ABSTRACT Background The MENA region witnesses significant changes in lifestyle and dietary patterns. These shifts raise concerns about the potential impact on nutritional awareness and dietary habits, which can influence professional performance. Purpose This study assessed the relationship between nutritional awareness, dietary quality, and professional performance within the region. Methods A cross-sectional study relied on data collected from 967 individuals in various countries. The research focused on evaluating nutritional awareness, dietary quality, and their association with self-reported professional performance. Data analysis was done with SPSS. Results The analysis revealed a robust correlation between nutritional awareness, the quality of diet, and professional performance. Individuals with heightened nutritional knowledge demonstrated a propensity for making healthier dietary choices, positively influencing their well-being. This translated into enhanced job performance, emphasizing a positive association between nutrition-related factors and professional success. Discussion The findings highlight the importance of nutritional awareness and healthy dietary choices in promoting higher professional performance within the region. Translation to Health Education Practice The results of the present study reflect prospects for Certified Health Education Specialists (CHES) focused on the need for interventions promoting nutritional education to optimize the well-being and productivity of the workforce in the MENA region in evolving socio-economic landscape. By targeting individuals and workplaces, health educators can play a crucial role in this endeavor.

ABSTRACT Background Today, the intensive use of technology necessitates more research on cyberbullying and victimization among adolescents. Purpose The purpose of this study was to evaluate a proposed model of the associations between self-esteem, digital game playing, cyberbullying, and victimization in early adolescents. Methods A total of 312 early adolescents participated based on the criterion sampling method. The age range of the adolescents was 10–14 years (Mean = 12.63; SD = 0.60). Two-stage structural equation modeling was used to analyze the data. Bootstrapping analysis was used to test mediation effects. Results The findings revealed the serial mediating relations of digital game playing and cyberbullying in the association between early adolescents’ self-esteem and cyber victimization. Discussion The results emphasize the role of individual differences in adolescents’ self-esteem as a significant factor in cyber victimization. This relationship operates through the behavioral pathways of digital game use and cyberbullying. Translation to Health Education Practice Based on the research findings, health educators can encourage students in this developmental period to establish healthier relationships in the digital world and develop strategies to protect mental health. In this direction, health educators should aim to develop healthy digital gaming habits in students by considering the negative effects of digital game addiction on cyber victimization. For this purpose, educators can organize awareness-raising educational programs against digital game addiction and guide students in determining balanced play times

ABSTRACT Background Utilizing the Blue ZonesⓇ framework and the nine lifestyle factors that promote well-being with longevity, an interdisciplinary team of researchers examined protective factors and barriers to engaging in each of the nine lifestyle factors. Purpose To report on protective factors and barriers to improving three of the nine lifestyle factors – sense of purpose, stress, and connection. Methods Using a mixed-method approach, 185 residents living in a rural community in the mid-southern part of the USA participated in this study via e-mail and social media. Results Notable demographic factors including age were significantly associated with fewer obstacles to achieving purpose, reduced stress, and leaving the home regularly. Qualitative responses link disruptions from the COVID-19 pandemic and isolation to feelings of disconnect. Discussion Work, hobbies, and resilience were protective factors to achieving purpose, low stress, and connections. Translation to Health Education Practice Barriers (isolation and disruption) were salient during the pandemic. However, direct human interactions mattered in promoting belonging, having a sense of purpose, and reducing stress. Technologies should also be promoted as a necessary alternative in periods like COVID-19, to help communities and senior residents feel engaged and less lonely. Likewise, hobbies, and the resilience of local residents should be highlighted as sources of inspiration to promote healthy lifestyle practices that achieve low stress levels, good relationships, and a sense of purpose.

