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Objective: This study aimed to review literature from the past five years, focusing on the use of educational videos as a guidance tool for parents and guardians of children with lip and palate clefts. Source of data: Conducted between April and July 2022, this integrative literature review was framed around the question: 'What is the evidence regarding the use of videos in health education for parents/guardians of children with cleft lip and palate? PICO strategy was used to develop the research. A literature search was undertaken across PubMed, Web of Science, Scopus, and the Virtual Health Library databases. Of the eight articles included in this review, four were sourced from the PubMed database, with three published in 2021. Summary of the findings: The findings indicated that YouTube videos were moderately satisfactory and met the needs of parents or legal guardians to a partial extent. The majority of the videos analyzed in this review were characterized by a moderate level of informational content. One study particularly underscored that the content of these videos only partially satisfies the requirements of the parents or legal guardians of the children. Conclusions: Nevertheless, such videos are considered viable alternatives for health education, offering numerous benefits yet facing challenges, primarily due to the scarcity of information on orofacial malformations.

Sexuality education should be integrated into educational centers as a human right of children and adolescents, and an international recommendation based on scientific evidence. This study sought to identify the sexuality education interventions that were carried out in Spain in year 2021–2022, and to analyze whether they are in line with best practice recommendations. A descriptive study was carried out, considering organization territorial called Autonomous Communities as the unit of study, through key informants identified by purposive sampling. The variables used were based on international recommendations and the information was collected via a telephone questionnaire, by e-mail or by consulting websites referenced by the key informant. Fifteen of 17 Autonomous Communities had sexuality education interventions. Most were programs and only three had optional curricular subjects. Ninety-four percent were aimed at secondary school and were taught by teachers (72 %). Only one program had an impact evaluation and only 28 % complied with best practice recommendations. The voluntary or optional nature of the interventions reduces their scope, which is usually limited to secondary school students. It is necessary to implement mandatory curricular subjects, with a focus on sexual rights and gender.

Background: Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with dyslipidemia recognized as a significant risk factor. Dyslipidemia, characterized by elevated levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), is associated with an increased lifetime risk of CVD. Although alfalfa’s cholesterol-lowering effects have been demonstrated in animal models, clinical trial data supporting its efficacy in human dyslipidemia treatment are limited. Methods: A randomized controlled trial was conducted from September 20, 2021, to January 12, 2023, involving patients diagnosed with dyslipidemia. Approved by the China Ethics Committee of Registering Clinical Trials, the study included multiple sites in China. Eligible participants were adults aged 18 years or older, meeting criteria from the Chinese Guidelines for the Prevention and Treatment of Adult Blood Lipid Disorders. Participants were randomly assigned to either a health education-only group or a combined alfalfa powder supplementation and health education group for a three-month intervention period. Results: A total of 160 eligible patients were enrolled and randomized into two groups: the Alfalfa group (n = 80) and the Education group (n = 80). The intervention resulted in significant improvements in key lipid parameters in the Alfalfa group, including reductions in TC, LDL-C, and Apo A1 levels. Although changes in HDL-C levels were not significantly different between the groups, the Alfalfa group exhibited a larger increase. Serum lipid metabolomics analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) indicated that the combined intervention did not significantly alter the overall blood lipid metabolome but identified fifteen regulated differential metabolites, with the glycerophospholipid metabolism pathway significantly affecting lipid metabolism levels. Conclusion: Supplementation with alfalfa powder combined with health education significantly reduced TC, LDL-C, and Apo A1 levels in patients with dyslipidemia. KEGG pathway analysis suggests an association between the glycerophospholipid metabolism pathway and dyslipidemia. Further research is warranted to validate these findings and explore the underlying mechanisms.

Background: The U.S. Food and Drug Administration authorized the sale and marketing of two very low nicotine cigarettes (VLNC) as modified risk tobacco products. The misperception that VLNC are healthier than regular cigarettes is common. This study explores effective message strategies to inform the public about health risks associated with VLNC use, encourage cigarette smokers to try VLNC, and prevent other tobacco users and non-users from product initiation. Methods: Following the Reasoned Action approach, a VLNC educational message was developed based on the salient beliefs associated with behavioral intention. The message was tested in an online survey conducted in 2018, where 410 participants were randomly assigned to one of the two message conditions (no-message, VLNC message). Message effects were assessed across four tobacco-use groups (non-tobacco users, cigarette-only smokers, cigarette dual/poly smokers, other tobacco users). Results: Compared to the no-message control, the VLNC message condition showed lower nicotine risk perception for all participants, lower misbelief in VLNC safety for non-users and cigarette-only smokers, higher belief in VLNC carcinogenicity for other tobacco users, stronger belief in second-hand smoke harm for cigarette dual/poly smokers and other tobacco users, and higher VLNC intention for cigarette-only smokers. Conclusions: Different messages are needed for different types of tobacco users. Both cigarette smokers and other tobacco users could benefit from messages that acknowledge the non-addictiveness but emphasize the health risks of VLNC. Regulators could consider making physical harm statements a requirement for VLNC packaging and marketing. New strategies need to be explored to inform cigarette dual/poly smokers.

The Smartphone Addiction Scale Short Version (SAS-SV) is a widely used tool for examining smartphone addiction, but its Hungarian validation has not been available yet. The purpose of this research is the adaptation of the SAS-SV in Hungarian among university students. A total of 456 university students aged between 18 and 31 years (Mage = 21.9, 74.6% female) participated in this cross-sectional study. We performed a test-retest evaluation with a convenience sample of 50 university students to examine the reliability of the questionnaire. The participants completed the questionnaire twice, 3 weeks apart. The online survey comprised four sections: (a) sociodemographic, (b) mobile phone usage habits, (c) the SAS-SV adapted into Hungarian (SAS-SV-HU), and (d) The Brief Smartphone Addiction Scale (BSAS). The reliability of the SAS-SV-HU was evaluated by internal consistency reliability and test-retest reliability, and the validity of the SAS-SV-HU was evaluated by structural, convergent, and discriminant validity. The internal consistency was assessed by Cronbach's alpha coefficient, which showed a good level of internal consistency (α = 0.79). The test–retest reliability of the SAS-SV-HU questionnaire was excellent (ICC = 0.96, 95% CI = 0.922–0.975, p

Background: Environmental hygiene in food establishments is an important determinant of health. Health education package using combination of strategies is essential in preventing cross-contamination. Objective: To determine change in environmental hygiene knowledge, attitudes and practices among food handlers following implementation of health education intervention. Methods: A before and after interventional study was conducted on 111 food handlers of food establishments in a tertiary care hospital of Delhi in 2021–22. Tool based on WHO & FSSAI guidelines was prepared with a scoring system to rate environmental hygiene knowledge (0–12), attitudes (0–10) and practices (0–12) including cleaning of surfaces, pest control, waste disposal & segregation, packaging of food along with utensil washing steps (0–10). Health education was given and scores on same tool were reassessed after 8 weeks of intervention. Nail bed swabs were taken as an indicator of bacteriological contamination. Results: The differences of mean scores of knowledge, attitudes and practices before & after intervention were statistically significant differences of 9.95 ± 0.95, 8.02 ± 0.68 and 7.91 ± 1.16 respectively (p

Background: Immigrant groups from Southeast Asia, the Pacific Islands, sub-Saharan Africa, and the Caribbean bear the heaviest burden of chronic hepatitis B and primary liver cancer in the United States. Educational campaigns to increase knowledge about these diseases and their connection are necessary to promote protective health behaviors within these communities, to ultimately reduce the burden of disease, lessen stigma, and eliminate health disparities. Objectives: This project sought to engage groups within highly impacted communities to identify existing gaps in hepatitis B- and liver cancer-related knowledge, in order to inform future health education programming that will aim to reduce stigma and promote liver cancer prevention and early detection behaviors within and across groups. Methods: Fifteen focus groups and two key informant interviews were conducted virtually with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Qualitative data were analyzed using thematic coding. Results: There are large gaps in knowledge and awareness of hepatitis B and liver cancer, and the link between these two diseases among Asian, Pacific Islander, African and Haitian immigrant communities. This limited knowledge and misinformation, exacerbated by stigma, hinder these groups’ utilization of hepatitis B and liver cancer diagnostic and preventative healthcare services. Conclusion: To reduce hepatitis B and liver cancer health disparities within heavily burdened groups, health education needs to be community-informed, culturally sensitive, and actionable. Study results can guide the development of culturally and linguistically appropriate education programs that focus on the link between hepatitis B and liver cancer and the need for vaccination and routine screening, and that are responsive to the knowledge gaps and misperceptions of diverse communities. The results also provide valuable insights for healthcare providers to improve the knowledge gaps of the diverse patient populations that they serve.

