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The article discusses a common-sense approach for librarians in activating their intelligence in assessing and using artificial intelligence (AI). Cited are the ways on how they can sift through the challenges posed by AI and create a balanced approach drawing on the strengths of the library, and seven things that librarians should consider in supporting and helping people they serve activate their intelligence using AI as a tool.

Research indicates a positive relationship between physical literacy and healthy aging; however, there is no consensus on the components required to become a physically literate adult. The objective of this study was to understand how physical literacy for adults with chronic conditions is characterized from the perspective of healthcare professionals. Physiotherapy leaders and physical literacy researchers within North America were invited to an online consensus panel and presented with questions related to physical literacy and rehabilitation. A nominal group technique was used for idea generation, clarification, and ranking. Confidence and safety with movements, motivation and commitment to physical activity, the ability to self-monitor changes in function, and understanding the benefits of physical activity were key components when defining physical literacy. There is a need to reconceptualize physical literacy to include the rehabilitation needs of adults living with chronic conditions, and to design programs that promote physical literacy to enhance function and mobility. [ABSTRACT FROM AUTHOR]

Limited research into professional rugby union players' experiences of seeking formal support for their mental health exists, despite comparable rates of mental health issues among elite rugby players with the general population. This qualitative study explored professional players' actual experiences of accessing Rugby Players Ireland's mental well-being service, via separate focus group discussions with professional players (n = 5) and player development managers (n = 4) who refer players into the service. An inductive reflexive thematic analysis identified three themes detailing players' (a) journey to disclosure of their mental health difficulties, (b) their expectations and engagement with the well-being service, and (c) participants' reflections on mental health experiences in a high-performance environment. Embedding mental health as a key component of player development in high-performance environments, improving mental health literacy, normalizing mental health experiences, and encouraging help-seeking would help promote player well-being and support holistic development alongside sporting performance. [ABSTRACT FROM AUTHOR]

Representation matters and contributes to student engagement, sense of belonging, and overall success. This is especially true for our most vulnerable student populations, which include transgender and non-binary students who do not often see themselves represented within the structure of the academic institution. While university-wide initiatives to engage students such as first year seminars are important, so too are smaller scale efforts such as creating representation through the use of teaching materials and exercises in courses and information literacy sessions. When discussing representation for the LGBTQ + community, and especially transgender and non-binary parts of that community, it is important to acknowledge that within this larger group, there are any number of intersectional identities impacting individuals' sense of belonging, support, and access to success, all of which cannot be addressed in the space of this column or in the time it takes to run an information literacy session. However, that does not mean we, as educators, should not try. [ABSTRACT FROM AUTHOR]

Teacher librarians (TLs) play a central role in developing students' information literacy capabilities, which are vital for effective participation in formal education and active engagement in society. This research enhances insights into information literacy instruction in Australian secondary schools, by investigating the perceptions of practicing TLs regarding the information literacy needs of teachers and students. This article presents the groundwork for this investigation, employing a phenomenological approach and discussing findings from an initial survey. The study will inform TL education and improve current information literacy education practices, addressing the demand for nurturing 21st century skills embedded in the Australian Curriculum. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although uncertainties exist regarding implementation, artificial intelligence-driven generative language models (GLMs) have enormous potential in medicine. Deployment of GLMs could improve patient comprehension of clinical texts and improve low health literacy. OBJECTIVE: The goal of this study is to evaluate the potential of ChatGPT-3.5 and GPT-4 to tailor the complexity of medical information to patient-specific input education level, which is crucial if it is to serve as a tool in addressing low health literacy. METHODS: Input templates related to 2 prevalent chronic diseases-type II diabetes and hypertension-were designed. Each clinical vignette was adjusted for hypothetical patient education levels to evaluate output personalization. To assess the success of a GLM (GPT-3.5 and GPT-4) in tailoring output writing, the readability of pre- and posttransformation outputs were quantified using the Flesch reading ease score (FKRE) and the Flesch-Kincaid grade level (FKGL). RESULTS: Responses (n=80) were generated using GPT-3.5 and GPT-4 across 2 clinical vignettes. For GPT-3.5, FKRE means were 57.75 (SD 4.75), 51.28 (SD 5.14), 32.28 (SD 4.52), and 28.31 (SD 5.22) for 6th grade, 8th grade, high school, and bachelors, respectively; FKGL mean scores were 9.08 (SD 0.90), 10.27 (SD 1.06), 13.4 (SD 0.80), and 13.74 (SD 1.18). GPT-3.5 only aligned with the prespecified education levels at the bachelors degree. Conversely, GPT-4s FKRE mean scores were 74.54 (SD 2.6), 71.25 (SD 4.96), 47.61 (SD 6.13), and 13.71 (SD 5.77), with FKGL mean scores of 6.3 (SD 0.73), 6.7 (SD 1.11), 11.09 (SD 1.26), and 17.03 (SD 1.11) for the same respective education levels. GPT-4 met the target readability for all groups except the 6th-grade FKRE average. Both GLMs produced outputs with statistically significant differences (P

