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Limited organizational capacity has hindered Extension's ability to address substance misuse in communities. To inform capacity-building efforts, we obtained Extension educator and health educator feedback on opportunities, challenges and resource needs using the Delphi technique. Opportunities included collaboration and partnerships with local entities. Stigma, inadequate resources, and limited knowledge and skills of educators were challenges. Top resource needs were updated youth curricula, funding, and clear guidance on what educators can do and what should be referred externally. Findings provide insights to educator perceptions and suggest additional training and resources needed to implement evidence-based approaches to address substance misuse.

Purpose: This project explains how students in a graduate-level health literacy and advocacy course can benefit from the design and development of a digital literacy data visualization. Additionally, this study seeks to look into the perceived worth of developing a lesson on digital literacy, health literacy, and data visualization to assist students in fulfilling the duties of Certified Health Education Specialists (CHES®). Methods: The pilot assignment and survey measured competencies based on CHES® Areas of Responsibility: Area IV: Evaluation and Research. Area VI: Communication. Graduate-level students enrolled in the courses (n = 23) were evaluated in the winter semester and spring quarter of 2023. Students responded to questions rating their proficiency and learning experience while participating in a digital literacy and health literacy assignment. Results: Fourteen students (61%) across the two levels started the survey. Ten students (44%) fully completed the survey. A majority of the students reported that at the conclusion of the digital literacy and data visualization assignment, they had a fundamental awareness (basic knowledge) of 10 of the 12 questions. Conclusions: Insight into the degree of proficiency in using data visualization was supplied by the benefit of developing a digital literacy, health literacy, and data visualization course to assist students in meeting the CHES® areas of responsibilities. Recommendations: Since the vast majority of people now receive information through digital media, public health educators must have the communication and technological skills necessary to disseminate fact-based knowledge that may help lessen health literacy access disparities.

The notion of what constitutes a high-quality work-integrated learning experience has received increasing attention in the literature, particularly over the past decade. To date, the definitions of high-quality work-integrated learning have been broad and there remains a need to understand how elements of quality can be operationalized, particularly in niche settings. This paper describes an approach to developing a high-quality work-integrated learning program drawn from the experiences of a team of tertiary academics in the field of rural health. The design approach and quality assurance methods of a rural work-integrated learning program are discussed, including some of the preliminary outcomes. This paper demonstrates the complicated and complex nature of designing work-integrated learning programs in rural health environments. It is intended that this work will provide guidance to others seeking to create similar programs in rural contexts.

Psychological crisis intervention is a critical aspect of mental health education. A case study is present on the psychological crisis resulting from academic pressure among graduate students and the use of the Satir model is proposed for crisis intervention. Additionally, there are recommended to strengthen life and frustration education for graduate students, emphasize the importance of training graduate tutors in mental health knowledge and skills, assist graduate students in improving their mental resilience, and enhance their interpersonal skills.

The cultural challenge of educating Haitian rehabilitation professionals was identified by a Canadian francophone university which collaborated in the implementation and organization of international internships. Ethical cross-border internationalization should ensure reciprocity for partners. With this as a central value and in a context of pedagogical resource scarcity in Haiti, an intercultural educational partnership involved Haitian and Canadian university students situated in their respective countries in a Problem-Based Learning (PBL) course. Teachers and students applied principles of decolonization of health pedagogy principles were applied by teacher and students throughout this cross-border virtual synchronous PBL course. The aim of this study was to determine the feasibility and to identify facilitators and obstacles to conducting a cross-border virtual synchronous PBL course and its perceived benefits in the development of professional competencies. Five Canadian students and five Haitian students, all volunteers, took part in a 3-week cross-border virtual synchronous PBL course. Deductive qualitative content analysis of the transcripts from a 120-minute focus group discussion held one week after the course and a logbook kept during the project was conducted. The criteria deemed important to successfully replicate this project relate to: 1) The attributes of the students and teachers involved; 2) pedagogical preparation activities; and 3) the use of multiple communication strategies and connectivity plans. In addition to the acquisition of course content not readily available in Haiti, the student interactions inherent in the PBL method supported the acquisition of competencies such as collaboration, communication, and change agent advocacy promoted by the Canadian association of occupational therapy which contribute greatly to strengthening the students' professional identity.

Experts in public health and education alike have long advocated for the engagement of youth in nature to foster movement, human-nature connectedness, and mental wellbeing. Physical and health education teachers in school-based programs continue to find a variety of ways to help their students be physically active in the natural environment due to the plethora of positive benefits. This paper describes a unit entitled Nature-Based Physical Activity in Pictures that utilized Photovoice to engage youth and foster human-nature connectedness.

Background: Layperson cardiopulmonary resuscitation (CPR) is an important skill with the potential to save millions of lives. However, CPR courses often require commercial, complicated, and expensive manikins. To increase access to CPR training worldwide at very low costs, Do-It-Yourself (DIY) devices may be a suitable tool for practising compressions. Objective: This scoping review is the first step in scoping and mapping the evidence on the effectiveness of DIY devices for laypersons learning adult CPR, along with defining gaps for future research. Method: This inquiry was structured by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search of 14 academic databases and popular media archives, with additional hand searches, identified academic reports and resources describing DIY compression device construction and/or implementation. Research studies were synthesized narratively, and the main characteristics of all resources were presented in a table. Results: Fifteen studies compared learning outcomes of CPR practice either pre-post DIY practice or between DIY and commercial manikins. Studies varied in the intervention (e.g., learning modality, time, manikin) and measurement, which precluded formal meta-analysis. Of the 55 different DIY devices described throughout all resources, 26 (47.3%) used plastic bottles for compression practice. Analysis of the resources revealed gaps in the current evidence base, such as a lack of clear assessment criteria, standardized procedures for comparisons, and sociocultural questions. Conclusion: This scoping review has identified a small number of studies which described different DIY devices for learning basic CPR skills to different extents. While there is a need for a more comprehensive search and full systematic review, the findings serve as a starting point for future investigations and support evidence-based choices regarding DIY manikins for teaching adult CPR.

