobacco Consuming Youth (ACTIVITY) is a community-based group randomized intervention trial focused on disadvantaged youth (aged 10-19 years) residing in 14 low-income communities (slums and resettlement colonies) in Delhi, India. This article discusses the findings of Focus Group Discussions (FGDs) conducted to inform the development and test the appropriateness of Project ACTIVITY's intervention model. The findings of the FGDs facilitated the understanding of factors contributing to increased tobacco uptake and cessation (both smoking and smokeless tobacco) among youth in this setting. Twenty-two FGDs were conducted with youth (10-19 years) and adults in two urban slums in Delhi. Key findings revealed: (i) youth and adults had limited knowledge about long-term health consequences of tobacco use; (ii) socio-environmental determinants and peer pressure were important variables influencing initiation of tobacco use; (iii) lack of motivation, support and sufficient skills hinder tobacco cessation and (iv) active involvement of community, family, religious leaders, local policy makers and health professionals is important in creating and reinforcing tobacco-free norms. The results of these FGDs aided in finalizing the intervention model for Project ACTIVITY and guided its intervention development.

This article provides a theory-based, step-by-step approach to intervention development and illustrates its application in India to design an intervention to promote tobacco-use cessation among school personnel in Bihar. We employed a five-step approach to develop the intervention using the Social Contextual Model of Health Behavior Change (SCM) in Bihar, which involved conducting formative research, classifying factors in the social environment as mediating mechanisms and modifying conditions, developing a creative brief, designing an intervention and refining the intervention based on pilot test results. The intervention engages users and non-users of tobacco, involves teachers in implementing and monitoring school tobacco control policies and maximizes teachers' role as change agents in schools and communities. Intervention components include health educator visits, discussions led by lead teachers, cessation assistance, posters and other educational materials and is implemented over the entire academic year. The intervention is being tested in Bihar government schools as part of a randomized-controlled trial. SCM was a useful framework for developing a tobacco control intervention that responded to teachers' lives in Bihar.

Globally mosquito-borne lymphatic filariasis (LF) is targeted for elimination by 2020. Towards this goal, the scope of community-based vector control as a supplementary strategy to mass drug administration (MDA) was assessed through an intensive education campaign and evaluated using pre- and post-educational surveys in an intervention and comparison village in Tamil Nadu, South India. Environmental and entomological indicators for breeding sites and mosquito density were examined before and after the intervention. Significant ("P" less than 0.05) increase in knowledge was observed in intervention area with regard to transmission and control of LF. Relative change between intervention and comparison villages before and after intervention was also significant ("z" = greater than 1.96). Multiple mosquito control and personal protection methods were in use during the post-intervention assessment and was evident from the significantly ("P" less than 0.05) higher average score. Breeding sources declined significantly ("P" less than 0.05) in the intervention village with a significant relative change ("z" = 4.32). Significant reduction in per man-hour indoor resting density of mosquitoes was observed in the intervention area compared to baseline. The per capita cost for reducing 87% of the mosquito density was $0.32 indicating the effectiveness of community-based approach. The usefulness of this strategy in the elimination of LF is discussed.

At the foundation of most inequalities in expression of sexuality lie social constructions of gender. In this paper, sex education is considered as a possibility to challenge sexism and promote healthy and self-affirmative sex lives. In the past decade, the discourse of sex education in India has become a "battle of morality" where concerned citizens condemn sex education on the grounds it may encourage sexual activity and immoral conduct (e.g. promiscuity or infidelity). The work of non-governmental organisations (NGOs) is an alternative to the governmental national curriculum plan. This paper discusses NGO potential in terms of sexual empowerment by examining beliefs and understanding, choices of information, strategies and methods, and approaches apparent in sex education programmes and projects. Through qualitative data, findings were analysed by constructing a sexual empowerment model that divides components of sex education into four parts and utilises theories of empowerment. The main findings include that all four components of sex education--foundation, content, strategies and approaches--show great potential to challenge gender inequalities in regard to sexuality. Sexual health programmes and projects are seen to be highly participatory, deliberative and encouraging of critical thinking. Some concerns are highlighted: the strong focus on girls as the main actors of change, and external limitations such as parents and institutions. (Contains 1 figure.)

Community-based initiatives have become a popular approach to addressing the health needs of underserved populations, in both low- and higher-income countries. This article presents findings from a study of female peer facilitators involved in a community-based maternal and newborn health intervention in urban slum areas of Mumbai. Using qualitative methods we explore their role perceptions and experiences. Our findings focus on how the facilitators understand and enact their role in the community setting, how they negotiate relationships and health issues with peer groups, and the influence of credibility. We contextualize this within broader conceptualizations of peer-led health interventions and offer recommendations for similar community-based health initiatives. (Contains 2 figures.)

