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There is a clear need for highly competent health sciences experts. No instrument currently exists for assessing the generic competences of health sciences students. The aim of this study is to develop and psychometrically test the Health sciences Generic Competence (HealthGenericCom) instrument. The instrument development four step process has been conducted with a cross-sectional study design and according to the COSMIN guidelines. Face and content validity was tested by 13 experts, structural validity was tested with exploratory factor analysis, and internal consistency was evaluated by calculating Cronbach's alpha. The structural validity was tested using data from Finnish health sciences students (n=276). The content validity index of the whole HealthGenericCom instrument was 1 for relevance and for clarity. Using exploratory factor analysis a model of eight factors (with 88 items) was created: 1) competence in leadership, administration, and finance; 2) competence in people-centred guidance; 3) competence in health promotion; 4) competence in evidence-based practice; 5) digital competence; 6) competence in work well-being and self-management; 7) competence in collaboration and problem-solving; and 8) competence in societal interaction. The HealthGenericCom was shown to be valid and reliable and provides an evidence-based conceptual framework that can be used in developing curriculums and competence management.

African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.

Underrepresentation of historically marginalized populations in clinical trials continues to threaten the validity of health intervention research. Evidence supports the merits of intercept and other proactive forms of recruitment for achieving more equitable representation. However, researchers also report lower retention and adherence to protocols among these populations, particularly in longitudinal studies. Few studies have compared recruitment methods for longitudinal randomized trials testing health interventions, with even fewer having done so for trials involving ecological momentary assessment (EMA). As intervention research integrates EMA and other data collection approaches requiring substantial participant effort, it is critical to better understand the effectiveness and implications of strategies to improve the representativeness of health research. This secondary data analysis compared outcomes of proactive and reactive recruitment strategies (mobile lab intercepts and internet/flyer advertising, respectively) in study inclusion, task completion, and retention within a 14-day randomized controlled trial that used EMA to evaluate cigarette package health messages. Proactive recruitment resulted in higher proportions of participants with low income and education, limited health literacy, and of diverse racial/ethnic makeup. However, this recruitment method also resulted in lower task completion, especially in the second week of the trial period, and lower retention, although group differences were not explained by participant sociodemographic characteristics targeted by inclusion efforts. We conclude that proactive recruitment via intercepts is an effective strategy for health intervention research that aims to include stakeholders from historically marginalized groups but that researchers and funders must recognize these methods require additional resources, considerations, and capacity to address non-trivial challenges to successful participation.

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.

In the last two years, a growing number of studies have focused on the promotion of students' mental health to address the negative effects of the COVID-19 pandemic. However, less studies have been conducted on sustaining teachers' mental health which has been affected by the sudden changes in online teaching and the difficulties in keeping and building relationship with students. Even before the pandemic, teaching has long been recognised as one of the most challenging occupations characterized by high levels of stress. Although the research highlighted the key role of mental health promotion among teachers, there is still a lack of programs enhancing teachers' wellbeing. This study examined the impact of the PROMEHS program, a school-based curriculum, on teachers' mental health. A total of 687 teachers participated in the study. Applying a pre- and post-training study design with experimental and waiting list groups, teachers were evaluated in social and emotional learning, resilience, and self-efficacy. The results showed that there was a significant improvement in all competences of the teachers in the experimental group compared to those in the waiting list group. The paper discusses the implications of the findings with recommendations for further studies in the area.

Objective: Successful university wellness programs approach wellness holistically and regularly assess for improvements to program offerings. This case-study reports five lessons learned from a university wellness program evaluation that must be considered when developing wellness programming. Participants: Faculty, staff, and students at a public university health sciences center. Methods: A 23-question electronic survey with open-ended questions was administered to measure feedback on current and future wellness programming. Responses were analyzed with an open coding approach into five themes for program improvement to more holistically address wellness. Results: The five improvements to wellness programming identified by respondents were: wellness offering awareness, workplace culture and environment, racial representation, wellness programming policy enforcement, and creating an environmentally friendly campus. Conclusions: Themes identified in this case-study require additional attention by university wellness programs to ensure they are equitably accessible and comprehensive in their offerings.

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations.

Prior research about pupil welfare teams have identified problems at several levels: those of leadership, interprofessional cooperation, cooperation between the pupil welfare team and teachers, and type of work carried out. Perhaps most importantly, teams seem to work primarily with 'firefighting', i.e. acting reactively when problems already have occurred, rather than in a health promoting and preventive way. On the one hand, health promotion and prevention are endorsed as desired ways to work (e.g. SFS 2010, 800); on the other hand, reactive measures seem to dominate in practice. In order to try to bridge this gap, we carried out a study of a pupil welfare team in Sweden that we had reason to believe worked more in line with the health-promoting and preventive manner of working that is recommended. Since we could not know a priori whether the team studied worked in a qualitatively different way than other teams studied in prior research, we were led by two overarching research questions: (1) Is the studied team working in a heath promoting and preventive way? and (2) If so, how did their way of working emerge and how is it sustained? Our overriding purpose is to increase our knowledge concerning whether and how pupil welfare teams can become more health promoting and preventive in practice. More specifically, we are interested to find factors that contribute to the development and sustainability of health promoting and preventive work in pupil welfare teams.

