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Exercise is the single most effective strategy to reduce the risk of falls. Online classes have grown in popularity, but the benefits of online classes remain unknown. Zoomers on the Go is a peer-led 12-week exercise program offered twice weekly to adults 50+ years old. The main outcome was lower body strength measured by the 30-s chair stand test. Other outcomes included dropout, attendance, balance, cardiorespiratory fitness, and perceived health. A total of 74 participants (age 66.3 ± 7.1 years) in the online group and 84 participants in the in-person group (age 67.3 ± 7.2 years) completed the program, with attendance for the online group. Both groups significantly improved their 30-s chair stand, cardiorespiratory fitness, and balance (p <.001) with no difference in functional benefits between groups. The in-person group improved their perceived health and significantly reduced levels of stress and depression, while no such changes were observed in the online group. [ABSTRACT FROM AUTHOR]

Context: This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. Design and Methods: Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency). Results: Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. Conclusions: This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has accelerated the use of videoconferencing-delivered online exercise classes among community-dwelling older adults. This phenomenon is new, and no research has investigated older adults' relevant experiences and postpandemic perspectives. This study is situated in a naturalistic paradigm and adopted a descriptive qualitative methodology to understand the phenomenon. In-depth interviews were conducted with 23 older adults (aged 55–89 years) who have participated in videoconferencing-delivered online exercise since the COVID-19 pandemic. Utilizing thematic analysis, eight key themes were identified. Older adults experienced convenience, exercise regularity, technological transformation, and motivation when using this new form of exercise delivery. At the same time, they also experienced certain technological barriers and compromised quality of instructor supervision. Looking forward, older adults welcomed the increased opportunity for supervised exercise due to increased virtual capacity. They also envisaged that mobility-restricted groups such as frail older adults and caregivers would benefit from this form of exercise delivery. [ABSTRACT FROM AUTHOR]

Background: Access of all people to the healthcare they need, without financial hardship is the goal of Universal Health Coverage (UHC). As UHC initiatives expand, assessing the needs of vulnerable populations can reveal gaps in the system which may be covered by relevant policies. In this study we (i) identify the met and unmet primary healthcare needs of the poorest population of Khyber Pakhtunkhwa province (KP), Pakistan, and (ii) explore why the gaps exist. Methods: We used Leveque's Framework of Patient-centred Access to Healthcare to examine unmet primary healthcare (PHC) needs and their underlying causes for the poorest population in four districts of Khyber Pakhtunkhwa province, Pakistan. Using a triangulation mixed methods design, we analysed data from a quantitative household survey of744 households, 17 focus group discussions with household members and, 11 interviews with healthcare providers. Results: Our results show that indicate that despite service utilization, PHC needs were not met, primarily due to prohibitively high costs at each stage of access. Furthermore, gaps in outreach and information (approachability), and varying availability of medicines and diagnostics at facilities (appropriateness) the supply side as well as difficulties in navigating the system (inability to perceive) and adhering to prescriptions (inability to engage) on the demand side, also led to unmet PHC needs. Going beyond utilization, our findings highlight that engagement with care is an important determinant of met needs for vulnerable populations. Conclusion: Social health protection policies can contribute to advancing UHC for primary care. However, in our setting, enhancing communication and outreach, addressing gender and age disparities, and improving quality of care and health infrastructure are necessary to fully meet the needs of the poorest populations. Highlights: • The primary health needs of the poorest population of Khyber Pakhtunkhwa remain largely unmet or are met with difficulties, across the care-seeking pathway. • Major contributors to unmet primary healthcare needs in the study area are: low outreach, crowded facilities and, varying availability of medicines and diagnostics at facilities on the supply side, and difficulties in navigating care and inability to afford prescribed care on the demand side. • Social Health Protection is a crucial tool for advancing Universal Health Coverage and improving primary healthcare, however these needs cannot be met without quality service provision and outreach from facilities. • Levesque's framework of access to care (2013) can be effectively employed to identify broad-based unmet needs and assess gaps in primary healthcare systems. [ABSTRACT FROM AUTHOR]

Background: Australia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant. This study aimed to explore barriers and supports regarding the utilisation of healthcare services among Chinese international students studying in Australia. Methods: Semi-structured interviews were conducted in Chinese between October and December 2023 with 25 Chinese international students (age range, 19–30; female/male, n = 18/7; undergraduate/postgraduate/doctoral, n = 1/18/6) enrolled in three Australian universities to understand the healthcare challenges they encountered and the coping strategies they recommended. These interviews were recorded, and thematic analysis was applied to the interview data. An adapted social-ecological model was used to identify barriers and pragmatic strategies to deal with the challenges at different levels. Results: Chinese international students in Australia faced healthcare barriers at different levels. Individual barriers included language and cultural disparities, lack of knowledge about the healthcare system, and reluctance to seek help. Institutional barriers involved high costs, difficulties regarding appointments, and procedures related to the referral system. Policy barriers included insurance coverage and reimbursement issues. The students interviewed for this study proposed individual-level strategies, such as trying various methods to reduce language barriers, seeking information online, and using online resources and consultations. A central appointment platform and multilingual medical service were recommended from students to medical institutions, while medical service guidance and psychological support were suggested to education institutions. Higher-level strategies were also reported, which were mainly pertaining to insurance terms and coverage for overseas students and improving the accessibility of medical information. Conclusions: Our study identifies barriers to healthcare access for Chinese international students in Australia, including culture-specific challenges. To mitigate these issues, we recommend self-directed health promotion, targeted support by education institutions, enhanced cross-cultural communication and expanded telemedicine by hospitals, and attention to insurance coverage. Future research should explore optimising these approaches to improve support systems and policy frameworks. [ABSTRACT FROM AUTHOR]

Background: The article describes attitudes towards vaccinations in Poland in relation to issues such as voluntary versus compulsory vaccinations, the method of financing vaccinations, the method of organizing and carrying out vaccinations, the cognitive and educational aspect of vaccines (how to obtain knowledge about vaccines) and the preferred model of work and research on new vaccines. Taking into account these issues, the authors have created four ideal models of preferred vaccination policies: (a) the market model; (b) the state model; (c) the vaccine hesitancy model; and (d) the civic–social model. This perspective makes it possible to better understand and learn about the various motives behind the attitudes of anti-vaccination movements, as well as to notice cracks and divisions among vaccination supporters and their attitudes towards the financing and organization of vaccinations. Methods: The study was carried out using the CATI method on a representative random-quota sample of Polish society of 1000 people aged 18 and over. The study took age, sex, education and the size of the place of residence into account. Additionally, in the Socio-demographic factors influencing attitudes towards vaccination practices in Poland section, we used the chi-squared test and regression analysis of factors influencing vaccination practices in Poland. PASW Statistics 18 (a version of SPSS) software was used for statistical analysis. Significant correlations were demonstrated at a significance level of 0.05% Pearson. Results: This article has shown that attitudes towards vaccinations are embedded in broader divisions and orientations related to the vision of the social order: the role of the state, the organization of healthcare and payments for vaccinations and medical services, as well as preferred ways of knowledge production in society and work on new vaccines. The political sympathies and the age of the respondents were the most important variables influencing vaccination behaviour. The education of the respondents was less important. Conclusions: A few years after the peak of the pandemic, the scope of anti-vaccination attitudes in Polish society ranges from 20% of the population (dogmatic anti-vaxxers) to 30% (vaccine hesitancy occurring depending on attitudes towards vaccinations). [ABSTRACT FROM AUTHOR]

