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Purpose: Family physicians have a higher incidence of burnout, dissatisfaction, and disengagement compared to other medical specialties. Addressing burnout on the individual and systemic level is important to promoting wellness and preventing deleterious effects on physicians and patients. We used the Physician Wellness Inventory (PWI) to assess the effects of a wellness programme designed to equip family physicians with skills to address burnout., Methods: The PWI is a fourteen-item 5-point Likert scale broken down into 3 scores; (i) career purpose, (ii) cognitive flexibility, and (iii) distress. The PWI was distributed to a cohort of n = 111 family physician scholars at 3 time points: January 2021, May-June 2021, and October 2021. The response rate was 96.4% at baseline, and 72.1% overall. Demographic information was collected to assess differences. The survey was distributed online through Qualtrics (Provo, UT)., Results: Cognitive Flexibility scores at the endpoint were higher for POC scholars than white scholars (P = 0.024). Distress scores for all groups decreased over time. Female scholars were more nervous, and anxious at the start than male scholars (P = 0.012), which decreased over time (P = 0.022). New career scholars were more likely than later career scholars to be distressed (P = 0.007), but both groups' distress decreased over time (P = 0.003). Later career scholars' feelings of being bothered by little interest or pleasure in doing things decreased more than new career scholars (endpoint: P = 0.022; overall: P = 0.023)., Conclusions: The wellness programme shows improvement in PWI scores, indicating the programme content should be evaluated further for system level improvements., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: General practitioners (GPs) in Australia have an important role to play in preventing childhood obesity. Activities such as growth monitoring and promotion of healthy behaviours can contribute to obesity prevention efforts; however, the practicalities of how this is done are poorly documented., Objectives: Objectives were to understand current attitudes and practices regarding promoting healthy childhood growth and development and preventing childhood obesity in general practice, and identify practical barriers and enablers to routinely incorporating this into general practice based on the observations and personal experiences of general practice staff., Methods: A descriptive qualitative study was undertaken with Australian general practice staff. Barriers and enablers underwent thematic analysis and mapped to the ecological model., Results: Interviews were conducted with 9 GPs, 4 nurses, and 2 practice managers. Participants agreed that growth monitoring and healthy behaviour promotion should be done for children with a healthy weight. However, the thematic analysis indicated that obesity prevention in clinics is not supported well by the broader general practice system, there are complexities associated with obesity prevention discussions, and the COVID-19 pandemic has intensified challenges in general practice. Two themes for obesity prevention enablers were identified; these related to bridging the implementation gap and the need for changes outside the clinic to support behaviour within the clinic. Ecological model mapping implicated multiple ecological levels for each theme., Conclusion: Childhood obesity prevention through growth monitoring and healthy behaviour promotion is relevant to general practice; however, more support is needed to enable implementation and embed these practices day-to-day., (© The Author(s) 2024. Published by Oxford University Press.)

Background: Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling., Methods: We used data from a nationally representative sample of secondary school students (n = 5035) aged 12-17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE)., Results: Total weekly PA increased the most from the NE intervention (+ 0.2 h/week), followed by TAPE (+ 0.08 h/week), PAL (+ 0.05 h/week) and PL (-0.06 h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%)., Conclusions: On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents., (© 2024. The Author(s).)

The implementation of school-based obesity-prevention programs is understudied. Kids SIPsmartER is a 6-month, school-based, behavioral intervention for Appalachian middle school students and includes a teacher implementation strategy. Kids SIPsmartER effectively reduced students' sugar-sweetened beverages (SSB) when Researcher-Led. However, Teacher-Led effectiveness and fidelity are unknown. To explore the relative SSB effects when Kids SIPsmartER was Researcher-Led versus Teacher-Led and to examine teacher fidelity. This study of secondary outcomes used a quasi-experimental analytic approach of a Hybrid Type 1 effectiveness-implementation and cluster randomized controlled tria (RCT) of Kids SIPsmartER. Student SSB behaviors and teacher self-rated fidelity were assessed, respectively, with the validated Beverage Intake Questionnaire (BEVQ-15) and lesson-specific checklists. Analyses included descriptive statistics and modified two-part models with time-fixed effects and school-year cohort cluster controls. The analytic sample included students from six control schools (n = 220), six Researcher-Led intervention schools (n = 306), and five Teacher-Led intervention schools (n = 218), as well as eight teachers. Teacher-Led intervention students decreased SSB by -14.3 ounces/day (95% confidence interval = -15.4, -13.2; P < .001). Relative to control and to Researcher-Led intervention, the Teacher-Led treatment effect among students was -11.6 ounces SSB/day (P < .001, effect size = 0.75) and -4.3 (P = .004, effect size = 0.25), respectively. Teachers returned fidelity checklists for 90% of planned lessons. Fidelity averaged 94% (SD = 4.0%) among returned forms and 85% (SD = 18.9%) when missing forms were counted as zeros. Teachers can implement Kids SIPsmartER with high fidelity and produce statistically and clinically meaningful improvements in students' SSB behaviors. Findings have implications for the sustained implementation of Kids SIPsmartER and other school-based obesity-prevention programs. Clinical Trial information: NCT03740113., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