This action research project is intended to determine the effects of Chromebook technology on student engagement in the secondary classroom. The study involved a classroom of first-year students enrolled in a health course. These students used Chromebooks for the first time as part of the one-to-one (1:1) initiative. Chromebooks were utilized as a part of the curriculum, incorporating daily lessons, teaching tools, applications, and various activities for student learning. Data collection methods included observations, teacher journals, and field notes. On-task and off-task behaviors were noted, and the results of the data analysis showed the level of engagement involved when using Chromebooks in the classroom. Levels of engagement were explored through a six-week study in a 9th-grade classroom comprised of 28 students using Chromebook one-to-one. Engagement included focus, interest, participation in the lesson and activity, and positive social interactions between the teacher and classmates. This action research investigation indicated that incorporating Chromebook technology into lessons effectively increased student engagement and motivation.

Purpose: Countries with unique developmental paths and cultural lineages display significant variations in their out-of-school education systems. In this landscape, Belarus, a vestige of the disbanded Soviet Union, illustrates a distinct out-of-school education system, profoundly shaped by both Soviet and European Union countries' influences. A meticulous examination and scholarly investigation into the Belarusian out-of-school educational framework could enable a more profound comprehension of the metamorphosis and transitions in the out-of-school education systems of nations that surfaced following the dissolution of the Soviet Union. This knowledge could subsequently render a more transparent understanding of the patterns guiding the evolution of global out-of-school educational systems. Design/Approach/Methods: This article focuses on out-of-school education in Belarus and discusses its development status and the following main characteristics: the dimensions of its historical development stage, legislative guarantee, essence and extension, training goals, and typical cases. Findings: Influenced by historical and geopolitical factors, Belarusian out-of-school education is found to embody the characteristics of both the Soviet Union and European countries. National resources are found to play an important role in the development of out-of-school education, effectively reducing the cost of education for families and shaping students' positive values. Originality/Value: This study analyzes both the history and the current situation of out-of-school education in Belarus and summarizes the country's successful experience in the development of out-of-school education. It can provide a positive point of reference for optimizing the public out-of-school education system in China and exert a positive influence on related educational reforms.

The Choose Health Action Teens (CHAT) program of Cornell Cooperative Extension engages teens to teach a nutrition curriculum to younger youth, with the goal of enhancing the leadership skills and health behaviors of the teen teachers. Due to COVID-19, an in-person CHAT program in New York City was converted to virtual and implemented online during Summer 2020. Twelve teens, mentored by eight college interns, taught youth virtually in their homes. Quantitative and qualitative assessments demonstrated improvement in teen leadership and facilitation skills and health behaviors, and suggest that converting this type of programming to a virtual environment can be successful.

4-H academics responded to the COVID pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

There has been marked progress in access to education, representation of women in leadership, sexual reproductive health, and gender-based violence as a result of gender equality initiatives. However, there is still a strong focus on interventions targeting girls only. Through the adolescents' lens, this study sought to establish if there is a preference for interventions targeting girls compared to boys in two urban informal settlements; and what benefits were realized from programming for both adolescent boys and girls enrolled in an after-school support program. We employed a thematic analysis approach to answer the research questions. Results showed that most interventions at the community and school levels tended to favor girls over boys despite both facing similar challenges. Some of the benefits of programming for both sexes included sharing academic knowledge; boys gaining knowledge and skills to enable them to be future champions of change; enhanced ability for the adolescents to keep away from social ills; better gains for the society; breaking the gender inequality cycle; and enhanced social-emotional skills. Evidence from this paper highlights that there is a need for program and policy stakeholders to consider gender-transformative approaches and interventions targeting both sexes to maximize gains in education, health, and well-being.

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

The staffing and outsourcing of the marginalised curriculum area Health and Physical Education (HPE) has been an area of growing concern, alongside rising concerns for the decline of students' health due to increased sedentary behaviour and mental health problems, yet there has been little research attention to the staffing and delivery of HPE in Australian schools. This article addresses that gap in understanding with analysis of data from a larger study examining positioning and implementation of HPE in schools. A mixed methods questionnaire was completed by 30% of government schools in New South Wales (n = 556) providing data on staffing, delivery and outsourcing arrangements. Findings suggested that specialist HPE teachers are not in-charge of teaching HPE; and the majority (67%) of schools outsource at least some HPE, with far-reaching impacts on curriculum coverage and student exclusion from lessons evident. Findings also suggested that students experience varied methods of delivery in Physical Education (PE), and Health Education (HE) lessons. Together, these findings raise questions regarding the assurance of quality and equity, with implications for future policy and practice and the health and wellbeing of school children.

