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Quantitative microbial risk assessment (QMRA) is a growing interdisciplinary field addressing exposures to microbial pathogens and infectious disease processes. Risk science is inherently interdisciplinary, but few of the contributing disciplinary programs offer courses and training specifically in QMRA. To develop multidisciplinary training in QMRA, an annual 10-day long intensive workshop was conducted from 2015 to 2019--the Quantitative Microbial Risk Assessment Interdisciplinary Instructional Institute (QMRA III). National leaders in the fields of public health, engineering, microbiology, epidemiology, communications, public policy, and QMRA served as instructors and mentors over the course of the program. To provide cross-training, multidisciplinary teams of 5-6 trainees were created from the approximately 30 trainees each year. A formal assessment of the program was performed based on observations and surveys containing Likert-type scales and open-ended prompts. In addition, a longitudinal alumni survey was also disseminated to facilitate the future redevelopment of QMRA institutes and determine the impact of the program. Across all years, trainees experienced statistically significant increases (P < 0.05) in their perceptions of their QMRA abilities (e.g., use of specific computer programs) and knowledge of QMRA constructs (e.g., risk management). In addition, 12 publications, three conference presentations, and two research grants were derived from the QMRA III institute projects or tangential research. The success of QMRA III indicates that a short course format can effectively address many multidisciplinary training needs. Key features of QMRA III, including the inter-disciplinary training approach, hands-on exercises, real-world institute projects, and interaction through a mentoring process, were vital for training multidisciplinary teams housing multiple forms of expertise. Future QMRA institutes are being redeveloped to leverage hybrid learning formats that can further the multidisciplinary training and mentoring objectives.

Nicotine is a major alkaloid in tobacco plants and an addictive component of tobacco products. Some bacteria grow on tobacco plants and have evolved the ability to metabolize nicotine. As part of our microbiology teaching lab, we used minimal media with nicotine as the sole carbon source to isolate nicotine-degrading bacteria from tobacco leaves and commercial tobacco products. Students then identified these bacteria using 16S rRNA sequencing and biochemical assays and assessed their ability to catabolize nicotine using UV spectroscopy. Students were able to isolate and identify 14 distinct genera that can metabolize nicotine. This modification of the commonly used unknown project gave students firsthand experience using selective media, and students got the opportunity to work with largely uncharacterized microbes with a real-world connection to public health, which increased student engagement. Students had the opportunity to think critically about why nicotine-degrading microorganisms associate with tobacco plants, why there are different bacteria that use the same specialized metabolism, and how these organisms are isolated from other bacteria using selective media.

Training the next generation of public health practitioners to promote health equity requires public health graduate programs to cultivate students' skills in community partnership. The Council on Education for Public Health (CEPH) requires Master of Public Health (MPH) students to produce a high-quality written product as part of their culminating Integrative Learning Experience (ILE). Because CEPH recommends that ILE written products be useful to community partners, ILEs can draw lessons from the field of experiential education, especially the social justice aligned principles of critical service-learning (CSL). However, the current literature lacks descriptions of how to operationalize CSL's principles within graduate-level culminating experiences. To help fill this gap, we discuss a CSL ILE for MPH students, called Capstone. We describe CSL's key components and explain and assess how each is operationalized. We hope Capstone's model will help educators engage more deeply with CSL practices to advance health equity.

Objectives: There are essentially three schools of thought regarding critical thinking--humanistic, cognitive, and behavioral. Given the disagreement among them, confusion continues about what critical thinking means, and how it can be taught to students. Methods: In this qualitative phenomenological study, researchers interviewed students and faculty in a distance education master of public health program about their perceptions and experiences of what critical thinking means and how it is developed in the online classroom. Results: Themes emerging from student interviews included (a) differing thoughts on the meaning of critical thinking; (b) learning and meeting course requirements as students' primary role; (c) technology as useful in learning; and (d) confidence in learning linked to engagement, feedback, and course alignment. Themes from faculty interviews included (a) how online classrooms promoted critical thinking; (b) critical thinking identified when students demonstrate the application of independent thought; (c) facilitating and keeping students on track as faculty's primary role; (d) promotion of critical thinking through questioning and student collaboration; (e) assessment of critical thinking through discussion posts; and (f) faculty facilitation and focus on application as essential to student learning. Conclusions: Students and faculty engaged in the online classroom agree in some ways that critical thinking skills are gained through practical applications. But this is where agreement ceases. Students believe they are developing critical thinking skills in their online environments, when in fact they are reproducing rote information in assignments. Implications: Engaging in activities has been shown to develop critical thinking more effectively when it is accompanied by mentoring, dialogue, and authentic instruction. Online educators who want to help students develop their critical thinking skills can use mentoring, dialogue, and authentic instruction alongside online activities.

Preparing students enrolled in healthcare programs for industry is paramount. While providing administrative and clinical education is essential, students must understand the health literacy levels of the population they serve and work diligently to ensure the population understands and comprehends the health information. Adults with low or limited health literacy levels need help understanding health information and making informed decisions. Research shows that improvements in health literacy result in decreased ER visits, medication errors, increased patient satisfaction, and better health outcomes. Health literacy is an issue throughout the world. This reflection seeks to provide a narrative comparing health literacy concerns in the United States and Spain. The objective is to shed light on the need for all colleges and universities to teach students about health literacy and how to determine patients' health literacy levels. Increasing students' understanding can improve the comprehension and awareness of patients and the population that they serve, thus leading to more appropriate health decisions and outcomes.