For population-wide impact of interventions, evidence-based programs must be successfully disseminated and adopted at scale. Research-practice partnerships can legitimize programs and support organizational adoption, however, ways of leveraging the contributions of partners during dissemination processes are less clear. TransformUs is a school-based physical activity and sedentary behaviour program, and since 2018, has been disseminated at scale to all primary schools in Victoria, Australia, in partnership with 16 state and national organizations. The study objective was to investigate the experiences of partner organizations disseminating TransformUs within their networks, and factors associated with awareness and adoption of the program in schools, from the perspective of partner organizations. Semi-structured interviews with representatives from 15 (out of 16) partner organizations in 2019 involved in disseminating TransformUs state-wide. An interview guide was informed by the RE-AIM framework. Interviews were audio-recorded, transcribed, and coded anonymously. Data were analysed thematically. Four themes (and 13 sub-themes) were identified: (i) organizational barriers and facilitators to dissemination; (ii) implementation support for partners; (iii) overall research experience; and (iv) dissemination strategy. Partners used multiple dissemination channels to increase adoption, and strong alignment between TransformUs and the partner organization's goals appeared to enable dissemination. Partners outlined several local, regional, and state organizations to partner with, and offered suggestions regarding preferred content and timing of dissemination activities for their networks. Researchers planning research-practice partnerships should proactively consider organizational barriers partners may face during dissemination. Regular communication and feedback on dissemination outcomes may contribute to positive research-practice experiences and allow for tailored dissemination strategies., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Multicomponent, community-based programs aiming to improve health behaviors in youth are needed but can be challenging to implement. Research is needed to better understand the factors that facilitate and inhibit effective implementation of these programs especially for youth at increased risk of health disparities. This study aimed to identify and explore the implementation determinants and outcomes of a multicomponent health intervention conducted from 2021 to 2022 for middle school students living in underserved communities in Philadelphia, PA, USA. Mixed methods approaches, including self-report surveys and semi-structured qualitative interviews, were administered to 18 members of the implementation staff at the end of the program, including coaches (n = 7), assistant coaches (n = 2), school champions (n = 6), administrative leaders (n = 2), and a school district administrator (n = 1). Survey and interview questions were guided by the Consolidated Framework for Implementation Research (CFIR), and interviews were thematically coded following transcription based on 26 CFIR constructs. Innovation source, evidence strength and quality, cosmopolitanism, and the personal attributes of individuals were key constructs associated with implementation effectiveness. Data revealed three multidimensional themes that highlighted broader challenges influencing implementation: (i) broad consensus, different interpretations, (ii) staffing challenges, and (iii) continuity is key. The need for the program was clearly recognized and overall belief in the purpose of the intervention was strong among key program staff and administration. However, issues including limited engagement with training, staffing turnover, and the rotational programming design hindered implementation. Future projects aiming to implement multicomponent after-school time interventions must ensure a consistent vision among partners and continuity in program delivery., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The modern work environment is constantly evolving, and with it, the emphasis on employee health and well-being is increasing., Background: Nutritional education has become a key component of health promotion strategies in many companies that recognize the benefits of healthy eating habits for enhancing efficiency and job satisfaction., Objectives: The aim of this study was to understand employees' nutritional needs at work, and to assess the support provided by employers. The analysis focused on employees' eating habits and their attitudes towards eating at work, motives and barriers to healthy eating., Methods: The study was conducted using an anonymous survey completed by 1.056 individuals from across Poland. A discriminant function was selected for data analysis, which examined the differences between groups., Results/conclusions: The larger enterprises are more inclined to establish meal consumption spaces, which contributes to a more organised work culture. The larger the business, the more time employees spend eating meals, it being influenced by better-developed eating facilities, which undoubtedly encourages the workers to take longer breaks. The people with obesity were found to place the highest value on healthy food options and the people with a normal BMI are more responsive to healthy food subsidies, nutritional advice provided by a dietitian, and access to fitness facilities.

Policy interventions in the school food environment can improve dietary behaviors. However, the literature describing its development and implementation is scarce. This manuscript aims to describe the process of co-creation, implementation, monitoring, and evaluation of a Healthy Snacks Policy, in the scope of Sintra Grows Healthy intervention. Through a community-based participatory research methodology, the co-creation of the Healthy Snacks Policy comprises six stages: snacks evaluation, feedback sessions, class assemblies, school community assemblies, school cluster policy approval, and process evaluation. Within one school year, a Healthy Snacks Policy was co-created, approved, incorporated in the school regulations, implemented, continuously monitored, and evaluated. Regarding snacks evaluation, 1900 snacks were evaluated at the beginning of the school year and 1079 at the end of the school year. There were three feedback sessions, twenty-two class assemblies, and three school community assemblies. Most teachers perceived that children began to consume healthier snacks (72%); 66% of the children were considered to have started eating healthier; and most families said "yes or sometimes" when asked whether their children started requesting healthier snacks (70%), trying new foods (63%), and noticing improvements in their eating habits (74%). The co-creation of a Healthy Snacks Policy establishes an approach to effectively implement existing guidelines for school food supplies, complying with national priority implementation recommendations.

Objective: Healthy food retail programmes (HFRP) in the USA generally aim to increase healthy foods access to improve diet quality and health, yet the impact is mixed. These programmes primarily target adults, even though adolescents frequently and independently visit stores to purchase snacks. This study's aims are to explore successes and challenges of implementing HFRP (Aim 1) and examine how HFRP can be tailored to adolescents (Aim 2)., Design: One-time, virtual, semi-structured interviews with individuals who were involved in a HFRP, followed by a socio-demographic characteristics survey. Interviews were designed based on the RE-AIM framework and the Hexagon Tool and analysed using Braun and Clark's (2006) thematic analysis approach. Descriptive statistics were used to summarise participants' socio-demographic characteristics., Setting: New York City (NYC)., Participants: Adults (18 years or older) who have designed, implemented and/or evaluated an HFRP in NYC and speak/understand English ( n 21)., Results: Aim 1: For successes, strategies to build relationships with the community were most discussed. Regarding challenges, securing reliable funding was the hardest to overcome. Suggested solutions included designing profitable HFRP, targeting shortcomings in food distribution systems and increasing consumer demand. Aim 2: Most participants had not considered adolescents in previous HFRP but suggested involving youth in developing HFRP to encourage youth-driven solutions and promote youth advocacy., Conclusions: Future HFRP should focus on activities that help store owners purchase affordable healthy foods from distributors, which translates to affordability for customers. Federal and local policies can assist by funding complementary programmes. Additionally, adolescents should be considered in these efforts.

Objective: Evaluate the 5-year changes in the consumers' food environment in the area of a health promotion service in Brazilian primary health care. Our hypothesis is that the consumers' food environment in the areas with primary healthcare services has changes that may favour healthy eating habits over time., Design: Longitudinal study., Setting: The territory around the primary healthcare services in Belo Horizonte, Minas Gerais, Brazil., Participants: All food stores and open-air food markets that sell fruits and vegetables around the primary healthcare services in 2013 ( n 272) and in 2018 ( n 265)., Results: Fruit diversity increased by 13·4 % ( P < 0·001) and vegetables variety and quality by 16·1 % ( P = 0·003) and 12·5 % ( P < 0·001), respectively. Corn snacks showed an increase in availability (13·5 %; P = 0·002). The increase in advertising was observed for fruits and vegetables (34·6 %; P < 0·001) and ultra-processed foods (47·6 %; P < 0·001). Supermarkets showed an increase in the Healthy Food Store Index (three points; P < 0·001), while fruits and vegetables stores showed a decrease of one point in the index ( P < 0·001)., Conclusions: The unequal changes in the consumers' food environment according to the food stores types demonstrate the importance of food supply policies that promote a healthy environment and favour the maintenance of traditional healthy food retailers.