BackgroundPatients find technology tools to be more approachable for seeking sensitive health-related information, such as reproductive health information. The inventive conversational ability of artificial intelligence (AI) chatbots, such as ChatGPT (OpenAI Inc), offers a potential means for patients to effectively locate answers to their health-related questions digitally.ObjectiveA pilot study was conducted to compare the novel ChatGPT with the existing Google Search technology for their ability to offer accurate, effective, and current information regarding proceeding action after missing a dose of oral contraceptive pill.MethodsA sequence of 11 questions, mimicking a patient inquiring about the action to take after missing a dose of an oral contraceptive pill, were input into ChatGPT as a cascade, given the conversational ability of ChatGPT. The questions were input into 4 different ChatGPT accounts, with the account holders being of various demographics, to evaluate potential differences and biases in the responses given to different account holders. The leading question, "what should I do if I missed a day of my oral contraception birth control?" alone was then input into Google Search, given its nonconversational nature. The results from the ChatGPT questions and the Google Search results for the leading question were evaluated on their readability, accuracy, and effective delivery of information.ResultsThe ChatGPT results were determined to be at an overall higher-grade reading level, with a longer reading duration, less accurate, less current, and with a less effective delivery of information. In contrast, the Google Search resulting answer box and snippets were at a lower-grade reading level, shorter reading duration, more current, able to reference the origin of the information (transparent), and provided the information in various formats in addition to text.ConclusionsChatGPT has room for improvement in accuracy, transparency, recency, and reliability before it can equitably be implemented into health care information delivery and provide the potential benefits it poses. However, AI may be used as a tool for providers to educate their patients in preferred, creative, and efficient ways, such as using AI to generate accessible short educational videos from health care provider-vetted information. Larger studies representing a diverse group of users are needed.

Coaches' knowledge, attitudes, and beliefs about mental health—or mental health literacy (MHL)—affect teams' mental health climates and the detection, referral, and treatment of athletes' mental health concerns. Thus, assessing collegiate coaches' MHL, and factors related to its presence, is critical. Using the Mental Health Literacy Scale, 1,571 NCAA (National Collegiate Athletic Association) coaches were surveyed regarding their MHL and demographic and mental health experience factors. Overall, 99.9% of the coaches surveyed believe that athletes' mental health affected their sport performances. Through hierarchical regression analyses, coaches' exposure to mental health treatment, perceived helpfulness of mental health treatment, gender (i.e., woman), years coaching (i.e., fewer years), and current NCAA division (i.e., Division III) were significantly related to their MHL, explaining 15.5% of variance. However, coaches' race/ethnicity did not reach significance. Recommendations regarding increasing coaches' MHL and hiring appropriately trained and licensed mental health and sport psychology professionals are offered. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Health literacy is a critical health determinant, for which few computerized, self-administered assessments exist. This study adapted and tested the reliability of the Newest Vital Sign© (NVS) as a computerized, self-administered health literacy screener. METHODS: Phase one involved 33 participants to create response options for a computerized, self-administered NVS (C-NVS). Phase two was a randomized crossover trial to test the consistency of C-NVS and original, interviewer-administered NVS (I-NVS) scores in 89 participants. RESULTS: Linear mixed-effects regression model results showed a significant carryover effect (p

BACKGROUND: Interventions are needed to help people reduce exposure to harmful chemicals from everyday products and lifestyle habits. Report-back of individual exposures is a potential pathway to increasing environmental health literacy (EHL) and readiness to reduce exposures. OBJECTIVES: Our objective was to determine if report-back of endocrine-disrupting chemicals (EDCs) can reduce EDC exposure, increase EHL, and increase readiness to change (i.e., to implement EDC exposure-reduction behaviors). METHODS: Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 174) a report-back intervention. Participants used mail-in kits to measure urinary biomarkers of EDCs. The report-back of results included urinary levels, information about health effects, sources of exposure, and personalized recommendations to reduce exposure. RESULTS: EHL was generally very high at baseline, especially for questions related to the general pollution. For questions related to chemical exposures, responses varied across several demographics. Statistically reliable improvements in EHL responses were seen after report-back. For readiness to change, 72% were already or planning to change their behaviors. Post-intervention, women increased their readiness (p = 0.053), while men decreased (p = 0.007). When asked what challenges they faced in reducing exposure, 79% cited not knowing what to do. This dropped to 35% after report-back. Participants with higher propylparaben were younger (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02-0.003 and p = 0.001-0.003, respectively). After report-back, monobutyl phthalate decreased among the 48 participants who had valid urine tests before and after the intervention (p < 0.001). CONCLUSIONS: The report-back intervention was successful as evidenced by increased EHL behaviors, increased readiness to change among women, and a decrease in monobutyl phthalate. An EHL questionnaire more sensitive to chemical exposures would help differentiate high and low literacy. Future research will focus on understanding why men decreased their readiness to change and how the intervention can be improved for all participants.