Background: Medicine retailers, considered here as any person or setting dedicated to the sale of retail medicines, fill an important gap in terms of access to healthcare in areas where population are not covered by universal healthcare schemes. In Goma in the Democratic Republic of the Congo, such retailers have proliferated and are consulted as the first port of call by more than half of the population, playing therefore a key role as an alternative source of healthcare for any type of health condition. The objective of this study is to understand people of Goma's rationale for using the medicine retailers over the formal healthcare system. Methods: Twelve focus groups, gathering 147 participants in total, were conducted in four worship communities, covering the most common faiths practised in Goma. Three focus group discussions were organised per worship community: one with fathers, another with mothers, and another with chronic patients and/or highly vulnerable people. We used a qualitative and inductive approach to analyse the participants' practices and perceptions in terms of their use of medicine retailers. We identified central categories explaining the reasons for using medicine retailers and the choice of a specific medicine retailer. Results: When facing a health problem, most of the participants in our study tended to first buy medicines at medicine retailers because it was cheap, quick, and easily accessible. Most were aware of the risks and limitations of such practices and had developed a number of mitigation strategies in order to reduce those risks: evaluating medicine retailers' expertise; developing a "medical expertise"; and seeking proactively out empathetic care. Conclusions: People in Goma make a conscious and rational choice when resorting to medicine retailers as it is seen as the least-worst option in a complex situation. In order to reduce the risks, they have developed a number of mitigation strategies. Future research should focus on the organisation of medicine retailers as a professional group to improve their supervision in a sensitive context such as Goma and on modalities to articulate them to the formal health system to guarantee a financial accessibility to healthcare for all. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsTo investigate the attitudes of mental health professionals towards Routine Outcome Monitoring (ROM) in Eastern and Western cultures.Two samples of American (N = 455) and Chinese (N = 505) mental health professionals completed the prevalent Monitoring and Feedback Attitudes Scale (MFA). We tested the measure’s psychometric characteristics, measurement invariance, and latent mean difference across cultures.Confirmatory factor analysis (CFA) found a two-factor structure of the MFA within both cohorts. The MFA subscales showed excellent internal consistency in both the Chinese and American samples. The MFA demonstrated partial scalar invariance between the two cultural groups, supporting the comparison of latent means among Chinese and American professionals. Chinese professionals perceived greater harm from ROM than their American counterparts.The findings show that the MFA is a valid tool to evaluate and compare the US and Chinese mental health professionals’ attitudes toward ROM, suggesting that the measure may be useful in both Eastern and Western cultures. [ABSTRACT FROM AUTHOR]

Introduction: The Diabetes Prevention Program (DPP) is effective; enrollment is low. Little research has examined factors driving individuals' enrollment decisions. Methods: In our final survey of a randomized trial comparing methods to increase enrollment in the DPP, we asked participants about factors impacting enrollment. We conducted interviews with a subgroup. Results: Participants who completed the survey (n = 299) were primarily female (96 male); middle-aged (mean 52.9, SD = 14.7); white (86%); non-Hispanic (85%). Only 19% reported awareness of the DPP prior to the study. Cost, online availability, and behavior-change motivation were the most highly rated factors influencing enrollment. The median amount participants were willing to pay for the program was $66.50. Phone interviews included 17 individuals who were/were not interested in receiving a referral to the DPP. Those interested described risk awareness, family history, social support, and healthcare-provider influence as facilitating enrollment. Cost, time, travel, unsupportive family, incomplete knowledge about the program's impact and low self-efficacy were barriers. Among those uninterested, some were already engaging in lifestyle change, and some didn't see a benefit. Conclusions: Results suggest that, even among high-risk individuals, efforts to increase awareness and benefits of the DPP are needed, as are efforts to address cost of enrollment and low motivation. Trial Registration: ClinicalTrials.gov protocol ID: 00132307. The Effect of 360 Video and MAPS on Enrollment in the DPP. URL: https://www.clinicaltrials.gov/study/NCT04746781?id=00132307&rank=1. [ABSTRACT FROM AUTHOR]

Background: Fall risk and incidence increase with age, creating significant physical and mental burden for the individual and their care provider. Lift assistive devices are used in multiple healthcare facilities, but are generally not portable nor self-operational, limiting their use outside of medical supervision. The Raymex™ lift is a novel lift assistance device within a rollator to address these limitations. We aim to gather user-centered feedback on the Raymex™ lift, set up instructions, safety protocols to improve feasibility and usability, and explore the potential usability as a fall recovery or prevention device. Methods: Four older adults, two informal caregivers and 16 formal caregivers (clinicians and continuing care assistants) participated in a focus group. Participants provided feedback on the Raymex™ lift after viewing a demonstration and using the device. Qualitative and quantitative data were analysized using thematic and descriptive analysis respectively. Results: Participants highlighted three major themes: (1) Design features requiring improvement, (2) Positive feedback and suggestions to optimize the Raymex™ lift and (3) Pricing vs. social utility. Participants suggested widening the seat, changing the braking button layout, and lowering the device weight to improve usability. Participants believed the main device feature was fall recovery and had implications for social utility by reducing the need for ambulance visits to the home. Price point led to a concern on affordability for older adults. Conclusion: The feedback gained will advance the development of the Raymex™ lift and may highlight cost-effective design choices for other developers creating related aging assistive technologies. [ABSTRACT FROM AUTHOR]

Conscientiousness and sense of purpose consistently predict health, wellbeing, and health behavior. However, it remains an open question whether they are unique or overlapping predictors of health and wellbeing. The current study considered this question using the MOSAiCH study, a nationally representative sample of 2305 Swiss adults (M : 52.33 years old; SD = 17.36). Participants reported on sense of purpose and conscientiousness, in addition to multiple health, wellbeing, and health behavior indicators (e.g. dietary practices, activity engagement, health conditions, psychological concerns, and doctor visits). Results found conscientiousness and sense of purpose were moderately associated with multiple health, wellbeing, and health behavior indicators. Bifactor modeling was employed to test the incremental validity of conscientiousness and sense of purpose, when accounting for their shared variance. The specific factor for purpose predicted outcomes even when accounting for conscientiousness. However, conscientiousness had little incremental validity over the general factor. [ABSTRACT FROM AUTHOR]

Background: Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China. Methods: From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately. Results: Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes. Conclusion: Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women's motivation for and factors related to breast cancer screening. Methods: A mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening. Results: The average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women's health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation. Conclusions: This study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community. [ABSTRACT FROM AUTHOR]