Objective: In this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. Methods: Elderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. Results: Between January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. Conclusion: Health education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Background: Maternity waiting homes are used to enhance women's access to health facilities in low-resource settings; however, its use remains low in Ethiopia. It is important to investigate strategies that can enhance the usage of maternity waiting homes in Ethiopia. Methods: The purpose of his study is to assess how well couple-focused health education works to increase maternal knowledge, attitudes, and use of maternity waiting homes in rural Ethiopia. A cluster-randomized trial with two parallel groups will be the study's design. Three hundred twenty samples will be drawn from 16 clusters (160 in each group). Clusters will be assigned to intervention or control groups using a restricted randomization with a 1:1 allocation ratio. Women who are in their 14–16 weeks of gestation, or in the early stages of their second trimester, along with their male partners, will participate in the study. Health education, home visits, and the distribution of leaflets will be the intervention packages. Discussion: The trial results will provide conclusive evidence on whether couple-based health education can improve women's access to maternity waiting homes in rural Ethiopia.

In underserved areas of Costa Rica, community veterinary services aim to provide comprehensive care for companion animals, covering preventive, therapeutic, and surgical medicine. Emphasizing a One Health approach, our model focuses on animal welfare, health, and public well-being in vulnerable regions. The project's goal is to ensure the overall well-being of animals, people, and the environment by collaboratively addressing animal health issues and recognizing their interconnected impact on optimal health. Limited resources in underprivileged areas, including restricted access to veterinary care for pets, pose challenges to overall health. Despite its global health benefits, the absence of companion animal veterinary care in these regions has been largely overlooked. Our One Health approach not only addresses animal health but also has a significant impact on human and environmental health, economies, and social factors. This innovative strategy is a pioneering effort to tackle complex health issues in Costa Rica.

ABSTRACT: Objective: The aim of this research was to collate and analyse the data on the oral health knowledge and the related habits of a Hungarian cohort of monozygotic (MZ) and dizygotic (DZ) twins using the newly developed World Health Organisation Oral Health Questionnaire for Adults (Annex 7). Method: A total of 15 sets of MZ twins and 14 sets of DZ twins (58 individuals) aged between 18 and 71 years were enrolled in the study. Each participant had to fill out a web-based questionnaire which comprised 23 questions (Google Forms). The data were collated and the oral health/hygiene habits of MZ and DZ twins were compared. Results: No significant differences were detected between MZ and DZ twins with regards to their daily tooth-cleaning habits or the tooth-cleaning products used by the 2 groups. For instance, when asked how often they clean their teeth, 80% of MZ twins and 71% of DZ twins responded similarly. Further, both groups provided similar responses when questioned about the use of fluoride toothpaste, frequency of dental visits, and dental counselling received as well as a number of other parameters such as snacking of sweets and fear of visiting dentists. Conclusions: Our pilot analysis of the questionnaire responses from MZ and DZ twins in Hungary did not indicate any significant differences in their oral care habits in general. Further studies with a large cohort are required to confirm or refute our findings.

Objectives: To evaluate the contribution of the digital platform “Meu Diário de Quarentena (MDQ)'' or My Quarantine Diary concerning the monitoring and self-care of individuals with COVID-19 in Brazil. And to analyze the epidemiological and clinical characteristics related to the disease and the users who adhered to the support provided by MDQ. Methods: MDQ was developed by a multidisciplinary team and offered to the general population to provide self-care and health education during the COVID-19 pandemic, relying on users' self-reporting of information (such as signs and symptoms, pre-existing health conditions, and medications used during quarantine). The outcomes were measured, and the web app's support experience for public health was reported. Results: MDQ had 2439 active users on the platform, with 485 (19.9 %) self-reporting a COVID-19 diagnosis, mostly from individuals in the southeastern region of Brazil (56.5 %). The most common pre-existing health condition reported was related to circulatory system diseases. The most frequent reported signs and symptoms included headache, cough, myalgia, nasal congestion and muscle weakness. Corticosteroids, multivitamins, and anti-inflammatories were the most used medications during the pandemic period. There were several reports related to how users were feeling during the pandemic, and among these reports, negative feelings toward isolation stood out, such as “feeling lonely”, “anxious”, and “feeling useless”. A significant association was found between sex (p

With the growing demand for health education, enhancing nurses' ability to deliver such education is vital. This phenomenological qualitative study, employing convenience sampling, investigates pre-service nurses' experiences in simulated health education classes. The study included 32 fourth-year pre-service nurses from the Department of Nursing at a South Korean university. Between April 20 and June 30, 2022, these participants documented their perceptions of the simulated classes in self-reflection journals. The researcher utilized the phenomenological research method as proposed by Colaizzi (1978) to analyze the data. The findings suggest that simulated health education classes offer an opportunity to bolster pre-service nurses’ practical knowledge, fostering their growth as nursing educators. The pre-service nurses reported gaining confidence in their roles as educators and enhancing their professionalism through these simulated classes. Therefore, as public health promotion becomes increasingly crucial and the demand for health education rises, simulated health education classes serve as a valuable adjunct to teaching methods in health education.

Resumen: Introducción-objetivos: en la formación de los residentes en ciencias de la salud resulta fundamental desarrollar un pensamiento bioético. Este reto docente debe adaptarse a las tecnologías actuales. Se analiza el curso telemático «Introducción a la bioética cotidiana para residentes de primer año». Pocas actividades de este tipo han sido diseñadas para residentes o analizadas con métodos cuantitativos. Material y métodos: los datos se extrajeron de la plataforma a distancia y de una encuesta de satisfacción de 3 ediciones (2021-2023). Se incluyeron variables del rendimiento del curso y la influencia del cambio de diseño tras la 1ª edición. Las variables cuantitativas fueron analizadas mediante distintos test estadísticos (R versión 4.2.0). Resultados: el curso fue completado por 1.268 alumnos/as (72% mujeres). La mayoría accedieron al menos al 75% del contenido audiovisual, no hubo diferencias entre módulos ni por sexo. Se registraron 4.132 intervenciones en el foro de debate, tras la 1ª edición la participación se incrementó significativamente, así como la satisfacción con la estructura y tiempos del curso. Un 57,3% de los alumnos/as presentaron una puntuación superior a 8/10 en el test inicial y más del 90% en el final. El 89% estuvo satisfecho con el aprendizaje. Conclusiones: El curso parece haber sido útil y formativo para los alumnos. La autogestión de los contenidos, así como el formato con píldoras audiovisuales de breve duración han sido bien valorados. Los métodos de e-deliberating siguen teniendo limitaciones para el debate bioético. A largo plazo podría verse un impacto en la calidad asistencial. Abstract: Introduction-objectives: In the training of Health Science residents, it is essential to develop bioethical thinking. This teaching challenge must be adapted to current technologies. The online course “Introduction to everyday bioethics for first-year residents” is analysed. Few activities of this type have been designed for residents or analysed using quantitative methods. Material and methods: Data were extracted from the online platform and from a satisfaction survey of 3 editions (2021-2023). Course performance variables and the influence of the design change after the 1st edition were included. Quantitative variables were analysed using different statistical tests (R version 4.2.0). Results: The course was completed by 1,268 students (72% female). Most accessed at least 75% of the audiovisual content; there were no differences between modules or by gender. After the first edition, participation increased significantly, as did satisfaction with the structure and timing of the course. 57.3% of the students scored more than 8/10 in the initial test and more than 90% in the final. 89% were satisfied with the learning. Conclusions: The course seems to have been useful and formative for the learners. The self-management of the content as well as the format with short audio-visual pills were well appreciated. The e-learning methods still have limitations for the bioethical debate. In the long term, an impact on the quality of care could be seen.

Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. While the control group continued with routine services. Descriptive statistics was used to analyze demographic data. The chi-square test and Difference-in-Difference analysis were used to compare the intervention's proportion differences and net effect. Results: At baseline, no significant differences in the knowledge level existed. Proportions of women who were knowledgeable of >3 danger signs increased significantly during pregnancy [(89.7%) vs. (62.5%), p

Summary: Purpose: Controlling blood pressure minimizes the risk of cardiovascular events among patients with hypertension. Despite regular follow-ups, the hypertension management for patients aged ≥45 years is limited as evidenced from a decreased control rate. This pilot study aimed to test a theory-guided educational program for community-dwelling patients with hypertension. Methods: Sixty-nine patients with hypertension aged ≥45 years and having high blood pressure (>130/80 mmHg) were recruited in this two-arm pilot randomized controlled trial. Participants in the intervention group underwent a program guided by the Health Promotion Model, whereas those in the control group received usual care. Data were collected at baseline, week 8, and week 12 and used to assess the blood pressure, pulse pressure, self-efficacy, and adherence to hypertension management. Data were analyzed using a generalized estimating equation based on the intention-to-treat principle. Process evaluation was conducted to assess the feasibility and acceptability of the educational program. Results: The results obtained using the generalized estimating equation revealed that the educational program led to reduction in the systolic blood pressure (β = −7.12, p = .086) and pulse pressure (β = −8.20, p = .007) and to improve self-efficacy (β = 2.61, p = .269) at week 12. The program had a small-to-moderate effect on the reduction of systolic blood pressure (effect size = −0.45) and pulse pressure (effect size = −0.66) and self-efficacy (effect size = 0.23). The participants were highly satisfied with the educational program. Conclusions: The educational program was found to be feasible and acceptable and may be incorporated into current hypertension management practices at the community level. Trial registration: ClinicalTrials.gov with identifier: NCT04565548.