Background: It is well established that emergency department (ED) crowding leads to worse health outcomes. Although various patient surveys provide information about reasons to visit EDs, less is known in terms of beliefs about EDs among the general population. This study examines public beliefs regarding accessibility and quality of EDs and their associations with social characteristics (gender, age, education, immigration background) as well as knowledge about emergency care services and health literacy.Methods: We conducted a cross-sectional study based on a random sample of 2,404 adults living in Hamburg, Germany, in winter 2021/2022. We developed eight statements regarding accessibility andquality of EDs leading to two scales (Cronbach’s α accessibility = 0.76 and quality of care = 0.75). Descriptive statistics of the eight items are shown and linear regression were conducted to determine associations of the two scales with social characteristics as well as knowledge about emergency care services and health literacy (HLS-EU-Q6).Results: Nearly 44% of the respondents agreed that “you can always go to an ED, if you do not get a short-term appointment with a general practitioner or specialist.” And 38% agreed with the statement, “If you do not have the time during normal practice hours due to your work, you can always go to an ED.” In terms of quality, 38% believed that doctors in EDs are more competent than doctors in general practice, and 25% believed that doctors in EDs are more competent than doctors in specialized practices. In the fully adjusted model, public beliefs about emergency care accessibility and quality of EDs were significantly associated with all social characteristics and knowledge of emergency care options with the strongest associations between knowledge and accessibility (β = −0.17; P < 0.001) and between education and quality (β = −0.23; P < 0.001).Conclusion: We found endorsement of public beliefs about accessibility and quality of EDs that can lead to inappropriate utilization. Our results also suggest that knowledge of different emergency services plays an important role. Therefore, after system-related reorganizations of emergency care, information campaigns about such services tailored to socially deprived populations may help alleviate the issue of crowding.

Purpose: To identify the relationship between periodontal health knowledge and oral health-related quality of life among Caribbean adults. Materials and Methods: A cross-sectional study was conducted in a representative sample from 3 Caribbean cities (weighted N = 1805). Participants completed a questionnaire on oral health knowledge, hygiene habits, and other practices, as well as the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The associations between knowledge and habits and OHIP-14 score and its tertiles were evaluated using negative binomial and multinomial logistic regression models, respectively, adjusting for confounders. Odds ratios and regression coefficients were reported. Results: Participants reporting none, little, and adequate knowledge about gum health had higher odds of being in the worst tertile for OHRQoL, compared to those reporting “good knowledge” (ORnone vs good = 2.38, 95% CI: 1.59– 3.54; ORlittle vs good = 1.82, 95% CI: 1.19–2.78; ORadequate vs good = 1.68, 95% CI: 1.11–2.57). Participants reporting toothbrushing ≥ twice/day were less likely to be in the worst tertile for OHRQoL, compared to those brushing less often (OR = 0.67, 95% CI: 0.48–0.92). Self-reported gum bleeding was associated with double the odds of being in the worse tertile (OR = 2.03, 95% CI: 1.60–2.58). Conclusion: According to the findings of this study, periodontal health knowledge is associated with reduced OHRQoL in Caribbean Adults. In addition, the frequency of brushing and the self-reported gum bleeding was related to a worse quality of life (QoL) level. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to develop, implement, and evaluate a 16-lesson integrated physical education program focusing on Indigenous games: Education, Movement, and Understanding (EMU). Method: The study aligned with current physical education, English, and mathematics syllabi and involved 105 children (9–12 years) from two primary schools (Awabakal Country, Australia; 2020). Children participated in sixteen 45–60 min EMU lessons over 8 weeks, with feasibility and preliminary efficacy outcomes assessed via mixed methods. Results: EMU was delivered successfully by the research team, with excellent student and teacher evaluations (M = 4.36–5.0 across 20 items). Improvements resulted for children's cardiorespiratory fitness (d = 0.37, p =.001), enjoyment of sport (d = 0.27, p =.024), physical self-perceptions (d = 0.27, p =.043), and academic achievement (spelling d = 0.91, addition d = 0.40, subtraction d = 0.53, and division d = 0.68). No significant changes in well-being or multiplication scores resulted. Conclusion: Our results provide support for the feasibility and preliminary efficacy of EMU as a beneficial and enjoyable integrated primary school physical education program. [ABSTRACT FROM AUTHOR]