In the past decade concern about the mental health of university students has been growing worldwide. Yet epidemiological data and intervention research on student mental health comes predominantly from high income western countries in the Global North, with a relative scarcity of studies from sub-Saharan Africa and other countries in the Global South. While universities in the Global North and Global South face similar challenges to provide accessible, acceptable, and effective mental health services to students, there are also important historical, cultural, economic, and political issues that make it necessary for context-sensitive research which is responsive to the needs of students in the Global South. Using South Africa (SA) as a case study, this commentary aims to explore the relevance and appropriateness of uncritically importing knowledge and "evidence-based" strategies to student mental health challenges from the Global North into sub-Saharan Africa. The article draws on research from South Africa to illustrate how distinct and varied contextual issues create unique challenges to promoting student mental health that cannot be solved with foreign knowledge. Recommendations are made for how equitable partnerships between countries in sub-Saharan Africa could support student well-being in the region. Key to creating equality in the global provision of appropriate student support services is a strategy and funding to redress global knowledge-power imbalances and set research agendas from within the Global South.

Service-learning is a critical component of public health education, especially students of Doctor of Public Health (DrPH), designed for public health professionals. As an evidence-based approach to impactful teaching improving students' learning outcomes, service-learning enables future public health practitioners to engage in the learning and reflective practices developing skills needed to be leaders of social change within their communities. E-service learning has been gaining popularity among faculty and students. This study describes a grant writing course for DrPH students of various concentrations delivered online. We draw attention to the growing need to incorporate service-learning into the public health curriculum to promote social change, address local health disparities, improve students' learning experiences and outcomes, and stay relevant with the educational landscape.

Cyberbiosecurity and workforce development in agriculture and the life sciences (ALS) is a growing area of need in the curriculum in higher education. Students that pursue majors related to ALS often do not include training in cyber-related concepts or expose the 'hidden curriculum' of seeking internships and jobs. Exposing students through workforce development training and hands-on engagement with industry professionals can provide learning opportunities to bridge the two and is an area of growth and demand as the workforce evolves. The objectives of this work were (1) to learn key concepts in cybersecurity, including data security, visualization, and analysis, to name a few, through class activities and engagement with professional partners and (2) to understand what knowledge students gained from participating in the course could transfer over for when they enter the workforce. Three themes emerged from the study where students, through direct engagement with industry partners, gained more insight about the industry applicable to their studies; they established work environment expectations for entering internships and official job placements and established ways in which the workforce development training informed their future careers.

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

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.

Introduction: Easy Read health documents prepared for people with intellectual disabilities are often generated from Standard Texts. Language in Easy Read versions is typically assumed to be simpler. However, simplification of language may have unintended consequences. This study aimed to explore the differences in language used between Easy Read health material and the Standard Text versions of the same material produced for the general population. Methods: Five Easy Read/Standard Text pairs were sampled and analysed using Systemic Functional Linguistics. This addressed: how people with intellectual disabilities and others were represented by language, the author stance in relation to the reader and the overall organisation of the text. Results: The Easy Read versions often used language that was less empowering and inclusive. Conclusion: Increased awareness of author power and better knowledge of the impact of language choice could help to redress these issues.

South African research ethics committees (RECs) faced significant challenges during the COVID-19 pandemic. Research ethics committees needed to find a balance between careful consideration of scientific validity and ethical merit of protocols, and review with the urgency normally associated with public health emergency research. We aimed to explore the views of South African RECs on their pandemic preparedness and response during COVID-19. We conducted in-depth interviews with 21 participants from RECs that were actively involved in the review of COVID-19 related research, at seven academic institutions across South Africa. Interviews were conducted remotely using an in-depth interview guide that included questions regarding REC preparedness and response to COVID-19. Interviews were conducted until data saturation, and audio-recordings were transcribed verbatim and coded. An inductive approach to thematic analysis was used to organise data into themes and sub-themes. This study focused on three main themes: coping during COVID-19, building REC capacity during pandemic times and a consistently cautious approach to mutual recognition of REC reviews. Despite an initial sense of unpreparedness, RECs were able to adapt and maintain careful ethical oversight of both COVID and non-COVID research, and the rigour of REC reviews. Several important lessons for preparedness and response to future pandemics were identified, including heightened awareness of publication, funding and political pressures, the importance of regular training for RECs and researchers, and strategies to enhance moral resilience of REC members. Incremental steps are needed to build trust and authentic partnerships among RECs in inter-pandemic times, to facilitate collaboration during future public health emergencies.

Research represents an essential component of the response to infectious disease outbreaks and to other public health emergencies, whether they are localised, of international concern, or global. Research conducted in such contexts also comes with particular ethics challenges, the awareness of which has significantly grown following the Ebola outbreak in West Africa, the Zika outbreak in Latin America and the COVID-19 pandemic. These challenges include the need for implementing meaningful community engagement with the researched communities, not just to build unidirectional trust towards the research team, but to achieve a genuine and mutually respectful partnership before, during and after the research. Here, we describe the real-life experience of 10 well-established research clinics in Nairobi, where a successful experience of community engagement linking prevention and care to research was interrupted during the COVID-19 pandemic. We contrast this experience with the concept and processes of community engagement as described in selected scientific manuscripts and guidelines, to formulate some conclusions and recommendations. We contend that more action is needed, from research ethics committees and other key-research stakeholders, to align policies and practices with ethics guidance and with evidence-based recommendations from the academic literature, to achieve meaningful community engagement during emergency research, irrespective of the scale and location of an outbreak or public health crisis. Failure to do so, will aggravate the (postcolonial) asymmetries of power in global health and local systems.