Background: Assessing how interventions are implemented is essential to understanding why interventions may or may not achieve their intended outcomes. There is little evidence about how interventions against Neglected Tropical Diseases (NTDs) are being implemented. Guided by the Context and Implementation of Complex Intervention (CICI) framework, we evaluated an ongoing intervention against the NTD podoconiosis to examine the implementation process and its effectiveness in terms of improving shoe wearing practices, increasing knowledge and reducing stigmatizing attitudes towards podoconiosis in rural Ethiopia. Methods: We employed an exploratory mixed methods approach, qualitative followed by quantitative, between April and July 2022 to assess implementation agents, theory, strategy, process and outcomes of the intervention. We conducted document analysis, observations, focus group discussions, in-depth interviews and key informant interviews for the qualitative phase. We administered a survey to 369 rural residents, of whom 42 were affected by podoconiosis. Results: The implementers utilized government healthcare centers in a bid to mainstream podoconiosis services within local healthcare structures. The implementers provided training for health professionals and the public and distributed supplies to patients over a three-month period. The intervention reached 62% of patients, but female patients were less likely to participate than male patients. Only 18% of community members had participated in health education campaigns linked to the intervention. Involvement in the intervention resulted in improved shoe wearing practice and holding fewer stigmatizing attitudes. However, internalized stigma among patients was still rife; and the plan to utilize community assets to extend the intervention activities was not effective. Conclusions: Implementers must monitor the fidelity and progression of programs on a constant basis to make corrections. They also need to expand health education, provide psychosocial support and design economic empowerment programs for patients to reduce stigma. They must also collaborate with policy makers and international partners to sustain program activities at intervention delivery points. Author summary: Although many interventions against Neglected Tropical Diseases (NTDs) have been conducted in low- and middle-income countries, little is known about how intervention activities have been put into practice or their outcomes in improving health behaviour or reducing stigma. In this study, the authors examined a health intervention against one of the NTDs known as podoconiosis. The disease causes leg swelling among patients and attracts stigma. Podoconiosis can be prevented by wearing shoes consistently. The evaluated intervention was implemented by two non-governmental organizations (NGOs). The NGOs delivered the project activities using local healthcare settings and professionals. The intervention improved access to treatment and health resources for affected individuals. It also contributed to reduction of stigmatizing attitudes and improved shoe wearing practices. Despite this success, the intervention activities were not sustainable ‐ some activities were not implemented as intended and others curtailed due to limited budget. Existing socio-cultural factors such as gender inequality and low economic status of patients also created constraints. These findings may contribute to the design of complex interventions to improve the lives of people affected by NTDs. [ABSTRACT FROM AUTHOR]

Background: Hesitancy rates for childhood vaccines are increasing on a global scale. It was reported in previous studies that many factors affect vaccine hesitancy. The present study was designed to determine the prevalence of childhood vaccination hesitancy in parents and to determine the factors affecting it. Methods: This descriptive, cross-sectional study was conducted with 350 parents who had at least one child aged two years and younger, who applied to Family Health Centers in the city of Mardin in the Southeastern Anatolia Region of Turkey, between January and March 2022. The "Parental Attitudes Towards Childhood Vaccines (PATCV) Questionnaire" was used to collect the data, which were analyzed by using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. The Logistic Regression Analysis was used to determine the factors affecting parental attitudes toward childhood vaccines. Results: A total of 32.0% of the parents were found to be hesitant about vaccinations and 3.4% did not have at least one vaccination for their children. Significant relationships were detected between income status, education status, thoughts about vaccinations, parents having adult vaccinations, hesitant to have self-vaccination, considering vaccine necessary, and parental attitudes towards childhood vaccinations (p < 0.05). According to the Regression Analysis, parents who had adult vaccinations had reduced hesitation about childhood vaccines 0.506 times (p = 0.032; OR = 0.506; 95%CI = 0.271–0.943). Considering the vaccine necessary reduced the hesitation about childhood vaccines by 0.440 times (p = 0.011; OR = 0.440; 95%CI = 0.234–0.828). Conclusions: The hesitations of parents about childhood vaccines were found to be high. The reasons for vaccine hesitancy must be examined in detail and strategies must be developed in this regard. [ABSTRACT FROM AUTHOR]

If properly used, condoms can serve as an effective family planning method and preventive tool towards sexually transmitted diseases (STDs). Despite its anticipated effectiveness, there are different myths and misconceptions which have been observed as hindrances to both its use and effectiveness. This review examines the myths and misconceptions of condom use among youths and explores challenges in condom usage in sub‐Saharan Africa (SSA). A narrative review was employed of which different journal articles were reviewed. The search words/phrases were "condom use in SSA, condom use among youths in SSA, myths and misconceptions on condom use among youths in SSA." A total of 1074 studies were identified, 93 were relevant to the topic, and only 71 suited the review. The identified myths and misconceptions of condom use include that males were the ones to decide on the use of condoms during sexual intercourse, economic power determines the use of condoms, condom use reduces sexual pleasure, condom use relates to the spread of HIV/AIDS, and condom use is against God's will. Other identified myths and misconceptions of condom use include that the use of condoms is a sign of lack of trust associated with fornication and adultery, also the use of condoms is only for family planning purposes. The challenges identified were breakage of condom during sexual intercourse, condom slippage, condom leakage, incorrect storage, and reuse of condoms. The identified myths and misconceptions lead to low knowledge of condom use within communities. There is a need for collaboration between governments, researchers, and NGOs to provide education on condom use to communities, particularly youths. [ABSTRACT FROM AUTHOR]

Background: At present, there is no culturally appropriate scale designed to measure Chinese people's attitudes and beliefs about COVID-19 vaccines. Understanding people's attitudes and beliefs about vaccines can help policy makers and health care professionals better evaluate local beliefs to increase vaccine coverage and minimize COVID-19 vaccine hesitancy. Methods: We developed a COVID-19 vaccine attitudes and beliefs scale comprising items based on qualitative research data. We then conducted an explorative and confirmatory factor analysis using data from two online sources. Results: The 26-item vaccine belief scale includes a five-factor model: vaccine benefit (VB), vaccine concern (VC), observing others' reactions to vaccination (VR), the influence of authority and others toward vaccination (VI), and common sense about vaccination (VS). The multivariate analysis results showed that VB (OR = 1.065, 95% CI 1.035–1.097), VR (OR = 0.878, 95% CI 0.832–0.927), and VS (OR = 1.076, 95% CI 1.032–1.122) were associated with the intention to receive the vaccine. These results implied that VC (OR = 0.957, 95% CI 0.928–0.987) could predict the choice not to be vaccinated. A correlation between beliefs about vaccines and conspiracy theories and fear of COVID-19 was also found and discussed. Conclusions: These findings suggest that the locally designed and culturally sensitive scale has good reliability and validity. The questionnaire provides researchers with a standardized assessment tool to measure Chinese people's beliefs about the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Background: Few validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one's risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS). Methods: As part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18–29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach's alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables. Results: For the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach's alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r =.55, p <.001), stigmatizing attitudes (r =.24, p <.001), attitudes towards mpox vaccination (r=-.12, p =.030), and worry about contracting mpox (r =.44, p <.001). The MKS was correlated with worry about contracting mpox (r =.30, p <.001) and mpox disclosure (r=-.16, p =.003). Conclusions: The MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations. Trial Registration: ClinicalTrials.gov NCT05490329. [ABSTRACT FROM AUTHOR]