Objectives: This study aimed to assess the impact of an educational intervention on middle-aged women's knowledge and behaviour regarding various aspects of a healthy lifestyle. Design: Quasi-experimental study involving 150 middle-aged women (divided into experimental and control groups). Setting: Participants were selected from health centres of Tehran, Iran. Method: Data collection included demographic information, knowledge of a healthy lifestyle and healthy lifestyle behaviour. Participants in both the intervention and control groups completed the questionnaires before and 2 months after the educational intervention. The intervention involved 10 minutes of face-to-face training followed by distribution of training booklets provided by the Ministry of Health in Iran. Statistical analyses were conducted using SPSS. Results: Within the intervention group, significant differences were observed in total healthy lifestyle knowledge and subscales for physical activity knowledge, anthropometry knowledge, healthy diet knowledge, and smoking knowledge, between the pre- and post-intervention periods. Other than for smoking behaviour, there was no significant difference in healthy behaviours pre- and post-intervention for the experimental and also the control group. Conclusion: While there was an increase in knowledge about healthy lifestyles following the intervention, this knowledge increase was not associated with a change in healthy lifestyle behaviours. Attention should therefore be given to other influences including socio-economic factors, mental health status, environmental factors, cultural influences, duration of the intervention and psychological factors if changes in healthy behaviour are to be achieved

This paper reports on the first phase of a longitudinal project investigating the perceived purposes that different stakeholders have for primary physical education (PE). In the study, the views of 19 teacher educators from seven countries across Europe were sought. While teacher educators may have some influence across the layers of an education system, little is known about this stakeholder group and their views about primary PE. Analysis of focus group conversations depicts that, while the teacher educators come from a wide range of contexts, their views on the purposes of primary PE were more similar than different. With primary PE in danger of disconnecting into different schools of thought, this finding is important because it suggests that more coherent and connected approaches have the potential to be developed. In line with most government policies from the seven countries, similarities focused on both an educational and outward-looking view of primary PE. Significantly, while the teacher educators recognised the key role of physical learning in primary PE, they also highlighted how children's social, emotional, and cognitive learning form part of an integrated view of primary PE. Teacher educators recognised the importance of primary PE expanding beyond the hall/gymnasium and into classroom, school, and community settings. However, some concerns were voiced about the influence of outsourcing and sport agendas that currently dominate. The views of these teacher educators offer a useful starting point for further investigation, particularly as they present the purposes of primary PE from both an integrated and educational perspective.

Anatomy outreach is a well-documented practice by many academic institutions, defined here as when anatomy-related services are provided to external communities. However, most of the current literature on this topic is largely descriptive, focusing on the 'what' of anatomy-related outreach, rather than the generalizable 'why' or 'how'. There exists no shared conceptual model of what anatomy outreach tries to achieve from the perspective of 'outreachers', and how anatomists support these goals. Thus, this study aimed to explore the comprehension of anatomy outreach as a social phenomenon in the anatomy education community. This qualitative research used constructivist grounded theory to explore the perspectives of anatomists with experience facilitating anatomy outreach. A total of 18 participants completed semi-structured interviews. Analysis resulted in the construction of nine broad categories of themes relating to anatomy outreach: "types of outreach," "specific activities," "goals of outreach," "subject benefit (why anatomy?)," "enablers," "challenges," "appraisal," "motivators/drivers," and "community perspectives from the immediate anatomy community and wider field" (Science, Technology, Engineering, and Mathematics (STEM) and health professions education (HPE)). These results were constructed into a conceptual model of anatomy outreach. The findings suggest that anatomists view the subject matter as a socially connecting experience that can engage a wide variety of individuals. The multimodal nature of anatomy, combined with teaching expertise, lends well to productive outreach. Most 'outreachers' do not have a strong understanding of the impact of their activities, however, and operate on a level of optimism that activities will support diversity, belonging, and health/anatomical literacy.

Embedding musicians' occupational health training in music education curricula is widely recommended due to the well-documented high prevalence of performance-related health problems (PRHPs) among musicians across their lifespan. A scoping review was conducted to examine the range of evidence from implementations of musicians' health education programs, regarding the maintenance of hearing, musculoskeletal, psychological, and vocal health, as well as injury prevention strategies to minimize the risk of PRHP. Eligible sources of evidence included published and unpublished studies reporting occupational health education programs (which may have incorporated information on physical or psychological health, exercise, or somatic movement training) implemented with pre-tertiary and tertiary music students and teachers. Studies reporting stand-alone psychological health education were excluded. Key characteristics from included studies were extracted and charted. Data charts outline commonalities across the reported results, including physical, psychological, educational, and behavioral change outcome measures. Out of 46 records included for data extraction, 35 reported programs with tertiary-aged music students, seven reported programs with pre-tertiary-aged music students, two reported programs with music teachers, and two reported systematic reviews. Reported benefits from this research with both pre-tertiary and tertiary music students suggest that musicians' health education and injury prevention strategies reduce self-reported playing-related pain and music performance anxiety. However, future implementation studies need to address identified challenges such as effective behavior change and the enablers and barriers to the long-term adoption of strategies for optimal music performance and health outcomes. This review highlights the need for further research into designing and embedding musicians' health education into all music training settings, including more implementations with pre-tertiary music students, as well as training to support the professional development needs of instrumental and vocal teachers.