Global health emergencies often lead to a proliferation of health-related research and resultant data, which is shared across borders to help control the outbreak of disease and support decision-making regarding public health interventions. However, efforts to share data can be hindered by diverse international ethical and legal frameworks. The frameworks aim to govern coordinated processing, sharing and transfer of health data across borders thus placing burdens on researchers who are willing or obligated to share data. In this paper, we investigate ethical values and legal principles that can be applied to ensure a more streamlined approach in the governance of cross-border health data sharing during global health emergencies. A scoping review approach was used to better understand emerging evidence about issues related to the ethical and legal governance of cross-border health data sharing. We first highlight the challenges of sharing health data across borders. We then discuss how the challenges might be overcome through the application of ethical values and legal principles that have been identified in literature. This is followed by a proposal for possible ways of streamlining the governance of health data sharing from ethical and legal perspectives in a bid to better prepare for future global health emergencies and promote the responsible sharing of health data.

Background: Religious institutions play a crucial role in health promotion and hold significant influence in the public health field. Aim: The aim of this review is to examine outcomes of health-promoting interventions involving the use of mosques as the intervention venue, its role in promoting health behavior change, and the role of theory in each intervention. Methods: A scoping review was conducted across 17 databases for relevant publications published up to and including August 2023 that involved the use of mosques as the intervention venue. Fourteen articles met inclusion criteria and were reviewed. Results: The studies featured a wide range of interventions. However, only eight of these studies integrated theoretical frameworks into their approaches, indicating a need for more structured guidance in this field. These theoretical frameworks included Participatory Action Research (PAR), the theory of planned behavior, behavior-change constructs, the patient-centered outcomes research (PCOR) framework, and prolonged exposure techniques within Islamic principles. The review identified three main health-focused intervention categories: mental health, prevention, and communication, each providing valuable insights into initiatives within Muslim communities. Conclusions: This review underscores the significance of inclusive and culturally sensitive health interventions, emphasizing the effectiveness of faith-based approaches in improving health outcomes, promoting positive health behaviors, and addressing communication and cultural barriers. The reviews findings stress the need for further research that incorporates theoretical frameworks and tailored interventions to meet the specific cultural needs of these communities, ultimately contributing to enhanced well-being within them.

The burden of childhood visual impairment and disparities in access to pediatric vision care remain pressing issues in the United States. School-based vision programs (SBVPs) serve as one approach to advancing health equity. Operating at the intersection of schools and healthcare, SBVPs can increase access to pediatric vision services, improve academic performance, and facilitate referrals to community vision care providers. To maximize their impact, SBVPs must tailor their services to the individual needs and resources of local school communities. School nurses, who have strong ties to school health care services and the school community, are trusted partners in building SBVPs. This article aims to facilitate SBVP development, implementation, and sustainability processes by offering guidance for school nurses and other stakeholders who aim to build a SBVP, support local programs, or learn more about how SBVPs operate.

BACKGROUND: The emergence of COVID-19 resulted in a substantial loss of education because of global school closures. Face masks are a potential measure to restrain the COVID-19 spread; therefore, this paper evaluated the effectiveness of face masks in reducing COVID-19 incidence in school settings. METHODS: A systematic review was conducted by searching the literature in the Cochrane COVID-19 Study Register and the World Health Organization COVID-19 global literature. Data were summarized in tabular forms, and the findings were presented as narrative synthesis. RESULTS: A total of 15,709 records were retrieved. The screening and selection led to the inclusion of 12 observational and 2 quasi-experimental studies. Nine studies were conducted in different states, counties, or districts of the United States, and the remaining 5 were reported from Germany, Finland, Spain, and the United Kingdom. The results of 10 out of 14 studies favored mask use in reducing school COVID-19 incidence. Three studies found no link between mask use and COVID-19 incidences, whereas 1 quasi-experimental study noted a higher COVID-19 incidence with mask use in students aged 6-11 years than no use of mask among preschool children aged 3-5 years. CONCLUSION: Mask mandates may lessen the incidence of respiratory infectious diseases in school settings during a pandemic; more well-designed studies are warranted to clarify further the evidence regarding mask use in school settings.

Objectives: Overweight and obesity among school-aged children pose a threat to both their academic performance and public health. The Healthy Primary School of the Future (HPSF) initiative was established to address this issue. Our objective was to explore the conditions that make HPSF sustainable based on the perspectives of relevant stakeholders. Design: The study utilised Group Concept Mapping, a structured methodology for conducting mixed-methods participative research, combining qualitative data collection with quantitative data analysis measures. Method: Participants included parents, teachers, school directors, politicians, labour unions, educational, nutrition and health scientists and policymakers. They were asked to respond to the prompt, 'A necessary condition to make the HPSF sustainable is . . .'. The statements generated were then assessed for their importance and feasibility. Using multidimensional scaling and hierarchical cluster analyses, we identified the shared vision among the stakeholders. Results: A total of 106 unique statements were generated and grouped statistically into 10 clusters. The most significant clusters were identified as Financing; Accessibility for everyone; and Content/Lifestyle/School Programme. The clusters that were deemed most feasible included Content/Lifestyle/School Programme; Accessibility for everyone; and Evaluation. Conclusion: Achieving sustainability for the HPSF requires a comprehensive approach that addresses the conditions outlined in all 10 clusters. Based on the ratings of feasibility and importance, our recommendation is to prioritise implementation of Content/Lifestyle/School Programme and Accessibility for everyone. Subsequently, efforts should be directed towards realising the less feasible but crucial conditions, such as Financing and Evaluation, followed by the remaining six clusters of conditions as identified.