Purpose: This prospective cohort study investigated the impact of online and hybrid teaching of university-required physical education on students' physical literacy-related correlates. To avoid the widespread pandemic, the university decided to offer courses online through video conferencing or via a hybrid mode. When compared with face-to-face instruction, these formats may intensely affect students' physical literacy journey during early adulthood. Methods: A group of 1,738 students (42% males and 58% females) aged 18.52 (±1.29) responded to a three-phase online survey in various courses. Results: The structural equation modeling determined that motivation and physical activity levels were negatively related to physical competence and knowledge and understanding. Further repeated-measure analyses recognized the interaction effect of amotivation. Results indicated that participants in the online teaching mode may experience a learning predicament over those in the hybrid one. Conclusion: Practically, the physical literacy teaching strategies in nurturing motivation and physical competence should be reinforced. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine pedagogies of teacher socialization for physical education teacher education candidates through the context of literacy integration. Method: We situated our data collection in qualitative case study methodology, emphasizing data from focus group interviews conducted during the final month of physical education teacher education candidates' programs. Results: We demonstrate three primary insights and/or adjustments to their perceptions about literacy integration in physical education settings: (a) Literacy integration should support physical education objectives, (b) literacy integration could be easily implemented in a myriad of ways and for different age groups, and (c) literacy integration can improve student learning and outcomes. Discussion/Conclusion: Extending current teacher socialization literature, we emphasize three factors instrumental in shifting physical education teacher education candidate subjective theories and beliefs: movement-oriented literacy activities, reflection, and experiential applications. [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]

BACKGROUND: Antenatal care (ANC) is critical to reducing maternal and infant mortality. However, sub-Saharan Africa (SSA) continues to have among the lowest levels of ANC receipt globally, with half of mothers not meeting the WHO minimum recommendation of at least four visits. Increasing ANC coverage will require not only directly reducing geographic and financial barriers to care but also addressing the social determinants of health that shape access. Among those with the greatest potential for impact is maternal education: past research has documented a relationship between higher educational attainment and antenatal healthcare access, as well as related outcomes like health literacy and autonomy in health decision-making. Yet little causal evidence exists about whether changing educational policies can improve ANC coverage. This study fills this research gap by investigating the impact of national-level policies that eliminate tuition fees for lower secondary education in SSA on the number of ANC visits. METHODS: To estimate the effect of womens exposure to tuition-free education policies at the primary and lower secondary levels on their ANC visits, a difference-in-difference methodology was employed. This analysis leverages the variation in the timing of education policies across nine SSA countries. RESULTS: Exposure to tuition-free primary and lower secondary education is associated with improvements in the number of ANC visits, increasing the share of women meeting the WHO recommendation of at least four ANC visits by 6-14%. Moreover, the impact of both education policies combined is greater than that of tuition-free primary education alone. However, the effects vary across individual treatment countries, suggesting the need for further investigation into country-specific dynamics. CONCLUSIONS: The findings of this study have significant implications for policymakers and stakeholders seeking to improve ANC coverage. Removing the tuition barrier at the secondary level has shown to be a powerful strategy for advancing health outcomes and educational attainment. As governments across Africa consider eliminating tuition fees at the secondary level, this study provides valuable evidence about the impacts on reproductive health outcomes. While investing in free education requires initial investment, the long-term benefits for both human development and economic growth far outweigh the costs.

ObjectiveDespite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic failure (DDF) and to identify patient-centered strategies to help reduce future occurrences of DDF.MethodsThrough social media recruitment, we conducted a screening survey, initial assessment, and 67 individual patient interviews to capture the effects of misdiagnosis, missed diagnosis, or delayed diagnosis on patient lives. Audio recordings of patient interviews were transcribed, and a hybrid thematic analysis approach was used to capture details about 4 main domains of interest: the patient's DDF experience, contributing factors, impact, and strategies to mitigate future occurrences.ResultsDental patients endured prolonged suffering, disease progression, unnecessary treatments, and the development of new symptoms as a result of experiencing DE. Poor provider communication, inadequate time with provider, and lack of patient self-advocacy and health literacy were among the top attributes patients believed contributed to the development of a DE. Patients suggested that improvements in provider chairside manners, more detailed patient diagnostic workups, and improving personal self-advocacy; along with enhanced reporting systems, could help mitigate future DE.ConclusionsThis study demonstrates the valuable insight the patient perspective provides in understanding DEs, therefore aiding the development of strategies to help reduce the occurrences of future DDF events. Given the challenges patients expressed, there is a significant need to create an accessible reporting system that fosters constructive clinician learning.