Objectives: This case study examined multi-level social-ecological supports in promoting well-being through college students impacted by one of the deadliest wildfires in U.S. history. Participants: College students attending a large public university were surveyed (N = 354, M[subscript age] = 22.7, 76.2% female, 61% white).Methods: Measures included demographics, individual factors (mindfulness, sleep problems), social support (emotional support, family support, and friendship), and sense of community. Multiple linear regression models on well-being were constructed. Results: Findings indicated that mindfulness, sleep disturbances, emotional support, family support, number of close friends, and sense of community were significant predictors of well-being. Conclusion: Findings highlight the importance of universities in proactively bolstering critical social-ecological needs of college students living in communities vulnerable to climate-change accelerated environmental disasters.

Diverse approaches to the treatment of depressive disorders are necessary to improve evidence-based practice and maximize treatment outcomes. As a result, a range of behaviors and other factors associated with the onset and course of depressive disorders should be examined more comprehensively. Behavioral activation (BA) is a treatment approach to these disorders that can be tailored to address certain health behaviors within the context of depression in an attempt to promote health behaviors whose adoption and maintenance can prove complementary in the treatment of depression. We conducted a scoping review of published studies in which BA-based interventions were used to promote certain health behaviors in individuals with depression. Our search of Medline and the Web of Science identified 336 potential candidate studies. Following screening and with the application of inclusion and exclusion criteria to isolate potentially eligible full-text records, we ultimately identified and evaluated 20 papers that report the nature and efficacy of these modified interventions. Across various domains, including substance use, exercise, medication adherence, and occupational and social success, we found evidence that many--but not all--of the studies we reviewed demonstrated that BA-based interventions were efficacious in promoting the health behavior of interest as well as reducing depressive symptomatology in participants. Implications for more widespread dissemination of such interventions, especially via mobile and web-based platforms due to their accessibility and affordability, are discussed. More research on the feasibility and efficacy of BA-based interventions tailored toward various determinants of health behavior and comorbidities of depressive disorders is warranted.

Motivational interviewing is an evidence-based counseling approach. However, its learning processes and their influencing factors are understudied, failing to address the suboptimal use of motivational interviewing in clinical practice. A participatory action research was conducted in collaboration with 16 primary care clinicians, who encountered similar challenges through their previous counseling approaches. The study aimed to facilitate and describe the clinicians' professional transformation through interprofessional communities of practice on motivational interviewing (ICP-MI). Data were collected using the principal investigator's research journal and participant observation of four independent ICP-MIs (76 h) followed by focus groups (8 h). The co-participants performed inductive qualitative data analysis. Results report that learning motivational interviewing requires a paradigm shift from health experts to health guides. The learning processes were initiated by the creation of an openness to the MI spirit and rapidly evolved into iterative processes of MI spirit embodiment and MI skill building. The intrinsic influencing factors involved the clinician's personal traits and professional background; the extrinsic influencing factor was the shared culture disseminating the expert care model. Previously described in a fragmented manner, motivational interviewing learning processes, and its influencing factors were presented as integrated findings. Considerations in elaborating effective MI training/implementation programs are discussed for clinicians, trainers, and decision-makers. Future areas of investigation are also highlighted calling forth the research community to contribute to knowledge advancement on health education in primary care.

Background: The National School Lunch and School Breakfast programs reduce food insecurity and improve dietary intake. During the COVID-19 pandemic, school meals were provided to all children at no cost, regardless of income. This policy is known as Healthy School Meals For All (HSMFA). The purpose of the study was to examine the feasibility of a HSMFA policy in Utah. Methods: A mixed-methods approach was used, including qualitative interviews for policymakers, surveys for school foodservice directors, and financial modeling of Utah Child Nutrition Programs data. Analysis included a phenomenological analytic approach for qualitative data, descriptive statistics for surveys, and development of a cost model with 6 scenarios. Results: Qualitative data revealed themes of (1) awareness; (2) responsibility; (3) perspectives on school meals; and (4) new opportunities. Most (81%) foodservice directors believed HSMFA should continue post-pandemic. HSMFA would cost $51,341,436 to $82,358,375 per year. Implications for School Health Policy, Practice, and Equity: HSMFA would result in the equitable treatment of all children regarding access to healthy school meals. Conclusions: Given the support of foodservice directors but the lack of political consensus, considering stepwise implementation and providing cost estimates may increase feasibility of a HSMFA policy in Utah.

The Recipe 4 Success preventive intervention targeted multiple factors critical to the health and well-being of toddlers living in poverty. This randomized controlled trial, which was embedded within Early Head Start home visits for 12 weeks, included 242 racially and ethnically diverse families (51% girls; toddler mean age = 2.58 years; data collected 2016-2019). Compared to parents in usual practice home visits, parents in Recipe 4 Success displayed greater sensitive scaffolding of toddlers' learning and more responsive food parenting practices (Cohen's d = 0.21-0.30). Toddlers in Recipe 4 Success exhibited greater self-regulation and had healthier eating habits (Cohen's d = |0.16-0.35|). Results highlight the value of Recipe 4 Success in promoting parent and toddler behavior change that could have life-long benefits.