Objectives: Among Aboriginal children, the year between birth and 1 year of age has the highest mortality rate compared with any other age. Prompt administration of cardiopulmonary resuscitation (CPR) leads to better outcomes and a lower likelihood of ongoing sequalae. Current education on infant CPR is not provided to parents except in certain circumstances in a neonatal intensive care unit. Currently, there are no identified CPR education courses specifically available for Aboriginal or Torres Strait Islander people, meaning that current infant CPR education courses are not culturally responsive. Design: Partnering with an Aboriginal community from the Bindjareb region of the Western Australian Noongar nation, the researchers used a co-design approach and an Aboriginal Participatory Action Research (APAR) design to explore how to deliver culturally safe and responsive infant CPR community education. This resulted in the development of the Koolangka Infant Life Saving Education Framework (KILSEF), which can be used to guide future planning and delivery of culturally safe and responsive community level infant CPR education. Results: The study findings identified that members of the Aboriginal community were very interested in receiving infant CPR education, but the barriers identified from mainstream CPR course delivery need to be removed for the community to benefit from culturally responsive ways of learning. Culturally responsive community CPR education should be provided in culturally safe places and the focus of learning should be on the practical applications of CPR and less on the academic pre-reading and written requirements. Explanations should be provided in lay terms and patience is required to communicate ideas in ways that facilitate understanding, and the course may need to be delivered over several days to accommodate community participant availability. Conclusion: Addressing Aboriginal community concerns and barriers allowed for the implementation of culturally responsive infant resuscitation education which was highly valued by community members and led to increased community confidence and participation in CPR education.

Rheumatic diseases are known to be associated with the development of metabolic syndrome, which increases mortality rates due to cardiovascular complications. Although a variety of self-management programs for rheumatic diseases have been developed, few have concentrated on metabolic syndrome. This study aimed to develop and verify a blended (a mixture of telephone and online interventions) metabolic syndrome self-management program. The program was developed in four stages: analysis to identify program contents, website design, website development, and validity testing. A quasi-experimental nonequivalent control group, pretest-posttest design was adopted to verify the program effectiveness in 54 patients with rheumatic disease. The program was initially implemented via telephone for 4 weeks and then self-administered via a web-based platform for 20 weeks. Indices of metabolic syndrome and self-management and quality of life scores were measured as outcome variables. Data were collected three times: before intervention, after 4 weeks of telephone interventions, and after 20 weeks of online self-interventions. The devised program had a significant overall effect on metabolic syndrome indices, metabolic syndrome-related self-management behaviors, and quality of life. Detailed analysis showed the program effectively reduced body mass index, waist circumference, systolic blood pressure, and blood glucose levels and improved metabolic syndrome self-management behaviors. Based on our findings, it can be expected that the use of this program may retard or prevent the progression of metabolic syndrome by improving some metabolic syndrome indices and metabolic syndrome-related self-management behaviors, which are key components of care in rheumatic disease patients with metabolic syndrome. This web-based program appears to be beneficial in public health care settings because it is cost-effective, readily available, and may provide long-term support.

Recently, multiple health organizations and advocacy groups have pushed for giving an R-rating for movies depicting tobacco imagery. This study examined several predictors of U.S. adults' opinion toward an R-rating policy for movies depicting cigarette smoking. We used data from the Health Information National Trends Survey (2020 cycle), for a nationally representative sample of 3,865 US adults (aged = 18). The outcome variable was opinion toward an R-rating policy (support, neutral, and oppose) for movies depicting cigarette smoking. A weighted adjusted multinomial logistic regression analysis with comparisons of support versus oppose, support versus neutral, and neutral versus oppose was performed. About 48.2% of respondents were supportive of, 31.1% were neutral toward, and 20.7% were opposed to an R-rating policy. Adults aged 50 to 64 years (adjusted odds ratio [aOR] = 2.28, p = 0.008) and =65 years (aOR = 4.54, p <0.001) (vs. 18-34 years) were more likely to support the R-rating policy than oppose it. Non-Hispanic Black respondents (vs. non-Hispanic Whites) were 1.74 times more likely to support than oppose the policy (aOR = 1.74, p = 0.04), whereas adults with a household annual income of US$75,000 or more (vs. <$20,000) and those with moderate (vs. liberal) political viewpoints were more likely to be neutral than oppose the policy. Former and current e-cigarette users (vs. never users) were less likely to support than oppose the policy. Tailored messaging addressing the rationale behind R-rating policy should be directed towards communities based on age, race/ethnicity, household income, e-cigarette usage, and political ideologies.