Objective: This study aimed to determine the impact of training based on the Common-Sense Model of Self-Regulation (CSM) on blood pressure and self-management of patients with hypertension. Methods: This randomized controlled trial study was conducted. Seventy-two hypertensive patients were referred to the Farshchian Hospital clinic in Hamadan from April 2021 to March 2022. Samples were selected and randomly assigned to the intervention group (n = 36) and control group (n = 36). The intervention group participated in a training program based on the CSM in five sessions of 30–45 min for one month. Phone follow-up was also done once every three days. The control group only received routine clinic education. The clinic’s nurse measured the patients’ blood pressure, and the participants completed the self-management questionnaire before and three months after the start of the study. Results: A total of 68 participants completed the study. Results showed that before the intervention, there was no statistically significant difference in the mean scores of self-management and its dimensions, systolic, diastolic, and mean arterial pressure between intervention and control groups (P > 0.05). However, after the intervention, the mean of systolic blood pressure (116.21 ± 14.52 vs. 128.62 ± 16.88) mmHg, mean arterial pressure (88.03 ± 8.47 vs. 98.11 ± 11.69) mmHg and the scores of self-management and its dimensions among patients in the intervention group were decreased comparison with control group (P

الملخص: أهداف البحث: إن عدم وجود إجراءات تشغيل معيارية لتوفير التثقيف الصحي لمرضى السكري يعني أن هذه الخدمة تقدم بطريقة غير متجانسة ومعزولة ومتقطعة ، مما يحد من جودتها. طريقة البحث: تم تصميم إجراءات التشغيل القياسية من التحليل النظري للابحاث المتاحة ؛ تم استخدام تقنية العصف الذهني التشاركي لتحديد العمليات المدرجة في إجراءات التشغيل القياسية. تم إجراء البحث في عيادة الرعاية الصيدلانية الشاملة التابعة للمعهد المكسيكي للعلوم الصحية ، من أغسطس 2017 إلى مارس 2020. تم إجراء الاختبار التجريبي للإجراء على 15 مريضًا في العيادات الخارجية يعانون من مرض السكري من النوع الأول والثاني. تم إجراء التحقق من قبل لجنة من الخبراء باستخدام منهجية دلفي ، وتم تقدير الإجماع بين الخبراء من خلال تحديد معامل التوافق في كيندال. تم تحديد فعالية عيادة الممارسة لإجراءات التشغيل القياسية من خلال دراسة تجريبية على 15 مريضًا مصابًا بالسكري باستخدام مؤشرات العملية. النتائج: تم تنظيم إجراءات التشغيل القياسية في تسعة أقسام مع نهج العملية الموضح في معايير ISO 9001: 2008. سمحت المعايير التي أصدرها الخبراء بشأن المحتوى والسجلات وأدوات استخراج البيانات بتحسين إجراءات التشغيل القياسية. أظهر الاختبار التجريبي الذي تم إجراؤه أن التثقيف الصحي ، باتباع إجراءات التشغيل القياسية ، يحسن التحكم في التمثيل الغذائي ، ومستوى المعرفة ، والالتزام العلاجي ، وسلوك أكثر من 80 ٪ من المرضى. الاستنتاجات: كانت إجراءات التشغيل القياسية المصممة والمصادقة من قبل الخبراء فعالة في تثقيف مرضى السكري بسبب التأثير الكبير الذي تحقق مع التدخل ويتضمن مؤشرات لضمان جودة الخدمة الصحية المقدمة. Abstract: Introduction: The lack of standard operating procedures (SOPs) to provide health education to patients with diabetes means that this service is provided in a heterogeneous, isolated and intermittent manner, thus limiting quality. Objective: To validate a SOP to provide health education to diabetic patients using Delphi methodology and determining its efficacy in clinical practice by performing a pilot study. Methods: The SOP was designed from a theoretical analysis of the available literature; a participatory brainstorming technique was used to define the processes included in the SOP. The research was carried out at the Comprehensive Pharmaceutical Care Polyclinic of a Mexican Institute of Health Sciences, from August 2017 to March 2020. The pilot test was carried out on 15 outpatients with diabetes type 1 and 2. The validation was carried out by a panel of experts using Delphi methodology, the consensus among the experts was estimated by determining Kendall's coefficient of concordance. The practice clinical efficacy of the SOP was determined by a pilot study in 15 diabetic patients using process indicators. Results: The SOP was structured in nine sections with the process approach described in the ISO 9001:2008 standards. The criteria issued by the experts relating to content, records and data extraction tools allowed improvement of the SOP. The pilot test showed that health education, following the SOP, improved metabolic control, level of knowledge, therapeutic adherence and the attitudes of more than 80% of patients. Conclusions: The SOP designed and validated by experts was effective in educating patients with diabetes due to the high impact achieved with the intervention and incorporates indicators to guarantee the quality of the health service provided.

Background: Tonsillectomies are generally performed on paediatric patients in ambulatory settings. The children are discharged after a short post-operative period of three to four hours which results in their parents becoming the primary caregivers at home. It is imperative that they receive extensive preparation and guidance on how to prevent, identify and manage complications related to the surgery at home. In this study, rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science were used to show how health education can be revised during implementation. Aim: The study aimed to evaluate and adjust the paediatric tonsillectomy primary caregiver health education at a designated ambulatory hospital. Design: A rapid cycle evaluation and adjustment of paediatric tonsillectomy health education was done through qualitative research in implementation science. It was guided by the contextual and interventional facilitators and barriers of the Consolidated Framework for Implementation Research. Two rounds of semi-structured interviews were conducted with parents as the primary caregivers of children and nurses who was directly involved with the health education. Results: The process of evaluation and adjustment provided the researcher with valuable information that were applied to create a more compressive piece of primary carer health education. A guideline was created with current information to manage pain, eating practices and to limit post-operative haemorrhaging. Conclusion: Rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science is effective to revise health education processes and material.

Resumen: Introducción: este estudio tuvo como objetivo identificar las necesidades de formación de los profesionales en salud (PS) sobre educación en salud a partir de su experiencia educando adultos mayores (AM) con enfermedad crónica en la región Sabana Centro en Colombia. Métodos: este es un estudio cualitativo con enfoque fenomenológico con PS que interactúan con los AM con enfermedad crónica que residen en los municipios de la región Sabana Centro, Cundinamarca, Colombia. Se incluyeron 20 PS con una media de edad de 34,3 años, el 95% de la población entrevistada fue del género femenino. Los datos fueron recolectados mediante entrevistas semiestructuradas. La recolección de datos concluyó una vez que se obtuvo la saturación teórica y los datos fueron analizados en el software Atlas.Ti 22. Resultados: el análisis de los datos permitió identificar 2 temas principales que representan las necesidades de formación de los PS: cómo aprende el adulto mayor, el cual incluye habilidades comunicativas, didácticas analógicas y tecnológicas, metodología, creencias y presaberes del AM y la familia en el proceso educativo; y conocimiento de las condiciones de salud, el cual abarca características y seguimientos de la enfermedad y autoevaluación de sus competencias en educación para la salud. Conclusión: las necesidades de formación de los PS sobre educación en salud se dirigen hacia la forma de cómo aprende el adulto mayor para mejorar las didácticas, metodologías y superar las barreras de aprendizaje, además de la actualización en evidencia que mejore la interdisciplinariedad para el abordaje integral de los AM. Abstract: Introduction: This study aimed to identify the training needs of health professionals (HP) regarding health education based on their experience educating older adults (AM) with chronic non-communicable diseases in the Sabana Centro region of Colombia. Methods: This is a qualitative study using a phenomenological approach with HP who work with AM with chronic non-communicable diseases in the Sabana Centro region of Cundinamarca, Colombia. Twenty semi-structured interviews were conducted. The participants were 20 HP with a mean age of 34.3 years; 95% of the individuals interviewed were females. Once the theoretical saturation was achieved, the data were analyzed using Atlas.Ti 22. Results: Data analysis identified two main themes representing the training needs of healthcare professionals: How the AM learn, which includes communication skills, analog or technological teaching techniques, methodologies and perceived barriers, and the inclusion of family in education, and knowledge of health conditions, in which healthcare personnel self-evaluate their competencies regarding their interprofessional knowledge and skills. Conclusion: Training needs for HP on health education are focused on improving didactics, methodologies, and eliminating learning barriers for AM. In addition, they need updated evidence that improves interdisciplinarity for the comprehensive approach to AM.