Background: Hypertension affects approximately 1 in 2 adults in the US. Home blood pressure (BP) monitoring programs are effective in the diagnosis and management of hypertension. Free clinics serve as an integral safety net for millions of uninsured and economically disadvantaged patients in the US. The feasibility and effects of a free home BP monitoring and follow-up program in a free clinic setting is not well characterized. Methods: This was a prospective study of the implementation of a pilot BP monitoring and follow-up program between March 2021 and August 2023 at 2 free clinics in the San Francisco Bay Area. A total of 78 hypertensive patients were enrolled in the program and given a free BP monitor. We surveyed via telephone the change in systolic and diastolic BPs and BP monitor use and comfort at 3 weeks. Volunteers in clinic roles involved in the BP monitoring program were surveyed to assess their time spent and perceptions of the program. Results: Of the 78 patients, 37 provided responses to the 3-week survey. A total of 36 of 37 (97%) patients reported using their BP monitor. A total of 35 patients reported using it at least once a week (95%), with the majority reporting at least four uses a week (68%). A total of 36 patients (97%) planned on continuing to use their BP monitor. At 3 weeks, the mean systolic and diastolic BP changed by −6.40 mmHg (95% CI, −10.8 to −2.01 mmHg; P =.00577) and −2.72 mmHg (95% CI, −5.62 to 0.188 mmHg; P =.0657), respectively. The time commitment for this program ranged from 130 ± 51 min for program leaders to 16 ± 14 min per week for patient-facing roles. All volunteer roles (patient-facing, phone follow-up, program leaders) expressed that they had a clear understanding of their responsibilities in the program (median 4 on Likert scale, IQR 3-5). Conclusion: Home BP monitoring and follow-up is feasible to implement in free clinics, resulting in high rates of patient engagement among respondents. Our findings suggest that home BP monitoring and follow-up programs may be beneficial in vulnerable patient populations. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy was a major challenge during the COVID-19 pandemic. A common but sometimes ineffective intervention to reduce vaccine hesitancy involves providing information on vaccine effectiveness, side effects, and related probabilities. Could biased processing of this information contribute to vaccine refusal? We examined the information inspection of 1200 U.S. participants with anti-vaccination, neutral, or pro-vaccination attitudes before they stated their willingness to accept eight different COVID-19 vaccines. All participants—particularly those who were anti-vaccination—frequently ignored some of the information. This deliberate ignorance, especially toward probabilities of extreme side effects, was a stronger predictor of vaccine refusal than typically investigated demographic variables. Computational modeling suggested that vaccine refusals among anti-vaccination participants were driven by ignoring even inspected information. In the neutral and pro-vaccination groups, vaccine refusal was driven by distorted processing of side effects and their probabilities. Our findings highlight the necessity for interventions tailored to individual information-processing tendencies. [ABSTRACT FROM AUTHOR]

Background: The aging population in Poland poses significant challenges to social and health systems. By 2050, the percentage of people over 65 in Poland is projected to reach 32.7%. Promoting physical activity among seniors is crucial for preventing chronic diseases, improving quality of life, and reducing healthcare burdens. Local governments play a pivotal role in implementing healthpromoting measures. Objective: The study aims to analyze seniors’ satisfaction with local government activities in promoting physical activity and to identify the best activities and future needs of seniors in the Silesia, Mazovia, and Pomerania regions of Poland. Material and Methods: The survey, conducted between May 2023 and May 2024, utilized the Computer Assisted Web Interviewing (CAWI) method to gather data from 1,500 seniors aged 65 and above across the Silesia, Mazovia, and Pomerania regions. The study population was carefully selected to ensure representativeness in terms of gender, age, education, and place of residence. Data analysis included chi-square tests and logistic regression to assess satisfaction levels and identify influencing factors. Results: The survey revealed regional differences in satisfaction levels. Seniors in the Mazovia region exhibited the highest satisfaction (74% positive ratings), followed by the Silesian (64%) and Pomeranian (56%) regions. Factors influencing satisfaction included gender, age, education, and place of residence. Women, older seniors, those with higher education, and urban residents reported higher satisfaction levels. The most appreciated local government activities were related to sports infrastructure and sports programs. Future needs emphasized the demand for more sports programs and better infrastructure, with regional variations in preferences. Conclusion: Seniors’ satisfaction with local government activities in promoting physical activity varies significantly across regions. Tailoring activities to regional preferences and continuous evaluation of programs are essential for enhancing effectiveness and satisfaction. Increased funding and support for physical activity programs are necessary, especially in less developed regions. [ABSTRACT FROM AUTHOR]

Background: The HIV epidemic in sub-Saharan Africa has a disproportionate gender impact, with women bearing the brunt of the epidemic. South Africa carries the largest share of the global HIV burden, with similar trends seen for women due to unequal socio-cultural and economic status. Objectives: This study aims to understand 30–49 year-old women's barriers and facilitators to accessing HIV services in order to maximize health in resource limited settings and reach women missing from HIV care. Design: Employing a convenience sampling strategy, we recruited, informed, and consented participants at clinics and public areas. Interviews were conducted in respondent's preferred languages, transcribed verbatim, translated into English if needed, and thematically analyzed using grounded theory. Methods: We conducted 81 interviews with women aged 30–49 either missing from care (n = 21), having unknown HIV status (n = 30) or linked to care (n = 30) within two sites: City of Johannesburg district, Gauteng Province and Mopani district, Limpopo Province. Results: Participants missing from care reported negative staff attitudes, queues, family rejection, medication side effects, and painful blood tests as key deterrents. Participants with an unknown status were deterred by fear of being diagnosed as HIV positive and family rejection, which was similar to women missing from care who often dropped out from care due to actual family rejection. Participants linked to care reported that long queues and staff shortages were challenges but stayed in care due to a will to live for themselves and their children, in addition to counselling and feeling emotionally supported. Interestingly, participants missing from care often accessed medication from friends but, similarly to those with unknown status, noted that they would access care if attended to by supportive nurses and by having non-clinical HIV services. Conclusions: The accounts of women in this research highlight significant improvements needed to address inequities in the fight against HIV in South Africa. Additionally, the healthcare service access preferences of women aged 30–49 need to be further explored quantitatively in order to design policy relevant interventions. Plain language summary: Understanding HIV service preferences of South African women 30–49 years old missing from or linked to care: An exploratory study of Gauteng and Limpopo provinces The HIV epidemic in sub-Saharan Africa harms women more than men. South Africa carries the largest share of the global HIV burden, with similar trends seen for women. This study aims to understand 30–49 year-old women's ability to access HIV services in order to reach women missing from HIV care. We conducted 81 interviews with women aged 30–49 either missing from care (n = 21), having unknown status (n = 30) or linked to care (n = 30) within two sites: City of Johannesburg district, Gauteng Province and Mopani district, Limpopo Province. We recruited, informed, and consented participants at clinics and public areas. Interviews were conducted in respondent's preferred languages, transcribed, and translated into English for analysis. Participants missing from care reported negative staff attitudes, queues, family rejection, medication side effects and painful blood tests as key deterrents. Participants with an unknown status were deterred by fear of being diagnosed as HIV positive and family rejection, which was similar to women missing from care who often dropped out from care due to family rejection. Participants linked to care reported that long queues and staff shortages were challenges but stayed in care due to a will to live for themselves and their children, in addition to counselling and feeling emotionally supported. Interestingly, participants missing from care often accessed medication from friends but, similarly to those with unknown status, noted that they would access care if attended to by supportive nurses and by having non-clinical HIV services. The healthcare service access preferences of women aged 30–49 needs to be further explored in order to improve interventions. [ABSTRACT FROM AUTHOR]

Aims. To understand what domains of acculturation are experienced by Chinese immigrants with cardiovascular disease (CVD) in Australia and how these domains of acculturation influence their CVD self‐care behaviours. Design. A qualitative descriptive design. Methods. Individual phone interviews were conducted among Chinese immigrants with CVD in Sydney, recruited from Chinese Community associations and social media. Inductive and deductive thematic analysis was employed, guided by the Middle‐Range Theory of Self‐Care of Chronic Illness and the conceptual model of acculturation. Results. Twenty participants, mean age 69.9 years, were interviewed. The domains of acculturation in relation to CVD self‐care behaviours encompassed cultural practices, cultural values, healthcare system navigation, and new living environment. Retaining their Chinese culture and integrating into Australian culture regarding dietary practices, social networks, traditional values and family relationships served as both enablers and barriers of self‐care maintenance through factors such as heart‐healthy diets, physical activity, stress management and medication adherence. Many participants denied encountering difficulties to utilize primary care services, but language barriers deterred them from accessing acute services and heart‐health information from mainstream sources. Some preserved beliefs and practices in Traditional Chinese Medicine may complicate their self‐care maintenance (medication adherence) and self‐care management (responding to acute angina episodes). Conclusion. The influence of acculturation on CVD self‐care behaviours among Chinese immigrants is multifaceted and individualized. Clinicians and community health workers should assess patients' acculturation experiences to enable culturally sensitive practices. The lack of culturally and linguistically appropriate heart health information in the community should be addressed urgently to mitigate the cardiac health disparity. Collaboration with Chinese community associations offers an opportunity for co‐design and dissemination of information about Australian healthcare systems and heart health education to upskill CVD self‐care practices and mitigate the health inequities experienced by Chinese immigrants. [ABSTRACT FROM AUTHOR]