Opioid overdose deaths are dramatically increasing in the United States and disproportionately affecting minority communities, with the increasing presence of fentanyl exacerbating this crisis. Developing community coalitions is a long-standing strategy used to address public health issues. However, there is a limited understanding of how coalitions operate amid a serious public health crisis. To address this gap, we leveraged data from the HEALing Communities Study (HCS)--a multisite implementation study aiming to reduce opioid overdose deaths in 67 communities. Researchers analyzed transcripts of 321 qualitative interviews conducted with members of 56 coalitions in the four states participating in the HCS. There were no a priori interests in themes, and emergent themes were identified through inductive thematic analysis and then mapped to the constructs of the Community Coalition Action Theory (CCAT). Themes emerged related to coalition development and highlighted the role of health equity in the inner workings of coalitions addressing the opioid epidemic. Coalition members reported seeing the lack of racial and ethnic diversity within their coalitions as a barrier to their work. However, when coalitions focused on health equity, they noted that their effectiveness and ability to tailor their initiatives to their communities' needs were strengthened. Based on our findings, we suggest two additions to enhance the CCAT: (a) incorporating health equity as an overarching construct that affects all stages of development, and (b) ensuring that data about individuals served are included within the pooled resource construct to enable monitoring of health equity.

Violence is a major public health problem globally, with the highest rates in low- and middle-income countries (LMICs) in the Americas and southern Africa. Parenting programmes in high-income countries can diminish risk for violence, by reducing risk factors such as child aggression and harsh parenting, and increasing protective factors such as child cognitive development and school readiness. However, there is critical need to identify low-cost programmes with replicable benefits that work in real-world LMICs contexts. A three-arm, randomised, single-blind trial evaluated effects of two low-cost, group-based parenting programmes recommended for LMICs (ACT: Raising Safe Kids; DBS: dialogic book-sharing) on child aggression (primary outcome), child development, parenting, maltreatment, and stress. Participants were 369 children with medium-high levels of aggression (mean age 3.1 years at baseline) in poor households. Interventions were implemented in city health and education services in southern Brazil. Maternal reports, filmed observations, child tasks, and hair cortisol were assessed at baseline, 1-month post-intervention, and 8-month follow-up. Intention-to-treat analyses compared each of ACT and DBS with a control group. Three hundred sixty-eight (99.7%) participants completed follow-up assessments 8 months after the interventions. There was no effect of ACT (standardised mean difference, SMD 0.11, 95% CI - 0.05, 0.27) or DBS (SMD 0.05, 95% CI - 0.11, 0.21) on the primary outcome of child aggression. ACT reduced harsh parenting behaviour post-intervention (SMD - 0.23; 95% CI - 0.46, 0.01), but not at follow-up. DBS improved book-sharing practices at both time points (e.g., maternal sensitivity at follow-up SMD 0.33; 95% CI 0.08, 0.57). There were no benefits of either programme for other parenting, child development, or stress outcomes. Two parenting programmes in Brazil had small effects on parenting practices but did not reduce child aggression or several other important risk/protective factors for violence. Effective early interventions that reduce violence in real-world LMIC settings are highly desirable but may be challenging to achieve.

Over the last three quarters of a century, international guidelines and regulations have undergone significant changes in how children are problematised as participants in biomedical research. While early guidelines enacted children as vulnerable subjects with diminished autonomy and in need of special protection, beginning in the early 2000s, international regulatory frameworks defined the paediatric population as vulnerable due to unaddressed public health needs. More recently, ethical recommendations have promoted the active engagement of minors as research partners. In this paper, I adopt a post-structuralist approach to policy analysis to examine deep-seated assumptions and presuppositions underlying the changes in the problematisation of children as biomedical research participants over time. While biomedical research ethics focuses on the autonomy and vulnerability of minors, ethical guidelines are situated in specific sociocultural contexts, shaped, among other things, by contingent public health needs and changing conceptions of the value of research and science for society. In the process, I demonstrate the challenge of moving away from an approach that in taking adults as the model overshadows the complexity of children's lived experiences as well as their personal, cultural, and social lives. The lack of acknowledgement of this complexity makes children vulnerable to epistemic injustice, which is particularly crucial to address in public involvement initiatives.

Background: The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under-represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society. Aims: To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field. Methods & Procedures: This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. Main contribution: This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field. Conclusions & Implications: Conclusions & Implications: PHR remains an under-represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research-practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production.

Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.

A revised way of thinking is essential for promoting harm reduction strategies and reducing the negative implications of injection drug use (IDU). Despite the growth of harm reduction approaches in the United States, there is limited guidance for designing and implementing multi-sector efforts that address the external determinants that promote and facilitate IDU. Current frameworks fail to acknowledge the individual's role and influence in multi-sector change. To address the multifaceted nature of IDU, we must address the complex relationship between people who inject drugs (PWID) and their external environment. As part of a community-academic partnership, a framework was developed to address the gaps in current theoretical models and community practice. Our Harm Reduction Collaboration Framework (HRCF) accepts PWID as key stakeholders and presents a practical framework in which PWID and community organizations partner in decision making to influence policy, systems, and environmental change. We provide examples of two organizations that have made substantive changes in implementing harm reduction strategies in their communities by utilizing the HRCF.

