ABSTRACT Background Awareness that heart disease is the leading cause of death declined from 65% in 2009 to 44% in 2019 among women over the age of 25. It is unclear whether this decline has disproportionately affected Black women who have a higher risk of heart disease than White women. Purpose This study examined the possible race and sex differences among young adults regarding their awareness of heart disease as the leading cause of death, their concern about developing heart disease, and their motivation to improve their heart health and reduce their heart disease risk. Methods A cross-sectional survey was distributed to 404 young adults who were Black or White and aged 20 to 39. Results Racial disparities were not reflected in awareness or motivation to improve heart health or reduce disease risk. However, Black respondents reported lower levels of concern about developing heart disease compared to White respondents. Discussion A lack of concern may contribute to worse heart health among young Black women. This is alarming given that this population is disproportionately affected by heart disease. Translation to Health Education Practice Health educators need to tailor messaging and advocacy strategies to raise Black women’s awareness of their heart disease risk.

ABSTRACT Background In advancing best practices of diabetes empowerment education programs such as DEEPTM, capacity building in-network from systems theory underscores the importance of continual learning about program delivery among implementing organizations. Purpose As part of HEART ATX, a community health worker (CHW)-led initiative aimed at promoting health of at-risk populations in Texas, we examined the impact of DEEPTM on diabetes prevention and self-management practices and related factors among ethnically diverse adults, along with participant highlights and improvement recommendations. Methods A one-group pretest/posttest, mixed-methods design was implemented based on a pooled analysis of self-report data from DEEPTM classes implemented 2021–24. Results Participants (n = 336; 81.0% female; mean 59.6 years) reported significant increases in fruit/vegetables consumed (p < .001), food portion measuring and counting carbs (p ≤ .003), and physical activity (p < .001), and significant decreases in sugary drinks (p < .001). Significant improvements were also found in diabetes knowledge (p = .028) and perceived problems (p < .001). Class highlights included: participatory nature, goal-setting, and social support. Recommendations included: schedule flexibility, more experiential activities, and participants as change agents. Discussion Findings provide practice-based evidence of CHW-implemented DEEPTM for diabetes prevention and management among urban-based, ethnically diverse adults. Translation to Health Education Practice Highlights and recommendations represent promising best practices and future directions for diabetes health educators.

ABSTRACT Globalization has reduced barriers to communication, accelerating cultural diversity in school settings and increasing the need for culturally responsive health education. Food and nutrition are tightly linked to culture, religion, and socioeconomic context, and these influences shape adolescent learning and eating behaviors. Building from recent AJHE scholarship examining teacher experiences delivering school-based nutrition education in secondary classrooms in the United Arab Emirates (UAE), this commentary emphasizes practice implications for Certified Health Education Specialists (CHES). The commentary highlights how health education specialists can strengthen curriculum design, communication, and evaluation to support health literacy for diverse school cohorts. These practice considerations align with Health Education Specialist Practice Analysis III (HESPA III) competencies related to identifying determinants and social drivers of health and learning, engaging priority populations and stakeholders across program phases, tailoring messages to the audience and setting, and applying cultural humility in professional practice.

ABSTRACT Background Youth with behavioral health challenges, such as major depressive, generalized anxiety, or attention deficit disorders, often experience reduced health-related quality of life (HRQoL). Integrated care models grounded in the wraparound approach offer coordinated, family-centered strategies to address complex behavioral and physical health needs. Purpose This report details a Certified Health Education Specialist (CHES®)-led health education intervention within a wraparound-based behavioral health home (BHH) and explores its impact on youth HRQoL using the Pediatric Quality of Life Inventory™ (PedsQL™). Methods Since 2014, a BHH providing health education within a Wraparound-based care management system utilized the PedsQL™ 4.0 for internal program evaluation. Paired pre- and post-intervention data were reviewed to assess changes in physical (physical functioning), psychosocial (emotional, social, and school functioning), and overall HRQoL. Results Significant improvements were observed across all HRQoL domains following participation in Wraparound-based integrated care. Discussion Findings support the effectiveness of wraparound-based integrated care in improving youth well-being within behavioral health systems. Translation to Health Education Practice Health education and CHES® professionals played a fundamental role in this wraparound-based integrated care program. CHES® professionals are well positioned to develop, implement, and sustain holistic, integrated care frameworks that enhance HRQoL and strengthen responses to youth behavioral health needs.

ABSTRACT Background Colleges and universities are well-positioned to implement opioid overdose prevention programs due to their role in supporting student health. However, implementation varies widely and is shaped by leadership decisions. Purpose This study explored higher education leaders’ perspectives on opioid misuse and overdose prevention programming using an implementation science framework. Methods We conducted semi-structured interviews with 25 U.S. college and university leaders. Guided by the Consolidated Framework for Implementation Research (CFIR 2.0), data were analyzed using thematic coding to identify implementation barriers and facilitators. Results Four themes emerged: (1) Reframing overdose as “poisoning” and linking prevention to mental health services increased institutional support. (2) Implementation was driven by students, faculty, and external advocacy (e.g. state policy). (3) Cross-campus and community partnerships addressed resource gaps. (4) Institutions described a phased implementation process evolving from external support to “in-house” programs offering naloxone training and overdose education. Discussion This is the first multi-campus study to examine how institutional leaders approach overdose prevention. Results highlight a common implementation pathway and underscore the importance of shifting institutional narratives, leveraging advocacy, and fostering external and internal collaboration. Translation to Health Education Practice Findings inform strategies for developing and sustaining overdose prevention efforts tailored to college settings. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