Resumen: Objetivo: Analizar intervenciones educativas en pacientes pediátricos asmáticos para conseguir una técnica adecuada de inhalación y mejorar su automanejo. Diseño: Revisión sistemática basándose en las recomendaciones PRISMA. Fuentes de datos: Se revisaron las bases de datos PubMed, Scopus, Cuiden, Web of Science y Google académico. Selección de estudios: Se incluyeron 16 artículos publicados entre 2014-2021, con acceso a texto completo, idiomas: inglés, francés y español y población pediátrica: 0-18 años. Extracción de datos: Participaron 2.313 niños/as. Las variables analizadas fueron: nivel asistencial, tipo de intervención, realización correcta de la técnica de inhalación, seguimiento de la técnica, entrega de recomendaciones por escrito, categoría profesional-educador, variables relacionadas con la patología respiratoria, absentismo escolar, calidad de vida y costes económicos. Resultados: El nivel de atención sanitaria fue atención primaria, hospitalaria y comunitaria, donde destacaron como educadores: médicos especialistas, enfermeras y farmacéuticos. Las intervenciones educativas más prevalentes son demostración in situ y entrega de recomendaciones o intervenciones multimedia. Varios artículos reportan que no se realiza correctamente la educación en asma, otros enuncian que su técnica mejora tras la intervención, pero la mayoría de ellos resalta la importancia de una revisión periódica de la técnica. Conclusiones: Los autores refieren mejoría de la técnica de inhalación en todas ellas, así como un mayor automanejo de la enfermedad y adherencia al tratamiento. Es necesario intensificar la educación a los pacientes en el correcto manejo de los dispositivos, y el seguimiento y revisión posterior para optimizar el control de la enfermedad. Abstract: Objective: To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management. Design: Systematic review based on the PRISMA recommendations. Data sources: Pubmed, Scopus, Cuiden, Web of Science and Google Scholar databases were reviewed. Study selection: Sixteen articles published between 2014 and 2021 were included, with access to full text, languages: English, French and Spanish and pediatric population: 0–18 years. Data extraction: Two thousand three hundred and thirteen children were participated. The variables analyzed were: level of care, type of intervention, correct performance of the inhalation technique, follow-up of the technique, delivery of written recommendations, professional-educator category, variables related to respiratory pathology, school absenteeism, quality of life and economic costs. Results: The health care level was primary, hospital and community care, where specialist doctors, nurses and pharmacists stood out as educators. The most prevalent educational interventions are on-site demonstration and delivery of recommendations or multimedia interventions. Several articles report that asthma education is not carried out correctly, others state that their technique improves after the intervention, but most of them highlight the importance of periodic review of the technique. Conclusions: The authors report improvement in the inhalation technique in all of them, as well as greater self-management of the disease and adherence to treatment. It is necessary to intensify the education of patients in the correct handling of the devices, and the follow-up and subsequent review to optimize the control of the disease.

Objective: Statins are the cornerstone for the prevention and treatment of cardiovascular disease. Patients often consult online patient education materials (OPEMs) to inform medical decision-making. We therefore aimed to assess the readability and reliability of OPEMs related to statins. Methods: A total of 17 statin-related terms were queried using an online search engine to identify the top 20 search results for each statin-related term. Each OPEM was then grouped into the following categories based on 2 independent reviewers: government OPEMs (national, state, or local government agencies); healthcare/nonprofit OPEMs (major health systems and nonprofit organizations with a specific cardiovascular health focus); industry/commercial OPEMs (pharmaceutical manufacturers and online pharmacies); lay press OPEMs (healthcare-oriented news organizations); and dictionary/encyclopedia OPEMs. Grade-level readability for each OPEM was calculated using 5 standard readability metrics and compared with AMA-recommended readability recommendations. Reliability of each OPEM was evaluated using the JAMA benchmark criteria for online health information and certification from Health on the Net (HONCode). Results: A total of 340 websites were identified across the 17 statin search terms. There were 211 statin OPEMs after excluding non-OPEM results; 172 OPEMs had unique content. Statin OPEM readability exceeded the recommended 6th grade AMA reading level (average reading grade level of 10.9). The average JAMA benchmark criteria score was 2.13 (on a scale of 0–4, with higher scores indicating higher reliability), and only 60% of statin OPEMs were HONCode-certified. There was an inverse association between readability and reliability. The most readable results were from industry and commercial sources, while the most reliable sites were from lay press sources. Conclusions: Statin OPEMs are written at an overall averaging reading grade level of 10.9. There was an inverse association between readability and reliability. Lack of accessible, high-quality online health information may contribute to statin nonadherence.

Introduction: The school has an important role in promoting health and preventing accidents, providing a suitable environment for teaching first aid in order to make teachers and students capable of providing primary care in case of accidents. Objective: Map the fundamental aspects of first aid education in schools regarding those responsible for teaching and the main methodologies used. Method: This is a scoping review carried out in March 2023, according to the recommendations of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, in 10 international data sources and national. The eligibility criteria were scientific articles without time or language restrictions. Results: A total of 2,136 documents were found and after screening, there were a total of 12 articles. The years ranged from 2005 to 2022. Health professionals act as the main instructors for teaching first aid to teachers, who become responsible and able to teach their students. Expository and practical classes on the topic stood out regarding the main methodologies. Conclusion: First aid teaching can be carried out by teachers to students after adequate training by health professionals.

Summary: Background: Hypoglycaemia from diabetes treatment causes morbidity and lower quality of life, and prevention should be routinely addressed in clinical visits. Methods: This mixed methods study evaluated how primary care providers (PCPs) assess for and prevent hypoglycaemia by analyzing audio-recorded visits from five Veterans Affairs medical centres in the US. Two investigators independently coded visit dialogue to classify discussions of hypoglycaemia history, anticipatory guidance, and adjustments to hypoglycaemia-causing medications according to diabetes guidelines. Findings: There were 242 patients (one PCP visit per patient) and 49 PCPs. Two thirds of patients were treated with insulin and 40% with sulfonylureas. Hypoglycaemia history was discussed in 78/242 visits (32%). PCPs provided hypoglycaemia anticipatory guidance in 50 visits (21%) that focused on holding diabetes medications while fasting and carrying glucose tabs; avoiding driving and glucagon were not discussed. Hypoglycaemia-causing medications were de-intensified or adjusted more often (p

Introduction: In the context of increasing rates of methamphetamine (meth) overdose in Los Angeles County, California, USA, in 2021 the Los Angeles County Department of Public Health relaunched Meth Free LA County, a methamphetamine public education campaign built on Rescue Agency’s Decision BlocksTM Strategic Framework. Methods: To assess campaign reach and reception, we examined media data and an online cross-sectional post-campaign survey in 2021 with a convenience sample of 750 county residents ages 18–54 who had used meth, were at-risk, or had personal relationships with people at-risk. We assessed campaign awareness, receptivity, and perceived effectiveness. Participants also reported concern about meth use in their community, recall of 10 facts from campaign content, and if they had taken promoted actions such as seeking help. We compared proportions between campaign-aware and unaware participants and explored if recall predicted these measures. Results: Most participants recalled the campaign (84.1%), felt it offered a new way of looking at meth (73.8%), and reported it made them feel that help is available (84.0%) or that it could help reduce their own use (82.4%). Video advertisements received high perceived effectiveness scores. Greater campaign recall was associated with significantly increased odds of being concerned about meth use in the community, recalling facts, and taking promoted actions. Conclusion: In 2021, Meth Free LA County reached its high-risk audiences. Unlike fear-based campaigns its message resonated with high-risk individuals, providing an example of how public education campaigns on meth and similar illicit substances can connect with their audiences.

Objective: This study aimed to evaluate the impact of pre-operative education tailored to percutaneous coronary intervention (PCI) patients’ information-seeking styles on pre-operative anxiety and depression. Methods: A single-blind randomized control trial was conducted. A total of 114 participants were recruited from the cardiology department in a tertiary hospital in Kunming, Southwest China from April to September 2020 and randomly allocated to the intervention group (n = 57) or control group (n = 57). All patients received oral pre-operative education as well as printed pre-operative education manuals and divided into monitors or blunters by the Chinese Version of the Monitoring Subscale of the Miller Behavioral Style Scale (C-MMBSS). The intervention group received pre-operative education tailored to information-seeking styles, while the control group received routine education. Anxiety and depression were measured at baseline and 1 h before the operation. Satisfaction with pre-operative education and length of stay were assessed at discharge. Results: A total of 104 participants completed the study (52 participants in each group). Pre-operative education tailored to information-seeking styles was beneficial for reducing pre-operative anxiety (P

Introduction: Malignant Hyperthermia (MH) is an inherited hypermetabolic syndrome triggered by exposure to halogenated anesthetics/succinylcholine. The lack of knowledge regarding this condition might be associated with the rare occurrence of MH reaction and symptoms. Methods: This observational study evaluated 68 patients from 48 families with confirmed or suspected MH susceptibility due to medical history of MH reaction or idiopathic increase of creatine kinase or MH-related myopathies. Participants were assessed by a standardized questionnaire and submitted to physical/neurological examination to assess the characteristics of patients with MH, their knowledge about the disease, and the impact suspected MH had on their daily lives. Results: Suspected MH impacted the daily life of 50% of patients, creating difficulties in performing surgical/clinical/dental treatment and problems related to their family life/working/practicing sports. The questionnaire on MH revealed a correct answer score of 62.1 ± 20.8 (mean ± standard deviation) on a scale 0 to 100. Abnormal physical/neurological examination findings were detected in 92.6% of susceptible patients. Conclusions: Suspected MH had impacted the daily lives of most patients, with patients reporting problems even before MH investigation with IVCT. Patients showed a moderate level of knowledge about MH, suggesting the need to implement continuing education programs. MH susceptible patients require regular follow-up by a health team to detect abnormalities during physical and neurological examination.