Most people start experimenting with and/or initiating health-compromising behaviors and establishing behavioral patterns during adolescence. Possible selves and episodic future thinking have been used to foster behavioral changes. In this study, we aimed to: (1) develop a program incorporating possible selves and episodic future thinking to decrease the risks associated with health-compromising behaviors, and (2) examine the feasibility and fidelity of implementing this intervention among Taiwanese adolescents. A novel combination of existing intervention approaches tailored for the Taiwanese context was applied to develop a school-based intervention, which we named the Future Mapping Master program. This program contains four core units: exploring the self, setting goals, developing strategies and problem solving, and understanding the threats of health-compromising behaviors. It includes daily episodic future thinking visualization exercises. The feasibility evaluation was conducted with 88 adolescents aged 12-14 years. Feedback from teachers and students supported the proposed program's feasibility and revealed favorable reactions to the intervention. The Future Mapping Master program is feasible and offers promising strategies for implementation in Taiwanese school settings.

Children should engage in at least 60 min of physical activity daily to develop or maintain healthy habits (Centers for Disease Control and Prevention, 2021a). Previous research suggests that contingent attention is a powerful tool for increasing moderate to vigorous physical activity. In this study, the researchers examined the effects of a group game on steps per minute at recess in an inclusive classroom with preschoolers. The researcher taught the game called the T-Rex game in which the game rules (chasing students who were moving) involved contingencies for natural attention to follow moderate to vigorous physical activity. The results showed a functional relation between step count and the group game in which students engaged in higher step counts when the group game was in place than during baseline. These findings extend other work by demonstrating that contingent attention embedded in group games can increase step count.

Health education can elevate health literacy, which is associated with health knowledge, health-seeking behaviors and overall improved health outcomes. Refugees are particularly vulnerable to the effects of low health knowledge and literacy, which can exacerbate already poor health stemming from their displacement experience. Traditional learning methods including classroom-based instruction are typically how health-related information is presented to refugees. Through a series of interactive classes focused on specific health topics relevant to the resettled refugee population, this study evaluated the effectiveness of a classroom-based health education model in enhancing the health knowledge of recently resettled refugees. We used the Wilcoxon signed-rank test to evaluate differences in pre- and post-class knowledge through test performance. We found a significant improvement in health knowledge in two refugee groups: females and those who were employed. Culturally and socially sensitive considerations including language inclusiveness, class timing, transportation and childcare provisions are important when creating an educational program for individuals with refugee backgrounds. Developing focused approaches to instruction that enhance health knowledge could lead to better health literacy and ultimately improve health-related behaviors and outcomes in the refugee population.

People from culturally and linguistically diverse (CaLD) backgrounds in Australia generally experience poorer health outcomes, explained in part by low levels of health literacy. We conducted a systematic review to examine the development and evaluation of health education resources designed for CaLD populations. Five electronic databases were searched for English language, peer-reviewed studies published between 1980 and 2020. Thirty-four studies met the inclusion criteria. Twenty-four different health education resources were described and broadly categorized into four types: media campaigns (n = 10), text-based materials (n = 5), films (n = 8) and radio (n = 1). Studies were assessed against domains adapted from a health literacy guideline incorporating: need, collaboration, audience, health literacy, theory, test and process and impact evaluation. All but one study met the majority of the domains. All studies reported positive evaluation outcomes; this may be due to studies involving community early in resource design and including health literacy considerations in their design. Reporting resource design and evaluation against standard practice controls is recommended to build a more robust evidence base for developing effective health education resources for use by audiences from CaLD backgrounds.

Although sexual and reproductive health is critically important for women with intellectual and developmental disabilities (IDD), there is limited research elucidating the role of family caregivers in assisting women with IDD access sexual and reproductive health services and information. Understanding the family caregivers' attitudes and perspectives is essential to improving access to sexual and reproductive health services and information for women with IDD. A cross-sectional online survey of family caregivers of women with IDD was administered between June and October 2018. Quantitative analysis was conducted for closed-ended responses, and qualitative analysis was conducted for open-ended responses. The analytic sample included 132 family caregivers. Most participants were parents and reported being closely involved in their family member's access to sexual and reproductive health services and information. Although most participants expressed that sexual and reproductive health services and information are essential for women with IDD, qualitative analysis of participants' open-ended responses revealed both supportive and restrictive attitudes and perspectives on sexual and reproductive health services and information for women with IDD. Supportive attitudes and perspectives included (1) "knowledge is power;" (2) supported decision-making; and (3) protection against sexual abuse. Restrictive attitudes and perspectives included (1) dependent on the individual; (2) lack of autonomy; and (3) placing responsibility on disability. Greater attention from policymakers and practitioners to systems-level changes, including universal and accessible sexual education for women with IDD, supported decision-making, and sexual abuse prevention measures, are urgently needed.

This original teaching idea for a semester-long course encompasses a team-based project in which students worked together to create persuasive campaign materials for a local community health organization. The purpose of this project was for students to apply learned concepts related to theories and principles of persuasion to a real-world situation. As a team, students engaged in working sessions to develop persuasive messages related to a health issue and create campaign materials that could be used by the organization to reach target audiences. Students produced a comprehensive final report and presentation documenting the development process and showcasing their work. Overall, while there are opportunities to shrink, expand, and otherwise customize this type of project, it produced an exciting and engaging experience for students. They reported development of their small-group communication skills, greater confidence in their unique leadership capabilities, and a greater understanding of how to connect communication theory to professional experiences. Courses: Persuasion or related graduate or upper-level undergraduate courses focusing on message design, social influence, or public communication campaigns. Objectives: This semester-long, team-based project, designed for a seminar on persuasion, required a graduate class to partner with a local community health center to: identify a specific, relevant community health concern; develop theoretically grounded, evidence-based persuasive campaign materials suitable for the organization to use on social media platforms and/or in print format; and deliver a comprehensive project report and presentation of the materials to the community organization at the end of the semester.