Background: According to the 2016-2017 Tanzania HIV Impact Survey, only 45% of men living with HIV (MLWH) were aware of their HIV status. In an effort to increase HIV testing in Tanzania, including among men, the Government of Tanzania passed a law in December 2019 allowing HIV self-testing (HIVST) to be included in the national testing strategies. The objective of this paper is to describe the development and pilot feasibility assessment of the Self-Testing Education and Promotion (STEP) intervention, which includes male peer education and demand creation for HIVST, and nurse-led distribution of HIVST kits in a community setting., Methods: The development and piloting processes were guided by the ADAPT-ITT model and informed by a national PEPFAR/USAID-funded HIV implementation science project called Sauti. The adapted STEP intervention included the following two components: 1) peer-based HIVST promotion; and 2) nurse-led HIVST distribution. For the feasibility assessment, 25 men were selected and trained as peer educators in 2019 to promote HIVST among their peers before recruiting 253 men who received instructions and an HIVST kit from a nurse at a community-based study tent site., Results: Of the 236 participants who completed the 1-month follow-up survey, 98.3% reported using the kit. The majority (92.4%) of participants reported a negative HIVST result while 4.2% (n = 10) received a positive result. Most (70%, n = 7) of the participants with a positive result sought follow-up services at a healthcare facility while 40.3% (n = 95) of the participants with a negative self-test result visited the community-based project site. Most of the men (53%, n = 129) did not visit a healthcare facility or the study site., Conclusion: The findings demonstrate that the combined peer-based promotion and nurse-led distribution of HIVST intervention was acceptable and feasible, though seeking follow-up services at healthcare facilities remained low. Future research should evaluate the effectiveness of offering nurse-led community-based clinical follow-up services in addition to HIVST rather than referral to facilities., (© 2024. The Author(s).)

Young people account for over half of new STI cases and youth of color face increased sexual health disparities. In partnership with Fact Forward, researchers conducted qualitative formative audience research to develop a culture-centered health communication campaign to increase access to and use of sexual health services among youth of color in South Carolina. Grounded in a reproductive justice theoretical framework, this study employed innovative strategies, including training youth ambassadors to moderate peer-to-peer focus groups. A total of 134 participants were recruited for the study with 51 individuals participating in 9 focus groups and 83 respondents completing a web-based survey (ages 15-24). Qualitative data analyses used Nvivo 1.5.1. Statistical analyses used R Studio®. Findings revealed barriers including lack of education about risks. Participants identified dimensions of inequity and the importance of intersectional messaging to address intimacy, sexuality, and trust. They emphasized normalizing conversations about sexual health and the need for important others "in your corner" to provide support. Participants suggested an empowering storytelling approach to reduce shame surrounding sexual health services. Social media emerged as an optimal communication channel. UNC Perceived Message Effectiveness (PME) Scale scores ranged from 4.42 to 4.57 (out of 5) indicating that messages were well received by participants. Sex-positive campaign messaging focused on self-love, empowerment, and taking control of sexual health. This study offers practical suggestions to develop effective communication strategies to reach youth of color to increase use of sexual health services, including contraceptive counseling, STI prevention, screening, and treatment.

Each year, more than 700 000 people die by suicide globally, the majority of whom are men. The United Nations and World Health Organization have set targets to reduce suicide rates by one-third by 2030. While large-scale suicide prevention programmes are required to meet these targets, diffusion of these types of initiatives is difficult-particularly with male populations. This qualitative study investigated the MATES in Construction suicide prevention programme in Australia. Guided by Social Identity Theory and the Social Identity Model for Collective Action, the study aimed to understand why construction workers chose to volunteer and advocate for industry-based suicide prevention programmes, and how their worker identity, solidarity and relationships impacted their volunteering and advocacy. Semi-structured interviews were conducted with 28 participants who had chosen to engage with MATES as volunteers. Data were interpreted using a reflexive approach to thematic analysis, and four themes were constructed from the data relating to feelings of belonging, connection and solidarity between workers and their industry; how specific context and roles impacted identity while existing within an overall sense of identity and solidarity; how industry mateship supported engagement in suicide prevention; and how the role of lived experience, mateship and responsibility provided hope for change. Providing intervention skills to workers, particularly workers with a lived experience of mental ill-health, empowered them to believe that they could make a difference by acting collectively. The MATES engagement model described in this study may have applications for other health promotion prevention programmes targeting male cultures., (© The Author(s) 2024. Published by Oxford University Press.)

Health literacy is a vital asset needed to empower individuals to take control of their health. An individual's health literacy is the ability to find, use and apply health information and services to manage their health. They interact with the health services and members of their community who can offer additional support. Creating the role of a health literacy mediator (HLM) may help to improve health literacy outcomes for all. For this role to be accepted by individuals within a community, the community itself should be involved in the development of the roles and associated responsibilities. The aim of this study was to engage with community members to acquire their perspectives on the potential of this role. Qualitative semi-structured online interviews were used to engage in discussions with local community members. This study implemented a constructivist epistemology with qualitative research design. Data were thematically analysed to identify evolving themes that were important to the HLM role. The analysis identified three main themes that need to be considered when adopting an HLM role: (i) health empowerment of individuals, organizations and communities, (ii) meeting the needs of the community and (iii) addressing the existing barriers in navigating and accessing the healthcare system. Those working in the health promotion space must adopt novel and innovative ways to improve HL on both a local and an international scale. This study concluded that for the role of a HLM to be accepted, it would need to encompass these attributes., (© The Author(s) 2024. Published by Oxford University Press.)

Active travel is a widely recognised strategy for promoting active living but its co-benefits beyond increasing physical activity, such as broader health, environmental, and social benefits, have rarely been synthesised. We conducted a systematic review to examine the co-benefits of active travel interventions. Following a preregistered protocol (PROSPERO CRD42022359059), we identified 80 studies for the search period from Jan 1, 2000, to Sept 13, 2022. Across studies, there was consistent evidence that active travel interventions offered co-benefits beyond physical activity. Particularly, 25 (71%) of 35 studies favoured improved safety outcomes, 20 (67%) of 30 showed improved health, 17 (85%) of 20 supported economic benefits, 16 (84%) of 19 highlighted improved transport quality, 12 (92%) of 13 showed environmental benefits, and four (80%) of five documented social benefits. Despite the overall low-certainty evidence, mostly limited by the quasi-experimental design and natural-experimental design of many of the studies, active travel interventions offer unique opportunities to engage stakeholders across sectors to jointly address major societal issues, such as physical inactivity, traffic safety, and carbon emissions. This evidence can inform the design, implementation, and evaluation of active travel interventions., Competing Interests: Declaration of interests DS received royalties for a textbook from the publisher Human Kinetics and speaker honoraria for a keynote presentation in Chile; travel funds to teach a methods course at the National Institute of Public Health of Mexico; is an executive board member of the International Society of Behavioral Nutrition and Physical Activity; and is chair of The Council on Environment and Physical Activity. BZ-D received consulting fees from Public Health England. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Many alcohol-industry-funded (AIF) organizations disseminate eHealth/mHealth tools that claim to assist users in making health decisions by monitoring alcohol consumption, e.g. blood alcohol calculators, AUDIT scores, consumption trackers. Previously, AIF materials were found to contain health misinformation that could increase consumption (dark nudges) or make healthy behaviour change more difficult (sludge). The accuracy and functionality of AIF tools have never been analysed, and given the history of AIF materials it is possible they contain misinformation and function as covert marketing channels to promote alcohol-industry-friendly narratives on the causes and possible solutions of alcohol-related harms. We evaluated the information accuracy and framing, behaviour change techniques (BCTs), and functions of AIF digital tools (n = 15, from the UK, Ireland, the USA, Canada, New Zealand, Australia; including Drinkaware, Drinkwise, Educ'alcool and others), compared to a non-industry-funded independent sample (n = 10). We identified misinformation and 'dark patterns' (interface design strategies for influencing users against their interest) throughout AIF tools; significantly fewer provided accurate feedback (33% vs 100%), and significantly more omitted information on cancer (67% vs 10%) and cardiovascular disease (80% vs 30%) and promoted industry-friendly narratives (47% vs 0%). AIF tools encouraged consumption through priming nudges (53%) and social norming (40%). AIF tools utilized fewer BCTs, provided users with more limited pre-set options (54%), and fewer drink choices (mean 24 vs 275). Their input structure often impeded their ability to provide guideline advice. We conclude that AIF tools contain pro-industry misinformation strategies and dark patterns that misinform users about their consumption and could 'nudge' them towards continuing to drink alcohol-characteristics of 'Dark Apps' designs., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The authors describe the development of a model that focuses on how primary care providers can facilitate health promotion in older adults. The health-promoting self-care in older adults (HPSOA) model was developed through a synthesis of key concepts from the Health Promotion model and the Modeling Role Modeling Theory. Walker and Avant's strategy for theory synthesis was used in its development. The model prioritizes rapport building to foster a trusting patient-provider relationship and focuses on long-term solutions to health promotion. Further model use through testing, research, and application in practice is recommended., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the authorship and/or publication of this review.