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

Context: The influence of several psychological characteristics on the willingness of athletes to report concussion behaviors has not been well explored. Therefore, the purpose of this study was to understand how athletic identity and sport passion predicted participants' willingness to report symptoms above what was explained by athlete demographics, concussion knowledge, and perceived seriousness of concussions. Design: The study was cross-sectional. Methods: Three-hundred and twenty-two male and female high school and club sport athletes completed survey measures of concussion knowledge, athletic identity, harmonious and obsessive passion, and degree to which athletes indicated they would report concussions and concussion symptoms. Results: Athletes scored moderately high on their knowledge of symptoms and other concussion information (mean = 16.21; ± = 2.88) and above the midpoint on their attitudes and behaviors toward reporting concussion symptoms (mean = 3.64; ± = 0.70). There were no differences between gender, t(299) = −.78, P =.44, and previous concussion education, t(296) = 1.93, P =.06, related to concussion knowledge. Results of a hierarchical regression indicated that after entering athlete demographics, concussion knowledge, and perceived seriousness of concussions, of the 3 psychological variables in the final stage of the model, only obsessive passion was a significant predictor of athlete's attitudes to report a concussion. Conclusions: Perceived seriousness of concussion, perceived threat to long-term health, and obsessive passion were the strongest predictors of athlete's willingness to report concussions. Athletes who did not believe concussions posed a threat to their current or future health, and those that held an obsessive passion for sport were most at risk for not reporting concussions. Future research should continue to investigate the relationship between reporting behaviors and psychological factors. [ABSTRACT FROM AUTHOR]

Purpose: To assess elite racewalkers' preparation strategies, knowledge, and general practices for competition in the heat and their health status during the World Athletics Race Walking Teams Championships (WRW) Muscat 2022. Methods: Sixty-six elite racewalkers (male: n = 42; mean age = 25.8 y) completed an online survey prior to WRW Muscat 2022. Athletes were grouped by sex (males vs females) and climate (self-reported) they live/trained in (hot vs temperate/cold), with differences/relationships between groups assessed. Relationships between ranking (medalist/top 10 vs nonmedalist/nontop 10) and precompetition use of heat acclimation/acclimatization (HA) were assessed. Results: All surveyed medalists (n = 4) implemented, and top 10 finishers were more likely to report using (P =.049; OR = 0.25; 95% CI, 0.06%–1%), HA before the championships. Forty-three percent of athletes did not complete specific HA training. Females (8% [males 31%]) were less likely to have measured core temperature (P =.049; OR = 0.2; 95% CI, 0.041–0.99) and more likely to not know expected conditions in Muscat (42% vs 14%; P =.016; OR = 4.3; 95% CI, 1%–14%) or what wet bulb globe temperature is (83% vs 55%; P =.024; OR = 4.1; 95% CI, 1%–14%). Conclusions: Athletes who implemented HA before the championships tended to place better than those who did not. Forty-three percent of athletes did not prepare for the expected hot conditions at the WRW Muscat 2022, primarily attributed to challenges in accessing and/or cost of equipment/facilities for HA strategies. Further efforts to bridge the gap between research and practice in this elite sport are needed, particularly in female athletes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Wildfire smoke exposure has become a growing public health concern, as megafires and fires at the wildland urban interface increase in incidence and severity. Smoke contains many pollutants that negatively impact health and is linked to a number of health complications and chronic diseases. Communicating effectively with the public, especially at-risk populations, to reduce their exposure to this environmental pollutant has become a public health priority. Although wildfire smoke risk communication research has also increased in the past decade, best practice guidance is limited, and most health communications do not adhere to health literacy principles: readability, accessibility, and actionability. This scoping review identifies peer-reviewed studies about wildfire smoke risk communications to identify gaps in research and evaluation of communications and programs that seek to educate the public. METHODS: Four hundred fifty-one articles were identified from Web of Science and PubMed databases. After screening, 21 articles were included in the final sample for the abstraction process and qualitative thematic analysis. Ten articles were based in the US, with the other half in Australia, Canada, Italy, and other countries. Fifteen articles examined communication materials and messaging recommendations. Eight papers described communication delivery strategies. Eleven articles discussed behavior change. Six articles touched on risk communications for vulnerable populations; findings were limited and called for increasing awareness and prioritizing risk communications for at-risk populations. RESULTS: This scoping review found limited studies describing behavior change to reduce wildfire smoke exposure, characteristics of effective communication materials and messaging, and communication delivery strategies. Literature on risk communications, dissemination, and behavior change for vulnerable populations was even more limited. CONCLUSIONS: Recommendations include providing risk communications that are easy-to-understand and adapted to specific needs of at-risk groups. Communications should provide a limited number of messages that include specific actions for avoiding smoke exposure. Effective communications should use mixed media formats and a wide variety of dissemination strategies. There is a pressing need for more intervention research and effectiveness evaluation of risk communications about wildfire smoke exposure, and more development and dissemination of risk communications for both the general public and vulnerable populations.

