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BackgroundBaby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. ObjectiveThe intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. MethodsA random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. ResultsAlmost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=−2.98, P=.003. Younger age (b=−0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R2 =.17, R2adj =.14, F9,229=5.277, P

BackgroundPatients with chronic obstructive pulmonary disease (COPD) often report inadequate access to comprehensive patient education resources. ObjectiveThe purpose of this study was to incorporate community-engagement principles within a mixed-method research design to evaluate the usability and acceptability of a self-tailored social media resource center for medically underserved patients with COPD. MethodsA multiphase sequential design (qual → QUANT → quant + QUAL) was incorporated into the current study, whereby a small-scale qualitative (qual) study informed the design of a social media website prototype that was tested with patients during a computer-based usability study (QUANT). To identify usability violations and determine whether or not patients found the website prototype acceptable for use, each patient was asked to complete an 18-item website usability and acceptability questionnaire, as well as a retrospective, in-depth, semistructured interview (quant + QUAL). ResultsThe majority of medically underserved patients with COPD (n=8, mean 56 years, SD 7) found the social media website prototype to be easy to navigate and relevant to their self-management information needs. Mean responses on the 18-item website usability and acceptability questionnaire were very high on a scale of 1 (strongly disagree) to 5 (strongly agree) (mean 4.72, SD 0.33). However, the majority of patients identified several usability violations related to the prototype’s information design, interactive capabilities, and navigational structure. Specifically, 6 out of 8 (75%) patients struggled to create a log-in account to access the prototype, and 7 out of 8 patients (88%) experienced difficulty posting and replying to comments on an interactive discussion forum. ConclusionsPatient perceptions of most social media website prototype features (eg, clickable picture-based screenshots of videos, comment tools) were largely positive. Mixed-method stakeholder feedback was used to make design recommendations, categorize usability violations, and prioritize potential solutions for improving the usability of a social media resource center for COPD patient education.

Background: Although receiving the HPV vaccine can help to prevent the development of cancer and HPV-related diseases, many individuals are not vaccinated in adolescence. Purpose: To examine knowledge about changes to the FDA's approval of the HPV vaccine for adults ages 26-45 years and to utilize the Integrated Behavioral Model (IBM) constructs to understand the relationship between beliefs and HPV vaccine intention. Methods: An online survey was used to examine HPV vaccine-related beliefs, knowledge, and uptake among a sample of 421 U.S. adults 18-45 years old in April 2019. Results: Perceived norms, perceived control, sex, and provider recommendation were significantly related to vaccine intention. Perceived norms, age, and healthcare provider recommendation were significantly related to receiving the full dose of the vaccine. Fewer than half of the participants indicated having at least one dose of the HPV vaccine or having had a provider recommend the vaccine. Less than 4% knew the vaccine had been approved by the FDA for up to 45 years old. Discussion: Results highlight the importance of social norms and patient education on HPV vaccine uptake and intention. Translation to Health Education Practice: Findings can inform future interventions and instrument development

Founded in 1950, the Society for Public Health Education (SOPHE) provides leadership to the health education profession and promotes the health of all people through six strategic commitments: developing and promoting standards for professional preparation and credentialing of community and school health educators; stimulating research on the theory, practice, and teaching of health education; supporting elimination of health disparities and the achievement of health equity; providing continuing education of the health education workforce; advocating for policy and legislation affecting public health and health promotion; and supporting a network of local chapters. This article describes how SOPHE has pursued these strategic commitments during the past 70 years and discusses challenges that will influence the future of SOPHE and the contours of the research and practice agendas of the field going forward.

Background: The Internet is an important tool for empowering patients with chronic obstructive pulmonary disease (COPD) to learn about and self-manage their condition. Purpose: The purpose of this study was to understand which aspects of the online experience facilitates or hinders the perceived ability of patients with COPD to achieve their information and self-management goals. Methods: Semistructured interviews were conducted with medically underserved patients with COPD (N = 25) who access the Internet for health. A conventional content analysis approach was applied and data were analyzed with the constant comparative method. Results: The following themes were derived: (1) desire to associate with "in-group" members; (2) relationship building with other online users; (3) security of information and identity; (4) source and channel credibility appraisal; (5) user assistance and tutorials; and (6) strategies to adapt technological functions. Discussion: Success in using the Internet was dependent on the functional use of technology and the ability and resilience to engage with similar online users to build meaningful and trustworthy connections. Translation to Health Education Practice: Prior to directing patients with COPD to a disease-specific online support platform, Certified Health Education Specialists must assess patients' information goals and their skills to critically appraise and communicate with other online users.