Although it is well known that vaccines against many infectious diseases confer positive economic externalities via indirect protection, analysts have typically ignored possible herd protection effects in policy analyses of vaccination programs. Despite a growing literature on the economic theory of vaccine externalities and several innovative mathematical modeling approaches, there have been almost no empirical applications. The first objective of the paper is to develop a transparent, accessible economic framework for assessing the private and social economic benefits of vaccination. We also describe how stated preference studies (for example, contingent valuation and choice modeling) can be useful sources of economic data for this analytic framework. We demonstrate socially optimal policies using a graphical approach, starting with a standard textbook depiction of Pigouvian subsidies applied to herd protection from vaccination programs. We also describe nonstandard depictions that highlight some counterintuitive implications of herd protection that we feel are not commonly understood in the applied policy literature. We illustrate the approach using economic and epidemiological data from two neighborhoods in Kolkata, India. We use recently published epidemiological data on the indirect effects of cholera vaccination in Matlab, Bangladesh (Ali et al., 2005) for fitting a simple mathematical model of how protection changes with vaccine coverage. We use new data on costs and private demand for cholera vaccines in Kolkata, India, and approximate the optimal Pigouvian subsidy. We find that if the optimal subsidy is unknown, selling vaccines at full marginal cost may, under some circumstances, be a preferable second-best option to providing them for free. (Contains 14 footnotes, 2 tables, and 8 figures.)

Purpose: The purpose of this paper is to describe the use of ICT to disseminate preventive health care information to combat the AIDS epidemic in India. The role of information professionals in various libraries and information centres and the challenges they are facing to increase HIV/AIDS awareness are discussed. Finally, recommendations are given and the conclusion is drawn that libraries and information professionals must develop AIDS literacy programmes to cater to the growing health information needs of the community. Design/methodology/approach: Literature search, web site information and personal interaction with the key persons associated with various HIV/AIDS awareness projects. Findings: Lack of knowledge about AIDS, its modes of transmission and ways to avoid infection, are major challenges in India. Staff in ICT-based library and information centres can make a high impact on the local community by developing community-based AIDS literacy programmes and hopefully save the society from an AIDS epidemic. There is a perceived need for providing health information services through public libraries to the illiterate rural population who are increasingly making themselves vulnerable to HIV/AIDS. However, awareness of e-channels is low, especially in rural India; one solution is to increase take-up and run AIDS awareness campaigns through electronic media. Originality/value: A summary is provided of ICT-based projects and initiatives by libraries and other agencies to disseminate AIDS information. Few multi-type consortia have been formed in the USA and UK to develop AIDS databases and e-learning modules are listed. These can be used as examples by Indian libraries with limited resources wishing to enhance community awareness through ICT. The concerted efforts amongst stakeholders are emphasized with the objectives of enhancing information professionals' skill in the AIDS information dissemination process.

This article discusses the findings of Focus Group Discussions (FGDs) that were conducted as a formative assessment for Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, multicomponent, school-based trial to prevent and control tobacco use among youth in India. Forty-eight FGDs were conducted with students (N = 435) in sixth and eighth grades in six schools in Delhi, India. Key findings include: (a) students in government schools reported as "consumers" of tobacco, whereas students in private schools reported as "commentators"; (b) parents and peers have a strong influence on youth tobacco use; (c) chewing "gutkha" is considered less harmful and more accessible than smoking cigarettes; (d) schools are not promoting tobacco control activities; and (e) students were enthusiastic about the role government should play in tobacco control. These findings are being used to develop a comprehensive intervention program to prevent and control tobacco use among Indian youth. (Contains 1 figure and 1 table.)

This article examines sociocultural expectations of sexual behavior and the reasons why not using condoms may be logical to married heterosexual couples in India. Married women who report monogamous sexual relationships with their husbands are a high-risk group for HIV infection in India. Based on the public health model and a population-based perspective on HIV infection prevention, this article illustrates the underlying mechanisms that link the role of women in society, holistic health beliefs, and cultural beliefs about the transmission of HIV with the precursors to nonuse of condoms. The author concludes that promoting condom use requires an emphasis on family health, not only as contraceptives. Challenges for reducing the social stigma and developing a comprehensive policy on HIV prevention and AIDS treatment and care are discussed. (Contains 1 figure.)