Courses: Health Communication, Public Communication Campaigns, Public Relations, Introduction to Communication. Objectives: By the end of this workshop, students will be able to: (1) understand how artificial intelligence--based large language learning models work and be able to explain core concepts such as word embeddings, neural networks, and prompting; and (2) apply what they have learned by building and improving an expert health chatbot. Overall, the workshop aims to empower students with the necessary knowledge to use rapidly advancing artificial intelligence responsibly for health communication.

BACKGROUND: Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS: Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS: After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS: The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.

Background: Students with intellectual and developmental disabilities (IDD) and the staff who support them were largely in-person during the 2021-2022 school year, despite their continued vulnerability to infection with SARS-CoV-2. This qualitative study aimed to understand continued perceptions of weekly SARS-CoV-2 screening testing of students and staff amidst increased availability of vaccinations. Methods: Twenty-three focus groups were held with school staff and parents of children with IDD to examine the perceptions of COVID-19 during the 2021-2022 school year. Responses were analyzed using a directed thematic content analysis approach. Results: Four principal themes were identified: strengths and opportunities of school- and district-level mitigation policies; experience at school with the return to in-person learning; facilitators and barriers to participation in SARS-CoV-2 screening testing; and perceptions of SARS-CoV-2 testing in light of vaccine availability. Implications for School Health Policy, Practice, and Equity: Despite the increased availability of vaccines, school staff and families agreed that saliva-based SARS-CoV-2 screening testing helped increase comfort with in-person learning as long as the virus was present in the community. Conclusion: To keep children with IDD in school during the pandemic, families found SARS-CoV-2 screening testing important. Clearly communicating school policies and mitigation strategies facilitated peace of mind and confidence in the school district. [This article was written for the COMPASS-T Study Group.]

The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m2 up to 3 months; -0.27 kg/m2 for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > 0.05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.

Introduction: Community health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community's needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts. Methods: The protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria. Results: Most interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised. Discussion: CHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions.

This study described integrative community therapy (ICT) in the online modality as a health promotion resource in the context of COVID-19 in Latin America, characterizing the ICT circles, the ICT training centers, and the community therapists involved in this practice. It is a descriptive, observational, and cross-sectional study with a quantitative approach. Data were collected from November 2020 to July 2021 through an online questionnaire created on the Google Forms platform. The study's first stage involved the participation of ICT training centers, while the second involved community therapists. Forty-three centers participated in the first stage; 86.1% offered online ICT in the period evaluated, and 74.4% trained professionals to implement this modality. In the second stage, 66 community therapists responded to the questionnaire. Of these, 49 (74.2%) resided in Brazil, 84.8% were female, and 72.7% performed the work voluntarily, with an average of 6.1 hours per week dedicated to online circles. Community-based circles were the most cited, followed by those linked to the public sector, with an average of 20.7 participants/circle in the period. The most frequent themes were stress and negative emotions, problems with work/unemployment, and family conflicts. Strengthening self-care, participation in ICT circles, and personal empowerment stood out among the coping strategies. In conclusion, online ICT proved to be an innovative resource for health promotion during the pandemic through the articulation and engagement of community therapists and different institutions, expanding solidary social networks, and showing itself as a sustainable practice in the Latin American scenario.

Background: This study examined student and caregiver preference for school communication and explored the feasibility and acceptability of a digital tool to assist with communication about school meal program between schools and families. Methods: The study used qualitative methodology through youth focus groups and caregiver semi-structured phone interviews. The study was conducted in 4 high schools in a large, urban city. The phenomenon of interest included the exploration of preferences regarding communication around school meal programs and feasibility and acceptability of a digital tool for communication and promoting the ordering of healthful foods in the school environment. Interviews were transcribed, coded, and analyzed through NVivo qualitative software using thematic analysis approach to examine themes. Results: Forty-seven students (ages 14-21, grades 9-12) participated in 7 focus groups and 24 caregivers participated in semi-structured phone interviews. Three themes emerged around (1) communication preferences, (2) accessibility, and (3) extrinsic motivational factors for engagement in healthy eating behaviors. Conclusion: Results indicated that communication methods could potentially influence motivation and engagement in youth school meal participation.

Background: Since 2002, the Chinese Ministry of Education has conducted reform in the physical education (PE) curriculums of schools in China, with a focus on shifting from sports skills to regular participation in physical activity (PA) and promoting health. The aim of the study, therefore, is to examine the effects of school PE on the exercise habits of children and adolescents in China over time. Methods: Data based on 5941 observations of 3708 individuals aged 6 to 17 were collected from the China Health and Nutrition Survey (CHNS) for the period 2004 to 2015. The data were analyzed using the fixed-effect Logit model and the random-effect Tobit model. Results: The likelihood of exercising outside of school is 20.2% higher for students who have school PE than those who do not. Our study found that increasing the duration of PE at school by 100%, increases the duration of out-of-school PA by 22.3%. The variety of the types of sports schools offer encourages students to participate in out-of-school physical activity. The likelihood of students exercising outside of school increases by 5.6% when 1 more exercise type is provided in school PE. In addition, soccer, basketball, badminton, and volleyball education increases students' participation in after-school exercises. Soccer and basketball education, in particular, improves the duration of after-school PA. Conclusions: To form exercise habits in children and adolescents, we encourage the promotion of a variety of physical activities in schools, especially team sports such as soccer and basketball.