Today, physical activity is one of the most effective preventive and health-promoting factors for people with diabetes. Understanding the issues involved and how to implement it will help you to support patients in maintaining this practice., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Sleep is essential for a healthy, productive life, but access to sufficient and quality sleep is not universal. Sleep equity is influenced by both pathological and nonpathological sources. This article considers nonpathological determinants of adequate sleep, defines 3 features of sleep insecurity, and suggests how to promote sleep literacy to remove some barriers to adequate sleep, promote sleep equity, and improve individual and community health and well-being., (Copyright 2024 American Medical Association. All Rights Reserved.)

Objective: To analyse the feasibility and acceptability of a culinary nutritional intervention aimed at increasing plant-based foods consumption in the context of the Mediterranean diet in parent-child dyads., Design: The Nutritional and Culinary Habits to Empower Families (n-CHEF) is a 9-month feasibility study that included four culinary nutritional workshops (two face to face, two online) led by a chef and a dietitian-nutritionist. These workshops combined cooking with plant-based foods, with nutritional advice and experimental activities. The main outcomes were retention, quality of the intervention (monitoring workshops, acceptability and perceived impact) and changes in dietary and cooking habits., Setting: Parent-child dyads, Spain., Participants: Parent-child (aged 10-14 years) dyads., Results: Fifteen parent-child dyads were recruited, of which thirteen were retained during the 6-month follow-up. All but one parent-child dyads attended the four workshops. The overall assessment of the workshops was positive, although the online workshops were rated lower than the face to face. In general, parent-child dyads reported benefits in terms of nutrition and cooking aspects. Parents significantly increased their adherence to the Mediterranean diet, but non-significant changes were observed in children. However, children increased their consumption of vegetables and legumes and reduced snacks and ready meals. Parents also changed some of their culinary habits and increased their confidence in cooking at home., Conclusions: The n-CHEF showed that the culinary nutritional intervention had good levels of recruitment, retention and acceptability among parent-child dyads. In addition, dietary and culinary knowledge and habits can be improved, although further studies are needed to know the long-term effects in larger populations.

Obesity is a major public health problem that frequently begins in early childhood and persists into later life. While obesity's multifactorial causes and solutions largely lie outside of the individual and family levels, pediatric clinicians can support families with infants in preventing obesity and promoting long-term health and well-being. They can do so by focusing on counseling during well visits on exclusive breastfeeding, limiting bottle size, delaying solid food introduction, avoiding juice and sugar-sweetened beverages, limiting screen time, and promoting physical activity and healthy sleep., Competing Interests: Disclosure Dr H.W. Williams discloses receiving food and beverages totaling US$15.08 from Glaxo Smith Kline in 2019. Otherwise, the authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

As part of a program evaluation of the New York City Test & Trace program (T2)-one of the largest such programs in the USA-we conducted a study to assess how implementing organizations (NYC Health + Hospitals, government agencies, CBOs) communicated information about the T2 program on Twitter. Study aims were as follows: (1) quantify user engagement of posts ("tweets") about T2 by NYC organizations on Twitter and (2) examine the emotional tone of social media users' T2-related tweets in our sample of 1987 T2-related tweets. Celebrities and CBOs generated more user engagement (0.26% and 0.07%, respectively) compared to government agencies (e.g., Mayor's Office, 0.0019%), reinforcing the value of collaborating with celebrities and CBOs in social media public health campaigns. Sentiment analysis revealed that positive tweets (46.5%) had higher user engagement than negative tweets (number of likes: R 2  = .095, p < .01), underscoring the importance of positively framing messages for effective public health campaigns., (© 2024. The New York Academy of Medicine.)

Objectives: To describe the frequency of preventive healthcare practice (assess, advice, refer for support) provided by allied health professionals (AHPs) practicing in regional and rural healthcare settings to address smoking, diet and physical inactivity. To identify factors that influence the delivery of preventive healthcare practice., Methods: AHPs working in public healthcare services in the Loddon Mallee region of Victoria were surveyed. Clinicians reported on the proportion of clients where they had provided preventive care. Likert scale questions measured factors influencing preventive healthcare practice., Results: In total, 115 clinicians completed the survey. AHPs reported that they assess for smoking and physical activity behaviours but not diet. Preventive health practice that included providing advice or referrals for follow-on support was rarely undertaken. Availability of screening tools and automated referral letters increased the likelihood of preventive healthcare practice., Conclusions: Greater attention to addressing modifiable lifestyle behaviours by AHPs might be warranted to match the rates of risk factors in rural and regional Victoria. Integrating support systems, for example, embedding screening questions within clinical assessments can assist preventive healthcare practice., Implication for Public Health: Many AHPs are not promoting healthy behaviours to prevent poor health. We present some strategies that could potentially improve this., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive-inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration., (© The Author(s) 2024. Published by Oxford University Press.)