Simulation-based medical education is becoming a cornerstone in health education. Simulators are commonly expensive and not available in developing countries.We propose a very low-cost simulator that any educator can realize. We describe here the steps to follow to develop this proposed simulator.

Resumen: Introducción: Los programas de autocontrol de anticoagulación oral han demostrado eficacia en los últimos años. Objetivo: Evaluar el nivel de conocimientos y de control de la coagulación de pacientes anticoagulados autocontrolados tras un programa educativo. Métodos: Se diseñó un estudio cuasi-experimental, pre-test y post-test, Emplazamiento: Área de salud del Servicio de Hematología del Hospital Universitario Virgen de la Victoria (Málaga, España). Participantes: Pacientes anticoagulados autocontrolados. Intervenciones: Intervención educativa sobre conocimientos de anticoagulación oral enfocada a pacientes que iniciarán el programa de autocontrol en la consulta. Mediciones principales: Para comprobar la adherencia y el nivel de coagulación del paciente, se evaluó el Tiempo en Rango Terapéutico Rosendaal (TTRr), antes y después de la intervención. Resultados: Se incluyeron 145 pacientes desde 2016 a 2022 con una edad media de 49,18 años (desviación estándar [DE] 17,24). La puntuación media de la primera prueba sobre conocimientos fue de 14,61 (DE 3,26) y la de la segunda de 17,01 (DE 2,14) (p

Background: Maintaining optimal oral health requires a combination of knowledge, awareness, and consistent behavioral practices. Smartphone technology has revolutionized various aspects of modern life, including healthcare. The widespread smartphone usage in India offers an opportunity to study its positive influence on oral health behaviors. Aim: to assess the impact of smartphone application “Dent-O-Xpert” on oral health-related knowledge, attitude, and behavior among young adults. Methods: The randomized double-blind controlled trial involved 168 young adults aged 18–25 from professional institutions in Indore, India. The intervention group received oral health education through “Dent-O-Xpert” smartphone application with educational content, interactive modules, reminders and personalized recommendations, while the control group received traditional oral health sessions. Primary outcome measure including knowledge, attitude, behavior, and oral hygiene were evaluated through validated questionnaires and clinical examinations at baseline, 1 month, and 2 months. The data were analyzed using SPSS-23. Results: The Dent-O-Xpert group showed significantly improved oral health knowledge scores at both follow-ups. By second follow-up visit, both plaque and oral hygiene scores were significantly reduced in Dent-O-Xpert group (0.25 ± 0.4) compared to control group (0.71 ± 0.48). Tooth-brushing frequency (96.4 %), brushing techniques (59.5 %), timely toothbrush changes (97.6 %), and use of supplementary oral hygiene aids (31–35.7 %) improved in the Dent-O-Xpert group. Attitudes toward oral health care were also more positive in this group. No significant changes in oral health behavior and attitude were observed in the control group. Conclusion: the study findings indicate that Dent-O-Xpert smartphone application is effective in improving the oral health related knowledge, attitude and behavior.

Resumen: Objetivo: Aportar la mejor evidencia científica disponible sobre la efectividad de los programas de educación terapéutica mediante salud digital en pacientes con insuficiencia cardiaca. Diseño: Revisión sistemática de ensayos clínicos aleatorizados. Bases de datos: Se incluyeron 6 bases de datos por su relevancia en Ciencias de la Salud: PubMed, EMBASE, Scielo, Cochraine, CINAHL y Web of Science. Selección de los estudios: Se seleccionaron estudios realizados entre el año 2018 y 2023, en idioma inglés y español, tras evaluar la calidad metodológica de los estudios; se utilizó la herramienta Jadad para discriminar aquellos que no cumplían con dicha calidad. En total se incluyeron 8 artículos de 6 países diferentes. Extracción de datos: La revisión y análisis de los documentos se realizó por pares de manera independiente. Para evaluar el riesgo de sesgo se utilizó la herramienta Cochrane para ensayos clínicos aleatorizados RoB 2. Resultados: Todas las aplicaciones contaban con educación terapéutica; también se valoró que contasen con monitorización, evaluación de signos y síntomas, titulación de fármacos y seguimiento de profesionales a través de la aplicación. Conclusión: Esta revisión revela el impacto significativo de la educación terapéutica en el aumento de conocimiento del paciente, la reducción de reingresos hospitalarios y la mejora del estado funcional y el autocuidado. Esto convierte a la salud digital en una herramienta válida para complementar la atención enfermera en pacientes con insuficiencia cardiaca. Abstract: Objective: To provide the best scientific evidence available on the effectiveness of therapeutic education programs through digital health in patients with heart failure. Design: Systematic review of randomized clinical trials. Data sources: Six databases were included due to their relevance in Health Sciences: PubMed, EMBASE, Scielo, Cochrane, CINAHL, and Web of Science. Selection of studies: In English and Spanish, studies carried out between 2018 and 2023 were selected. After evaluating the methodological quality of the studies, the Jadad tool was used to discriminate those that did not meet said quality. In total, 8 articles from 6 different countries were included. Data extraction: The review and analysis of the documents were carried out by independent pairs. The Cochrane tool for RoB 2 randomized clinical trials was used to assess the risk of bias. Results: All the applications had therapeutic education, it was also assessed that they had monitoring, evaluation of signs and symptoms, drug titration, and professional follow-up through the application. Conclusion: This review reveals the significant impact of therapeutic education in increasing patient knowledge, reducing hospital readmissions, and improving functional status and self-care. This makes digital health a valuable tool to complement nursing care in patients with heart failure.

Local markets are primarily the center for trade and distribution of fruits and vegetables in Ghana. Fruit and vegetable vendors are responsible for keeping food hygienic and safe from contamination. However, little is known about fruit and vegetable vendors' knowledge, attitudes, and practices (KAP) toward food hygiene and safety in local markets. This study aimed to assess the KAP of fruit and vegetable vendors in Ho City. Data on KAP was collected from 113 fruit and vegetable vendors in the Ho Central Market using a structured questionnaire. The data was analyzed using a two-way multivariate analysis of variance (MANOVA) and one-way analysis of variance (ANOVA) to examine the association of demographic variables with knowledge, attitude, and practice of food hygiene and safety. A correlation analysis was conducted to determine the intercorrelation among the KAP variables. The results suggest significant differences for vendors with medical examination certificates on knowledge (Wilks = 0.60, F = 2.82, p˂0.00), attitude (Wilks = 0.71, F = 2.10, p˂0.01), and practice (Wilks = 0.59, F = 1.79, p˂0.01). A significant correlation was found between the three domains, but the influence of knowledge and attitude on practice was weak. Fruit and vegetable vendors' knowledge and attitudes toward food hygiene and safety were supportive and favorable. However, some practices were not supportive and encouraging toward food hygiene and safety. The lack of basic amenities in the market influenced the practice of vendors. Improved environmental sanitation conditions at local markets are vital to the practice of food hygiene and safety to prevent foodborne diseases.