Background: For approximately one in five children who have social, emotional, and behavioral (SEB) challenges, accessible evidence-based prevention practices (EBPPs) are critical. In the USA, schools are the primary setting for children's SEB service delivery. Still, EBPPs are rarely adopted and implemented by front-line educators (e.g., teachers) with sufficient fidelity to see effects. Given that individual behavior change is ultimately required for successful implementation, focusing on individual-level processes holds promise as a parsimonious approach to enhance impact. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a pragmatic, multifaceted pre-implementation strategy targeting volitional and motivational mechanisms of educators' behavior change to enhance implementation and student SEB outcomes. This study protocol describes a hybrid type 3 effectiveness-implementation trial designed to evaluate the main effects, mediators, and moderators of the BASIS-T implementation strategy as applied to Positive Greetings at the Door, a universal school-based EBPP previously demonstrated to reduce student disruptive behavior and increase academic engagement. Methods: This project uses a blocked randomized cohort design with an active comparison control (ACC) condition. We will recruit and include approximately 276 teachers from 46 schools randomly assigned to BASIS-T or ACC conditions. Aim 1 will evaluate the main effects of BASIS-T on proximal implementation mechanisms (attitudes, subjective norms, self-efficacy, intentions to implement, and maintenance self-efficacy), implementation outcomes (adoption, reach, fidelity, and sustainment), and child outcomes (SEB, attendance, discipline, achievement). Aim 2 will examine how, for whom, under what conditions, and how efficiently BASIS-T works, specifically by testing whether the effects of BASIS-T on child outcomes are (a) mediated via its putative mechanisms of behavior change, (b) moderated by teacher factors or school contextual factors, and (c) cost-effective. Discussion: This study will provide a rigorous test of BASIS-T--a pragmatic, theory-driven, and generalizable implementation strategy designed to target theoretically-derived motivational mechanisms--to increase the yield of standard EBPP training and support strategies.

Purpose: We studied innovation processes in agriculture and nutrition to discuss a scaling approach that encompasses the technical, institutional, and behavioral dimensions of change. Approach: To understand dynamics across these dimensions, we analyzed farmers' innovation processes through two analytical lenses: farmer-centered and structural. Focus group discussions in Kapchorwa, Uganda, and Teso South, Kenya, looked at farmers' choices of innovations. Individual interviews and stakeholder workshops at both study sites increased understanding of the local innovation system. Findings: To address local challenges, strive for livelihood aspirations, and fulfill personal taste preferences, farmers selected and adapted practices promoted by a research project. A wide range of additional support providers encouraged farmers to develop innovations in agriculture, marketing, and nutrition. Practical implications: By promoting innovation as a process rather than an outcome, it is possible to address context-specific needs and enhance farmers' adaptive capacities. Scaling these processes necessitates the involvement of innovation support service providers in order to create an enabling environment for experimentation. Theoretical implications: Analytical dualism highlights the different roles of human agency and structures in innovation processes needed to design successful scaling strategies. Originality/value: This paper sets out a novel approach to understanding the increasingly discussed dimensions of scaling by linking them with concepts from innovation studies.

Objective: To evaluate the effects of a nutrition education programme conducted during health education lessons on students' adherence to the Mediterranean Diet (MD) and their body mass index (BMI). Design: Quasi-experimental pre-test/post-test research design: two study conditions (intervention and control groups). Setting: Two urban schools, the 11th and 21st primary schools in Limassol, Cyprus. Method: Two hundred and thirty-five fifth- and sixth-grade students participated in the programme. One hundred and fifteen were in the intervention group school (the 11th primary school), and 120 were in the control group school (the 21st primary school). Students in the intervention school participated in nine 80-minute lessons during the health education class. The curriculum focused on the MD and included cooking activities, food tasting and parental involvement. The primary outcomes were subsequent adherence to the MD, nutritional knowledge, self-efficacy physical activity and BMI. Results: Following the implementation of the intervention, the intervention group showed a significant increase in nutritional knowledge, self-efficacy and adherence to the MD (p < 0.001). The intervention group also had significantly higher nutritional knowledge and MD Quality Index scores than the control group (p < 0.001). However, no effect was observed on children's BMI (p > 0.05). Conclusion: The intervention successfully improved children's dietary habits in the intervention group by increasing adherence to the MD, but it did not affect their BMI. The results show some promise for addressing poor nutrition through education.