Background: Influences on physical activity and sedentary behavior may differ for migrants moving from their country of origin to a new country. This study aimed to explore the range of contextual factors that influence physical activity and sedentary behavior among Indian migrants, making comparisons with India. Methods: Semistructured interviews were conducted with 21 Indian migrants (10 men and 11 women) aged between 18 and 65 years living in Melbourne, Australia. Data were analyzed thematically, coded inductively, and managed with NVivo. Results: Participants perceived a lack of social connection as a key barrier to physical activity participation. Group-based physical activity fostered social connections. Cultural associations were sites to engage in cultural physical activity and integrate with other Indians. Australia's physical contexts (eg, availability of facilities and built environment) facilitated physical activity behavior. Workplace environments (eg, the nature of the job) prompted sedentary behavior. Other contextual shifts with migration related to activities of daily living (eg, shifts in transport [walking] behavior in India to a greater reliance on cars in Australia) and migrant-friendly health communication (messaging from Australian health/allied health practitioners). Conclusions: Sociocultural contexts remain key influences on migrant physical activity participation. Prioritizing integrated approaches and engaging insider codesign are important in tailoring and promoting migrant physical activity and limiting sedentary behavior. [ABSTRACT FROM AUTHOR]

This study provides a comprehensive exploration of the working conditions and associated health challenges faced by carpet weavers in Kashmir. The detailed examination of various factors contributes significantly to understanding the intricacies of their daily lives and provides valuable insights into an often-overlooked aspect of occupational health. The data was collected through 22 individual interviews and 5 Focus Group Discussions (FGDs). A semi-structured interview schedule was used to collect data allowing researchers to engage with participants. The results of the study emphasize that carpet weavers are not satisfied with the existing working conditions of the workshops they work in. Most carpet weavers suffer from multiple and sometimes chronic health ailments like musculoskeletal problems, respiratory problems, skin problem, fatigue and other health problems such as abdominal pain, nose problem, and anaemia owing to the unsafe working environment, long working hours, inappropriate sitting postures, poorly designed tools, exploitative circumstances, and low wages. The study recommends need for recognition of carpet weavers as vulnerable workers. The call for improved working conditions, better infrastructure, and awareness initiatives aligns with the goal of fostering a healthier and supportive environment for these workers. There is a significant need to address the identified health problems to safeguard both the carpet industry and the livelihoods of the weavers. [ABSTRACT FROM AUTHOR]

Background: Stigma against mental health problems is a common issue for adolescents aged 14–18 years. However, comprehensive programs that simultaneously address awareness and stigma reduction tailored to the specific needs of this age group are lacking. Method: This study investigated the effectiveness of the Mental Health Awareness and Destigmatisation Program (MHAD) in reducing stigma and improving knowledge and attitudes towards peers with mental health problems. A quasi‐experimental pre‐post design was employed among adolescents aged 14–18 years from an educational institution in Bangalore. After excluding those with high baseline mental health symptoms (PSC‐17 > 20), a preassessment was conducted on adolescents' knowledge, attitude, and stigma (n = 52) using the Mental Health Knowledge Schedule, Self‐structured Case Vignettes, and Peer Mental Health Stigmatization Scale. After completing the 6‐week program, three participants were excluded from the post‐assessment, as their attendance was less than 50%. A total of 49 (mean age = 16 years) adolescents were included in the post‐assessment. Results: The paired sample t‐test revealed significant improvements in all stigma scores. The Wilcoxon signed‐rank test indicated a significant improvement in Recognition of Mental Illness scores. Conclusion: Findings showed that MHAD, an education‐based program, was effective in reducing adolescents' stigma towards peers with mental health problems and improving their overall recognition of mental health symptoms. Research across larger adolescent populations is essential to enhance these interventions' long‐term impact and sustainability. By closely monitoring and expanding research efforts, we can gain deeper insights into how these programs foster self‐awareness, a crucial factor in recognizing mental health needs, challenging stigma, and promoting help‐seeking behaviors among adolescents. Summary: The study introduces an intervention that directly addresses stigma and enhances adolescents' ability to identify mental health problems in their peers. This is crucial for fostering help‐seeking behaviors and nurturing supportive environments. Better knowledge and awareness among adolescents about mental health, well‐being, and the detrimental effects of stigma can prevent mental health problems and facilitate early intervention. Active collaboration among healthcare providers, including social workers, school nurses, psychologists, and counselors, is crucial in implementing interventions. [ABSTRACT FROM AUTHOR]