Evidence-based population interventions rely on intervention testing (efficacy and effectiveness trials) to determine what works to improve public health. We investigated the characteristics of real-world public health interventions to address obesity and explored the extent to which research testing was undertaken prior to scale-up. We identified 90 population health interventions targeting physical activity, nutrition or obesity-related health behaviours and collected publicly available information on their key characteristics and outcomes. We then assessed the differences between interventions that followed a research pathway and those that did not. Two-thirds (n = 60) of the interventions were reported as having followed a research pathway. Univariate logistic regression analysis revealed that these interventions were more likely to be health education interventions [odds ratio (OR): 5.56; 95% confidence interval (CI): 1.38-22.38], developed by research institutes (OR: 12.81; 95% CI: 3.47-47.34), delivered in North America (OR: 4.13; 95% CI: 1.61-10.62), and less likely to be owned (OR: 0.35; 95% CI: 0.14-0.88) or funded by government organizations (OR: 0.37; 95% CI: 0.14-0.95). Interventions that followed a research pathway were nearly three times more likely to have a positive impact on population health (OR: 2.72; 95% CI: 1.04-7.14). Interventions that followed a research pathway to scale-up were no more likely to be sustained longer than those that did not. Differences exist across real-world interventions between those that follow a research pathway to population-scale delivery and those that do not, regarding organizational and environmental context. A key benefit of research pathway to scale-up is the impact it has on health outcomes., (© The Author(s) 2024. Published by Oxford University Press.)

This perspective piece calls for health promotion action to regulate alcohol product marketing targeting women and create environments where it is possible to mitigate the harms of alcohol and protect women's health. Drawing on the Global Alcohol Action Plan in the context of the Australian National Women's Health Strategy 2020-30, we consider critical actions for gender-responsive health promotion to protect women from the ways alcohol companies market their products utilizing women's gendered social roles and entrenched stereotypes. We show how these subtle yet powerful gendered approaches to alcohol marketing have the potential for harm yet are not covered by the current mechanisms of the self-regulated Alcohol Beverages Advertising Code. We draw on the World Health Organization's 2024 Framework on Gender-Responsive Approaches to the Acceptability Availability and Affordability of Alcohol and make a call to regulate alcohol marketing targeting women., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: This study explores experiences of the Healthy Housing Initiative (HHI). Aimed at children at risk of housing-related illness, the HHI package includes the provision of items such as curtains, heaters, bedding, and insulation, advocacy to encourage landlords to install improvements, and education and advice to help people optimise their home environment., Methods: We conducted semi-structured, in-depth interviews with 20 people living in rental housing who received the HHI intervention., Results: Participants felt heard and supported by HHI assessors. They reported that the intervention increased the warmth and dryness of the home, improved their respiratory and mental health, reduced their bills, and enabled the use of more parts of their home. However, some continued to live in cold and damp conditions due to structural inadequacies and energy poverty., Conclusions: The qualitative evidence presented in this study shows how health-focussed interventions also benefit quality of life., Implications for Public Health: This research emphasises that healthy housing interventions can yield extensive benefits by adopting a holistic and home-based approach. Such interventions have the potential to create improvements in individuals' lives far beyond health., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

This article analyzes the films produced and broadcast between 1976 and 1978 by the National Agency and the Public Relations Office (ARP) for the campaign to publicize the mandatory vaccination that was instituted by the National Immunization Plan (PNI), created in 1975 and regulated by Decree No. 78,231 of August 12, 1976. The objective is to understand the narrative constructed through images and speeches aimed at convincing the population to make vaccination a culturally accepted practice. To achieve this, we examine the legislation on the subject during the period under analysis, namely the civil-military dictatorship. The dictatorial regime is approached based on the conceptual aspects that guide the analysis of the appropriation of health campaigns as propaganda and investments in a private and curative health model. We can therefore conclude that the initiative to create the PNI is a hiatus in this process of privatizing health, since it is not an action guided by the dictatorship's responsibility for the health of the population, but an action that involved the management of multiple actors in the health field, and which was embraced by the regime because it was a process directly linked to interests connected to the country's conservative modernization project.

Social media (SM) is increasingly utilised to disseminate mental health (MH) public service announcements (PSAs) and campaigns, connecting the public with support or resources. However, the effectiveness of MH campaigns/PSAs is often overlooked, and actions following exposure are rarely measured. We aimed to i) systematically review research on MH campaigns/PSAs disseminated via SM to determine their efficacy in eliciting engagement, help-seeking/behavioural change and ii) identify components that may facilitate engagement, help-seeking/behavioural change. The review followed PRISMA guidelines. Fourteen studies were eligible. The campaigns/PSAs targeted various MH concerns and country dissemination was diverse. Twitter/X was the most prevalent SM platform (n = 11), followed by Facebook (n = 8). All campaigns/PSAs generated engagement although engagement level benchmarks were inconsistent or absent, a proportion measured formal help-seeking behaviours (n = 1) or behavioural/language/knowledge change (n = 8). Components influencing engagement included videos/live streams, relatable content, the organisation/account disseminating the content, how information was conveyed, and external events. We highlight the heterogeneity of research in SM MH campaign/PSA evaluation and identify commonalities across studies potentially responsible for eliciting engagement, behavioural change and/or help-seeking in future campaigns/PSAs., Competing Interests: Declaration of competing interest The authors declare no competing interests that are relevant to the content of this article., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Autistic children, as well as their primary caregivers (e.g., parents), experience greater health disparities when compared with the general population. Despite this reality, there has been relatively little priority placed on promoting positive trajectories of health in either of these underserved populations. The primary purpose of this study was to examine the impact of participation in a 12-month, longitudinal health promotion program designed for both autistic children and their parent. A total of 27 families participated in the intervention, including 29 autistic children (83% male, M = 8.28 ± 3.60 years) and 27 parents (93% female, M = 40.04 ± 7.95). Families attended in-person health promotion programming for 90 min per week. Children and parents were evaluated at four time points across the program, including baseline (0-months), 4-months, 8-months, and 12-months. Children were measured on fundamental motor competence, physical fitness, body composition, and proxy-reported physical activity. Parents were measured on body composition, physical fitness, and self-reported physical activity. Significant improvements were observed for autistic children in motor competence (p < 0.001) and grip strength (p = 0.006), and for parents in body mass index (p = 0.004) and aerobic capacity (p = 0.003) across the 12-month intervention. Differing trajectories of improvement were noted between urban- and suburban-dwelling families on multiple outcomes. The knowledge acquired from this research may offer initial support for the need to bolster opportunities for accessible and ongoing health promotion programs for both autistic children and their parents., (© 2024 International Society for Autism Research and Wiley Periodicals LLC.)