ABSTRACT Background Utilizing the Blue ZonesⓇ framework and the nine lifestyle factors that promote well-being with longevity, an interdisciplinary team of researchers examined protective factors and barriers to engaging in each of the nine lifestyle factors. Purpose To report on protective factors and barriers to improving three of the nine lifestyle factors – sense of purpose, stress, and connection. Methods Using a mixed-method approach, 185 residents living in a rural community in the mid-southern part of the USA participated in this study via e-mail and social media. Results Notable demographic factors including age were significantly associated with fewer obstacles to achieving purpose, reduced stress, and leaving the home regularly. Qualitative responses link disruptions from the COVID-19 pandemic and isolation to feelings of disconnect. Discussion Work, hobbies, and resilience were protective factors to achieving purpose, low stress, and connections. Translation to Health Education Practice Barriers (isolation and disruption) were salient during the pandemic. However, direct human interactions mattered in promoting belonging, having a sense of purpose, and reducing stress. Technologies should also be promoted as a necessary alternative in periods like COVID-19, to help communities and senior residents feel engaged and less lonely. Likewise, hobbies, and the resilience of local residents should be highlighted as sources of inspiration to promote healthy lifestyle practices that achieve low stress levels, good relationships, and a sense of purpose.

ABSTRACT Background Restaurant-based interventions are a promising strategy to improve community food environments and customer food choices. Purpose Describe the extent to which a restaurant-based program, Ochsner Eat Fit (EF), may influence healthier food choices, and identify factors associated with EF food item selection. Methods Cross-sectional intercept surveys with 608 customers in 34 EF restaurants. Results Of 608 respondents, 17.3% ordered an EF item. Of 307 respondents familiar with EF, 89.6% believed EF can help them make healthier food choices. Respondents who agreed the restaurant environment supported healthy choices were 3.4 times more likely to order EF than those who did not agree (95%CI:1.5–7.7, p = .003); African American respondents were 2.1 times more likely than White respondents (95%CI:1.1–3.7, p = .017); and customers trying to make dietary changes were 4 times more likely than those who were not (95%CI:1.2–13.1, p = .024). Discussion Customers believed EF can positively influence food choices. Race, desire to make dietary changes, beliefs about healthy foods, and perceptions of the restaurant environment were associated with food choices. Future programming efforts should consider increasing the number and promotion of healthy options to support healthy decision-making. Translation to Health Education Practice Findings can be used to inform the development of restaurant-based healthy eating programs.

ABSTRACT Background Although there are a growing number of studies investigating the benefits of music therapy interventions with patients diagnosed with cancer, few studies have taken an approach that specifically examines indices of perceived well-being in women with breast cancer. Overcoming these challenges can be an important step in the recovery process. Purpose The purpose of our study was to know the positive influence of responsive music therapy through gong sounds, emitted live, on different areas of well-being of women with breast cancer. Methods Four individual sessions of responsive music therapy with live gong sounds were conducted in which three women (M = 54; SD = 5.57) participated both in the music therapy program and in the completion of the Functional Assessment of Cancer Therapy – Breast (FACT-B) and a semi-structured interview with ad hoc designed questions about perception of qualitative aspects. Results The results showed that the music therapy sessions significantly improved, p = .043 < 0.05, various domains of perceived well-being in women with breast cancer. Discussion This article highlights several key benefits associated with music therapy and various indices of well-being in women with breast cancer, identifies the limitations of the study, and discusses the findings. It is considered necessary to replicate this practice in future studies that include a larger sample and age range over longer follow-up periods. Translation for Health Education Practice The text highlights the importance of considering music therapy as a complementary intervention in comprehensive cancer care programs, which may be relevant to health educators when considering intervention and support approaches for cancer patients. Health education interventions targeting the enhancement of cancer patients’ well-being should incorporate music therapy techniques.