Objective: Psychoactive substance use is prevalent among young people in Nigeria. However, the dearth of accessible and good-quality treatment for substance use disorders in Nigeria creates a treatment gap. This study evaluated the effectiveness of a substance use prevention education programme (SUPEP) for young people in Nigeria. Design: A quasi-experimental study using a pre- post-test was conducted. The experimental group (n = 100) and comparison group (n = 100) comprised students in four senior secondary schools. Data were collected using a validated self-report questionnaire and the WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) version 3.0. Paired sample t-tests, analysis of covariance (ANCOVA) and generalised and linear mixed models (GLMM) were used for data analysis. Setting: Two hundred young people aged 14-20 years prone to substance use participated in SUPEP in four secondary schools in Enugu State, Southeast, Nigeria. Results: Students' psychoactive substance knowledge and substance use attitudes in the experimental group (p < 0.001) improved significantly post-intervention. ANCOVA results showed that the mean psychoactive substance knowledge score increased significantly between the time points, F(1, 123) = 8.89, p = 0.003. In contrast, mean psychoactive substance use attitudes reduced significantly between the same time points, F(1, 123) = 12.390, p = 0.001. However, no significant difference between the groups was observed in the mean psychoactive substance use behaviour post-intervention. Conclusion: The school-based SUPEP increases psychoactive substance knowledge and improves attitudes. However, the intervention did not reduce substance use among adolescents.

Objectives: More than 2.5 million middle and high school students in the United States reported current use of e-cigarettes in 2022. With continued curiosity and initiation of e-cigarette use among youth, it is critical to explore new and innovative ways to communicate about the dangers of e-cigarettes. The purpose of this study was to determine youth never-user and ever-user interpretations of a novel, educational comic book, 'The Villainous Vape'. Method: A 43-question survey was distributed to a convenience sample of middle and high school students across Kentucky. Results: Of the 76 respondents, 85.5% (n = 65) reported having never using e-cigarettes and 14.5% (n = 11) reported having tried e-cigarettes at least once in their lifetime. Never-users were more likely to say that the comic book would be an effective method of e-cigarette education for their peers, compared with ever-users. In addition, never-users were more likely to report that the comic book deterred them from using e-cigarettes. Conclusion: Further research is needed to determine how perceptions of story-based education through novel comics affect young people's health decisions regarding e-cigarette use.

Objective: To explore the perspectives and practices of high school health education teachers implementing health literacy with a focus on the social determinants of health within the context of a concern for social justice. Design: Qualitative content analysis was used to assess high school teachers' accounts of the practices used to teach health education in line with their professional preparation, the Texas Essential Knowledge and Skills (TEKS) standards, the textbook(s) used and the district's health education curriculum. Setting: A large urban independent school district in southern Texas, USA. Method: Six high school health education teachers' interviews were analysed using the social ecological framework and a social justice framework to identify themes that aligned with the teaching practices used to facilitate critical health literacy. Results: Although teachers were unfamiliar with the term Social Determinants of Health, they were able to speak to the challenges that their students faced in everyday life. The need for support and the remedying of knowledge deficits were two important themes. Conclusion: Health education teachers often lack the preparation to teach about the social determinants of health in a manner that resonates with students' backgrounds. The current TEKS standards provide insufficient guidance, emphasising kinesiology, diet and movement over a focus on critical health literacy and the social determinants of health, resulting in a limited and inadequate curriculum for high school students.

Background: The most effective approach to food allergy management is to avoid consuming the specific allergens that trigger an allergic reaction. It is crucial to make school environments prepared for the potential of food allergic reactions, including anaphylaxis, which is a rare but documented outcome. The high prevalence of anaphylactic reactions in children makes food allergy and anaphylaxis management important topics in schools. Aim: This study aimed to determine the effects of food allergy and anaphylaxis management education on teachers' food allergy and anaphylaxis management self-efficacy and level of knowledge in Türkiye. Methods: This study used a random experimental design with a pre-test and post-test group. The study was conducted with 84 teachers who worked in kindergartens (school year prior to starting Grade 1) and primary schools in a city centre in eastern Turkey between September 2022 and January 2023. Data were collected through a socio-demographic form and the Food Allergy and Anaphylaxis Management Self-Efficacy Scale for School Personnel. Data analysis was performed using t-tests for independent groups, Chi-square tests and McNamara analyses. Results: The average age of the teachers was 31.08 ± 6.70 years, and the average years of experience in the profession was 6.68 ± 6.99 years. All the teachers wanted to learn about food allergy and anaphylaxis management, 59.5% did not know whether their schools had an emergency action plan for food allergy and anaphylaxis, 63.1% reported not having the necessary emergency treatment medicine for anaphylaxis in their school and 57.1% reported having no educated school personnel to administer the first intervention in case of a serious allergic reaction at school. While the mean scale score of the experimental group was 25.88 ± 7.26 before the training, it was 30.78 ± 6.98 after the training. While no differences were detected between the experimental and control groups' pre-test scale mean scores, the experimental group's post-test scale mean score was found to be statistically significantly higher (d = 0.79, p < 0.05). The results also indicate that the rates of providing correct responses to questions regarding what the most common symptom in a student with a food allergy is, and what the first intervention should be when a serious reaction develops in a student, increased significantly level. Conclusions: This study found that the health education given to teachers led to an increase in teachers' food allergy and anaphylaxis management self-efficacy.

Limited research on diabetes education and support implementation in Appalachia, which is a critical knowledge gap considering barriers to care, and high prevalence rates. The aim was to understand what each facility is providing regarding diabetes education and services within West Virginia. This study reports cognitive interview qualitative findings from a multi-methods study. Individuals were recruited through an online search to identify clinics, organizations, and hospital staff that provided diabetes education in the state of West Virginia. Eligible participants were individuals who facilitated and managed diabetes education and support in counties of West Virginia. The interviews followed an 11-item interview guide, approved, and reviewed by a practicing Registered Dietitian and Certified Diabetes Care Education Specialist in West Virginia. All qualitative data from the interviews were hand-coded using grounded theory, by two researchers. 15 participating organizations from the state of West Virginia were included and described three phenomena: Diabetes Education Implementation (differences in: evaluation measures, modality, delivery format, topical areas); Barriers to Care (staffing, lack of training, evaluation, loss of research partnerships and funding); and Facilitators to Care (community-based involvement, interdisciplinary collaboration, capacity building (trainings). There are concerns with program drift and "risky" adaptations such as inconsistent evaluative measures, lack of training for program facilitators, variety of delivery formats, and content material. Findings recommend more alignment in program delivery to better implementation. Further studies should assess patient experiences with implemented diabetes education programs in West Virginia to further support the current research findings.