This study examines the impact of menstrual management awareness training among beneficiaries of the Jalodari Project in Assam, India, covering three tea estates. Quantitative and qualitative data were gathered from 175 participants using various methods. The success of this project can be attributed to the successful implementation and monitoring of key performance indicators. The four-part training, covering menstrual basics and reproductive health, aims to empower participants to effectively manage their menstrual health. The study concludes that menstrual management training is a fundamental component of healthcare of women and that home visits can significantly enhance the effectiveness of awareness training. [ABSTRACT FROM AUTHOR]

Objective: To examine the content of Instagram posts about oral cancer and assess its usefulness in promoting oral cancer awareness and early detection practices. Methods: A systematic search of Instagram for posts about oral (mouth) cancer was conducted using the hashtags #oral cancer and #mouth cancer. Posts usefulness in promoting awareness and early detection was assessed using the early detection usefulness score, and caption readability was assessed using the Flesch Kincaid readability score. Results: A total of 81,000 posts were identified, and 200 posts were thoroughly evaluated. Included posts gathered a total of 48,118 (mean = 420.59 likes) and 27,898 views. Most posts (81.5%) were educational to the lay person, and India and the UK were the major contributors. The most discussed topics were prevention and early detection (55%). Representative clinical images were present in 35.5% of posts. Only 9.5% of posts mentioned the source of information, and the mean usefulness score was only 2.1 out of 10. The mean reading ease score was 56.7 ± 43.8 (range from 1 to 98 out of 100). Conclusion: Instagram shows potential for promoting oral cancer awareness, particularly in prevention and early detection. However, concerns regarding content quality, scientific validity, and clarity persist. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of non‐communicable disease risk factors among the nursing staff and educate them on prevention. Background: Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non‐communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non‐communicable disease risk factors among nursing staff are crucial for education on prevention. Design: A cross‐sectional digital survey‐based study. Method: We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community‐Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening. Result: Among 682 nursing staff who attended, 70% had never undergone screening for non‐communicable diseases. The prevalence of non‐communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non‐communicable diseases were significant risk factors among nursing staff. Conclusion: The study findings suggest that the nursing staff have suboptimal self‐health concerns on non‐communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion. Summary statement: What is already known about this topic? The prevalence of non‐communicable diseases (NCDs) among Indian nursing staff is a growing concern, underscoring the need for comprehensive research and targeted interventions.Despite the significant health risks faced by this demographic, there is a notable lack of data on NCD risk factors specific to Indian nursing professionals. What this paper adds? This paper adds information on the prevalence of NCD risk factors chiefly among nursing staff in the Delhi National Capital Region.Male nursing staff have particularly high NCD risk factors. The implications of this paper: Findings may help develop routine screening programmes for nursing staff, continued nursing education and good, safe nursing practice. [ABSTRACT FROM AUTHOR]

Background Breakfast intake is considered as one of the most important factors in nutrition for adolescents, but the intake of breakfast has declined in past 25 years especially among adolescents. Breakfast not only fuels your body but also aids in carrying out whole day activities by providing the required energy. Objectives The objectives of the study were to identify the breakfast eating and skipping patterns, identify the nutritional status, and find association between breakfast skipping and nutritional status among nursing students. Methods To achieve this aim, a cross-sectional survey was performed among nursing students. The data related to patterns of breakfast skipping and eating was collected followed by assessment of nutritional status by checking weight and height of each student and was interpreted as per the World Health Organization criteria. Results Out of 437 samples, a majority of 305 (69.8%) students belonged to (17–21) years of age and most of the students 409 (93.6%) were females. It was found that approximately 214 (48.97%) students were skipping breakfast three times in a week. A significant association was found between nutritional status and breakfast skipping (χ 2 = 6.61, p = 0.03). Conclusion Breakfast being first meal of the day not only provides us energy but also maintains our nutrition on everyday basis. Thereby, the study concludes that breakfast skipping affects nutritional status if skipped for more than twice in a week on a longer run. Thus, the students should be motivated to have breakfast before beginning their everyday's activity. [ABSTRACT FROM AUTHOR]