Background: Despite recent declines, youth nicotine vaping remains seen by experts as a national public health epidemic. Few, if any, researchers have examined how related high-profile and school-based prevention programs such as LifeSkills Training (LST) are further disseminated with cooperation from research-to-practice entities as well as the tobacco industry. Purpose: Provides a systems-driven documentary analysis of efforts pertaining to prevention entities at the University of Colorado, Boulder, as well as LST, and the tobacco industry. Methods: Employs focused synthesis data collection with constant comparative analyses. Results: Likely previously unseen and related to LST, is the degree to which prevention entities with a public mission appear to cooperate among themselves and with the tobacco industry as part of a longstanding, if not elaborate, school-based drug prevention social system characterized by patterned evidence of opaque or furtive representations and/or activities. Discussion: Along with limitations, summarizes a research-to-practice social system likely compromising school-based prevention and, in turn, the health of the young people they serve. Theorizes a symbolic politics explanatory mechanism while providing recommendations toward transparency for more informed school-based prevention decision-making. Translation to Health Education Practice: Emphasizes the National Commission for Health Education Credentialing Inc. (NCHEC) critical thinking and program evaluation competencies.

Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the United States and Canada since 2018 and in England since 2017 but with differing focus: youth vaping prevention (United States/Canada) and smoking cessation (England). We therefore examined country differences and trends in noticing vaping campaigns among youth and, using 2022 data only, perceived valence of campaigns and associations with harm perceptions. Seven repeated cross-sectional surveys of 16-19 year-olds in United States, Canada and England (2018-2022, n = 92 339). Over half of youth reported noticing vaping campaigns, and noticing increased from August 2018 to February 2020 (United States: 55.2% to 74.6%, AOR = 1.21, 95% CI = 1.18-1.24; Canada: 52.6% to 64.5%, AOR = 1.13, 1.11-1.16; England: 48.0% to 53.0%, AOR = 1.05, 1.02-1.08) before decreasing (Canada) or plateauing (England/United States) to August 2022. Increases were most pronounced in the United States, then Canada. Noticing was most common on websites/social media, school and television/radio. In 2022 only, most campaigns were perceived to negatively portray vaping and this was associated with accurately perceiving vaping as less harmful than smoking among youth who exclusively vaped (AOR = 1.46, 1.09-1.97). Consistent with implementation of youth vaping prevention campaigns in the United States and Canada, most youth reported noticing vaping campaigns/messages, and most were perceived to negatively portray vaping.

Health literacy (HL) in children is essential for healthy decision-making from early on. At six Austrian elementary schools, all children (aged 6-11 years) received 3 years of health education (HE). The participating schools were equipped with teaching materials to convey lessons in a child-oriented way. The teachers were professionally accompanied during the implementation process and received specific training. HL and its subprocesses (obtain, understand, comprehend and apply) in children >8 years were measured with a standardized test (QUIGK-K) after 1, 2 and 3 years of education and compared with values from two comparison schools without such lessons. t-Tests showed a significant increase in HL at the end of the second year of HE. After this period, the children showed above-average values on all subprocesses of HL and performed better than children without HE. The third year did not lead to a further increase. Hence, child-oriented HE is suitable to promote HL in elementary school students within 2 years. It is therefore recommended to start HE as early as possible in order to lay the foundation for a long and healthy life.

Purpose: Whole-of-school approaches to physical activity (PA) promotion are recommended internationally, but there remains little descriptive research detailing the implementation of such approaches, especially at the secondary level. The purpose of this case study, which drew upon a social-ecological perspective, was to examine a whole-of-school approach used by one secondary school in England. Method: Participants (N = 30) included three members of the school's senior leadership team, eight teachers, 15 students, and four parents. Data were collected during 5 months using open-ended questionnaires that all participants completed, 14 staff interviews with staff, three focus groups with students, six observations, and attendance records from various PA opportunities. Results: Thematic analysis identified five key PA opportunities and uncovered four themes in relation to these opportunities--Student Autonomy, Support from Leadership, New School, and Physical Education Time. Discussion/Conclusion: This study highlights the importance of targeting multiple levels of influence when implementing whole-of-school PA programming.

The purpose of this study was to examine the association between perceived weight change since high school and perceived factors contributing to weight change, or lack thereof, among college students. Students from a large university in the Northeast of the United States self-reported socio-demographic characteristics, and perceived factors contributing weight change (or lack thereof) via an online survey; and, completed an objective health assessment that included the anthropometric measurements. Of all participants (n = 183), most were men (61.2%), juniors/seniors (89.5%), non-Hispanic white (65.9%). Most participants reported gaining weight since high school (n = 113, 62.1%), and these participants had significantly greater abdominal girth, weight, and body fat percentage than those who maintained their weight (p < 0.005). Perceived factors contributing to weight change explained a significant portion of the variance in perceived weight change, and perceived factors contributing to weight change differed significantly between those who perceived that they had lost or gained weight. In summary, perceived weight gain despite awareness of contributing health behaviors among some students reinforces that supporting/facilitating actual health behavior changes, rather than mere awareness of healthy behaviors, should be the focus of health promotion efforts.