Objective: This study aimed to evaluate the association between the Yokohama Walking Point Program, which promotes walking through feedback on step counts and incentives, and the extension of healthy life expectancy., Methods: A total of 4298 individuals aged over 65 years who responded to the 2013 and 2016 surveys and who were not certified as needing long-term care in 2016 were included in this study. The participants were categorized into "non-participation," "participation without uploading," and "participation with uploading" groups based on their involvement and uploading of pedometer data. The objective variable was the occurrence of long-term care certification and deaths over the subsequent four years. A modified Poisson regression model was applied, adjusting for 15 variables before project initiation., Results: A total of 440 participants (10.2 %) were included in the "participation with uploading" group and 206 (4.8 %) in the "participation without uploading" group. Compared with "non-participation," the risk ratio was 0.77 (95 % confidence interval (CI): 0.59-0.99) for "participation with uploading" and 1.02 (95 % CI: 0.75-1.38) for "participation without uploading". In the sensitivity analysis censoring death as an inapplicable outcome and considering functional decline, participation with uploading showed a risk ratio of 0.79 (95 % CI: 0.60-1.04) for the likelihood of functional decline., Conclusions: The use of pedometers and health point programs based on walking activity is associated with enhancing the health of older individuals participating in the program, representing a population-centric strategy targeting all citizens., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is not an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for Preventive Medicine and was not involved in the editorial review or the decision to publish this article. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Walking enhances the health, quality of life, and independence of older adults. However, a global decline in urban walking necessitates a re-evaluation of segmented, quantitative approaches to policies and theoretical frameworks in geriatric medicine for promoting walking among older adults. This study conceptualized the perceptions, experiences, and behaviors regarding walking, from a health promotion perspective, among older urban adults., Research Design and Methods: Pedestrian-friendly communities were explored for older adults in Seoul, South Korea, using a grounded theory. Thirty-eight older adults actively engaged in walking were recruited between July and December 2020. A qualitative multimethod approach was used, and the collected data were analyzed using open, axial, and selective coding, with axial coding integrating textual and spatiobehavioral information., Results: The open-coding process yielded 92 concepts, 47 subcategories, and 19 categories. Using axial and selective coding principles, a conceptual framework was developed to explain how walking shaped the daily lives of older urban adults and provided multidimensional health benefits. Walking perception attributes were characterized by "embodied subjectivity as a healthy older adult," "autonomy of movement," and "walking as a way to enrich or sustain life." Active walking facilitated interactions between older adults and their neighborhood environment within the context of compact and accessible urban living., Discussion and Implications: A healthy and age-friendly community encourages interactions between older adults and their neighborhood environment by providing opportunities for daily walking for several purposes, such as providing a sense of autonomy, increasing health-promoting behaviors, and creating a sense of community., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Background: Considering the need to increase HIV testing among racial minority youth in the southern United States, we conducted an exploratory study in Alabama to elucidate recommendations on improving testing rates among Black young men who have sex with men (BYMSM)., Methods: We conducted in-depth interviews and focus groups with BYMSM and prevention and outreach workers. Data collection occurred online and in person between 2020-2022., Results: Our sample included data from n = 56 BYMSM and n = 12 prevention and outreach workers. BYMSMs' mean age = 24 years. Among prevention and outreach workers, 58% identified as male with mean age = 39 years; 83% identified as Black. Transcripts were coded thematically; five concurrent themes emerged from both BYMSM and prevention and outreach workers: promoting testing at younger ages, need for visibility and outreach, connecting through shared experiences, value of nonjudgmental approaches, and need to increase HIV knowledge in BYMSM., Conclusions: Findings suggest that cultivating trust is salient to promoting HIV testing in BYMSM. To end the epidemic in the southern United States, a region that is heavily rural with high rates of HIV, it may be necessary to begin prevention conversations at younger ages and equip prevention and outreach workers with communication skills that leverage de-stigmatizing approaches., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Issue Addressed: Australian children fall short of meeting the dietary, physical activity and sedentary behaviour guidelines. This study aimed to test the feasibility, acceptability and potential efficacy of a parental text message and social media program on, primarily, their school-aged children's vegetable consumption and movement behaviours, and, secondarily, their own., Methods: Between August and November 2022, we conducted a two-armed randomised controlled trial with 242 parents/caregivers of primary school-aged children in New South Wales. The 'Adventure & Veg' intervention ran for 8 weeks, promoting vegetable eating behaviours, local outdoor physical activity opportunities and ideas for reducing screen time. Feasibility and acceptability were assessed via recruitment and retention data, intervention metrics and self-reported participant data. Vegetable intake and movement behaviour data were collected via online-surveys and effect sizes were examined., Results: Most participants reported that they enjoyed receiving the text messages (88%) and the delivery frequency was acceptable (94%). Limitations to Facebook as a delivery platform were reported. The majority of participants used the text messages to influence the vegetable eating (65%) and movement (77%) behaviours of their child. Significant effects were observed among intervention child participants compared with control for mean daily vegetable consumption (0.45 serves, CI: .19; .71, p = .001, d = .5); weekly vegetable variety (1.85, CI: .25; 3.45, p < .001, d = .6); and weekly physical activity variety (.64 CI: .09; 1.19, p = .022, d = .3). Parents in the intervention group increased their daily vegetable intake by .44 serves (CI: .11; .78, p = .01, d = .4)., Conclusions: A parental text message and social media program has potential to support children's vegetable intake and movement behaviours. Further research is required to explore different online delivery methods to promote local outdoor activity options. SO WHAT?: The Adventure & Veg program holds promise as a stand-alone health promotion intervention or as a useful adjunct to current family or school-based healthy lifestyle programs., (© 2024 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Objective: In the United States, adult dental benefits are optional in the state-managed, public insurance program, Medicaid. States also have the option to adapt their Medicaid program via waivers which pair healthy behaviour incentives (HBI) with cost-sharing. These waivers have proven ineffective, but the empirical evidence has ignored differences between states. This study aims to evaluate the impact of four state's HBI Medicaid waiver on dental visits among low-income adult population subject to incentives and cost-sharing requirements by the HBI waiver., Methods: Analysing biannual data from the Behavioural Risk Factor Surveillance System's Oral Health module (2008-2018) with a Difference-in-Differences design, this study estimated the effect of a Healthy Behaviour Incentive waiver on the probability of visiting the dentist in the past year. The three states that implemented an HBI Waiver (Indiana, Michigan and Wisconsin) were analysed separately. Secondary outcomes included being uninsured and having all teeth extracted. Matrix Completion methods accounted for dynamic treatment and tested for non-common trends. Inference was based on randomization inference tests., Results: Only in Michigan was an HBI waiver consistently associated with a significant increase in the probability of a dental visit (Est. = 5.6%-points, p = .01). There was little convincing evidence that HBI waivers were associated with being uninsured or having all teeth extracted., Conclusions: Between 2010 and 2019, many states have implemented an HBI waiver, each with a different approach to incentivizing dental visits. These implementation differences may explain the heterogeneous effects by state. More work is needed to evaluate how Medicaid waivers impact health outcomes in low-income populations., (© 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Background: Public health campaigns have often used persuasive techniques to promote healthy behaviors but the use of persuasion by doctors is controversial. We sought to examine older women's perspectives., Methods: We conducted semi-structured interviews with 20 community-dwelling older women from the Baltimore metropolitan area. We asked whether participants thought it was ethically appropriate for doctors to try to persuade patients and explored their rationales. We probed about commonly used persuasive techniques and two example decisional contexts-stopping mammograms and moving out of one's house after multiple falls. We used qualitative thematic analysis to code the transcripts and summarized results into major themes., Results: We found mixed views on the ethical appropriateness of persuasion (theme 1); supporters of persuasion were motivated by the potential benefit to patients' health, whereas opponents thought patients should be the ultimate decision-makers. Perspectives depended on the persuasive technique (theme 2), where emotional appeals elicited the most negative reactions while use of facts and patient stories were viewed more positively. Perspectives also varied by the decisional context (theme 3), where higher severity and certainty of harm influenced participants to be more accepting of persuasion. Participants suggested alternative communication approaches to persuasion (theme 4) that emphasized respect for patients., Conclusions: Our findings suggest that the type of persuasive technique and the decisional context are important considerations in the ethical debate around the use of persuasion. Limiting the use of persuasion to high-stakes decisions and using facts and patient stories rather than emotional appeals are likely more acceptable., (© 2024 The American Geriatrics Society.)