It is important that educators understand how to adapt their health education lessons to ensure they are inclusive of all students. This article provides six strategies for teaching health education to students with intellectual disabilities, both in the classroom and in physical education class, to improve their health literacy.

Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations. Drawing on a mixed methods design, we explored consumer and community involvement practices in the design and delivery of health-related education using the capability, opportunity, motivation and behaviour framework (COM-B). In our results, we describe educator capabilities, opportunities and motivations, including identifying barriers and enablers to consumer and community involvement in health-related education. Educators have varying philosophical reasons and approaches for involving consumers and community. There is a focus on augmenting student learning through inclusion of lived and living experience, and on mutual transformative learning through embedding lived experience and co-creating learning. How these philosophical positionings and motivations shape the degree by which educators involve consumers and community members in health-related curricula is important for further understanding these educational partnerships within universities.

There is a high prevalence of adolescent girls with ovulatory menstrual (OM) dysfunction, which is associated with school absenteeism and mental health challenges. Low menstrual health literacy among this group has evoked calls to review OM health education. This qualitative study sought to explore gaps in current OM health education and to validate a holistic school-based OM health literacy program named "My Vital Cycles"®. Findings are based on 19 written reflections, six focus group discussions and three interviews conducted with 28 girls aged 14-18 years from 11 schools, and five mothers. Six themes compared current OM health education with "My Vital Cycles"®: understating health, comprehensiveness, resources, teaching, parents and cycle tracking. Future refinements to the program comprised: inclusion of the complete reproductive lifespan, use of visual media and developing a mobile application. These findings inform future research in a whole school approach, strengths-based teaching and changes in the health curriculum.

Background: In 2013, the Chicago Public Schools (CPS) district passed a policy requiring schools to deliver comprehensive sexual health education (SHE) to all K-12th grade students. A performance improvement case study was conducted in the 2019-2020 school year to evaluate the implementation of the policy and identify lessons learned to support implementation in schools. Methods: Key informant interviews were conducted with 11 school principals and 29 teachers to discuss SHE implementation at their school. Interviews were recorded, transcribed, and analyzed to assess school and classroom factors that affect implementation. Themes that cut across these factors were then identified and summarized by 2 evaluators. Results: The following themes were identified across key informant interviews: (a) principal prioritization of SHE helps ensure SHE is implemented, (b) the expansion of school and teacher capacity facilitates SHE implementation, and (c) the creation of accountability mechanisms in classrooms and schools fosters adherence to SHE policy. Conclusions: Principals play a crucial role in building capacity to deliver SHE and ensuring SHE accountability mechanisms are implemented in their school. CPS is using these findings to adjust technical assistance and resources provided to principals and SHE instructors.

Background: Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and their social validity (i.e., the feasibility, acceptability, and utility) is not yet known. Aims: We aimed to conduct a scoping study to determine: (1) the social validity and potential benefits of school-based suicide prevention interventions, (2) the perceived need for such interventions, and (3) barriers and facilitators to implementation. Sample and Methods: A total of 46 participants took part. Semi-structured interviews were conducted with mental health professionals (N = 8), school staff (N = 8), and parents whose children had experienced suicidal ideation/behaviours (N = 3) in England. Focus groups were also completed with children and young people (N = 27) aged 15-18 across three state secondary schools. Data were analysed using thematic framework analysis. Results: Three themes were identified: (1) the need for and importance of suicide prevention in children and young people, (2) schools as a setting for delivery, and (3) key components of suicide prevention programmes. Conclusions: Participants overwhelmingly agreed that there is a need for a greater and more consistent emphasis on school-based suicide prevention. School appears to be an acceptable location for suicide prevention, and participants felt discussions about suicide should begin at the start of secondary school. However, there are potential barriers that need to be considered, including tailoring for neurodiversity, challenging cultural/family beliefs and stigma, managing personal experiences of suicidal thoughts or previous bereavement from suicide, and a lack of existing training for school staff.

Despite research indicating evidence-based sexual health education results improved student outcomes, students with intellectual and developmental disabilities (I/DD) do not typically receive sexual health education. While school psychologists possess skills that could contribute to sexual health education for students with I/DD, there is no existing research on this topic. To address this, we conducted a survey of school psychologists in a state in the Southeastern United States regarding their attitudes, perceptions of social norm and self-efficacy, and training and familiarity in regard to sexual health education for students with I/DD. The survey's focus and design were guided by the Reasoned Action Approach. Data collection and analyzes addressed (a) the underlying structure and internal consistency of our survey's scales; (b) school psychologists' level of training, knowledge, and beliefs about implementing sexual health education programs with students with I/DD; and (c) the relationship between school psychologists' previous training, knowledge, and beliefs and their implementation of and advocacy for sexual health education for students with I/DD. Descriptive statistics, principal component analyzes, and multiple regression were used to summarize the data and address the research questions. Data from the multiple regression analysis indicated that a significant amount of the variance in participants' implementation/advocacy scores was explained by attitude, social norms, behavioral control/self-efficacy, and training/familiarity. Our findings suggest that school psychologists' engagement in implementation of and advocacy for sexual health education for students with I/DD can be influenced by level of training and knowledge and perceived capability and behavioral control.