Public health messages can be used to increase awareness about colorectal cancer screenings. Free or inexpensive images for creating health messages are readily available, yet little is known about how a pictured individual's engagement in the behavior of interest affects message outcomes. Participants (N = 360), aged 50 to 75 years, completed an online survey in which they viewed a colorectal cancer screening message and were then randomly assigned to view one of four different messages about the pictured individual's screening status. Analyses revealed no significant differences in message credibility, message effectiveness, or screening intention among the four conditions. The pictured individual's level of knowledge was rated significantly lower among those participants who were told the screening status of the pictured individual was unknown, compared with those who received no screening status information, U = 3574.50, p = 0.005. Future studies could build on the design of this study to examine the effects of using free or purchased images on intent to screen and other message outcomes over time.

For over six decades, the Society for Public Health Education (SOPHE) has been a leading professional organization for the field of health education (HE). This historical research extends the work of Cissell and Bloom by investigating the recent history of SOPHE. The aims of this historical study were to (1) identify key SOPHE and HE events from 2000 to 2015, (2) describe key contributions of SOPHE to the HE field during this time period, and (3) identify potential future directions for SOPHE. Johnson and Christensen's five steps for historical research were followed to conduct an eDelphi study and one-on-one interviews. During the three-round eDelphi study, SOPHE officers (n = 16) and senior staff (n = 5), who served between 2000 and 2015, identified significant SOPHE's leaders and rated the importance of SOPHE's recent events. Key leaders (n = 25) participated in semistructured interviews to describe their involvement in SOPHE, specific SOPHE activities, and future directions for SOPHE. Brief, structured intercept interviews were also conducted with student (n = 10) and professional SOPHE members (n = 11). Data collected during the eDelphi study were analyzed to determine central tendency statistics and percent agreement on each event evaluated in the second- and third-round surveys. Qualitative interview data were analyzed with NVivo using thematic analysis. Data from the eDelphi study revealed 29 SOPHE and 17 HE events that occurred between 2000 and 2015 as being "important" or "very important." Results from the thematic analysis revealed several themes in three areas: SOPHE accomplishments, benefits of SOPHE membership, and possible future directions for SOPHE to explore.

Background: College students actively seek online health information and use Instagram, an image- and video-based social networking website, to build social networks grounded in trust and behavioral norms (social capital), which have the potential to prevent chronic disease. Purpose: This study aimed to (1) examine how intensity of Instagram use moderates the relationship between eHealth Literacy and online social capital in college students and (2) discuss how Instagram can be used as a social awareness platform for chronic disease prevention among college students. Methods: Hierarchical regression analyses were conducted to analyze web-based survey data from a random sample of college students (N = 327). Results: Online bridging social capital was associated with greater ehealth literacy (P < 0.05) and intensity of Instagram use (P < 0.001), when controlling for sociodemographic variables. The relationship between ehealth literacy and online bridging social capital was strongest among respondents with average-intensity (P < 0.01) and high-intensity (P < 0.01) Instagram use compared to low Instagram intensity. Discussion: High intensity of Instagram use may strengthen college students' low ehealth literacy, especially when interacting with heterogeneous connections with weaker ties. Translation to Health Education Practice: Health Education Specialists should continue to explore how college students' intensity of Instagram use can be strengthened to build bridging online social capital and ultimately prevent chronic disease.

"The Belmont Report" was written in 1979 to address the abuse of human participants in biomedical research. In the report, three ethical principles were described: (1) "beneficence," which describes an act of charity or kindness that maximizes possible benefits while minimizing possible harms; (2) "justice," described as a method of just and fair decision making where individuals are treated equally and fairly; and (3) "respect for persons," which recognizes the power of an individual to make independent decisions through ensuring their rights to receive protection if they are unable to do so. These ethical principles led to federal regulations that are almost universally adopted today by researchers and used by institutional review boards (IRBs) to maximize the benefits and minimize the risks of research participation for potential human participants. These principles are epitomized by concepts such as informed consent, risk-benefit analysis, and fair inclusion of all potential participants. With the rising popularity of community-driven research initiatives, some have questioned the applicability of "Belmont Report" principles in modern-day behavioral science research. Following a discussion on the response by the National Bioethics Advisory Commission (responsible for establishing ethical research practice standards in the United States) to this discord, the IRB process, and the role of community advisory boards (CABs) in community-engaged research (CEnR), the authors conclude that the field of health education needs clear ethical practice standards to effectively foster important attributes of community engagement. Though the field of health education has a designated code of ethics to guide professional conduct, as well as a core set of responsibilities and competencies for Certified Health Education Specialists and master Certified Health Education Specialists, health education researchers often do not adhere to specific, competency-based ethical practice standards for strengthening community action through inclusive stakeholder engagement. Therefore, they propose using the "strengthening community action" element of the expanded chronic care model (ECCM) to begin establishing discrete ethical practice standards for CEnR in health education research. The ECCM provides a comprehensive, multifaceted framework for chronic disease prevention and management that fosters community partnerships between health professionals, individuals, and communities. Additionally, the authors propose 8 competency-based ethical practice standards for health education researchers to follow during CEnR.