This study reports on the feasibility and acceptability of a social justice infused service-learning (S-L) program to promote Black adolescent mental health and educational equity. We convened a community advisory board to help adapt and pilot test, via open trial mixed method design, an evidence-based service-learning program for Black middle school adolescents (n = 21) attending summer camp at a faith-based setting. We describe a S-L curriculum, with a focus on the achievement gap, and training for church staff and assess staff and youth reports of feasibility, acceptability, and promise to (a) improve/engage psychological engagement targets, and (b) improve academic motivation, and social-emotional and behavioral outcomes. Mixed method findings revealed high feasibility and acceptability of the S-L intervention as indicated by consistent attendance and enthusiastic engagement by staff and youth, high satisfaction, high completion rates of planned sessions, and emergent qualitative themes from staff interviews and adolescent focus groups highlighting that service-learning (1) facilitated skills (e.g., goal-setting, social-emotional and behavioral regulation, and problem-solving), (2) shaped perspectives and inspired openness, and (3) created a space for all to feel valued and included to address the inequities of education that directly impacted them. There was preliminary evidence for efficacy in that youth report of emotional symptoms, peer problems, and staff report of general internalizing symptoms decreased following the intervention, while youth report of prosocial behaviors increased. Implications suggest that S-L programming demonstrates promise to promote mental health outcomes, raise social awareness, and inspire critical consciousness and lift the voices of Black youth by providing tools for working toward systemic changes to reduce inequities in both education and mental health.

Despite the often-crucial roles played by music within theatre-based public health promotion strategies, theoretical explorations regarding music within applied theatre literatures remain largely underdeveloped. This article highlights musicking -- a reconceptualization of music from an object to a participatory act that can profoundly influence relationships and spaces -- as an approach to understanding the various roles that music can play within applied theatre programmes. The article draws from ethnographic accounts of an HIV/AIDS applied theatre group in South Africa to advocate for increased recognition of musicking as a robust theoretical and methodological component within applied theatre praxis.

Background: The whole school, whole community, whole child (WSCC) model suggests wellness councils, ongoing review of wellness policy, and a plan for evaluating set objectives are some of the key features needed to support school wellness infrastructure. This study explored the relationship between implementation of these infrastructure features and overall school wellness environment assessment scores among a sampling of Pennsylvania schools. Methods: The Healthy Champions program provides Pennsylvania schools an opportunity to self-assess their wellness environments across several school wellness topics. Staff enrolled their school in the program by completing a self-report electronic assessment. Enrollment data from the 2020/2021 program year were analyzed using the Kruskal-Wallis test and linear fixed model to identify the impact of varied implementation levels across 3 wellness infrastructure activities. Interactions between these variables and overall assessment score were also analyzed. Results: Of the 645 Pennsylvania schools enrolled and analyzed, we observed higher mean wellness environment assessment scores ([delta] 0.74 95% CI 0.40-1.07; p < 0.001) among schools that reported some frequency of all 3 wellness infrastructure activities, compared to schools that reported no frequency for the activities. Implications: Schools with existing policies and practices related to the 3 wellness infrastructure activities should consider the degree of implementation to best support overall wellness in their school setting. Additional research to explore implementation barriers and supports is needed. Conclusions: Analyses indicated that overall wellness environment assessment scores are impacted by implementation thresholds for wellness council meeting frequency, revision of wellness policy, and review of student health promotion objectives.

Background: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth-centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school-based clinics. Methods: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web-based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. Results: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. Implications for School Health Policy, Practice, and Equity: School-based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. Conclusion: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health-related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues.

Objective: Policy development is the biggest gap for health-promoting sports clubs. The present study aims to identify Irish sports club's involvement in health promotion (HP) policy development. Design: Mixed methods concurrent survey design, with quantitative data providing insights into priorities, activities and documentation and qualitative data documenting stakeholders' perceived needs. Setting: Two hundred and thirty-nine sports clubs in Ireland. Method: The survey measured perceptions of HP, the importance of promoting 10 health topics (e.g. suicide prevention, healthy eating, addictive behaviours) and corresponding actions relevant to HP in club policy documents and future needs. Quantitative data were analysed using multivariate statistics. The policy cycle was used to conduct a deductive analysis of qualitative data on sports clubs' perceived needs. Results: A high importance score (>70%) was found for the 10 health topics. Sports clubs reported their greatest investment was in physical activity promotion, and the lowest investment was in supporting the participation of disabled people. Up to two thirds of sports clubs had no HP policy. Irish sports clubs' perceptions of HP showed higher but similar patterns of response relative to sports clubs in other countries. Conclusion: Findings suggest that sports clubs consider HP to be an important part of their remit, but up to 66% have no policy in this regard. The policy cycle analysis helped identify the key tools needed to promote sports clubs' HP policy development. Practical implications include fostering the inclusion of HP in sports clubs' development plans by establishing templates and receiving support from sports federations.

To develop positive learning environments, it is important that supporting mental health and wellbeing is a priority. Whole-school programmes are considered an effective way of developing provision in schools; however, poor implementation can limit the impact of such programmes, and there is a lack of clarity about the key factors affecting the implementation of whole-school approaches. This small-scale study explored the implementation of a whole-school mental health and wellbeing programme, called Emotionally Friendly Settings (EFS). It aimed to consider the factors that facilitate and also act as a barrier to the effective implementation of whole-school wellbeing programmes. Individual semi-structured interviews were carried out with one member of staff in five settings: three primary schools, one secondary school, and one specialist setting. The sample included schools which reported the programme to have low impact, medium impact and high impact. Thematic analysis identified themes and sub-themes. Authentic versus tokenistic implementation was highlighted as a key factor influencing the impact of EFS. Linked to this were leadership; attitude to the programme; engagement; support; and programme characteristics. Findings are discussed in relation to existing implementation research, and implications for practice and areas for further research are highlighted together with the limitations of this study.