Background and Aim Health literacy and public awareness about common health problems are critical for individual and public health. The San Joaquin Valley (SJV) of California, home to four million people, is a medically underserved region with a lack of access to health resources, contributing to the region’s high prevalence of health concerns. In response to health education challenges in this region, our intervention aims to evaluate the effectiveness and feasibility of animated medical education videos in improving health literacy behavior by equipping high school students with medical knowledge to empower them to uplift their communities through informative outreach.Methods The intervention will involve the use of five-minute animated videos regarding relevant fundamental medical problems through the provision of age-appropriate health information given to all participating high school students (n=400) in Merced, CA. Relevant medical problems include health conditions endemic to the SJV, such as diabetes, asthma, and oral health. These conditions were selected based on public health data and interviews with public health experts in the region. The intervention will take place from January to March of 2024. The animated medical videos will be created based on information from federal government health agencies and will be peer-reviewed by physicians or health experts with relevant experience. The animated videos are based on the Health Belief Model, aiming to enhance perceived susceptibility, the severity of consequences, and the benefits of taking preventive actions. Effectiveness measures will include knowledge gained from the intervention and intention to engage in specific health behaviors. Feasibility measures will include accessibility of the materials, measured by perceived difficulty in understanding the video content.  To assess effectiveness and feasibility, we will employ a pre-and post-test design, where participants will be given a baseline questionnaire to assess their knowledge, attitude, perception, and behavior relevant to the medical topic. Students will then be presented with the video intervention, after which a post-test is administered using the same questions to assess post-intervention changes. Generalized mixed models will be used to analyze survey data.Results and Implications Results are expected in March. The findings will provide insights to educators and policymakers regarding the use of age-appropriate medical education resources and their potential benefits in medically underserved communities. We aspire to contribute valuable insights that may pave the way for innovative approaches to health education, ultimately empowering individuals in underrepresented communities with the knowledge needed to make informed health-related decisions.

Background: Patient health literacy (HL) affects health and wellbeing on both individual and population levels. The ability to receive, understand, manage and act upon health information can be positively influenced by nurses' use of HL strategies. This study examined the relationship between nurses' use of a HL checklist (intervention) and before and after patient HL scores, and the effects of frequency and types of strategies used in specialty consultations in Spain. Methods: This quasi-experimental, non-randomized study used the HLS19-Q12 to calculate HL scores for 149 patients. Calculations were performed both before and after a nursing intervention that consisted of using a HL checklist. Paired samples t-test assessed the difference between patient HL scores pre- and post-nurse intervention. Frequency analysis and Pearson correlation where used to examine frequencies of nursing HL strategies used and associations with HL scores. Results: The mean difference between the HLS19-Q12 scores before and after intervention was − 9.94, with a standard deviation of 11.50. There was a statistically significant effect of the intervention on HL score (t = -10.00, p < 0.001). No participant had HL classified as 'inadequate' after the nursing intervention. Verbal teach back method was the most frequent strategy used by nurses, and the use of a computer image was the most frequent visual aid. Conclusions: The use of a standardized HL intervention by nurses was shown to have a positive effect on patient general HL scores in specialty consultations in Spain. These results not only suggest that the use of a HL checklist can be an effective HL tool, but also reinforce the potential of nurses to make a positive impact on both individual and population health. Overall, these findings provide data that can be used by health systems, hospitals management, and nurse education programs to adopt strategies to improve patient HL and health outcomes, while potentially lowering costs and ineffective resource utilization related to inadequate HL. [ABSTRACT FROM AUTHOR]

Background: Health literacy has been linked to positive attitudes toward COVID-19 preventive measures among adolescents and young- or middle-aged adult populations. This study examined the relationship between health literacy and attitudes toward COVID-19 preventive measures among non-English speaking Korean American older adults and their caregivers. The study additionally investigated how sociodemographic characteristics were associated with attitudes. Methods: COVID-19 survey data was collected from potential participants for an ongoing randomized controlled trial involving both Korean American older adults and their caregivers in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347). Korean American older adults with normal cognition and their caregivers were allowed to participate in the survey. We used latent profile analysis to find unique clusters of participants with a similar pattern of responses to attitudes toward COVID-19 preventive measures. Based on the analysis, we employed multinomial logistic regression to investigate how health literacy and sociodemographic characteristics were associated with the clusters. Results: We found three clusters based on participant responses to COVID-19 preventive measures—Positive, Negative, or Mixed. Health literacy was not associated with COVID-19 related attitudes in the study sample. Men were 2.37 times more likely to be categorized as Mixed than having Positive Attitudes compared to women. The odds of a person living in the New York metropolitan area being categorized as having Mixed Attitudes compared to Positive Attitudes were also 2.67 times more than for a person living in the Baltimore-Washington area. Conclusions: Differences in attitudes toward COVID-19 preventive measures were found among sociodemographic variables but not health literacy. Investigating what information channels or methods drive perception of public health information such as COVID-19 may help identify effective dissemination strategies for non-English speaking Korean older adults. [ABSTRACT FROM AUTHOR]