AbstractResearch shows the significance of death attitudes for the mental health of somatically ill people, but findings that focus on multidimensionality in processing death are scarce. Patients with Chronic Obstructive Pulmonary Disease (COPD) report shortness of breath, pain and anxiety about suffocation and high mental distress. Utilizing a mixed-methods approach from 64 hospitalized COPD patients, we examined how they cope with mortality. We conducted a narrative interview with two questions. Patients completed the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F). Findings reveal a spectrum of death-related narratives, with most patients reporting at least 3 different attitudes. The sample showed below average scores in the Rejection of One’s Own Death and Dying subscale of the MODDI-F. Assessing death attitudes using two simple questions proved highly applicable in this population and may serve as a potential approach to engage patients in discussions about existential matters, as suggested in the literature. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance in agriculture is a global concern that is growing every day. As a result, there is increasing interest in investigating different approaches to disease control in both plants and animals. Research on the identification and synthesis of antimicrobial compounds derived from plants and microbes has exploded in the last few years. The purpose of this review is to give a broad overview of the current knowledge regarding antimicrobials derived from plants and microbes and their possible uses in agricultural practises. It discusses a number of topics, such as the origins of these antimicrobial agents, how they work, and how well they work to fight infections in plants and animals. Furthermore, the difficulties pertaining to their execution and potential outcomes are examined. [ABSTRACT FROM AUTHOR]

In this study, health risk attitude and health locus of control were included as dispositional factors in the Protection Motivation Theory (PMT) to explain people's protective behavior in the context of COVID-19 pandemic. Empirical data involved two waves of data with a sample of 526 adults with full-time jobs from Beijing, China, and structural equation model results confirmed a partial successful extension of the PMT. Specifically, health risk attitude had a direct effect on citizens' protective behavior, but without an indirect effect mediated by threat appraisal toward the COVID-19 pandemic; health locus of control did not directly associate with citizens' protective behavior, but had an indirect effect on it fully via coping appraisal toward the COVID-19 pandemic. Thus, the PMT has been extended by adding a distal dispositional factor on the impact of coping appraisal on protective behavior. Implications for advancing the government's anti-epidemic strategy are discussed. [ABSTRACT FROM AUTHOR]

Background: The prevalence of type 2 diabetes (T2D) in the French overseas department of French Guiana, South America, nearly doubles that in its European counterpart, Metropolitan France. This region is demographically diverse and includes several populations of Indigenous Peoples. Although such populations are at particular risk of developing T2D across the Americas, very little is known about their health status in French Guiana, and accurate numbers of diabetic patients do not exist. Methods: In light of a potential public health crisis, an ethnomedicinal study of diabetes experienced by Indigenous Parikweneh was conducted to provide better insight into the knowledge, attitudes and practices (KAP) related to this quickly emerging disease in French Guiana. Altogether, 75 interviews were conducted with community members and Elders, as well as healthcare professionals and administrators providing services to the Parikweneh population of Macouria and Saint-Georges de l'Oyapock. Results: Interviews suggest a high incidence of T2D in this population, with cases that have risen quickly since the mid-twentieth century. Parikweneh participants linked the development of the illness to dietary changes, notably through the introduction of new and sweet foods. Recognizing the complexity of diabetes and its symptoms, diabetic patients highlighted the importance of biomedical treatments and follow-ups, though they frequently alternated or used them concomitantly with Parikweneh medicines. With the help of biomedical tools (i.e. glucometer), local medicinal practices mirrored biomedical approaches through dietary adaptation and the use of medicinal animals and plants for glycaemic control and the treatment of complications from the disease. Conclusion: Parikweneh are appropriating T2D into their knowledge system and adapting their health system in response to this relatively new health concern. A greater understanding of local practices and perceptions relating to T2D among medical staff may therefore be beneficial for meeting patients' needs, providing greater autonomy in their health path, and improving treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Pakistani immigrants are the largest non-Western ethnic minority group in Norway. Traditional medicines (TM) are extensively used in Pakistan, and studies show that ethnic minorities also use them to recover from illness after migration to the Western world. This study aims to explore Pakistani immigrants' experiences and perceptions of risk regarding the use of TM to treat illnesses. Methods: A qualitative study was conducted through in-depth interviews (n = 24) with Pakistani immigrants in Norway from February to March 2023. Participants were recruited through purposive and snowball sampling methods. The data was analyzed using Braun & Clarke's reflexive thematic analysis (RTA) using Nvivo. Results: RTA revealed three main themes and six sub-themes. The main themes were: (a) House of knowledge, (b) Choosing the best possible approach for health restoration, and (c) Adverse effects of TM used. A total of 96 different TM were identified, including herbs, food items, animal products, minerals, herbal products, and ritual remedies. All participants used TM to restore health in acute and chronic diseases, and many used TM along with conventional medicines. The participants' mothers were the primary source of knowledge about TM, and they passed it on to the next generation. They also frequently used religious knowledge to recover from illness. Although TM is considered safe because of its natural origin, some participants experienced adverse effects of TM, but none of them reported it to the health authorities. Conclusion: The study helps to understand the experiences and perceptions of risk of Pakistani immigrants in Norway regarding traditional practices for treating health complaints. Public health policies to improve the health of these immigrants should consider the importance of TM in their lives. Further research is necessary to explore the safety and toxicity of those TM that are common in Pakistani households in Norway. [ABSTRACT FROM AUTHOR]

This study examined the influence of eHealth literacy on Chinese individuals' attitudes towards post-COVID-19 vaccination and explored methods to address obstacles related to eHealth literacy that could affect their comprehension and willingness to get vaccinated. In 2022, a web-based cross-sectional survey was conducted to assess the vaccination-related knowledge, attitudes and intentions of 950 participants. Vaccination knowledge was established by employing validated measures and conducting a Mokken scale analysis. Causal-directed acyclic graphs were used to illustrate the current comprehension of the correlation between eHealth literacy and the desire to receive vaccinations. This study utilised causal mediation and multiple linear regression analysis to determine the relationships between eHealth literacy, vaccination knowledge, vaccination willingness and subjective health status. The primary finding of this study was that an individual's comprehension of vaccination was a robust indicator of their inclination to receive vaccination. Moreover, eHealth literacy has an indirect effect on the propensity to get vaccinated by enhancing one's understanding of vaccines. This study emphasises the significant role of eHealth literacy in enhancing vaccination awareness and willingness, particularly among Chinese adults with poorer health in the post-COVID-19 period. The results affirm the efficacy of employing eHealth technologies to bolster immunisation initiatives, amplify vaccine consciousness, and promote compliance. Moreover, this study emphasises the significance of additional research to assess and record the function of eHealth literacy in immunisation practices. [ABSTRACT FROM AUTHOR]