Objective: In contrast to previous research that has primarily focused on gender differences in health behaviour compliance, this study explored the association between gender consciousness and sun protection in China - a cultural setting in which there is a pronounced gender bias towards sun protection. These article is the first attempt to examine gender norms concerning sunscreen use among Chinese individuals, encompassing both young women and young men. Design and setting: Cross-sectional analysis conducted on one Chinese campus. Methods: Utilising data from the 2020 cohort of first-year students (549 male students and 1,489 female students) at a local university in Shanghai and employing OLS regression analysis, our analysis sheds light on gendered patterns of sun protection use among young individuals in China. Results: Findings reveal that gender attitudes affect women's sun protection frequency without influencing their choice of specific products. Conversely, men's gender consciousness shapes their sun protection methods but not their overall frequency of sun protection. In addition, despite lower aggregate levels of sun protection, young women exhibit higher heterogeneity in their responses than young men. Socioeconomic status, health awareness and gender consciousness are all significant factors influencing sun protection among female students; however, among men, only health awareness shows a positive correlation with the use of sun protection. Conclusion: The results of this study exhibit some differences from initial expectations, suggesting that the full adoption of sun protection measures is still a work in progress. However, despite the differences identified, findings provide valuable insights to inform future public health efforts to promote sun protection among youth.

Objective: This study explored medical trainees' understanding of collaborative writing sessions in the Dominican Republic as a strategy to strengthen their technical writing and critical analysis skills in health education and communication. Method: We conducted semi-structured interviews with seven medical trainees who participated in a series of collaborative writing sessions and published their articles in medical journals. Thematic analysis was used to study coded notes and identify salient themes with quotations and a conceptual model. Results: Five perceived individual- and programme-level enabling factors of the collaborative writing sessions were described: (1) detailed agenda, (2) direct mentorship, (3) effective teamwork, (4) personal investment and dedication, and (5) future vision. Conclusion: Study findings highlight that collaborative writing sessions with direct mentorship offers medical trainees a unique opportunity to acquire key written communication and analytical competencies and publish their articles, as part of their professional development. The incorporation of these valuable health education training exercises for health professional students can help develop an academic culture of writing and publishing on emerging global health topics.

Background: National school curriculum statements detail what it is important to learn and are highly context- and discipline-specific. The health and physical education (H&PE) learning areas have multiple learning purposes, and facilitating this in curriculum design is a significant and challenging task. Objective: There is little reporting on 'behind-the-scenes' practices of H&PE curriculum writing, despite this being a key mechanism by which the shaping of curricula occurs. This article offers a descriptive case study of curriculum development for the Tokelau National Curriculum H&PE learning area for Years 0-13. Prior to 2021, this learning area did not formally exist in the Tokelau National Curriculum Framework. Design, Setting and Methods: The case reports on the processes and decisions of a multi-national transdisciplinary writing team from Tokelau, New Zealand and New Caledonia. We explore the questions: 'Why the need for an H&PE curriculum, and who is it for?' Document collection and team-based interviews formed the basis for deductive descriptive analysis of the writing processes. Results: Three key themes were developed. Related to 'why', findings illustrate the importance of formalising H&PE learning, representing knowledge, skills and capabilities useful for present and future generations of young people in Tokelau. Considering 'for whom', findings emphasise the involvement of the community in curriculum decisions, and the inclusion of distinctive features aligned with community values, needs and aspirations. Conclusion: The case study illustrates the requisite coming together of different groups and expertise in the creation of a curriculum, a synthesis of pre-existing and new knowledge and experiences. The focus on health promotion and health and physical literacies exemplifies the everyday use of school curriculum goals to support community health.

This study aims to document the emotional experiences of school counselors in promoting elementary school students' health literacy during and after the coronavirus disease 2019 (COVID-19) pandemic. Six school counselors were voluntarily recruited as participants and invited to be interviewed. Interview data were analyzed using Andy Hargreave's (2001) emotional geography. Findings show that school counselors felt dissatisfied, forced, and lonely when they promoted elementary school students' health literacy remotely using synchronous and asynchronous modes during the pandemic. School counselor skills should be capable of promoting elementary school students' health literacy after the COVID-19 pandemic and beyond.

Objective: Over the past three decades, cultural competence has been widely promoted in the health disciplines, including in health education and promotion, as a tool to address health disparities and promote health equity among diverse populations. Cultural intelligence (CQ), or the individual's capability to adjust to cultural situations based on multiple factors including cognitive, metacognitive, motivational and behavioural characteristics, can be another useful tool when addressing the needs of diverse groups. The goal of this study was to assess the level of CQ among health education specialists and its relationship with cultural competence skills (CCS) among members of this group. Design: Five hundred and forty randomly selected health education specialists in the USA completed an online survey. The survey included questions to assess CQ, CCS and demographic information. Descriptive statistics and analysis of variance were used to analyse the data. Results: Results from the study showed that there was a significant variation in CQ among health education specialists based on race/ethnicity, education, the percentage of cultural/racial/ethnic diverse people they serve, and participation in professional development training. There was also a positive correlation between CQ and CCS, and between each of the CQ capabilities and CCS. Finally, both CQ metacognitive and cognitive capabilities were significant predictors of the overall CCS score. Conclusion: Findings from this study showed that CQ is associated with CCS among health education specialists. The results of the study suggest that health education specialists should consider CQ a useful tool with which to increase CCS.