The aim of this research is to evaluate the effect of visual education for the basic needs of people with disabilities on the health literacy and life quality of caregivers. The study sample comprised 268 caregivers evaluated in a pretest-posttest pattern. The data were collected using a Personal Information Form, the Health Literacy Scale, and the World Health Organization [WHO] Life Quality Scale-Short Form. Data were evaluated with the Wilcoxon test and Spearman correlation analysis. Following the education given to caregivers, an increase was determined in the Health Literacy Scale sub-dimension of information comprehension and in the WHO Life Quality Scale-Short Form sub-dimension of social relations. Thus it was seen that the visual education increased the health literacy and life quality of the caregivers. [ABSTRACT FROM AUTHOR]

Background: Since chronic kidney disease is highly insidious in the early stages, most diagnosed patients have already developed irreversible renal failure. There is a lack of effective implementation and standardization of health education management for patients with chronic kidney disease, and the impact of health education management on health information literacy is not yet known. Methods: This randomized controlled clinical trial was conducted from March 2022 to March 2023. A total of 130 patients with chronic kidney disease stage 3–4 were selected from a tertiary hospital in Zhuhai via a convenience sampling method and were then randomly assigned to intervention and control groups. The Health Information Literacy Questionnaire for Chronic Kidney Disease was used to assess the health literacy of the patients at month 0 and month 12. In addition, the renal function-related indices of the patients were measured before and after the intervention. The study adhered to SPIRIT guidelines. Results: There was no significant difference between the two groups in health information literacy, platelet count, estimated glomerular filtration rate, or albumin level. However, the intervention group showed a significant improvement in health behavioral status such as information acquisition, checkups, and physical activity. Subgroup analysis revealed that hemoglobin was significantly higher in non-employed patients than in the intervention group. There was a significant improvement in hemoglobin level after receiving health guidance in patients with intermediate education, and acquisition capacity and estimated glomerular filtration rate in the intervention group were lower than in the control group for patients with elementary education. Conclusion: Receiving health coaching helped to improve self-management behaviors and hemoglobin levels of patients with stage 3–4 chronic kidney disease. Education level is an important factor influencing the effectiveness of health coaching techniques. Trial registration: This study was prospectively registered in the China Clinical Trial Registry on November 10, 2021, with registration number: ChiCTR2100053103. [ABSTRACT FROM AUTHOR]

Background: First-year nursing students are at a critical juncture in their education. They are transitioning from laypersons to healthcare professionals, and students are frequently exposed to medical information in academic settings and through personal research. This exposure can sometimes lead to cyberchondria; improving health literacy and managing health anxiety are critical strategies for reducing the incidence of cyberchondria. Aim: Investigate the mediating effect of health anxiety on cyberchondria and health literacy among first-year nursing students. Methods: A cross-sectional correlational research design was used in this study. The study was conducted with 475 students in October 2023 during the first semester of the academic year 2023–2024. Results: Cyberchondria and health literacy levels were both moderate. In addition, the degree of health anxiety among first-year Nursing Students was mild, too. The results showed that the association between Cyberchondria and Health Literacy was partially mediated by health anxiety. Conclusion and implications: This study highlights the sophisticated relationship between cyberchondria, health literacy, and anxiety among first-year nursing students. It demonstrates that lower health literacy can lead to increased health anxiety, which in turn exacerbates cyberchondria. To mitigate these issues, it is essential to enhance health literacy and provide support for managing health anxiety within nursing education programs. By doing so, we can help nursing students navigate online health information effectively and reduce unnecessary health-related anxieties, promoting better educational outcomes and overall well-being. [ABSTRACT FROM AUTHOR]