Background: Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. The Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England, UK. Methods: The findings from a qualitative systematic review and a Q methodology study were triangulated. Framework analysis, in line with the SEM, was used to develop an integrated set of findings. Findings: Women with learning disabilities may lack knowledge of cancer symptoms, and cancer screening, as well as being scared about the process and getting the results. The attitudes of family and paid carers towards screening may influence women with learning disabilities' decisions as to whether screening is seen as favourable; support and training may ensure unbiased perspectives. Barriers were also associated with how cancer screening programmes are designed, such as postal invitations which assumes an ability to read. In addition, screening staff need to be aware of the general needs of people with learning disabilities, such as the benefits of easy-to-read documents. Lastly, multidisciplinary working is required so reasonable adjustments can be embedded into cancer screening pathways. Conclusion: This article highlights multiple methods to reduce the inequalities faced by women with learning disabilities, which can be achieved through reasonable adjustments. Embedding reasonable adjustments can support women with learning disabilities in making an informed decision and accessing screening if they choose to. This may result in women with learning disabilities getting a timely cancer diagnosis.

Background: Across the life course, women and girls with learning disabilities and their carers report difficulties in accessing information and support with menstruation, yet their experiences are often overlooked in initiatives to improve menstrual health and wellbeing. Our aim was to collaborate with women with learning disabilities to co-produce future research priorities in a UK context. Methods: We undertook a two-part scoping exercise to explore what is known about this topic from a life course perspective, beginning pre-menarche and extending to post-menopause support. This combined a rapid scoping review of the literature since 1980 with a stakeholder consultation where people with learning disabilities, family carers, advocacy groups and staff working across education, health and social care were invited to share their experiences of menstruation support. Findings: UK and international literature provided insight across five narrative themes. Seventy stakeholders took part in our consultation, enabling the identification of five key themes. Findings across both highlight examples of supportive practice and valued resources alongside enduring health inequalities and barriers to menstruation support faced by women and girls with learning disabilities across the life course. Conclusion: Our scoping exercise identified multiple gaps in research and practice, ongoing reproductive health inequalities and a need for improved access to peer support, resources and training that take a life course approach. The scoping exercise indicates the need for further empirical research on menstruation and learning disability, with a particular focus on collating people's lived experiences.

Behaviour change communication (BCC) remains a central component of the interventions used in the fight against malaria in Ghana. However, there is limited evidence of its effectiveness. This study evaluated the effects of BCC strategies on knowledge (symptoms, causes and prevention) and overall knowledge of malaria among Ghanaian women aged 15-49 years. The propensity score matching (PSM) approach and logistic regression were used to analyse data from the 2016 edition of the Malaria Indicator Survey (MIS). Women who participated in community-level education or heard/saw media messages on malaria, or both, had significantly more knowledge of the disease than women who lacked access to any of these mediums of communication. The effect of these strategies on women's overall knowledge of malaria is about 2% to 4% and is higher on their knowledge of the symptoms (3% to 6%) and prevention (2% to 4%) than the causes (2%). The combined effects of both mediums of communication are relatively higher than the effect of either of them as a single medium of communication. Further analysis showed that improved knowledge of the disease is associated with higher preventive measures taken by women for themselves and for their children. The results are more significant in rural and poor households than in urban and non-poor households. These findings underscore the need for the Ministry of Health and its partner institutions to adopt an innovative approach which combines the two strategies in intensively educating Ghanaians, and women in particular, on the symptoms and prevention of malaria, giving due cognisance to households' socioeconomic status and geographical location.

Kids SIP"smart"ER is a 6-month behavioral and health literacy intervention effective at reducing sugar-sweetened beverage (SSB) intake among middle school students and their caregivers in the rural Appalachian region. This exploratory mixed methods study utilized a convergent parallel design to assess participant acceptability of a school-based curriculum for students and a text messaging program for caregivers. Acceptability was assessed using surveys (873 students and 453 caregivers), five focus groups (34 students) and telephone interviews (22 caregivers). Quantitative data were analyzed descriptively, and qualitative data were content coded. On a 5-point scale, average quantitative survey acceptability ratings ranged from 2.7 to 3.3 among three student-rated questions and 4.1 to 4.2 among four caregiver-rated questions. Qualitative focus group findings suggested that students preferred curricular activities that were hands-on and involved social interaction, while caregiver interview results showed high acceptability of the text messaging program's design, including usability, content messages and personalization. Students and caregivers reported similar program benefits: increased knowledge of SSBs and health risks, increased awareness of SSB behaviors and support to make beverage behavior changes. Results from this study can be used to understand Kids SIP"smart"ER's effectiveness data, communicate the intervention's acceptability with stakeholders and plan for future implementation studies.

In a group randomized trial of 45 elementary schools, a whole-child health and wellness curriculum introduced as a regular part of the educational programming was compared to education as usual over 2 years with a 2-year follow-up. The curriculum focused on integrating multiple SEL skills--mindfulness, compassion, and physical awareness--with the intent to advantage developmental patterns for these skills, academic engagement, personal well-being, and student behavior. The program design and trial implementation were launched with end-use delivery and long-term sustainability as integral considerations. Effects were shown for several SEL skills and behavioral indicators previously robustly correlated to long-term outcomes. Effects were demonstrated more broadly in schools serving high-poverty communities, suggesting the impact was stronger where the need was greater. Results are interpreted regarding supporting school-based SEL, the potential of applying group randomized trials with end-use conditions of implementation, and the value of fitting innovation efforts to school system operations, mandates, and priorities for promoting sustainability.

