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Abstract Background This scoping review aimed to identify and present the evidence describing key motivations for breast cancer screening among women aged ≥ 75 years. Few of the internationally available guidelines recommend continued biennial screening for this age group. Some suggest ongoing screening is unnecessary or should be determined on individual health status and life expectancy. Recent research has shown that despite recommendations regarding screening, older women continue to hold positive attitudes to breast screening and participate when the opportunity is available. Methods All original research articles that address motivation, intention and/or participation in screening for breast cancer among women aged ≥ 75 years were considered for inclusion. These included articles reporting on women who use public and private breast cancer screening services and those who do not use screening services (i.e., non-screeners). The Joanna Briggs Institute (JBI) methodology for scoping reviews was used to guide this review. A comprehensive search strategy was developed with the assistance of a specialist librarian to access selected databases including: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Web of Science and PsychInfo. The review was restricted to original research studies published since 2009, available in English and focusing on high-income countries (as defined by the World Bank). Title and abstract screening, followed by an assessment of full-text studies against the inclusion criteria was completed by at least two reviewers. Data relating to key motivations, screening intention and behaviour were extracted, and a thematic analysis of study findings undertaken. Results A total of fourteen (14) studies were included in the review. Thematic analysis resulted in identification of three themes from included studies highlighting that decisions about screening were influenced by: knowledge of the benefits and harms of screening and their relationship to age; underlying attitudes to the importance of cancer screening in women's lives; and use of decision aids to improve knowledge and guide decision-making. Conclusion The results of this review provide a comprehensive overview of current knowledge regarding the motivations and screening behaviour of older women about breast cancer screening which may inform policy development.

Abstract Objective A digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies. The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology. Results Forty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants’ experience with a range of digital health technologies. All participants had used at least one digital health technology. Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information. Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost. Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy. We present opportunities to support community members in using and accessing digital health technology.

BackgroundDigital health literacy has emerged as a critical skill set to navigate the digital age. ObjectiveThis review sought to broadly summarize the literature on associations between digital health literacy and (1) sociodemographic characteristics, (2) health resource use, and (3) health outcomes in the general population, patient groups, or parent or caregiver groups. MethodsA rapid review of literature published between January 2016 and May 2022 was conducted through a search of 4 web-based databases. Articles were included on the basis of the following keywords: “measured digital health literacy,” “digital literacy,” “ehealth literacy,” “e-health literacy,” “electronic health literacy,” or “internet health literacy” in adult populations; participants were from countries where English was the primary language; studies had to be cross-sectional, longitudinal, prospective, or retrospective, and published in English. ResultsThirty-six articles met the inclusion criteria. Evidence on the associations between digital health literacy and sociodemographic characteristics varied (27/36, 75% included studies), with higher education (16/21, 76.2% studies that examined the association) and younger age (12/21, 57.1% studies) tending to predict higher digital health literacy; however, other studies found no associations. No differences between genders were found across the majority of studies. Evidence across ethnic groups was too limited to draw conclusions; some studies showed that those from racial and ethnic minority groups had higher digital health literacy than White individuals, while other studies showed no associations. Higher digital health literacy was associated with digital health resource use in the majority of studies (20/36, 55.6%) that examined this relationship. In addition, higher digital health literacy was also associated with health outcomes across 3 areas (psychosocial outcomes; chronic disease and health management behaviors; and physical outcomes) across 17 included studies (17/36, 47.2%) that explored these relationships. However, not all studies on the relationship among digital health literacy and health resource use and health outcomes were in the expected direction. ConclusionsThe review presents mixed results regarding the relationship between digital health literacy and sociodemographic characteristics, although studies broadly found that increased digital health literacy was positively associated with improved health outcomes and behaviors. Further investigations of digital health literacy on chronic disease outcomes are needed, particularly across diverse groups. Empowering individuals with the skills to critically access and appraise reliable health information on digital platforms and devices is critical, given emerging evidence that suggests that those with low digital health literacy seek health information from unreliable sources. Identifying cost-effective strategies to rapidly assess and enhance digital health literacy capacities across community settings thus warrants continued investigation.

