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 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.

ABSTRACT Background Nutrition practices are increasingly moving online with the rise of digital health tools. However, the limitations of fully digital approaches demand hybrid solutions. Purpose The purpose of this study was to examine the effectiveness of phygital (physical and digital) nutrition approach, which blends physical and digital strategies, in improving dietary adherence among adults with obesity or overweight. Methods A total of 432 responses were analyzed, with a body mass index of more than 25. A quantitative and cross-sectional research design was used. This design was used to measure variables in a systemic way, where statistical generalization is probable. Results The findings of this study show that behavior change is more likely to last when digital tools are combined with in-person support that helps individuals with obesity in promoting nutrition-related positive behavior change. Discussion The study indicates that combining in-person support with digital tools improves dietary adherence through strengthening self‑efficacy, whereas excessive dependence on digital delivery alone may decrease motivation. Translation to Health Education Practice This study guides Health Educators toward hybrid approaches in prevention of obesity. It also guides Health Educators to monitor digital overload, so that technology stays at the background as a support and human connection remains central.

ABSTRACT Background Time spent in physical activity (PA), sedentary behavior (SB), and sleep has distinct effects on health and may change across adolescence. Purpose To identify movement behavior (MB) profiles among adolescents and examine changes in profiles membership over one school year. Methods Students, part of the Movimente Program, self-reported time spent on sports and non-sports PA, recreational screen time (e.g. smartphone), and sleep. Latent transition analysis identified behavioral profiles and assessed membership transition. Results The sample included 609 adolescents (52.9% girls; age ± sd: 13.0 ± 1.01). Five profiles emerged: (1) “Inactive and unplugged” (n = 144; 23.6%), (2) “Sport practitioners” (n = 48; 7.9%), (3) “Smartphone users” (n = 230; 37.8%), (4) “Gamers” (n = 160; 19.0%), (5) “Non-sport Movers” (n = 71; 11.7%). Most adolescents (n = 458; 75.2%) remained in the same profile over time. A higher number of adolescents transitioned to profile (3) “Smartphone users” (n = 46) and profile (4) “Gamers” (n = 36). Conclusions Profiles reflected a blend of healthy and unhealthy behaviors, underscoring the complexity of MB patterns. Translation to Health Education Practice This study assists Health Educators in designing tailored interventions based on adolescents’ behavior trajectories, allowing them to target the behaviors most in need of change and ensuring school-based interventions are relevant, engaging, and effective.

ABSTRACT Background Individual differences in hope are associated with mental and physical health, academic achievement, and career success. However, little is known regarding how hope develops and changes over time. Theory and empirical evidence support the notion that central figures [parents, teachers, peers] are imperative for fostering hope in children/adolescents, although mechanism(s) for hope installment from central figures to youth is unknown. Purpose We hypothesized that behavioral engagement in school would mediate the relationship between various sources of school-related social support and changes in hope for adolescents. Methods This study utilized two-wave longitudinal data from a sample of 555 middle school students. Results Behavioral engagement fully mediated the association between perceived social support from teachers and hope, while behavioral engagement partially mediated the association between perceived social support for learning from family and changes in hope. Despite increasing involvement with middle school peers, peer support at school was not associated with students’ hope differences. Discussion Results imply that teacher and family support for learning promote hope in adolescents, partially, by facilitating school engagement. Translation to Health Education Practice Study results have implications for school and behavioral health professionals in promoting behavioral engagement, school-related social support and hope for adolescents.

ABSTRACT Background Energy drinks (EDs) are a broad category of beverages that typically include high levels of caffeine along with taurine, simple sugars, inositol, B vitamins, flavorings, preservatives, and acidity regulators. Purpose This study aimed to assess how the Theory of Planned Behavior explains energy drink consumption among college students in the Kurdistan Region of Iraq, examining the effects of attitude, subjective norms, and perceived behavioral control on consumption intentions and behavior, and the influence of past consumption on recent use. Methods This cross-sectional study was conducted among 726 participants at Raparin University between September 2025 and December 2025. Results The mean age of the students was 21.03 years (95% CI: 20.87, 21.18). Compared to non-consumers, student consumers reported significantly more positive attitudes, stronger subjective norms, and higher intention to consume energy drinks. Discussion The discussion emphasizes constructs of the Theory of Planned Behavior and energy drink consumption, situating the findings within a broader theoretical framework. Translation to Health Education Practice This study supports the role of health educators in monitoring behavioral trends, planning future programs, and assessing the success of subsequent health education initiatives within college settings by offering baseline data on energy drink consumption and its psychosocial correlates.