Background: Although menstruation is a monthly biological phenomenon, it is shrouded in stigma and shame which directly impacts health, education, gender equality, decent work, and economic growth. However, there is scarce evidence on how personal agency, an individual's ability to access resources, may act as a protective factor to adequate menstrual health and hygiene practices. Therefore, we assess the association between attitudes toward menstruation and personal agency among very young adolescent girls. Methods: We use cross-sectional data from the Global Early Adolescent Study in São Paulo, Brazil, among 10- to 14-year-old girls who have experienced menarche (n = 325) and completed a home-based self-administered questionnaire in 2021. "Attitudes toward menstruation" was created based on five indicators on a Likert scale, with a higher score indicating more positive attitudes. The main covariate was personal agency, comprised of three scales and modeled as three continuous variables: voice, decision-making power, and freedom of movement. Data were analyzed using multivariable linear regression. Results: Attitudes toward menstruation mean score was 12.5 (range 5–19). Older adolescents (12–14 years-old) had higher mean scores (more positive) than younger adolescents (10–11 years-old) on attitudes toward menstruation, whereas no other sociodemographic or menstrual health indicator (knowledge or access to products) were associated with attitudes toward menstruation. In the multiple regression model, older age and higher freedom of movement remained positively associated with attitudes toward menstruation (βadjust = 0.5; 95%CI 0.1 to 0.8). Conclusion: Positive attitudes toward menstruation are associated with higher freedom of movement among very young Brazilian adolescent girls. The promotion of personal agency should be recognized as key strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being. Plain language summary: Menstrual Health and Hygiene Attitudes are associated with Personal Agency Our results show that positive attitudes toward menstruation among very young adolescent girls are associated with personal agency, measured through freedom of movement. This information can inform strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being. [ABSTRACT FROM AUTHOR]

This document contains summaries of various articles related to blood donation and transfusion. The articles cover topics such as efforts to improve ethnic minority blood donor numbers, collaborations to recruit blood donors for research programs, trends in malaria antibody testing, testing for Transfusion Related Acute Lung Injury (TRALI), and the accuracy of point-of-care testing methods. Other topics include restless legs syndrome and sleep disorders in blood donors, lookback investigations for transfusion-transmitted infections, and various parameters related to blood transfusion and testing. The document also discusses studies on red blood cell manufacturing methods, safe transfusion plans for patients with specific needs, predictors for red blood cell transfusion in pregnant women, and the appropriateness of blood transfusions in different hospital settings. Additionally, it covers initiatives to improve transfusion practices, patient safety, and the management of blood supply chain. The document emphasizes the importance of collaboration, education, and quality improvement in transfusion services. [Extracted from the article]

Background: Primary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia. Methods: This exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation. Results: Four main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness. Conclusion: African refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences. [ABSTRACT FROM AUTHOR]

Public health measures (PHMs) implemented during the COVID-19 pandemic introduced sudden changes to adolescents' everyday routines and required adolescents to repeatedly adapt their routines at a critical developmental stage. While meant to protect physical health, the PHMs destabilized mental health. Using a youth-engaged approach and interpretive description, this study explored adolescents' perspectives on their mental health in relation to the COVID-19 pandemic-related PHMs in Canada from March 2020 to the time of data collection in March 2022. Four Youth Research Collaborators contributed an adolescent lens to informing study activities, and a total of 33 high-school aged adolescents ages 14 to 19 completed individual interviews. Findings suggest an overarching concept of a "timeline" through which adolescents described their experiences. Most adolescents described their mental health as worsening during the initial lockdown, although some adolescents experienced positive mental health outcomes. Several adolescents felt their mental health had not recovered after the PHMs were fully lifted. This study contributes young Canadians' unique voices to the literature on the pandemic-related PHMs and adolescent mental health. It is essential that the impacts of the pandemic on adolescent mental health continue to be a focus of research and programming to better understand and address its ongoing effects. [ABSTRACT FROM AUTHOR]

Objective: Hand hygiene is an essential step in preventing healthcare-associated infections. Gaining information and improving hand hygiene among healthcare workers can contribute to the prevention of nosocomial infections. Although studies in the literature emphasize hand hygiene compliance, data on hand hygiene beliefs are limited. Methods: This study was a descriptive research among employees between May and July 2022. Data obtained from surveys called the Hand Hygiene "belief scale" and "practice inventory" administered to healthcare workers were collected. Results: A total of 1556 healthcare workers were interviewed. As the education level increased, a significant increase was found in the belief in hand hygiene and its importance scale. Women have a higher belief in hand hygiene than men. The hand hygiene belief scale scores of healthcare workers working in outpatient clinics were higher than those of healthcare workers in the emergency room and intensive care. Compliance with hand hygiene decreases with increasing risk and workload. When the shift times were evaluated, daytime workers scored higher on the belief scale than night workers. Conclusion: Our study revealed that hand hygiene was affected by factors such as education, profession, gender, length of service, shift time, and department. Therefore, unit-specific or individual plans are required. [ABSTRACT FROM AUTHOR]

Studies investigating autistic community research priorities indicate a mismatch between what autism research focuses on and what autistic people want to see researched. Furthermore, there has not been a research priority-setting exercise specifically with autistic people in Scotland, where there are unique cultural, political and social contexts. Using a community-based participatory design, we aimed to identify the research priorities of autistic adults living in Scotland. Autistic and non-autistic researchers designed and conducted a survey where 225 autistic adults rated and ranked research topics in order of importance and provided qualitative feedback on issues and questions important to them. The top five research priorities were mental health/well-being, identification and diagnosis of autistic people, support services, knowledge and attitudes towards autistic people and issues impacting autistic women. There were differences in priorities according to different intersections of identity, and qualitative responses indicated a desire for research to focus on support and understanding. The bottom three priorities concerned genetics, treatments and interventions and causes. These findings emphasise the need to address the gap between what autism research focuses on and the everyday lives of autistic people. Although research has the potential to improve autistic people's lives, lots of funding goes towards research looking at topics which autistic people say has little impact in their everyday lives. Autistic people's lives can be different depending on where they live, and Scotland is a unique country in many ways. We wanted to find out which topics autistic people in Scotland want to see research on. Our team of autistic and non-autistic researchers (including university-based and community researchers) created a survey where 225 autistic adults rated and ranked the importance of possible research topics and shared their thoughts on what topics mattered to them. The five most important topics were mental health and well-being, identifying and diagnosing autistic people, support services (including healthcare and social care), non-autistic people's knowledge and attitudes and issues impacting autistic women. The three least important topics were genetics or biological aspects of autism, autism treatments/interventions and causes of autism. Our findings indicate that autistic people in Scotland want research to focus on things that matter to their day-to-day lives. Also, the Scottish government says they will be listening to autistic people in their latest policy plans, and we believe that considering autistic people's research priorities is an important part of this. Our findings also add to growing calls for change to happen in how and what autism researchers do research on. [ABSTRACT FROM AUTHOR]