Background: Patient education is a crucial strategy for promoting prevention and diabetes self-management since glycemic control achievement involves taking medications, medical nutrition therapy, physical exercise, and behavior changes. However, patient education programs are still barely implemented in low- and middle-income countries. This trial aims to investigate whether a lifestyle education intervention added to physical exercising is superior to sole physical exercising regarding functional capacity, disease-related knowledge, health behaviors, cardiometabolic health parameters, quality of life, depression, and diet quality in individuals with prediabetes or diabetes. Methods: Multicenter double-blinded randomized controlled trial with two parallel arms involving 12-week intervention and 6-month follow-up. The eligible individuals (≥ 18 years, living with prediabetes or diabetes, literate, no clinical decompensation and/or physical and/or mental limitations that contraindicate physical exercising, written physician permission for exercise, no cognitive impairment, no vision limitations for reading, no confirmed diagnosis of unstable coronary disease or heart failure, no pacemaker and/or implantable cardioverter-defibrillator, no complex ventricular arrhythmias, no intermittent claudication, no recent cardiovascular event or cardiac surgery, and no currently enrolled in a structured exercise program) were recruited from two Brazilian cities and randomized to either (1) an Exercise and Lifestyle Education Program (ExLE) or (2) an Exercise Program (Ex), which can be delivered on-site or remotely based on the participants' internet access and technology literacy. The primary outcomes will be changes in functional capacity and disease-related knowledge. The secondary outcomes will involve changes in health behaviors (health literacy, physical activity level, exercise self-efficacy, and medication adherence) and cardiometabolic health parameters (glycemic control, anthropometric measures, and cardiac autonomic control). Program adherence, satisfaction with the program, diabetes-related morbidity, and changes in quality of life, depression, and diet quality will be the tertiary outcomes. Assessments will occur at baseline, post-intervention, and after 6-month follow-up. Discussion: If superior effectiveness of ExLE compared to Ex program to improve the outcomes measures is found, this program could be delivered broadly in the Brazilian health system, especially in the primary care facilities where most individuals living with prediabetes and diabetes in our country are assisted. Trial registration: ClinicalTrials.gov, NCT03914924. Registered on April 16, 2019. [ABSTRACT FROM AUTHOR]

When parents are expected to play a significant role in the management of their children's health perioperatively, information overload for parents could have particularly detrimental consequences. Our study investigated information communication and overload in 380 parents of children undergoing any elective surgical procedure at our institution. Participants completed an online questionnaire and were asked to respond to a newly designed Information Overload scale based on a modified 5 item Cancer Information Overload Scale and an 8-item atrial fibrillation information overload scale. Nineteen respondents (5%) identified as Aboriginal or Torres Strait Islander. More than a quarter of respondents (n = 102, 27%) primarily spoke a language other than English at home. 56% of respondents (n = 211) indicated that neither themselves nor any of their children had undergone a similar surgery in the past. Most respondents disagreed or strongly disagreed with the majority of the 5-item Information Overload scale statements. University undergraduates had lower total information overload score on average (-1.63, p = 0.002). People who spoke a language other than English had higher total score on average (0.98, p<0.001). Semi-structured qualitative interviews including the BRIEF health literacy screening tool were conducted with 24 parents. 23 interviewees scored 17–20 points in the BRIEF health literacy screening tool, indicating they were able to read and comprehend patient education materials. Overall, parents were satisfied with the amount of information that they received. Very rarely did any parent complain of 'information overload'. Our results show that parents of children undergoing elective paediatric surgery are not suffering from information overload in general, but they do want more information on immediate and late postoperative recovery. [ABSTRACT FROM AUTHOR]

Background: Animation has promise for teaching complex health content through smartphone applications. However, smartphones have had limited use in Thailand for health literacy improvement among adults with chronic diseases. This study aims to explore the perceptions of adults with diabetes and/or hypertension resulting from 2D short animated videos for literacy against chronic disease that are available via smartphones. Methods: Four animated videos were initially developed based on clinical practice guidelines and nursing experience. Physicians, an expert in health education, and an animation team developed and revised scripts and storyboards of the animated videos. Lastly, videos were validated by physicians and health educators for content breadth and depth and by media experts for motion graphics and illustration. Each video presents a different situation in diabetes, hypertension, missing appointments, and obesity, ranging from 2.18 to 4.14 min in duration. The inclusion criteria were adults 35–70 years old with diabetes or hypertension who received care from primary care units. Thematic analysis was performed on the extracted data. Results: Twenty participants with a mean age of 58.4 years (SD 6.7; ranged 41–68) were focus-group interviewed. Three animation elements were assessed, including presentation, impacts, and suggestions. Participants had positive responses regarding the presentation (suitability of images and smooth motion graphics, short length of videos, simple language, understandable content, and clear sound) and impacts (recalling information, enhancing engagement, and motivating health awareness and behavior change). Suggested improvements were for a bigger font size for subtitles and considering the use of spoken text instead of on-screen text for recommendations at the end of the animations. Conclusions: Animated videos are acceptable for delivering health information. Pilot testing animated videos for promoting literacy against chronic diseases in adults with diabetes and hypertension is needed for optimal utility. [ABSTRACT FROM AUTHOR]