Summary: Background: Children and adolescents’ myopia is a major public problem. Although the clinical effect of various interventions has been extensively studied, there is a lack of national-level and integral assessments to simultaneously quantify the economics and effectiveness of comprehensive myopia prevention and control programs. We aimed to compare the cost-effectiveness between traditional myopia prevention and control strategy, digital comprehensive myopia prevention and control strategy and school-based myopia screening program in China. Methods: A Markov model was used to compare the cost-utility and cost-effectiveness among school-based myopia screening, traditional myopia prevention and control strategy, and digital comprehensive myopia prevention and control strategy among 6 to 18-year-old rural and urban schoolchildren. Parameters were collected from published sources. The primary outcomes were quality-adjusted life-year, disability-adjusted life-year, incremental cost-utility ratio, and incremental cost-effectiveness ratio. Extensive sensitivity analyses were performed to test the robustness and sensitivity of base-case analysis. Findings: Compared with school-based myopia screening strategy, after implementing digital comprehensive myopia prevention and control strategy, the prevalence of myopia among 18-year-old students in rural and urban areas was reduced by 3.79% and 3.48%, respectively. The incremental cost-utility ratio per quality-adjusted life-year gained with the digital myopia management plan ($11,301 for rural setting, and $10,707 for urban setting) was less than 3 times the per capita gross domestic product in rural settings ($30,501) and less than 1 time the per capita gross domestic product in urban settings ($13,856). In cost-effectiveness analysis, the incremental cost-effectiveness ratio produced by digital comprehensive myopia management strategy ($37,446 and $41,814 per disability-adjusted life-year averted in rural and urban settings) slightly exceeded the cost-effectiveness threshold. When assuming perfect compliance, full coverage of outdoor activities and spectacles satisfied the cost-effectiveness threshold, and full coverage of outdoor activities produced the lowest cost ($321 for rural settings and $808 for urban settings). Interpretations: Health economic evidence confirmed the cost-effectiveness of promoting digital comprehensive myopia prevention and control strategies for schoolchildren at the national level. Sufficient evidence provides an economic and public health reference for further action by governments, policy-makers and other myopia-endemic countries. Funding: National Natural Science Foundation of China, NSFC (82171051), Beijing Natural Science Foundation (JQ20029), Capital Health Research and Development of Special (2020-2-1081), National Natural Science Foundation of China, NSFC (82071000), National Natural Science Foundation of China, NSFC (8197030562).

Objectives: To examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabetes. Methods: Quasi-experimental, two-group, pretest-posttest design was applied. Using random geographic cluster sampling, older adults who met the inclusion criteria were assigned to two groups, 62 in the intervention group and 71 in the control group. The intervention group received the comprehensive health education plus village health volunteer monitoring support program. The control group received only the comprehensive health education program. Study outcomes, including blood glucose level, knee pain and range of motion, body weight, physical ability (Timed Up and Go Test), fatigue, depressive symptoms, quality of sleep, and quality of life, were assessed at baseline, 3 months, and 6 months after enrollment and analyzed using descriptive statistics and multivariate analysis of variance. Results: One hundred and ten participants completed the study (55 participants in each group). Most patient outcomes in the two groups showed general improvement with statistical significance (P ≤ 0.001): pain decreased, physical ability improved, less depressive symptoms and fatigue, quality of life and sleep improved. The interaction effect (the group and time) demonstrated statistically significant differences between the intervention and control groups on pain, knee range of motion, and fatigue according to each time follow-up (P

Background: Oral health literacy (OHL) is a key factor for reducing inequalities in oral health and promoting better health outcomes, including those related to periodontal health. This study aimed to evaluate associations between OHL and periodontal disease amongst users of primary health care services. Methods: This cross-sectional study was carried out with a sample of 250 adult users of primary health care services in Brazil. OHL was measured using the Oral Health Literacy Instrument-Brazilian (OHLA-B). Participants also answered a structured questionnaire addressing sociodemographic and behavioural data. Clinical oral examination was performed using the Community Periodontal Index. Analyses of the crude associations were performed by simple logistic regression models, and estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Variables associated with a significance level

Objective: The standard path of health education is a standardised health education method formulated according to the characteristics of the disease in question. This study aimed to explore the effect of traditional Chinese medicine (TCM) nursing combined with the health education standard path in terms of acute myeloid leukaemia (AML). Methods: Sixty patients with AML at Shijiazhuang Ping'an Hospital were recruited and divided into the control group (n = 30) and the intervention group (n = 30). Both groups received the same chemotherapy treatment, while the control group received routine nursing and the intervention group received a combined TCM–health education standard path intervention. The scores for the self-rating anxiety scale (SAS), Spitzer quality of life index (QLI), self-rating depression scale (SDS), awareness of TCM health education standard path content and nursing satisfaction were then compared. Results: The SAS and SDS scores of the patients decreased following the intervention, while the QLI score increased, with the intervention group significantly improved compared to the control group (P 0.05). Conclusion: The application of TCM combined with the health education standard path has an effect in terms of reducing patients' anxiety and depression, improving their awareness of health education content and enhancing their nursing satisfaction.

Resumen: Objetivo: Evaluar la mejora en la adherencia terapéutica (AT) de una intervención basada en el seguimiento telefónico por parte del farmacéutico de atención primaria (FAP). Diseño: Ensayo clínico abierto aleatorizado con grupo control. Emplazamiento: Este estudio se realizó en el ámbito de la atención primaria por un equipo multidisciplinar de 13 centros de salud pertenecientes a 4 direcciones asistenciales de la Comunidad de Madrid durante el año 2021. Participantes: Pacientes polimedicados (60-74 años) que aceptasen participar y fueran clasificados como no adherentes según el test Morisky-Green. Se captaron 224 pacientes, de los cuales 87 fueron no adherentes. De estos se perdieron 15, aleatorizándose finalmente 72. Terminaron el estudio 71 pacientes, 33 en el grupo intervención y 38 en el grupo control. Intervenciones: Al grupo intervención se le incluyó en un programa de seguimiento telefónico que consistía en una entrevista para mejorar la adherencia en los meses 1, 2 y 3. Para evaluar la mejora se repetía el test Morisky-Green al 4.° mes. En el control únicamente se realizó el test de AT al 4.° mes. Mediciones principales: Adherencia, medida por el Morisky-Green al inicio y a los 4 meses. Resultados: En el grupo intervención el 72,7% de los pacientes pasaron a ser adherentes, mientras que en el grupo control el 34,2%, siendo la diferencia del 38,5% (IC 95%: 17,1-59,9) estadísticamente significativa (p = 0,001). Conclusiones: Tras la intervención de seguimiento telefónico educacional-conductual a pacientes no adherentes por parte del FAP se mejora la AT de forma estadísticamente significativa en el grupo intervención respecto al grupo control. Abstract: Objective: Evaluate the improvement in therapeutic adherence of an intervention based on telephone monitoring by the primary care pharmacist. Design: Randomized open controlled trial. Location: This study was carried out in 2021 by a multidisciplinary team working with health professionals of thirteen health centers belonging to four health districts in Community of Madrid, Spain. Participants: These were patients (60-74 years) with polipharmacy classified as non-adherent according to the Morisky-Green test. Two hundred and twenty-four patients were originally enrolled, 87 of them were non-adherents. Of these, 15 were lost and 72 were finally randomized. Seventy-one patients completed the study (33 intervention group and 38 control group). Interventions: Patients randomized to the intervention arm were included in a follow-up telephone program consisting of an interview at months 1, 2, and 3 to improve adherence. The Morisky-Green test was repeated at month 4 to assess improvement. In the control group this test was only performed at month 4. Main measurements: Adherence measured by Morisky-Green at baseline and at 4th month. Results: The 72.7% of patients in the intervention group became adherent while only 34.2% did in the control arm, being the difference 38.5% (95% CI: 17.1-59.9), statistically significant (P=.001). Conclusions: After a follow-up educational-behavioral telephone intervention in non-adherent patients by the primary care pharmacist, therapeutic adherence was improved statistically significantly in the intervention group compared with the control group.

Resumen: Introducción: se analizan las relaciones entre los patrones de aprendizaje de estudiantes de posgrado en salud pública y las representaciones sociales sobre identidad profesional, trabajo docente y formación de profesores, en una institución brasileña. Método: participan 166 estudiantes de posgrado que respondieron al cuestionario ILS. Se realizó análisis de conglomerados para identificar los patrones de aprendizaje. Además, se entrevista a 25 docentes en sesiones de grupo focal para identificar identidad profesional, formación pedagógica y trabajo docente. Los datos son analizados aplicando la técnica del Discurso de Sujeto Colectivo. El estudio tuvo aprobación de un comité de ética en Brasil. Resultados: el análisis de conglomerados evidenció 4 patrones de aprendizaje de estudiantes: RD-flexibles (28,3%), AD (31,9%), MD (25,4%) y UD (14,5%). Los grupos focales permitieron describir categorías para cada una de las dimensiones analizadas en los docentes: identidad profesional (contexto sociopolítico y compromiso con los servicios públicos, credibilidad y diversidad del ambiente institucional, experiencia y práctica docente), trabajo docente (gestión del trabajo, condiciones y proceso) y formación pedagógica (necesidades y demandas, perfil de los alumnos y relaciones interpersonales). Conclusión: las percepciones sobre las dimensiones de identidad profesional, trabajo docente y formación pedagógica permitieron incorporar elementos intersubjetivos y contextuales a la comprensión de los patrones de aprendizaje; y sobre la base de ello se definen lineamientos para el diseño de itinerarios formativos en la educación superior en salud que promuevan una educación crítica y reflexiva con participación activa de los estudiantes. Abstract: Introduction: The relationships between the learning patterns of postgraduate students and their social representations of professional identity, teaching work and pedagogical training at the postgraduate level in health at a Brazilian institution are analyzed. Method: 166 graduate students who responded to the ILS questionnaire participated in the study. Cluster analysis was performed to identify learning patterns. In addition, 25 teachers were interviewed in focus group sessions to identify professional identity, pedagogical training and teaching work. The data are analyzed using the Collective Subject Discourse technique. The study was approved by a Brazilian ethics committee. Results: Cluster analysis revealed four patterns of student learning: RD-flexible (28.3%), AD (31.9%), MD (25.4%) and UD (14.5%). The focus groups made it possible to infer certain categories for each of the dimensions analyzed in the teachers: Professional identity (socio-political context and commitment to public services, credibility and diversity of the institutional environment, teaching experience and practice), Teaching work (work management, conditions and process) and pedagogical training (needs and demands, student profile and interpersonal relations). Conclusion: The perceptions on the dimensions of professional identity, teaching work and pedagogical training made it possible to incorporate intersubjective and contextual elements to the understanding of learning patterns; and based on this, guidelines are defined for the design of training itineraries in higher education in health that promote a critical and reflective education with active participation of students.