Background: The experiences and perceptions of Community Health Workers toward mental illness are vital for tailoring interventions, reducing stigma, improving access to services, and fostering community engagement in mental health initiatives. Aims: This study investigates the experiences of community health worker and their perception of mental illness. Methods: A multi-settings cross-sectional study was conducted among 487 Community Health Workers. Their experience and perception toward mental illness were studied with questionnaires, which examined their general perception, religious-related perception, cause, treatment, and expectation for mental treatment. Results: Most participants concurred that serving as a community health worker enhances their communication abilities (90.4%), strengthens connections with community health center staff (84.8%), boosts self-confidence (84.6%), and refines their capacity to identify signs of mental disorders (77%). Most notably, they consider their fellow community health workers essential to their extended family. Furthermore, a notable proportion associates' mental illness with religious elements, with 19.5% believing it can result from a lack of religious worship and a minority attributing it to witchcraft or black magic (3.5%). In terms of treatment, 14.2% think Ruqyah can cure mental illness, 6.4% believe in treatment by religious scholars, and a similar percentage (6.4%) think no medication or treatment is necessary for mental problems. Conclusion: Participants overwhelmingly recognize the positive impact of serving as community health workers, citing improvements in communication, relationships with health center staff, self-confidence, and mental disorder identification. The strong bond among community health workers, likened to an extended family, emphasizes their collective importance. Additionally, the majority advocates for compassionate treatment of individuals with mental illness. These findings underscore the complex interplay of professional, communal, and cultural elements in addressing community mental health. [ABSTRACT FROM AUTHOR]

Imagery rescripting commonly seeks to target memories by imagining the intervention of a caregiver. In some cases, such as obsessive-compulsive disorder (OCD), the target imagery may also be episodic future imagery, and a sense of mastery may be more salient than an intervening caregiver. We aimed to compare how varying the target image and rescripting approaches influenced beliefs, emotions, or characteristics of idiopathic imagery relevant to OCD. We recruited 250 online participants high in OCD traits. Participants were randomly assigned to one of four conditions, reflecting variations in target image (memory/future) and rescripting approach (attachment/mastery). Self-administered audio-guided exercises were used to elicit the target image and facilitate rescripting. Participants completed a range of measures before and after rescripting. Participants in all groups tended to report changes in self-related beliefs, emotions, and imagery characteristics. In general, these results did not differ between target images or rescripting approaches. However, mastery-based rescripting reduced anxiety associated with episodic future imagery to a greater extent than attachment-based rescripting. These results suggest that the general benefit of modifying emotionally salient imagery tends to outweigh differential effects of varying the target image or rescripting approach. Standardised re-scripting protocols could be varied based on the individual's needs. [ABSTRACT FROM AUTHOR]

Psychological distress in women represents a critical aspect; however, few studies have comprehensively addressed how health management strategies, consideration of future consequences (CFC), cognitive reappropriation, and self-efficacy may influence this phenomenon, especially in contexts that require a comprehensive approach to women's mental health. This study aimed to evaluate the effects of future consequence consideration, cognitive reappraisal, and self-efficacy in health management on psychological distress in American women, as well as to demonstrate their equivalence according to age. Data from 2788 women responding to the 2019 Health Information National Trends Survey 5, cycle 3 were used. A predictive model was considered using structural equation modeling (SEM). Cognitive reappraisal and self-efficacy in health management (SEHM) have a significant mediating effect between CFC and psychological distress. In addition, the invariance of the SEM model was presented as a function of age. The findings underscore the importance of incorporating cognitive components into mental health interventions for women, focusing on modifying thoughts and perceptions about the efficacy of health care to mitigate negative emotions. [ABSTRACT FROM AUTHOR]

Introduction: Culture and acculturation influence nutritional beliefs. Little is known about the Arabic population in the United States. In this study, Arabic-speaking Middle Eastern mothers' perceptions of motherhood and childhood nutritional beliefs and practices are explored. Method: Semi-structured interviews with 12 mothers from Arabic-speaking Middle Eastern countries. Results: Food and family are central to everyday life. Mothers worked hard to maintain traditional nutritional practices with their school-age children. Discussion: Findings can enhance school nurses' ability to collaborate with mothers in nutritional education and address any issues in the classroom. [ABSTRACT FROM AUTHOR]

Investigators undertaking goal-setting research in sport have often focused on the effects of goal content, while those writing professional practice literature have suggested how practitioners could set goals with clients. Few empirical investigations have concentrated on understanding how and why sport psychology practitioners (SPPs) use goal setting or the active ingredients contributing to intervention effectiveness. By adopting a 2-stage, multiple methods approach, we aimed to identify how and why SPPs used goal setting and what contributed to their successful and unsuccessful experiences of setting goals. In Stage 1, 84 accredited/certified SPPs and 16 SPPs in training on an accreditation/certification pathway completed an online survey to identify how and why they set goals. In Stage 2, we conducted semi-structured interviews with 14 participants that explored their experiences of goal setting and elaborated on findings generated in Stage 1. Our findings illustrate that goal setting is a dynamic process, and we identified several common steps across participants. Goal setting was used to enhance psychological and performance outcomes, but the process was influenced by client, contextual, and practitioner factors. Aspects perceived to influence the effectiveness of goal setting included: the attitude of the client toward goal setting; setting appropriate goals; and reflecting, tracking, and monitoring progress. When implementing goal setting in practice, our findings suggest that SPPs can expect steps of the intervention to differ between clients. Furthermore, practitioners might consider the commitment of the client to the process and following up after the intervention as factors that could contribute to successful outcomes. Lay summary: Sport psychology practitioners (SPPs) reported taking different steps to educate and evaluate their clients before they set goals. After setting goals, SPPs prepared clients to work toward them and followed up on their progress. A client's attitude toward goal setting, setting appropriate goals, and monitoring progress were reported to contribute to successful goal-setting interventions. IMPLICATIONS FOR PRACTICE: Goal setting is a dynamic process, dependent on the client, context, and practitioner. Setting the right type of goals with the client and following-up on their progress are important parts of the goal-setting process. Sport psychology practitioners should collaborate with clients through the goal-setting process, but also provide clients autonomy to select their own goals. [ABSTRACT FROM AUTHOR]

Previous research has indicated that a Rational Emotive Behavior Therapy (REBT)-Informed Group focused on changing irrational beliefs to address comorbid depression and anxiety (as well as anger and guilt) in a combat Veteran population diagnosed with Posttraumatic Stress Disorder (PTSD) demonstrated significant reductions in depression and PTSD symptoms at posttreatment. However, mechanisms of change associated with improvement have not been evaluated. REBT theory suggests that a decline in irrational beliefs predicts a decrease in PTSD, depression, and anxiety symptoms. This study aimed to test this tenet of REBT theory in a naturalistic treatment setting. Participants (N = 86) were post-9/11 combat Veterans, engaged in the REBT-Informed Group between October 2016 and February 2020. Results of hierarchical multiple regression analyses indicated that a reduction in irrational beliefs predicted notable decreases in PTSD, depression, and anxiety symptoms controlling for several covariates. This study extends previous research demonstrating the success of the REBT-Informed Group with combat Veterans and gives support to REBT theory regarding the effect of a decline in irrational beliefs. Future directions include replication of findings with Veterans who experienced military sexual trauma (MST), pre-9/11 Veterans, those at other military or Veterans Affairs (VA) medical centers, and civilians to determine generalizability. [ABSTRACT FROM AUTHOR]