ABSTRACT Background The dramatic increase in fast food consumption among students, particularly adolescents and children, over the past two decades reflects a significant shift in lifestyle, with nearly one-third of these young individuals consuming ready-made foods on a daily basis. Purpose This study aims to evaluate the effect of an intervention based on the Theory of Planned Behavior (TPB) in reducing fast food consumption among high-school students. Methods One hundred and sixty Iranian high-school students were randomly assigned to an intervention or control group in a pretest-posttest-follow-up field trial. The intervention comprised four, 45-min teaching sessions over 3 weeks. Fast food consumption beliefs and self-report practices were assessed at pretest, posttest, and follow-up using a validated scale. Data analysis included descriptive statistics analyses-tests and ANOVA tests. Results Findings revealed a statistically significant difference in the posttest between experiment and control groups in the major components of fast food consumption including behavioral beliefs (t = 5.1, p < 0001), evaluation of behavioral outcomes (t = 5.3, p < 0001), normative beliefs (t = 2.3, p < 05), motivation to comply (t = 5.5, p < 0001), control beliefs (t = 4.4, p < 0001), perceived power (t = 3.3, p < 0001), and behavioral intention (t = .68, p < 0001). Similar results were obtained in the follow-up stage. Discussion Results suggest a parent-teacher participation intervention effectively reduced fast food consumption among high-school students, impacting both cognitive and behavioral factors. This model offers potential for customization to promote healthy food intake in wider student populations and beyond the school setting. Translation to Health Education Practice According to our findings, several suggestions can be addressed. First, considering the crucial role of parents and teachers in shaping healthy food habits, future studies should always consider them as a key component of the training intervention. Second, parents and teachers should be trained on how to best transfer and express their knowledge to children and adolescents with regard to their disapproval of fast food consumption. As our findings show, students can perceive this disapproval and change their own attitudes accordingly. Third, future studies are recommended to use multilevel interventions to prevent students from consuming fast food. For both students and parents, we suggest adding more professionally designed visual and graphical messages (e.g. Infographics) or short video clips into interventions that could effectively demonstrate the differences between beliefs related to the consumption of fast food and healthy foods.

ABSTRACT Background Health literacy research in school gardening is lacking. Development of a psychometrically sound survey can fill this gap. Purpose The purpose of this study was twofold: 1) to develop and validate a Functional Health Literacy Survey for School Gardening (FHLS-SG), and 2) to determine the effect of health literacy on reciprocal determinism between the individual, environmental, and behavioral factors of school gardening. Methods 651 children in grades K-4 took the FHLS-SG with 31 questions about gardening and health literacy aligned to social cognitive theory. Results Cronbach’s alpha for 6 factors ranging from 0.69 to 0.84, and test-retest reliability ranging from 0.59 to 0.81 were statistically significant. Health literacy showed a small mediation effect (M) between vegetable eating behavior and the individual (M = 0.27) and vegetable eating behavior and the garden environment (M = 0.22). Health literacy had the strongest mediation effect (M = 0.36) between the garden environment and the individual. Discussion When classroom environment was used as a covariate, health literacy mediated all relationships between the individual, environmental, and behavioral factors with small to medium effects (p < .01). Translation to Health Education Practice Reciprocal determinism between individual, behavioral, and environmental factors was supported. Health literacy mediated all relationships with small to medium effects. The FHLS-SG can assess the mediating effect of health literacy on vegetable eating behavior within school garden environments.

ABSTRACT Background Health behaviors exhibit diverse characteristics and types, leading to health behavior theories with varied focuses. However, an integrated framework elucidating the intrinsic mechanisms of different behavior types is notably absent. Purpose This study aimed to establish such a framework offering a comprehensive basis for explanations and behavior interventions. Methods A systematic review and meta-synthesis of qualitative research concerning health behavior change and maintenance were conducted. Results A total of 556 records were identified and screened, with 170 meeting the inclusion criteria. Thematic synthesis, a form of meta-synthesis, generated 23 themes, with the qualitative relationships between them presented in a conceptual model, forming an integrated framework. Discussion This framework provides a dynamic and hierarchical platform that enables the interpretation and analysis of various health behaviors within a unified structure. Furthermore, the recognition of the dynamicity of constructs and the multiplicity of behavior routes offers certain implications for intervention design, including behavior setting guidance, immediate benefits provision, and behavior interactions utilization. Translation to Health Education Practice The study provides an integrated framework for health educators/promoters. It offers a comprehensive view of health behavior change mechanisms from multiple perspectives and provides insights for the design, implementation and evaluation of behavior intervention practices.