Objective: This study aimed to evaluate the feasibility and preliminarily estimate the effects of a theory-driven, culture-tailored, community-based educational intervention promoting cervical cancer screening among rural females. Methods: An experimental study with the two-arm parallel, nonrandomized control trial design was implemented, followed by individual semi-structured interviews. Thirty rural females between 26 and 64 were recruited, with 15 in each group. Both groups were exposed to the usual care about cervical cancer screening promotion from the local clinics, while participants in the intervention group additionally received five educational sessions in 5 weeks. Data were collected at baseline and immediately postintervention. Results: All participants completed the study, and the retention rate was 100%. Participants in the intervention group had more significant increments in cervical cancer screening-related self-efficacy (P ​

Background: COVID-19 has been a global burden and vaccinations have proven to be the most effective measure to fight this pandemic. Since the approval and distribution of the vaccines, approximately 75% of District of Columbia residents have been fully vaccinated leaving a quarter of the population at risk. With the availability and approval of the booster doses to people with high-risk chronic conditions, it is important to understand the attitude of people towards vaccinations. Objective: The objective of this research study is to analyze the COVID-19 vaccination uptake among people with underlying chronic conditions residing in District of Columbia residents and to determine the reason for the hesitancy to perform targeted outreach to unvaccinated populations. Study design/methods: In 2022, we conducted a cross sectional study via a short online survey that was distributed to the target populations via email and social media. Multivariable Regression Analyses were conducted to determine the factors associated with the acceptance of the vaccination across various demographics. Results: The findings of the study demonstrate that the acceptance of COVID-19 vaccination was low among people with chronic conditions compared to those with no underlying chronic conditions, and vaccination rates strongly differ based on social determinants like education, employment, and area of residence across District of Columbia. Conclusion: The public health significance of this study is to understand the reason behind the vaccine hesitancy so that we can work towards building trust, extending outreach, creating targeted health education, and increasing access to vaccination to all communities across District of Columbia.

Canada's infant vaccination rate is suboptimal. British Columbia (BC) is below the targeted national coverage for infant vaccines, and vaccine hesitancy is a contributing factor in BC's low coverage rates. The literature suggests that many mothers are primary vaccine decision-makers and begin this decision process during pregnancy. This project examined mothers' vaccine concerns, vaccine information needs and preferences, and mother's trusted information sources regarding vaccines during early childhood.Using a qualitative, longitudinal design, interviews were conducted with women in four phases: during the third trimester of pregnancy, when the infant was 3–4 months, 9–12 months, and 15–18 months of age. Data analysis was thematic and both deductive and inductive coding techniques were utilized.Although most mothers in this study followed the BC infant vaccination schedule, many could be regarded as cautious acceptors. We identified five major themes. Three themes describe the questions mothers had about infant vaccination: 1) the vaccination schedule, 2) basic facts about vaccines, and 3) risks and benefits. Two themes described mothers’ information sources and preferences: 1) information sources, and 2) vaccine information delivery. Mothers indicated they wanted their concerns to be addressed in a safe, non-judgmental environment by health care providers.The questions and concerns identified by mothers in this study suggest that many mothers have unasked and unanswered questions about infant vaccines. Because health care providers are the favored source of vaccine information for pregnant people and new parents, they should receive continuous education on vaccines to raise their competency in addressing parental concerns.

ABSTRACT: Introduction: Relationships amongst attention-deficit/hyperactivity disorder (ADHD), family factors, and oral health literacy (OHL) in adolescents are unclear. The objective of this research was to investigate whether family environment and signs of ADHD are associated with OHL at the onset of adolescence. Methods: A cross-sectional study was performed with 448 twelve-year-old adolescents enrolled in schools in Cajazeiras, Brazil. Adolescents responded to an instrument measuring OHL (Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a validated questionnaire addressing family cohesion and adaptability (Family Adaptability and Cohesion Scales [FACES III]). Parents and teachers answered subscales of the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) and a socioeconomic questionnaire. Adjusted Poisson regression analysis was employed for the data analysis (P < .05). Results: Greater OHL was found in adolescents with higher family cohesion scores (rate ratio [RR], 1.02; 95% confidence interval [CI], 1.01–1.03), those whose mothers had more than 8 years of schooling (RR, 1.07; 95% CI, 1.03–1.12), and those whose families earned more than the Brazilian minimum salary (RR, 1.08; 95% CI, 1.03–1.12). Higher family adaptability scores (RR, 0.99; 95% CI, 0.98–0.99) and more signs of ADHD (teachers’ reports) (RR, 0.95; 95% CI, 0.91–0.99) were associated with lower OHL. Conclusions: OHL in adolescents was influenced by family adaptability and cohesion, signs of ADHD, maternal schooling, and family income.

Resumen: Introducción: las redes sociales son actualmente un medio habitual de acceso a la información sanitaria, aunque no siempre están avaladas científicamente. El estudio tiene como objetivos la construcción de una escala que permita medir la satisfacción tras implementar una estrategia docente basada en el uso de redes sociales para la difusión de contenidos sanitarios fiables y valorar dicha satisfacción en los estudiantes de enfermería que cursan la asignatura de Salud Pública. Material y métodos: estudio descriptivo y transversal con 221 alumnos de 2° curso de Enfermería, quienes grabaron y subieron a las redes sociales videos con contenido sanitario elaborado por ellos, contrastado y siguiendo directrices preestablecidas. Se determinó su satisfacción a través de una escala Likert de 19 ítems. Resultados: se determinan las propiedades psicométricas de la escala, fiabilidad de 0,933 y adecuación muestral (Kaiser-Meyer-Olkin: 0,897; Bartlett X2 = 1313,285; p < 0,001). El análisis factorial exploratorio proporciona una solución de 5 factores con fiabilidades de 0,842, 0,842, 0,882, 0,759 y 0,765. La satisfacción global con la estrategia es 69,04% y las medias para los 5 factores son: disfrute de la actividad 58,27%, interés por la asignatura 67,66%, desarrollo de capacidades 69,78%, trabajo en equipo 76,25% y utilidad de los videos 81,31%. Conclusión: la escala empleada es un instrumento adecuado que permite medir la satisfacción tras la actividad basada en el uso correcto de redes sociales en educación para la salud. El impacto de la actividad fue positivo entre los estudiantes, por lo que podría recomendarse como complemento en la docencia de la asignatura de Salud Pública. Abstract: Introduction: Social networks are currently a common means of accessing health information, but they are only sometimes scientifically supported. The study has its objectives the construction of a scale that allows measuring satisfaction after implementing a teaching strategy based on the use of social networks for the dissemination of reliable health content and to assess said satisfaction in nursing students studying the subject of public health. Material and methods: Descriptive and cross-sectional study with 221 2nd year Nursing students enrolled in the public health subject recorded and uploaded to social networks videos with health content prepared by them, contrasted, and following pre-established guidelines. Their satisfaction was determined through a 19-item Likert scale. Results: The psychometric properties of the scale were determined: reliability of 0.933 and sample adequacy (Kaiser-Meyer-Olkin:0.897; Bartlett X2 = 1313.285; p < 0.001). Exploratory factor analysis provides a 5-factor solution with reliabilities of 0.842, 0.842, 0.882, 0.759, and 0.765. Overall satisfaction with the strategy is 69.04%, and the averages for the five factors are enjoyment of the activity 58.27%, interest in the subject 67.66%, capacity development 69.78%, teamwork 76.25%, and usefulness of the videos 81.31%. Conclusion: The scale used is a good instrument for measuring satisfaction after the activity based on the correct use of social networks in health education. The impact of the activity was positive among students, so that it could be recommended as a complement to the teaching of public health.