Culinary medicine and culinary nutrition programs have emerged as innovative approaches to influencing dietary and lifestyle behavior change. These models vary in reported use of behavioral frameworks for planning purposes and attributing efficacy to current inconsistencies in format and delivery. This report aims to review current practice of behavior change theories in culinary medicine/culinary nutrition, delineate constructs that support positive outcomes, and describe future directions for translational applications in integrating the skills of chefs, nutrition educators, and medical professionals., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The sedentary aspects of many U.S. occupations and the amount of time American workers spend in the workplace make it an ideal location to implement health promotion programs., Methods: This study assessed the effectiveness of a free smartphone app with a goal-setting feature to increase physical activity (PA) and impact anthropometric, body mass (BM), and body composition (BC) changes among overweight and obese women within a community health workforce. Eighteen overweight and obese (body mass index [BMI] = 32.18 ± 4.48 kg/m 2 ), adult (50.73 ± 8.76 years), female volunteers, tracked daily steps with a free smartphone app (Stridekick TM ) over an 8-week period. Pre- and post-program body composition (BC) measurements included: relative (%) body fat (BF), fat mass (FM), fat-free mass (FFM), and lean mass (LM), using dual X-ray absorptiometry (DEXA scan), and five anthropometric measurements (biceps, waist, abdomen, hips, and thigh)., Findings: Pre- to post-program average daily steps resulted in significant anthropometric changes for biceps, hips, and thigh measures, with encouraging changes in FFM, LM, and relative (%) BF. The goal-setting feature of the app did not result in significant differences between the experimental and control groups. No differences were noted in FM, BMI, waist, and abdomen or step goals compared with steps completed., Conclusions: An occupational PA health promotion intervention program that tracked daily steps through the Stridekick TM smartphone app resulted in anthropometric, BM, and BC changes., Application to Practice: The workplace is an ideal location to affect change in health behaviors via a free smartphone app to increase PA and improve health., Competing Interests: Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Scrub typhus is highly endemic in northern Thailand yet awareness and knowledge are low. We developed a community engagement project to improve awareness in communities at risk of contracting scrub typhus., Methods: We conducted a series of engagement sessions with healthcare workers and community health volunteers so they would, in turn, engage with their communities. We evaluated our activities by assessing the increase in scrub typhus knowledge, using a series of Likert-scale items and open-ended questions. Three to 6 months after the sessions, participants were followed up to collect their experiences training community members., Results: Of 134 participants who took part in eight sessions, 87.3% were community health volunteers. Disease knowledge increased substantially after the sessions and was well maintained for up to 5 mo. Satisfaction was high and, through participant feedback, engagement materials were improved to be more useful to the communities. People with higher education had higher scores and retention., Conclusions: Community engagement was shown to be an effective tool to develop and carry out health-promoting activities in a culturally and context-appropriate manner., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: This study aimed to evaluate the effectiveness of implementing an adapted, evidence-based 12-week Family Healthy Weight Program (FHWP), Building Healthy Families, on reducing BMI metrics and clinical health indicators in a real-world community setting. Methods: Ninety child participants with a BMI percentile greater or equal to the 95th percentile for gender and age and their parents/guardians ( n  = 137) enrolled in the program. Families attended 12 weekly group-based sessions of nutrition education, family lifestyle physical activity, and behavior modification. A pre-post study design with a 6-month follow-up was used. Results: Nine cohorts of families between 2009 and 2016 completed the program with 82.1% retention at 12 weeks and 53.6% at 6 months. Participants had statistically significant improvements at 12 weeks in BMI z-score, %BMIp95, body mass, body fat, fat mass, fat-free mass, and systolic blood pressure with greater improvement at 6 months in body mass, BMI metrics, body fat, fat mass, fat-free mass, and systolic blood pressure. Parents/guardians of the participants had similar statistically significant body composition and blood pressure improvements ( p  < 0.05). In addition, children had significant improvements in high-density lipoprotein (HDL) cholesterol and aspartate aminotransferase (AST) liver enzymes at 6 months. Conclusions: Overall, this study demonstrated that an evidence-based FHWP can result in statistically meaningful declines in BMI z-score and accompanied clinically meaningful changes in health risk. Participants lost ∼4% of their body mass in 12 weeks, while their parents/guardians lost closer to 7% of their body mass, which supports previous literature suggesting body mass changes influence health.

Front-of-pack nutrition labelling (FOPNL) on packaged foods is recommended by the World Health Organization to promote healthier diets. Our aim was to assess uptake of Australia's FOPNL, the Health Star Rating (HSR), overall and by HSR score received (0.5 (less healthy) to 5.0 (more healthy) in 0.5 increments) after ten years of voluntary implementation. In a sample of 21,197 products, we found HSR uptake of 37% overall in 2023. Uptake was unevenly distributed, with 24% of products with an HSR ≤ 3 displaying the label, compared to 53% of products scoring ≥3.5 (p < 0.001). Low HSR uptake on poorly rated products demonstrates that most food manufacturers will only display FOPNL where marketing value exists in a voluntary system. Poor and uneven HSR uptake limits consumers' ability to meaningfully use the label to compare and choose healthier products. Government action is urgently required to make the HSR system mandatory., (© 2024. The Author(s).)