Objective: Using the FAST (Face, Arms, Speech, Time) Heroes educational programme, this intervention sought to educate residents in a nursing home to recognise and recall the three main stroke symptoms and prepare them to act in an appropriate way, in the event of a stroke emergency. Design: Participatory action research. Setting: A nursing home in Northern Greece. Method: Fifteen residents (n = 15, aged 78-92, mean age = 86.6 ± 4.4) were enrolled and educated through a series of FAST Heroes activities, specially tailored for this new target population. Stroke awareness was measured before, after and 3 weeks post-programme implementation. Fourteen residents completed the programme. Results: Participants demonstrated significant increases in stroke definition, stroke symptom knowledge, appropriate course of action and emergency number knowledge after completing the programme. Notably, 64.3% of participants could accurately identify stroke symptoms, and all participants (100%) correctly knew to call an ambulance in case of witnessing a stroke; 78.6% of the participants correctly identified the European emergency number 112. In the follow-up period, knowledge gain was retained as residents scored significantly higher in three out of four sections of the questionnaire. Conclusion: This study is the first attempt to utilise the FAST Heroes educational intervention in target populations which hitherto have had limited or no access to such educational programmes. This initial intervention showed promising results and could form the basis for extension to a wider population.

Objective: Crack cocaine use has increased rapidly throughout Mexico, along with rising HIV and hepatitis C virus (HCV) infections among vulnerable groups. The Tirando Esquina: Interviniendo Muros de Salud (TE:IMS) project uses projection-mapping technology and is the first of its kind to reach and provide health education at an individual and community level to at-risk crack smoking populations in Mexico City. Setting: This intervention project took place in Mexico City. Design: A single-arm design was utilised. Method: The TE:IMS intervention used projection mapping, a community-based art form wherein 3-dimensional (3-D) images, videos and graphics are projected onto buildings in the community. A total of nine projection mapping episodes were projected and health promoters engaged individuals on the street to reinforce messaging and distribute safer crack kits. A sample of persons who use crack (n = 58) were recruited prior to the intervention to complete pretest-posttest evaluation questionnaires. Results: Findings provide evidence of initial effectiveness. Decreases pre- to posttest were found in weekly crack use (p < 0.05), sharing of paraphernalia (p = 0.002) and use of cans as pipes (p = 0.008), while increases were observed in the usage of Pyrex pipes (p = 0.002). While quantitative HIV knowledge assessments did not increase significantly, qualitative data suggest the intervention made a substantial impact on perceptions and knowledge of HIV among those who interacted with the health promoters and saw the projections. Conclusions: TE: IMS was successful in providing health education and harm reduction strategies at a community level to at-risk crack smoking populations in Mexico City. These findings provide evidence for the initial effectiveness of innovative education and harm reduction efforts in this population.

Objectives: Increasing childhood health literacy (HL) is a crucial means of improving health outcomes and reducing preventable deaths globally. Understanding how to best support children's HL development in schools is essential. However, identifying pedagogical strategies that develop children's HL relies on a fit-for-purpose measure. Currently, no universally accepted approach for measuring HL among children exists. The purpose of this paper was to propose and discuss how a curricular approach to assessing children's HL could provide a means to overcoming the challenges with existing children HL measures. Design/Methods: The discussion is framed by the key components of assessment -- outcome of interest, and collection, analysis and interpretation of data -- and is underpinned by contemporary HL and educational research. Setting: The Australian Curriculum is used to discuss the approach in practice. Results: A curricular approach to HL assessment suggests that HL assessment may work best when it is relevant to the child and their context, is integrated with other areas of the curriculum, allows children to demonstrate a wide range of HL skills and contains an element of open-endedness. Measurement could be guided by a rubric (underpinned by a taxonomy), and interpretation of scores consistently aligned with the learning intentions outlined in the curriculum. Conclusion: A curricular approach provides a contextually adaptive framework from which HL assessment tools for children can be developed

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

This paper reports on the design of a multimodal metalanguage developed by teacher education researchers to support pre-service teachers' understandings of critical literacy and critical health literacies in a changing communication landscape. The design of metalanguage constitutes the first stage of an ongoing transdisciplinary project, Multiliteracies Across Teaching Areas (MATA), which aims to design and implement cohesive disciplinary multiliteracies pedagogies across teaching areas of an initial teacher education (ITE) programme. The focus on metalanguage design is motivated by concerns shared by critical literacy scholars and scholars in health literacy to balance deconstruction of texts with actionable response through the 'deep moral grammar of narrative' Kindenberg and Freebody ("Australian Journal of Language and Literacy, 44"(2), 90-99, 2021). Such concerns also align with recent World Health Organisation calls for the use of solution-oriented literacies to empower communities. These sociocultural understandings of critical literacy and Kindenberg and Freebody's ("Australian Journal of Language and Literacy, 44"(2), 90-99, 2021) call to balance 'the analytical' and the narrative' in critical literacy practice provide the starting point for designing metalanguage for transdisciplinary research in Health and Physical Education (HPE) and English. We firstly review relevant models of the critical informing both subject areas to establish synergous understandings and then analyse expectations of critical practice in descriptions and elaborations of the HPE and English curricula. We provide an overview of the semiotic resources available for transdisciplinary conversations within the English curriculum with clarifying 'bridging' terminology informed by social semiotic descriptions. Through close analysis of four representative texts selected for critical literacy practice by English and HPE teacher educators in the MATA project, we demonstrate how such metalanguage was shared to build understandings of both critical analysis and actionable response. Along with analytical features to build and analyse issues according to disciplinary criteria, we show how stories are used to build rapport with their diverse audiences and to motivate their peers to take positive health action.