Introduction: Public knowledge of out-of-hospital cardiac arrest (OHCA), and initiation of basic life support (BLS) is crucial to increase survival in OHCA. Methods: The study analysed the knowledge and willingness to perform BLS of laypersons passing an AED at a public train station. Interviewees were recruited at two time points before and after a four year-long structured regional awareness campaign, which focused on call, compress, shock in a mid-size European city (270,000 inhabitants). Complete BLS was defined as multiple responses for call for help; initiation of chest compressions; and usage of an AED, without mentioning recovery position. Minimal BLS was defined as call for help and initiation of chest compressions. Results: A total of 784 persons were interviewed, 257 at baseline and 527 post-campaign. Confronted with a fictional OHCA, at baseline 8.5% of the interviewees spontaneously mentioned actions for complete BLS and 17.9% post-campaign (p = 0.009). An even larger increase in knowledge was seen in minimal BLS (34.6% vs 60.6%, p

Background/purpose: FAST and Stroke-112 are two campaigns to reduce the emergency room arrival time of stroke patients. No study has compared the effectiveness of these campaigns. This study aimed to compare recalling capacity of people in these two campaigns. Methods: A prospective, open-label randomized study was conducted in 2019. Recall ability for the items of the two campaigns on the 5th and 30th days post-education was compared using non-parametric methods. Subject characteristics including age, education level, presence of stroke in co-residents, and habitual language were evaluated using multiple ordered logistic regression. Results: There were 202 participants in FAST group and 193 participants in Stroke-112 group who completed the study. No differences were observed between the two groups in recall ability, either on day 5 or day 30 after receiving education. For both campaigns, recall ability was better for signs in the face (FAST: 87.1%, Stroke-112: 86.5%) and the arm (FAST: 87.1%, Stroke-112: 88.1%) than for abnormality in speech (FAST: 78.7%, Stroke-112: 76.7%) on day 5. Recall ability on day 30 remained the same only for the arm item (FAST: 86.1%, Stroke-112: 88.6%). The recall ability was correlated to education level equal or more than 7 years in FAST group, and was inversely correlated to age and being a stroke patient in Stroke-112 group. Conclusion: We found no difference in recall ability between the 2 campaigns. Education level was associated with recallability of FAST, and age and stroke history were associated with recallability of Stroke-112.

Resumen: Objetivo: Evaluar el impacto de la formación en la capacitación del profesorado para implementar Posem el Focus, una intervención socioeducativa adaptada de Lights4Violence para prevenir la violencia de género durante la adolescencia. Método: Estudio de evaluación de una formación mediante metodología cualitativa en Terrassa en 2019-2021. La perspectiva socioconstruccionista permitió comprender su impacto en el profesorado y su traslación en la praxis educativa. Se realizó un muestreo intencional del profesorado (n = 32). El análisis de los discursos fue descriptivo-interpretativo partiendo de las producciones escritas de los participantes en la formación y su respuesta a algunas preguntas abiertas. Se desarrolló un marco teórico explicativo. Resultados: El profesorado refirió adquirir conceptos, desarrollar nuevas habilidades y modificar algunas actitudes. Señaló la comprensión teórica del sistema sexo-género, la interseccionalidad y las violencias explícitas e implícitas. Sin embargo, reprodujo estereotipos de género, no comprendió el abordaje inclusivo y apuntó no identificar violencias implícitas. El profesorado percibió como útil la formación y se sintió capacitado para implementar la intervención. No se identificaron diferencias en la producción discursiva respecto a género o edad. Conclusiones: La formación al profesorado asegura los conocimientos mínimos y facilita la adquisición de algunas habilidades, aunque no consigue cambios en profundidad de las actitudes. Se concluye que la formación capacita al profesorado para implementar Posem el Focus, aunque se recomienda reformularla. Abstract: Objective: To evaluate the impact of the training on teacher capacity to implement Posem el Focus, a socio-educational intervention adapted from Lights4Violence to prevent the gender-based violence during adolescence. Method: Evaluation study of a training using qualitative methodology in Terrassa, 2019–2021. The socio-constructionist perspective was used to understand the impact of teacher training and its translation into educational practice. A purposive sampling of teachers (n = 32) was carried out. A descriptive-interpretative analysis of the discourses was carried out based on the written productions of the participants in the training and their answers to some open questions. An explanatory theoretical framework was developed. Results: Teachers reported acquiring concepts, developing new skills and modifying some attitudes. Teachers stated theoretical understanding of the sex-gender system, intersectionality and explicit and implicit violence. However, they reproduced gender stereotypes, did not understand the inclusive approach and pointed out not identifying implicit violence. Teachers perceived the training as useful and felt empowered to implement the intervention. No differences were identified in discursive production with respect to gender or age. Conclusions: Teacher training ensures minimum knowledge and facilitates the acquisition of some skills, although it does not achieve in-depth changes in attitudes. It is concluded that the training enables teachers to implement Posem el Focus, although it is recommended that it be reformulated.

Understanding sexually transmitted infections (STIs) is crucial for preventing their spread, especially among secondary school students who, as adolescents, are more vulnerable to STIs. However, the lack of information on secondary students' knowledge of STIs hampers development of health education programmes for secondary schools. The objective of this study was to establish the students’ knowledge about STIs and HIV/AIDS, and their attitudes towards prevention of STIs. Data were collected using a cross-sectional survey design in which respondents filled out a structured questionnaire. The results demonstrate a knowledge gap among Ordinary- and Advanced-level students regarding the types, symptoms, causes, and prevention of STIs. The main conclusion is that education level partially explains the association between knowledge of types of STIs and HIV/AIDS, as well as attitude towards prevention. To reduce disparity in knowledge, continued sensitization of students about STIs and HIV/AIDS is recommended.

Objective: This research explores the impact of patient education on reducing historical and current stigma. Methods: Participants were recruited through social media, parenting with community organizations, and snowball sampling. A pretest posttest method was utilized. Participants viewed five balanced educational videos about medicinal cannabis. Attitudes toward medical cannabis were measured with a modified version of the medical component of the Recreational and Medical Cannabis Attitudes Scale (RMCAS). In total, 111 participants completed all requirements of the study. Results: Results of a Wilcoxon Sign Rank Test demonstrated a significant increase in the modified medical component of the RMCAS (1.18, p = 0.029). Conclusion: Health education is an effective intervention to reduce stigma associated with medical cannabis. Future health policies must take a balanced, education-focused, and proactive stance in reducing barriers to care that exist due to the negative stigma associated with cannabis use.Innovation: Historically, patient education has focused on areas such as tobacco, automobile safety, vaccinations, obesity, and the like. This research applied patient education to the area of medical cannabis to improve attitudes toward it and improve patient access.

Objective: This study aimed to analyze the effectiveness of breast shells in preventing pain and nipple injury during breastfeeding. Method: A non-randomized clinical trial was carried out with blinding to the evaluators of the study results. The study included women with ≥35 weeks of singleton pregnancy, no nipple changes, and a desire to breastfeed. Resulting in 62 lactating women. The experimental group used breast shells and health education with clinical demonstration (n = 29), whereas the control group used no breast shells (n = 33). Pain and nipple injury were assessed three times, twice prenatally and once up to 14 days postpartum. Results: Nipple injury (50.0%) and nipple pain (67.7%) presented with similar frequency in both groups (p = 1). Breast engorgement (35,5%) was associated with nipple pain (p = 0.019) and its onset was delayed in the experimental group (p = 0.001). Health education contributes to breast and nipple care and increases favorable breastfeeding patterns. Conclusion: Breast shells do not prevent nipple pain or injury. Innovation: As far as we know, this is the first clinical research evaluating the use of breast shells since the antenatal care to prevent the occurrence of nipple pain and injury.

Objective: Health education is proven to be able to improve self-care behavior, reduce hospital readmission, hospitalization or death in the older people with chronic diseases. Strategies in delivering education can make it easier for the older people to understand the learning provided. The aim of this systematic study was to identify effective health education methods to improve self-care behavior in older people with Chronic Heart Failure. Methods: We performed literature searching in seven databases (Pubmed, Cochrane, Ebscohost, Proquest, DOAJ, Science direct, and Clinical Key) to identify studies published in the last five years (2015–2020) that review the health education methods in older people with CHF. Articles that meet the inclusion criteria will be assessed using critical appraisal skills program (CASP) tool from the Joanna Brigg's Institute, and the Cochrane of risk bias tools to assess the risk of bias of the articles. Results: Eight studies met the inclusion criteria. Health education methods included individualized with telephone follow-ups, lectures, and face-to-face deliveries. The duration of education started from 30 min to 3 h. Health education can significantly improve self-care behavior in older people, although some do not have a positive effect after the intervention. Conclutions and clinical implications: This review describes several health education methods for the older people in changing the self-care behavior of CHF patients. Although there are a variety of methods that we found, we can provide an overview of effective educational methods in the older people with CHF from the quality of the results of the studies we reviewed. This review is that only a few studies have focused on older people. Health education needs to be provided by a nurse to reduce the morbidity and mortality of older people with CHF.