Issue Addressed: Australian veterans suffer higher rates of both mental and physical health conditions than civilians, yet many do not seek treatment. Computerised Interventions (CIs) may provide an alternative approach to management, which can overcome some barriers to treatment uptake. We aim to evaluate the scope and quality of CIs designed specifically for Australian veterans and their families., Methods: A manual search of the Department of Veterans' Affairs and other Ex-service organisation websites was performed to map and describe CIs for Australian veterans and their families, followed by a scoping review of four databases to identify evaluations of relevant CIs., Results: Our search identified 10 CIs specific to Australian veterans and their families. The majority were structured, self-guided CIs, designed to elicit cognitive/behavioural change that addressed mental health and psychosocial needs during transition. Three evaluations examined previously identified CIs. The results showed mixed reviews from participants and clinicians, in two separate evaluations, regarding user experience, quality and perceived benefit. In addition, positive psychological outcomes, including the reduction of post-traumatic stress disorder (PTSD) symptoms, were demonstrated for participants of the online intervention., Conclusion: While Australian veteran-centric online interventions primarily focus on psychological conditions, the prevalent physical health concerns within the veteran population remain unaddressed. Additionally, despite the documented impact of military experience on family members, there is a lack of specific Australian interventions designed for families. Few tools have been formally evaluated, yet show promise as supportive self-directed resources for veterans with PTSD, and for navigating transition challenges. SO WHAT?: Further development of online interventions addressing prevalent physical and family needs, and conduction of comprehensive evaluations are needed to enhance overall quality, accessibility and holistic effectiveness of interventions for the Australian veteran community., (© 2023 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Background: Religious institutions play a crucial role in health promotion and hold significant influence in the public health field., Aim: The aim of this review is to examine outcomes of health-promoting interventions involving the use of mosques as the intervention venue, its role in promoting health behavior change, and the role of theory in each intervention., Methods: A scoping review was conducted across 17 databases for relevant publications published up to and including August 2023 that involved the use of mosques as the intervention venue. Fourteen articles met inclusion criteria and were reviewed., Results: The studies featured a wide range of interventions. However, only eight of these studies integrated theoretical frameworks into their approaches, indicating a need for more structured guidance in this field. These theoretical frameworks included Participatory Action Research (PAR), the theory of planned behavior, behavior-change constructs, the patient-centered outcomes research (PCOR) framework, and prolonged exposure techniques within Islamic principles. The review identified three main health-focused intervention categories: mental health, prevention, and communication, each providing valuable insights into initiatives within Muslim communities., Conclusions: This review underscores the significance of inclusive and culturally sensitive health interventions, emphasizing the effectiveness of faith-based approaches in improving health outcomes, promoting positive health behaviors, and addressing communication and cultural barriers. The reviews findings stress the need for further research that incorporates theoretical frameworks and tailored interventions to meet the specific cultural needs of these communities, ultimately contributing to enhanced well-being within them., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Social determinants of health (SDoH), including factors such as education level, housing, poverty, racism, and food insecurity and their impact on health outcomes have been well documented. The "Wayne Pediatrics Health and Nutrition Expo" held at Detroit's Eastern Market was an activity-based health and nutrition event addressing pediatric SDoH. Partnering with community organizations, the event had 10 stations addressing SDoH: access to a primary-care pediatrician; HIV-care and prevention; childhood literacy; clothing & winter coats; mental health and childhood development; nutrition; staying active; vaccination; and food insecurity. The free, public event featured a child-themed treasure hunt and map, music, giveaways, and live demonstrations, all in a family-friendly park atmosphere. While SDoH are considered "non-medical" factors that contribute to health and may be difficult to completely address for any individual child, our practice addressed several key SDoH at a single-day, hands-on, child-friendly community event based on the local needs of children., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EM serves as an Associate Editor (voluntary) for both Clinical Pediatrics and Global Pediatric Health.

Aim: Dietitians are a well-placed profession to be providing pre-emptive oral health promotion. Despite recommendations that oral health promotion should be routinely part of dietetic practice, there is limited data informing the current practices of clinical dietitians in this area across Australia. Hence, the aim of this study was to investigate the knowledge and practices of Australian dietitians and oral health promotion., Methods: A cross-sectional survey was undertaken involving registered clinical dietitians in Australia using purposive and snowballing sampling (social media/dietetic organisations/public databases). Data were analysed using descriptive and inferential statistics., Results: A total of 149 dietitians participated in the national survey. Overall, dietitians were knowledgeable about oral health risk factors and preventative measures across general health domains. Majority of dietitians agreed that oral health can affect nutrition interventions (95.5%) and dietitians should be discussing oral health (88.0%). However, nearly half were not confident in providing counselling or education and felt that undergraduate training for oral health promotion was inadequate (78.2%). A small proportion (6.0%) of dietitians were already providing oral health promotion regularly. Key barriers included a lack of clear guidelines for practice, limited training opportunities and indistinct referral pathways., Conclusion: Dietitians have acknowledged that oral health promotion should be incorporated into their practice. However, they are challenged by a lack of resources and training to support this in clinical practice. SO WHAT?: Capacity building dietitians to promote oral health allows opportunity for improvement in the oral health, nutritional status and quality of life of priority population groups., (© 2024 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

In response to COVID-19 social distancing restrictions, digitally delivered health interventions present as a potential solution for maintaining or improving individuals' physical activity. This study explored the feasibility of a web-based intervention, informed by the multi-process action control (M-PAC) framework to promote PA among individuals affected by social distancing. Fifty adults self-reporting as insufficiently active were randomized to a 6-week web-intervention (n = 27) or wait-list control (n = 23). Primary feasibility outcomes included recruitment and retention rates and usability and satisfaction scores; secondary outcomes of MVPA and M-PAC constructs and tertiary outcomes of mental health and wellbeing were also assessed. Overall, feasibility of the intervention was high, with a 96% recruitment rate, 84% retention rate, high satisfaction and usability scores, and comparable website usage to similar eHealth interventions. Intervention participants trended towards improved MVPA and M-PAC constructs and outcomes of mental health and wellbeing. Findings suggest study extension to a full-scale RCT., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: We proposed the Physical Activity and Cancer Control (PACC) framework in 2007 to help organise, focus, and stimulate research on physical activity in eight cancer control categories: prevention, detection, treatment preparation/coping, treatment coping/effectiveness, recovery/rehabilitation, disease prevention/health promotion, palliation, and survival., Methods: This perspective paper provides a high-level overview of the scientific advances in physical activity research across cancer control categories, summarises current guidelines, updates the PACC framework, identifies remaining and emerging knowledge gaps, and provides future research directions., Results: Many scientific advances have been made that are reflected in updated physical activity guidelines for six of the cancer control categories apart from detection and palliation. Nevertheless, the minimal and optimal type, dose, and timing of physical activity across cancer control categories remain unknown, especially for the understudied population subgroups defined by cancer type, age, race/ethnicity, and resource level of regions/countries., Conclusion: To achieve the full benefit of physical activity in cancer control, future research should use innovative study designs that include diverse at-risk populations and understudied cancer sites. Additionally, effective behaviour change strategies are needed to increase physical activity levels across populations that use implementation science to accelerate the translation from evidence generation into practical, real-world interventions., (© 2024. The Author(s).)