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.

Effective collaboration and teamwork skills are critical in high-risk sectors, as deficiencies in these areas can result in injuries and risk of death. To foster the growth of these vital skills, immersive learning spaces have been created to simulate real-world scenarios, enabling students to safely improve their teamwork abilities. In such learning environments, multiple dialogue segments can occur concurrently as students independently organise themselves to tackle tasks in parallel across diverse spatial locations. This complex situation creates challenges for educators in assessing teamwork and for students in reflecting on their performance, especially considering the importance of effective communication in embodied teamwork. To address this, we propose an automated approach for generating teamwork analytics based on spatial and speech data. We illustrate this approach within a dynamic, immersive healthcare learning environment centred on embodied teamwork. Moreover, we evaluated whether the automated approach can produce transcriptions and epistemic networks of spatially distributed dialogue segments with a quality comparable to those generated manually for research objectives. This paper makes two key contributions: (1) it proposes an approach that integrates automated speech recognition and natural language processing techniques to automate the transcription and coding of team communication and generate analytics; and (2) it provides analyses of the errors in outputs generated by those techniques, offering insights for researchers and practitioners involved in the design of similar systems.

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

Background: Return to school supports are recommended to facilitate adolescents' re-entry to school following a concussion. However, little is known as to what school stakeholders prefer for a return-to-school process. This study sought to describe the preferences of high school students, parents, and educators for a Return-to-School Framework for adolescents following a concussion. Methods: We conducted qualitative semi-structured, 1-on-1 or group interviews with high school students (n = 6), parents (n = 5), and educators (n = 15) from Calgary, Canada. Interviews aimed to describe participants' preferences for a Return-to-School Framework for students following a concussion. Interviews were analyzed using conventional content analysis. Results: We organized the data into 4 main themes: (1) purpose of the Return-to-School Framework; (2) format and operation of the Return-to-School Framework; (3) communication about a student's concussion; and (4) necessity of concussion education for students and educators. Implications for School Health Policy, Practice, and Equity: A Return-to-School Framework following concussion should be developed in consultation with families, educators, and students and supports should be tailored to each student. Conclusions: Participants preferred a standardized and consistent Return-to-School Framework including ongoing communication between stakeholders as well as feasible and individualized school supports.

Background: As summarized in this article, the widespread implementation of modern school health education (SHE) could become one of the most effective means available to improve the well-being of people in the United States and in other nations. However, the development and evolution of SHE largely remains unorganized, underdeveloped, and neglected by health and education agencies, policymakers, and the public. Methods: Essential to the development of any scientific discipline, scientists today use the word ontology to refer to efforts to organize knowledge in particular domains. A useful working definition of a scientific ontology is an explicit, formal specification of a shared conceptualization--a systematic set of shared terms and an explication of their interrelationships. Nine interdependent questions are outlined to help guide the development of an initial, broad, and actionable scientific ontology for SHE. Results: Whether and how we respond to these questions arguably will determine the future of SHE research, policy, practice, and equity in the United States. Conclusions: An initial ontology might help conceptualize, inform, and facilitate more systematic and strategic local, state, national, and international deliberations and actions to improve SHE.

Background: Pedagogical approaches that support young people's well-being and maximize their potential are among the "Journal of School Health" research priorities. A unique form of observational learning called biblioguidance could be a pedagogical approach. Methods: We, a team of researchers and teachers, implemented biblioguidance book clubs with 10th-grade health education students. While the initial focus was health literacy skills, we also aimed to generate psychosocial benefits. Those benefits are the focus of the current descriptive phenomenological research. A final book club reflection captured the benefits students received and documented their transformation. We randomly selected 42 reflections from the sample pool (n = 168) and coded them via descriptive document analysis. Results: The results indicate that the book clubs provided psychosocial benefits. Students identified with the stories and characters, gained insight into others' perspectives, lived experiences, and "ways of the world," and were, in many ways, transformed. Some students even experienced catharsis, citing hope, validation, and feeling less alone. Implications for School Health Policy, Practice, and Equity: Biblioguidance book clubs could offer an innovative pedagogical approach to advance students' psychosocial well-being and engage them as active participants in their own learning and health.

Objective: This paper forms part of a DigihealthPE project in which we have been working with physical education (PE) teachers to co-create critical and embodied digital health pedagogies. As part of the project, we invited PE teachers to mind map their personal engagements with digital health technologies. We aimed to explore the potential openings and opportunities (and limitations) within these maps for critical thinking and action. Method: Data were generated during a workshop with 12 PE teachers in Scotland. Informed by new materialism, we focus on the human and non-human factors and intra-actions evident within six narrative portraits generated from teachers' mind maps. Results: Our findings suggest that teachers were engaging complexly and extensively with digital health technologies, which we considered an opening for further critical work. Importantly, experiences of strong (negative) affect had the potential to transform engagements with digital health technologies. Conclusion: We conclude by exploring how the process of mind mapping helped us to see further opportunities for supporting teachers to engage critically with digital health technologies. We also argue that new materialist-informed critical practices in education may have transformative potential for helping teachers and pupils to engage critically with the moving body, technology and health.