This special issue provides real-world examples of the diverse methods health education researchers are using to expand existing applications of information and communication technologies (ICTs) for health promotion and chronic disease management. The original and review articles presented in this special issue investigate eHealth, mHealth, and social media use in health education and community engagement research that supports wellness, healthy eating, and active living among individuals living with or at risk for one or more chronic conditions(s). Challenges and opportunities stemming from the results of these studies are discussed within seven papers published in the special issue.

Purpose: The purpose of this study was to explore how Pinterest group pinboards are used to communicate health information on chronic obstructive pulmonary disease (COPD). Method A nonprobability census sampling method retrieved 399 pins from the 10 most followed COPD group pinboards. Pins were coded according to COPD information categories, visual communication tools, and sources of self-efficacy. Chi-square analyses explored whether COPD information categories varied by visual communication tools and sources of self-efficacy. Mann-Whitney Wilcoxon tests determined whether or not differences existed in the number of repins/likes of visual communication tools by COPD information categories. Results: Half of the pins included COPD self-management information (n = 214; 45.92%). Photographs of real people included more women than men (P = 0.032), more patients than providers (P = 0.001), and more self-management information than general COPD information (P = 0.021). Infographics were repinned (Mdn = 107.8; P = 0.03) and photographs of real people were liked (Mdn = 76.54; P = 0.04) more than other visual communication tools. Self-management pins incorporated verbal persuasion (P = 0.001) and social modeling (P = 0.001). Discussion: Pinterest may be a useful social networking website to disseminate COPD patient education targeted at women living with or at high risk for COPD. Translation to Health Education Practice: Health educators can refer female users of social media to Pinterest for literacy-sensitive information on COPD.

Name changes of university departments that have professional preparation health education programs have been ongoing and significant. This study analyzes changes in the names of health education degree-offering departments between 1974 and 2009. It also discusses the implications for the health education discipline going forward with respect to personal and professional identification, as well as credentialing and employment opportunities for health educators. A large change was seen in many of the department names between 1974 and 2009. The greatest changes were seen in the increasing use of "community health," kinds of health, "public health," and "health" and something else. A large decrease was noted in the use of "health education." Name changes present potential challenges for the professional and educational development of the field, employment opportunities, and personal and professional identification. This article does not purport to provide a prescription or solution but rather suggests that health education professionals and organizations should consider this concern.

Objective: The purpose of this study was to prospectively examine the effect of state stay‐at‐home mandates on weight of US adults by BMI over 3 months during COVID‐19. Methods: US adults completed an online questionnaire containing demographics, weight, physical activity, sedentary time, fruit/vegetable intake, depressive symptoms, stress, and sleep at baseline (May 2020) and after 3 months (August 2020). Results: Participants gained 0.6 kg (76.7‐77.3 kg, p = 0.002). A total of 26% of those with obesity gained > 2 kg compared with 14.8% of those with normal weight (p < 0.001). A total of 53.3% of individuals with obesity maintained weight within 2 kg compared with 72.5% of those with normal weight (p < 0.001). Greater weight gain was related to longer stay‐at‐home mandates (β = 0.078, p = 0.010), lower baseline minutes of physical activity per day (β = −0.107, p = 0.004), greater declines in minutes of physical activity per day (β = −0.076, p = 0.026), depressive symptoms (β = 0.098, p = 0.034), and greater increases in time preparing food (β = 0.075, p = 0.031). Conclusions: US adults gained weight, and stay‐at‐home mandates were associated with atypical weight gain and greater reported weight gain in individuals with obesity over 3 months. [ABSTRACT FROM AUTHOR]

Insufficient scientific evidence about electronic cigarettes (e-cigarettes) has led to conflicting recommendations (CRs) by credible scientific organizations, creating a public health debate that could prove especially difficult to reconcile as current and former smokers make decisions about whether to use e-cigarettes. To investigate how CRs about e-cigarettes may affect intentions to engage in healthy behaviors, 717 former and current smokers were randomly exposed to one of five conditions (varying in the level of conflict in recommendations) in this between-subject experiment. Our results indicated a significant interaction between the message level of conflict and individuals' information avoidance, employed to maintain hope and deniability. These results suggest the effects of CRs stemming from scientific uncertainty vary with subgroups of people, pointing to several pressing theoretical and practical implications. [ABSTRACT FROM AUTHOR]

We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006–15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach's α  = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries. [ABSTRACT FROM AUTHOR]