This article reports on a 3-year longitudinal study focused on the impact of cross-sector, collective impact approaches to creating cultures of campus health. The study sought to understand the integration of health and well-being concepts into university operations, including business practices and policies, as well as the contribution of public health initiatives focused on health-promoting universities to creating cultures of campus health for students, staff, and faculty. Research was carried out from spring 2018 to spring 2020 via focus group data collection and rapid qualitative analysis involving template and matrix analysis. A total of 18 focus groups were conducted across the 3-year study, six with students, eight with staff, and four with faculty. The initial cohort included 70 participants: 26 students, 31 staff, and 13 faculty. Qualitative analysis findings indicate a general pattern of change over time from a primary focus on well-being characterized by programs and services (e.g., fitness classes) to policy and structural-level interventions (e.g., stairwell beautification and hydration stations) promoting well-being for all. Grass-top and grassroots leadership and action were instrumental to changes in working and learning environments, policies, and campus environment/infrastructure. This work contributes to the growing literature on health-promoting universities and colleges and demonstrates the critical role of both top-down and ground-up approaches and leadership efforts to create more equitable and sustainable cultures of campus health and well-being.

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many arsoe unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.

Background: The main goal of a health system is to maintain or improve people's health. The COVID-19 pandemic showed the fragility of health systems worldwide. In Mexico, the pandemic affected the performance of the health system, along with the presence of contextual conditions such as its segmentation and high prevalence of chronic diseases. Aims: To analyze from an approach to the functions of the health system, the service delivery, human resources, financing, and stewardship/governance in the local health services of five states of Mexico, from the perspective of the staff working in health centers. Methods: This is an exploratory qualitative study conducted from November 2020 to August 2021, involving 124 health professionals from 39 health facilities (18 rural and 21 urban). The technique used was the semi-structured interview. Interview guides were developed according to core topics. Subsequently, the thematic analysis method was used. Results: The lack of financial resources delayed prevention efforts and made it difficult for health centers to adapt to the crisis. Inequity was found in the distributive efficiency of staff between rural and urban areas and levels of care. In addition, there was evidence of capacity for coordination, capacity sharing, and joint participation between health institutions, civil authorities, and the population to face the emergency. Conclusions: We identified relevant public health actions that showed the capacity of local health services to organize a response to the pandemic at the level of the actors responsible for these services.

Community-engaged patient navigation safety net programs are established as an evidence-based approach to address cancer prevention and early detection efforts, but barriers to expand and sustain such programs persist. In addition, few studies describe how these programs impact buy-in among communities and policy change within health care systems and government. We describe how we used the Capacity for Sustainability Framework to guide efforts for program sustainability and community, institutional, and policy level change in a breast cancer screening and patient navigation safety net program. The nine domains of the Capacity for Sustainability Framework were used to develop program logic models, to inform program implementation and quality improvement agendas, and to guide multi-level partner and stakeholder engagement, outreach, and dissemination of outcomes. The program is currently in its seventh year and continues to be annually funded by a city public health department. In 2021, additional 5-year renewable funding from a state public health department was secured. In addition, institutional program support was expanded for patients diagnosed with breast cancer. Program leaders worked with policymakers to draft legislation to support training certification and third-payor reimbursement for patient navigators and community health workers. The program is well-known and trusted among community members, community-based organizations, and providers. Community, organizational, and policy-level outcomes demonstrate that community-engaged patient navigation safety net programs can influence more than individual and interpersonal outcomes and can be sustained over time.

Every moment counts (EMC) is a multi-tiered mental health promotion initiative designed to build the capacity of practitioners to address the mental health needs of children and youth in school settings. This study evaluated the impact and cultural relevance of EMC workshops in supporting practitioners to apply a public health approach to children's mental health in Aotearoa New Zealand. A longitudinal mixed methods design employed a survey and semi-structured interviews to evaluate the applicability, impact and cultural relevance of the EMC workshops. Themes identified from participants' reflections on their experiences of implementing EMC represented everyday practices at individual, team, and organizational levels. Specifically, intersectorial collaboration was perceived as beneficial. There is a call to action for practitioners to work more cohesively and interprofessionally, at policy and practice levels, to effectively promote children's mental health and achieve equitable health and well-being outcomes. Communities of practice offer a potential mechanism to support translation of knowledge into practice in schools. Application of a public health approach to children's mental health in schools, facilitated by the EMC initiative, is applicable and positively impacts outcomes in Aotearoa New Zealand, with some modifications needed to better fit the cultural context.

Background: In March 2020, the rapid spread of the novel coronavirus (COVID-19) resulted in lockdowns of schools and businesses alike across the United States. For working parents of preschool age children, the forced closure of child care centers created a unique situation where parents suddenly become the major source of daily care and education for their children. Objective: The present study was conducted to provide new evidence concerning young children's perceptions of the COVID-19 stay-at-home mandate as a way to reveal children's understanding of the pandemic. Method: Child and parent interviews were conducted via teleconference with their child's regular preschool teacher in the spring of 2020. Narrative data were content analyzed using open and axial coding (Saldaña, The coding manual for qualitative researchers, Sage, 2016). Results: The majority of parents reported providing their children with information on why they were home. Use of advanced language specifically referencing the coronavirus in conversation with their children was associated with more non-responding or children repeating their parent's utterances verbatim. Preschoolers who were given more simplistic explanations (e.g., germs) could expand their responses indicating understanding (e.g., you will get sick, need to wash hands, wear a mask). When parents did not offer information, children generated their own meaning and interpretations, often citing erroneous ideas (e.g., people are sick because they ate rotten bananas), reflective of how young children make sense of their world. Conclusion: These findings indicate that using simplistic and factual age-appropriate language enhances the likelihood that young children will understand and accurately perceive potentially life threatening situations.l