Abstract Aim Student engagement is an important factor to the success of higher education. This study aimed to develop a Generic Student Engagement Scale (GSES) for face‐to‐face and online learning. Design This was a cross‐sectional psychometric study. Methods We tested the psychometric properties of GSES in 451 students at the school of nursing and health studies undertaking online and face‐to‐face learning at a local university in Hong Kong between 2016 and 2018. Results Content validity, face validity and test–retest reliability of GSES were satisfactory. The 29‐item GSES contains five factors “self‐regulated learning,” “cognitive strategy use,” “experienced emotion,” “teacher–student interaction,” and “enjoyment of school life” with the good model fit. The GSES is a reliable and valid psychometric instrument to measure student engagement in face‐to‐face and online learning among undergraduates and higher diploma students. Our results implied that student engagement can be assessed in routine or research by using our instrument.

Introduction Self-help interventions may offer a scalable adjunct to traditional care, but their effectiveness in relapse prevention is not well-established. Objectives: This review aimed to assess their effectiveness in preventing relapses among individuals with mood disorders. Methods We systematically reviewed the pertinent trial literature in Web of Science, EMBASE, PubMed, PsycINFO, and Cochrane databases until May 2024. Randomized controlled trials that examined the self-help interventions among individuals diagnosed with major depressive disorder (MDD) or bipolar disorder (BD) were included. The random-effects model computed the pooled risk ratios of relapse, with subgroup analyses and meta-regression analyses to explore heterogeneity sources. Results Fifteen papers and 16 comparisons of randomized trials involving 2735 patients with mood disorders were eligible for this meta-analysis. Adjunct self-help interventions had a small but significant effect on reducing the relapse rates of major depressive disorder (pooled risk ratio: 0.78, 95% confidence interval (CI): 0.66–0.92, P  = 0.0032, NNT = 11), and were marginally better in bipolar disorder (pooled risk ratio: 0.62, 95% CI: 0.40–0.97, P  = .0344, NNT = 12), as compared to treatment as usual (TAU). No subgroup difference was found based on intervention components, settings, delivery method, or guidance levels. The average dropout rate for self-help interventions (18.9%) did not significantly differ from TAU dropout rates. The examination of treatment adherence was highly variable, precluding definitive conclusions. Conclusions Self-help interventions demonstrate a modest preventative effect on relapse in mood disorders, despite low to very low certainty. Future research is essential to identify which elements of self-help interventions are most effective. [ABSTRACT FROM AUTHOR]

The Hong Kong government has sought to encourage environmental education (EE) in schools. However, little is known about how government and private initiatives impact at the level of the kindergarten. This article, based on a small-scale study, investigates what is happening in Hong Kong kindergartens in EE. The findings show that there have been positive changes in EE in Hong Kong kindergartens in the last decade: more hands-on environmental activities and resourcefulness of teachers in sourcing teaching materials. Teachers and parents were found to have positive attitudes. However, teachers had to tackle the following issues: the overloaded school curriculum and isolated environmental learning experience, teacher's insecurity and inadequate knowledge of EE, weakness of government support in terms of formal teacher training programmes and funding on EE. (Contains 1 table.)

Aim: Student engagement is an important factor to the success of higher education. This study aimed to develop a Generic Student Engagement Scale (GSES) for face‐to‐face and online learning. Design: This was a cross‐sectional psychometric study. Methods: We tested the psychometric properties of GSES in 451 students at the school of nursing and health studies undertaking online and face‐to‐face learning at a local university in Hong Kong between 2016 and 2018. Results: Content validity, face validity and test–retest reliability of GSES were satisfactory. The 29‐item GSES contains five factors "self‐regulated learning," "cognitive strategy use," "experienced emotion," "teacher–student interaction," and "enjoyment of school life" with the good model fit. The GSES is a reliable and valid psychometric instrument to measure student engagement in face‐to‐face and online learning among undergraduates and higher diploma students. Our results implied that student engagement can be assessed in routine or research by using our instrument. [ABSTRACT FROM AUTHOR]