Background: Patient online access to medical records is assumed to foster patient empowerment and advance patient-centred healthcare. Since July 2020, patients in the Netherlands have been legally entitled to electronically access their medical record in general practice. Experience from pioneering countries has shown that despite high patient interest, user rates often remain low. How to best support implementation depends on individual needs and expectations of patient populations, which are as yet unknown in the Dutch context. Objective: To understand Dutch patients' needs and expectations with regard to online access to their medical record in general practice. Method: Twenty participants completed semi-structured individual interviews via video or telephone call. Transcripts of interviews underwent template analysis combining deductive and inductive coding using Atlas.ti software. Results: Patients' needs and expectations ranged across three overlapping areas: (i) prerequisites for getting online access; (ii) using online access; and (iii) the impact on interaction with healthcare providers. Patients expected benefits from online access such as better overview, empowerment and improved communication with their general practitioner but identified needs regarding technological difficulties, data privacy and complex medical language in their record. Conclusion: The concerns and obstacles participants identified point towards the need for organisational changes in general practice, for example, adjusted documentation practices, and the key role of the general practitioner and staff in promoting and facilitating online access. Implications: Implementation strategies addressing needs identified in this study may help to unlock the full potential of online access to achieve desired outcomes of patient involvement and satisfaction. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a highly effective tool to prevent HIV, yet it is underutilized among women. The current study aims to evaluate the awareness, attitudes, and perceptions of PrEP among a large survey sample of Black and Latina women in New York City (NYC). Interviewer-administered surveys were conducted in high HIV incidence neighborhoods in NYC among Black, Latina, and Afro-Latina women who reported recent sex with a man in 2017 (n = 398) and 2018 (n = 405). About 40% of participants were aware of PrEP, whereas 30.4% indicated interest in using it. The top reason for not utilizing it was low HIV risk perception. However, most participants supported the idea that using PrEP meant asserting control over their health (94.1%). Primary care providers and obstetricians/gynecologists were participants' preferred sources for PrEP (91.6%). Across survey cycles, compared to non-Black Latina participants, Black participants had significantly higher PrEP awareness (44.4% vs. 29.1%). PrEP awareness was also significantly higher among survey participants in 2018 (45.2%) than in 2017 (34.3%). Less than half of the participants were aware of PrEP, but those who were aware expressed largely positive attitudes toward the medication. Our findings may inform future PrEP implementation strategies to optimize awareness and access to PrEP among women disproportionately affected by HIV, like focusing on personal empowerment instead of risk-based messaging and training women's sexual health care providers in PrEP provision. [ABSTRACT FROM AUTHOR]

Simple Summary: Skin cancer rates in Canada are rising quickly, with about one-third of Canadians likely to be affected in their lifetime. Despite this alarming trend, government actions to reduce skin cancer are limited. Our study, conducted in Manitoba, found that many residents have risky sun exposure habits and lack awareness about skin cancer. Over 65% reported a history of sunburns, more than half had used tanning beds, and a large majority recently tanned for pleasure. Misconceptions are common, with over 50% believing that tans are healthy or a sign of beauty. Moreover, sun protection practices are inadequate, with less than 60% using protective clothing and under 50% using sunscreen. These findings highlight the need for targeted public health campaigns to improve awareness and promote better sun protection behaviors to prevent future skin cancers in Manitoba. The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond. [ABSTRACT FROM AUTHOR]

Background Among the main barriers that prevent people with disabilities from seeking help and support are negative attitudes of society in general and health care professionals in particular. However, only a few studies looked into the attitudes of health care providers toward people with disabilities in Saudi Arabia. This study aimed to investigate the attitudes of health care providers in relation to people with disabilities. Participants and Methods The attitudes toward disabled persons (ATDP) scale was administered among n = 1,033 health care providers in the Eastern Province of Saudi Arabia. The data were analyzed using JASP version 19 and Orange 3.26.0. Demographic data were analyzed using dummy encoding. Results The mean ATDP score for 1,033 respondents was 58.03 (p = 0.000). Multiple linear regression analysis showed that respondents aged 24 to 25 years have significantly less positive attitudes, compared to participants aged 18 to 20 years (p = 0.004). No sufficient evidence was found whether marital status significantly affects attitudes toward people with disabilities. In contrast, participants with three or more children have a significantly (p = 0.014) less positive attitude compared to those who do not have children. Conclusion This study found that, overall, health care professionals had slightly negative attitudes, according to the ATDP scale. However, younger respondents and those without children were more positive. Future research is recommended to collect more data on the significance of having children and its association with attitudes toward disabilities. More educational programs are recommended that can increase attitudes and awareness about people with disabilities. [ABSTRACT FROM AUTHOR]

Introduction: Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past‐month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption. Methods: An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (n = 675). Results: Of respondents, 52.3% reported past‐month exposure to alcohol SMM (68.6% of past‐month drinkers and 48.0% of non‐past‐month drinkers, p < 0.05) while 71.6% reported exposure to non‐SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business‐to‐consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/'liked' alcohol brand posts). Of those exposed to alcohol SMM, 13.7–15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2–8.9% for direct alcohol SMM). Being male, lower‐income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (ORmv 1.71–3.14). Past‐month exposure to indirect alcohol SMM was independently associated with lower income, not working full‐time and drinking any type of alcohol (ORmv 1.59–4.44). Discussion and Conclusion: The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region. [ABSTRACT FROM AUTHOR]

Mental health issues are prevalent among young people. An estimated 10% of children and adolescents worldwide experience a mental disorder, yet most do not seek or receive care. Media mental health awareness campaigns, defined as marketing efforts to raise awareness of mental health issues through mass media, are an effort to address this concern. While previous research has evaluated the outcomes of specific media mental health awareness campaigns, there is limited data synthesizing their overall effects. This study addresses the knowledge gap by reviewing the existing literature on the impact of media mental health awareness campaigns on young people. A search was conducted on MEDLINE, EMBASE, PsychINFO, Web of Science, and Google Scholar for studies published between 2004 and 2022 with results specific to people aged 10 to 24. Out of 20,902 total studies identified and screened, 18 studies were included in the review. The following data were extracted from each study: characteristics and descriptions of the campaign, evaluation design and sampling, and summary of impact. The review identified evaluations of 15 campaigns from eight different countries. Outcome evaluation methods commonly comprised of surveys and quantitative data. The campaigns were generally associated with positive changes in the attitudes, beliefs, and intentions of young people (e.g., reduced stigma) and positive changes in behaviors (e.g., increased help-seeking behaviors). The inclusion of few studies in the review indicates a need for ongoing evaluations of media mental health awareness campaigns for young people to inform good practices in their development and distribution. [ABSTRACT FROM AUTHOR]

Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [ OR ]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR : 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR : 4.2, 95% CI = [2.6, 6.7]; OR : 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR : 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR : 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR : 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data (n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language, (2) deciding who to trust, (3) conveying rights and risk, and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice. [ABSTRACT FROM AUTHOR]

This study examined a set of background psychological and other variables of orthorexic (ON) tendency in a sample of young women with special interest in healthy lifestyle. The sample consisted of female young adults (N = 310; aged 18–35 years; mean age = 24.3 years; SD = 4.97 years) who were recruited through social media health sites. Besides Orthorexia Nervosa Questionnaire (ORTO‑15), BMI, regular sporting activity, the following scales were used: Eating Disorder Inventory (EDI, drive for thinness, ineffectiveness and maturity fears); Bergen Social Media Addiction Scale (BSMAS); and The Proactive Coping Inventory. In this sample, 37.7% were at risk for ON. Eating disorder attitudes, regular sporting and social media addiction were the most relevant predictors of orthorexic tendency with drive for thinness being the strongest contributor (β = 0.54, p < 0.001). For young women with a special interest in healthy lifestyle, drive for thinness together with regular sporting, ON tendency may serve as a tool for achieving their goal. Social media addiction and other psychological problems (feeling of ineffectiveness or maturity fears) can also contribute to orthorexic rendency. It would be important to ask for support from qualified health professionals when changing nutritional practices. [ABSTRACT FROM AUTHOR]