The prevalence and pervasive nature of emerging chemicals of concern have created widespread environmental injustice apprehensions in vulnerable communities. To alleviate and address these concerns, identifying, engaging, and training a diverse environmental health research workforce will be critical and necessary steps to combat and prevent the consequences of environmental injustice. While there is an obvious need to enhance diversity in environmental health research, this process is hampered by facets of systemic racism that reduce access to educational resources needed to build interest and knowledge in students and teachers. We present here a historical perspective to offer a guide for building programs and relationships with underserved schools to help overcome limiting factors that have plagued certain public school systems. With the proper training and mentorship, the untapped workforce present within these schools will be empowered to understand and address current and emerging environmental health and safety threats. Through this transformative 8-week high school research program, we will develop well-prepared, ethical researchers committed to scientific inquiry, intensive fieldwork, and collaborative problem solving to address environmental health challenges. Following the four-step risk assessment process, students, teachers, and faculty mentors will work collaboratively to identify toxicants, potential hazards and risks, and environmental disparities in urban neighborhoods, which provides the necessary training to formulate critical thinking skills for use in academic or nonacademic careers.

This paper introduces a Patron Counting and Analysis (PCA) system that leverages Wi-Fi-connection data to monitor space utilization and analyze visitor patterns in academic libraries. The PCA system offers real-time crowding information to the public and a comprehensive visitor analysis dashboard for library administrators. The system's development was driven by the need for occupancy restrictions during the pandemic, ensuring a spacious environment for library visitors as well as balancing between efficient utilization and adhering to social distancing regulations. Traditional methods of patron behavior performance and library spatial analysis, such as manual head counting or card-swiping systems, often incur additional costs for labor, hardware installation, or software subscription. The PCA system, however, utilizes existing Wi-Fi-connection data, providing a cost-effective solution to represent patron demographics and spatial usage. Limitations may arise when patrons do not carry Wi-Fi-enabled devices or during periods of low Wi-Fi service functionality. Implemented in Node.js and integrated with Python Flask framework and related libraries, the PCA system was piloted at the King Library in Miami University, successfully demonstrating a high validity compared to manually collected data. It filters out noise and redundancy, visualizes the occupancy index meter in real time, and generates statistical reports by linking user IDs with demographic information. The PCA system's reliability was validated through manually head counting data collected at the King Library in Miami University, establishing it as a reliable tool for library space management and patron analysis.

Greater Hazelwood, a neighborhood located in Pittsburgh, Pennsylvania, saw a decline in residents, businesses, and services at the steel industry's decline. Residents, philanthropic organizations, advocates, health centers, schools, universities, and community-based organizations continue collaborating to revitalize the Greater Hazelwood neighborhood by following the Greater Hazelwood Neighborhood Plan. Duquesne University Center for Integrative Health was engaged by a place-based grant-making strategy in Greater Hazelwood to explore the creation of a collaborative partnership between a university, federally qualified health center, school, residents, and community-based organizations to create a framework to improve access to comprehensive and quality healthcare in Greater Hazelwood. This collaboratively designed health and wellness programs based on community-identified health priorities to improve health outcomes. These programs provide opportunities for multi-sector partners and interdisciplinary health professionals to meet residents where they are, decrease disease disparity, and promote health equity.

The study examined the social and political circumstances in Ghana which evolved because of the pandemic created by COVID-19, and the extent to which President Akufo-Addo was able to effectively use the medium of speech to manage this global health emergency. This study focused on the stylistic choices of the speech and investigated how different sentence structures, repetitions, political jargon, and other linguistic characteristics were deployed. Textual analysis involves the appreciation of a text while explaining its ideological and cultural dimensions (Fursich, 2009). This study was underpinned by the Narrative Paradigm Theory and Sociolinguistics. Under Narrative Paradigm Theory, narratives have a plot and characters that are involved in an interaction and can therefore be seen as a narrative in form and function. Sociolinguistics shows how language can be presented in specific contexts of social life, and how it reflects and then includes meaning and structure in those contexts (Schiffrin, 1997). Also, textual analysis as a qualitative research methodology was used for this study, and as an interpretive approach, it concentrated on the embedded cultural and ideological positions on the material. The findings from this study showed that the speech that was in a narrative mood incorporated all the achievements and challenges identified during the pandemic. It also provided cases of semantic analysis of words and meaning, relations among words that included metaphors, semantics, argumentative, narrative, and cognitive frames.

Epidemiological transition, population ageing, and pandemics posed new challenges to the health system. Current global situation demands many new competencies within the scope of teaching public health in medical schools. The aims of this study were to identify the needs of public health competencies for medical doctors in Thailand and to assess the level of integration for technical collaboration in teaching public health. The national survey of all Thai medical schools applied the list of public health competencies framework recommended by the World Health Organization, Southeast Asia Regional Office (WHO-SEARO). Qualitatively, community representatives from 11 sample villages were interviewed in the focus groups and representatives from stakeholder organizations, particularly employers in the in-depth interviews. Data integration applied recursive mixed-method approach. While the survey identified that health economics, disaster management, leadership, and teamwork are not well addressed in curriculum, employers, and national health authority uttered the need to strengthen the health system sciences and leadership in new generation medical doctors. Almost two third of medical schools could not apply interdisciplinary integration to teach such public health subjects. Furthermore, experiential learning and role play are recommended, in addition to the usual teaching method and multiple-choice questions. Thai communities expect doctors to serve the community, lead the primary healthcare team and train the health professionals and community health volunteers. Therefore, future medical doctors require interdisciplinary competencies. The findings of this study may provide evidence to step forward to a national framework of public health core competencies and interdisciplinary collaborations.