The caste system and resulting social exclusion are important social determinants of health inequity in India. This article critically analyzes the influence of the caste system on health inequity in India, starting with a historical perspective and moving to the current status. The article argues that the caste system has deprived Dalits and tribal people in India of achieving health equity. The programs to promote health are often disease-specific and not culturally informed, leading to poor attention at the policy level to the intersecting disadvantages that make Dalits and tribal communities vulnerable, resulting in poor health. The authors suggest strengthening and promoting primary care, improving health access for Dalit and tribal populations, and the need for pivotal changes in the medical education system, shifting the emphasis from specialized care to training family physicians to be oriented toward community health needs, keeping health equity in perspective. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are rising rapidly in low- and middle-income countries, leading to increased morbidity and mortality. Reducing sedentary behavior (SB) and increasing physical activity (PA) offer numerous health benefits. Workplaces provide an ideal setting for promoting SB/PA interventions; however, understanding the barriers and enablers is crucial for optimizing these interventions in workplace environments. Methods: Nested within a cluster randomised controlled trial (the SMART-STEP trial), the present study employed in-depth interviews with 16 office workers who have completed 24 weeks of two distinct (technology assisted and traditional) workplace SB/PA interventions. Using a deductive analysis, semi-structured interviews were administered to explore the barriers and enablers to the SB/PA interventions at individual, interpersonal and organisational level using the socio-ecological model. Results: Several individual (poor goal setting, perceived health benefits & workload, attitude, intervention engagement), interpersonal (lack of peer support) and organisational (task prioritisation, lack of organisational norm and material or social reward) barriers were identified. Indian women engaged in desk-based office jobs often find themselves burdened with intense home and childcare responsibilities, often without sufficient support from their spouses. A primary concern among Indian office workers is the poor awareness and absence of cultural norms regarding the health risks associated with SB. Conclusions: Raising awareness among workplace stakeholders—including office workers, peers, and the organization—is crucial before designing and implementing SB/PA interventions in Indian workspaces. Personalized interventions for Indian female office workers engaged in desk-bound work are warranted. [ABSTRACT FROM AUTHOR]

Bullying victimisation affects an estimated 30% of individuals worldwide. While the prevalence and risk factors of bullying have been studied in India, comprehensive research on the phenomenon of bullying itself remains scarce. Our objective was to study the experiences, perceptions, and attitudes towards bullying among seventh to ninth-grade students. The study included all seventh to ninth graders (N = 205) from two schools in the Udupi district of South India. To collect information on bullying, we used the Bully Survey - Student Version with appropriate modifications for our context. The mean age of the participants was 13 (1.05) years, with 58% being females. Our findings showed that almost half of the students had bullying roles. Students attending private schools and residing in urban areas were more likely to be victims, bullies, and bully-victims. Seventh and eighth graders experienced higher rates of bullying, whereas ninth graders were more likely to engage in bully behaviours or be bully-victims. Verbal bullying, including name calling, playing jokes, and making fun of others, was more prevalent. No gender differences were observed in verbal or physical bullying. School teachers, staff, and parents were unaware of bullying incidents almost half of the time. Anti-bullying programs should consider these aspects of bullying to be effective. [ABSTRACT FROM AUTHOR]

Introduction: Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) leading to serious illness. The purpose of this cross-sectional study was to identify the clinical settings predisposing orthopaedic surgeons to NSSIs and assess their adherence to safety protocols in the Indian context. Materials and Methods: An online cross-sectional survey of 618 orthopaedic surgeons in India, stratified by experience into two groups: under five years and with 5 years or more was undertaken. The data were collected via an expert-validated online questionnaire to evaluate demographic distribution, injury characteristics, knowledge of safety protocols, and adherence to these protocols. Descriptive statistics summarized the data, Chi-square tests assessed variable associations, and odds ratios were computed for significant variables. Ethical integrity was maintained via electronic informed consent and for confidentiality assurances. Results: The study revealed that orthopaedic surgeons with less than 5 years of clinical experience had higher risks for NSSIs as compared to those with 5 or more years of clinical practice. Conversely, the latter group was more susceptible to bone spike injuries and viral positive needlestick incidents. The analysis shows that whilst the more experienced practitioners displayed greater proficiency in the application of universal precautions and NSSI prevention, they were also less likely to report injuries, often due to discomfiture. Risk profiles were consistent across different practice settings and affiliations, regardless of experience level. Conclusion: This cross-sectional study reveals less experienced orthopaedic surgeons face higher risks of NSSIs, possibly due to inadequate education or awareness. More experienced practitioners encounter distinct risks, likely owing to long-term exposure and traditional practices. There is an immediate need to raise awareness of the potential risks of NSSIs, enhanced education, appropriate training, collaboration with the hospital risk management team and developing a culture of transparent reporting to mitigate these risks. The emphasis should be on reducing the incidence and fostering open reporting of NSSIs to protect clinicians and promote health safety. [ABSTRACT FROM AUTHOR]