ABSTRACT Background Distracted driving (DD) continues to significantly impact the lives of young drivers, including high school and college students, with over 10,000 lives being lost in 2022 alone. Purpose The study aimed to identify DD behaviors, perceptions of risk related to DD, and perceived effectiveness of simulators compared to PSA videos among a college student population. Methods Students were randomly assigned to either the PSA video group or the One Simple Decision simulator group where a pretest was completed followed by the intervention, posttest, and a final posttest 30 days after the intervention. Results Thirty days after the intervention, a regression of safer driving patterns and perception of risk were identified among both groups. However, the Simulator group had a greater perception of risk and greater knowledge of driving laws. Discussion Repetition of engagement in prevention strategies is necessary to maintain safer driving habits among younger drivers. Future research should identify the impacts of repetitive interactions through longitudinal studies assessing the effectiveness of reducing DD incidents. Translation to Health Education Practice High school and higher education systems would be ideal for implementing repetitious DD education and intervention strategies within curricula to help young drivers develop and sustain safer driving habits. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

ABSTRACT Background Emotional dysregulation, defined as difficulties in monitoring, evaluating, and modulating emotional responses in accordance with situational demands, has been increasingly linked to psychosocial functioning among university students. Purpose This study examined the association between leisure-time engagement, leisure satisfaction, physical activity, and emotional dysregulation among undergraduates in a Nigerian university context. Methods Using a cross-sectional correlational design, involving 446 students using stratified random sampling techniques. The Brief Emotional Dysregulation Scale (BEDS), Leisure Satisfaction Measure (LSM), and Physical Activity Questionnaire (PAQS) were used in data collection. Descriptive statistics were used to determine prevalence rates, while Pearson correlation, multiple regression, and moderation analyses were conducted using the Hayes PROCESS Macro to examine relationships among the study variables. Results The prevalence of moderate emotional dysregulation was 59.6 (20.1% reporting low and 20.2% reporting high levels). There was a positive relationship between leisure satisfaction and physical activity (r = .41, p < .01) and negative relationship between leisure satisfaction and emotional dysregulation (r = -.34, p < .01). Emotional dysregulation was also negatively correlated with physical activity (r = -.55, p < .01). Moderation analysis revealed that the positive influence of satisfaction with leisure on emotional regulation was enhanced by the promotion by physical activity (β = .72, p = .05). Conclusion The findings underscore the significance of structured leisure activities and regular exercise in promoting emotional stability among university students. Translation to Health Education Practice Interventions that encourage balanced leisure and physical activity would significantly help reduce emotional dysregulation, thereby improving students’ mental health and academic performance. These relationships should be further investigated in future research in different populations and settings.

ABSTRACT Background Universities are well suited for tobacco-free advocacy efforts; university tobacco policy can change social norms around tobacco use, reduce secondhand smoke exposure, and help prevent occasional tobacco users from transitioning to daily use. Purpose This study took place in 2019 at a Midwestern public regional comprehensive university as part of a campaign to update campus tobacco policy. Researchers sought to increase the visibility of tobacco waste on campus under the current policy. Methods Researchers invited undergraduate students to create collages using nonhazardous tobacco waste collected on campus and participate in focus group discussions about their experiences. After verbatim transcription, researchers conducted template analysis to identify key themes. Results Undergraduate students (N = 16) shared concerns about human health and the natural environment on campus. Though students were passionate about reducing tobacco use on campus, they were uncertain that policy changes would be effective. Discussion In addition to engaging students in advocacy, policy change, and research, collages were displayed on campus and via social media. Students were able to create art to express their feelings about tobacco use and contribute to successful efforts to update university policy. Translation to Health Education Practice Collage can be an effective way to elicit discussion and create powerful visuals to use in advocacy. Engaging young adults in policy advocacy as students and increasing their civic engagement may help them develop skills and self-efficacy for advocacy activities in the future.

ABSTRACT Today’s health education professionals are faced with a host of complex issues which are exacerbated by a polarized political climate. The public health challenges of our time invite us to develop creative strategies, interventions, and programs, and to enter into healthy and productive dialogue with legislators, colleagues, and those we serve. One tactic for engaging in these processes is utilizing the power of “and” in health education practice and policy. To that end, the purpose of this paper is to present a rationale for “and” and its use as a method for effective health education practice and policy and to provide specific examples for applying this method.

ABSTRACT Background Approximately 12% of U.S. adults have mobility limitations, a group that may be at increased risk for poor bone health. Despite the importance of bone mineral density (BMD) as an indicator of skeletal health, recent syntheses of how BMD has been examined in this population are lacking. Purpose To examine the literature regarding BMD among people with specific mobility limitations including spinal cord injuries (SCIs). Methods MEDLINE, PubMed, and CINAHL were searched for studies published between 2014 and 2025. Twenty-five studies met the inclusion criteria. Results Studies consistently reported lower BMD in people with mobility limitations compared to those without mobility limitations. People with higher severity and duration of disability had lower BMD. Physical activity exerted a positive influence on BMD. Limitations of studies examined included small sample sizes and underrepresentation of female participants. Discussion Evidence indicates consistently reduced BMD and elevated osteoporosis burden among adults with mobility limitations, with low BMD risk enhanced by severity and duration of disability and modifiable behaviors. Translation to Health Education Practice Findings support targeted screening, tailored physical activity promotion, nutrition and risk factor counseling, and advocacy for research and programs that adequately represent women and incorporate sex-specific assessment of bone health needs.