This article introduces the Health in All Policies (HiAP) approach to the LIS community to propose a new way of thinking and teaching about how health is supported in public libraries. The topic of consumer health literacy has been a mainstay in the discourse of public librarianship, but we argue that this approach has not fully supported public librarians seeking to find uniquely local ways to support public health. Health in All Policies (HiAP) was developed by public health researchers and policy makers as a mechanism to promote health by facilitating action across sectors, including those where health is not a primary organizational focus. HiAP's focus on multi-sector community health systems opens a conceptual space for thinking about how to strategically and proactively support and advocate for public libraries and public librarians as one sector among many that contribute to community health. This approach could be a positive alternative to the sometimes negative experiences of public librarians being asked, or ordered, to fulfill public health duties, particularly during the COVID-19 pandemic, when public librarians were pressured to take on new public health roles as perhaps never before. After introducing the concept, the article discusses some of the ways in which it could be incorporated into LIS education, particularly for public librarians, as well as some of the topical areas that need further development to fully bring this perspective into the teaching and research of LIS.

Purpose: To explore factors influencing compliance with COVID-19 recommended preventive behaviours focusing on types of information sources about COVID-19, learning about disinfectant use and constructs of the Health Belief Model among adolescents at the start of the COVID-19 pandemic. Design: Cross-sectional descriptive design. Setting: A survey was distributed electronically to organisations, parents and student groups in Southern California 10 months after the declaration of the COVID-19 pandemic. Sample: A total of 217 students aged between 12 and 19 years old. Measures: Questions were adapted from a previous nationwide online survey about COVID-19. Analysis: Descriptive and logistic regression analyses were used to analyse the data. Results: The most common type of information (communication) source was an interpersonal one (parents), and the least common type was an official (federal, school) source. Statistically significant better protective behaviours aligned with COVID-19 recommendations were seen in students who received more information from official sources; less information from social media or friends; believed in the accuracy and benefits of utilising the COVID-19 pandemic information and learned about the use of disinfectants and were confident in cleaning surfaces of devices and equipped. However, those who perceived themselves at risk of COVID-19 infection and had perceived high risks in general reported lower (but not statistically significant) compliance with protective behaviour. The level of knowledge about COVID-19 was not statistically associated with compliance with protective behaviour. Conclusion: Parents' role in guiding adolescents is critical. Evidence-based information about COVID-19 should be delivered through official sources to facilitate adolescents' understanding and active participation in public health efforts.

Objectives: This study evaluated the effects of reading different versions of a fotonovela about diabetes in resource-poor settings in South Africa. Design: An experimental study was conducted with 411 participants, comparing a fotonovela with a younger protagonist, a similar fotonovela version with an older protagonist and a no message control condition. Differences between the two fotonovela versions were analysed for two age groups of readers (25-49 years, and 50 years and older). Setting: Community centres in vulnerable communities in the South African provinces of the Western Cape, the Northern Cape and Gauteng. Method: In the experimental conditions, participants completed a questionnaire after reading one of the fotonovela versions. Participants in the control condition answered similar questions without having read a fotonovela. Results: Both fotonovela versions resulted in more diabetes knowledge than the control condition. Limited positive effects were found for attitudes and behavioural intentions. In the younger participant group, age similarity between the protagonist and readers resulted in knowledge gain, while in the older participant group, no such effect was found. In both age groups, no age similarity effects were found for attitudes or behavioural intentions. Conclusion: This study confirms that fotonovelas can be an effective means of health communication. Furthermore, for a narrative on a health topic for which age is relevant, it can be beneficial to choose a young protagonist. For readers from the same age group, the impact of the story on knowledge acquisition may then be greatest, while for older readers, the age of the protagonist does not seem to influence the knowledge effects of the story.

There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency ([omega]>0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs.

Design-based Research (DBR) focuses on real-world problems, emphasizes studying an educational intervention in its supposed context, uses a cyclical process of design, implementation, evaluation, and improvement, utilizes mixed research methods, stresses reciprocal relationships between theories and practice, and involves a close collaborative relationship between researchers and practitioners. Three iterative DBR research cycles were conducted on a project-based learning (PjBL) implementation in three population health nursing clinical PjBL blocks at a Midwest university. Data were collected at the end of each cycle through surveys, focus group interviews with students, faculty, and clinical agency contacts, as well as student work and performance. The data were analyzed, and revisions and improvements were planned for subsequent blocks and future use in the course.

This paper discusses the implications of health literacy during the COVID-19 pandemic for adults with lower literacy skills. It highlights the challenges faced by individuals in understanding complex health information and emphasizes the role of adult educators in providing trustworthy and comprehensible health information. Incorporating health literacy into adult education programs has shown positive impacts on students' self-efficacy and health knowledge. Overall, improving health literacy in the ABE classroom can empower individuals to make informed health decisions.