ABSTRACT Background Cognitive anxiety and its associated physical symptoms are common among university students during exams. However, limited research has explored this issue within African higher education, particularly in Morocco. Purpose This study examined the relationship between cognitive anxiety and physical symptoms among Moroccan university students. Methods A cross-sectional correlational design was employed with 213 students from different academic levels. Data were collected using the Spielberger Test Anxiety Inventory (TAI). Reliability was evaluated through Cronbach’s alpha and McDonald’s omega. Analyses included Pearson’s correlation and simple linear regression using SPSS and JASP. Results The TAI showed good internal consistency (α = 0.870; ω = 0.866 for cognitive anxiety and α = 0.866; ω = 0.867 for physical symptoms). A strong positive correlation was observed between cognitive anxiety and physical symptoms (r = 0.673, p < .001). Regression results indicated that cognitive anxiety significantly predicted physical symptoms (β = 0.512, R2 = 0.453, F = 175.066, p < .001). Discussion Findings highlight the substantial physical impact of cognitive anxiety during exams. Translation to Health Education Practice Health education programs should include mental health support and stress-reduction strategies to enhance students’ well-being.

ABSTRACT Sudden Infant Death Syndrome (SIDS), often referred to as “crib death,” remains a leading cause of postneonatal mortality in the United States. This commentary synthesizes current guidance from the American Academy of Pediatrics (AAP) and public health resources to illustrate how an AI-powered avatar, paired with animation, can serve as an innovative patient-and-family education tool to promote infant safe sleep practices, counter misinformation, and support harm reduction. By grounding content in the Triple Risk Model and aligning with AAP 2022 recommendations, avatars can deliver interactive, culturally responsive education that addresses diverse literacy levels and emotional needs. Features such as conversational guidance, interactive prompts, and visual demonstrations can help caregivers understand and adopt safe sleep behaviors. This commentary discusses considerations for health literacy, cultural and linguistic accessibility, clinical integration, and barriers and facilitators to adoption, as well as strategies to ensure acceptability and feasibility. Proposed outcomes include increased caregiver knowledge and awareness, shifts in perceived benefits and risks, improved compliance with safe sleep guidelines, enhanced engagement, and robust safety measures. This approach leverages best practices in combating health misinformation while tailoring content to meet families where they are.

ABSTRACT Background The increasing prevalence of sedentary behavior in college and university settings highlights the need to explore alternative solutions, such as active desk. However, little is known about the impact of using active desks on other lifestyle habits, such as nutrition. Purpose To examine how cycling desks at light and moderate intensity affect energy intake and food preferences during academic tasks among university students. Methods Using a randomized crossover design, 18 university students completed tasks under three conditions: seated, light-intensity cycling, and moderate-intensity cycling. Energy intake was measured using an ad libitum buffet. Visual attention to food categories was assessed with eye tracking. Results The cycling moderate-intensity was associated with greater consumption of low-fat sweet foods, particularly sugar-sweetened beverages. Participants also showed increased fixation time on these items, although not statistically significant. Overall, there were no significant differences in total energy or macronutrient intake between conditions. Discussion This study contributes to the literature by demonstrating that while cycling desks do not significantly alter overall energy intake, moderate-intensity activity increases the consumption of low-fat sweet foods. Translation to Health Education Practice Findings suggest the need to integrate nutritional guidance when implementing active desk interventions on campus to support student health.

ABSTRACT Background Individuals use social media platforms and online forums to share personal and general health information, as well as interact with others who have similar health and medical issues. Purpose This study examines how social media health information exchange is related to interpersonal patient-health care provider (HCP) communication, health care discrimination, and trust in the U.S. health care system. Methods Informed by the social ecological model, we employed multiple linear regression to examine data from the Health Information National Trends Survey (HINTS) 7 (N = 5,195). Results For participants of color, both better interpersonal communication with HCPs and experiences of discrimination in health care interactions predicted more social media sharing and information exchange. However, higher trust in the U.S. health care system predicted less social media sharing and information exchange among participants of color. These associations were not observed among non-Hispanic White participants. Discussion Individuals who experience discrimination in the health care system and have low trust in the U.S. health care system might be more likely to engage in mediated communication about health, such as exchange health-related information. Translation to Health Education Practice Health Educators must consider how experiences of discrimination in the U.S. health care system intersect with patients’ likelihood to engage in information exchange with similar others online. It is uniquely important that HCPs and Health Educators incorporate culturally responsive approaches for working with populations who experience and/or are especially at-risk health care discrimination. Health Educators might use assessment tools or screening questions ahead of appointments to identify patients who have previously experienced prejudice and/or discrimination in health care settings or related to their health, especially related to their social media use.

ABSTRACT Background Adolescent smoking remains a significant public health challenge, particularly in low- and middle-income countries where prevention efforts are fragmented. Schools are strategic settings for health education, yet effectiveness increasingly depends on interactions with media, moral influences, and expert knowledge beyond the classroom. Purpose This study examined how adolescent anti-smoking communication is constructed, reinforced, and interpreted through interactions among schools, media, adolescents, moral actors, and health experts to develop an integrated health communication model. Method A qualitative study was conducted in Surakarta, Indonesia, in 2025 using focus group discussions and in-depth interviews with teachers, students, media practitioners, academics, health professionals, and religious leaders. Data were analyzed thematically to identify shared patterns. Results Schools shaped anti-smoking norms through curricula, activities, and institutional culture. Media reframed messages by linking health risks with moral values and future aspirations. Participatory communication increased adolescent engagement, while moral narratives complemented biomedical explanations. Expert involvement strengthened message credibility. Discussion Adolescent smoking prevention is strengthened when health communication operates as an interconnected, collaborative Pentahelix process. Translation into Health Education Practice Schools should function as hubs for participatory anti-smoking communication by collaborating with media, community leaders, and health experts to support scalable, culturally grounded prevention strategies.

ABSTRACT Background Campaign receptivity is critical in public education campaigns seeking to decrease e-cigarette use. Purpose This study explored the relationship between campaign receptivity, e-cigarette use, intentions to use, and campaign-targeted beliefs among young people. Methods Data were drawn from the Truth Continuous Tracker, a repeated cross-sectional survey of participants residing in the United States from a national online panel. Data were collected between September 2021 and October 2022 (N = 14,303; 15–24 years). This time frame corresponds to the launch of the truth mental health messaging campaign, “It’s Messing With Our Heads.” Results Results revealed a negative relationship between campaign receptivity score, past 30-day e-cigarette use, and intentions to use. Respondents with higher campaign receptivity had lower odds of past 30-day e-cigarette use (odds ratios ranging from 0.45 to 0.70) and intentions to use (odds ratios ranging from 0.34 to 0.60). Results also revealed a positive association between campaign receptivity and beliefs. Discussion Health Educators should design campaigns that influence e-cigarette beliefs and behaviors by emphasizing key aspects that shape the target audience’s response to health messages. Translation to Health Education Practice Tailoring e-cigarette prevention campaign messaging to the specific needs of the target audience may enhance receptivity, thereby influencing e-cigarette beliefs, use intentions, and patterns of use.

ABSTRACT Background Food insecurity and insufficient physical activity (PA) are known diabetes risk factors, but their combined impact and food security’s moderating role remain understudied. Purpose To estimate the combined effect of food security and PA on diabetes diagnosis and test whether household food security moderates the PA and diabetes association. Methods This study analyzed 2022 NHIS data (n = 25,338) using descriptive statistics and logistic regression to examine diabetes prevalence and odds across four joint food security – PA exposure groups, and tested moderation through PA by food-security status interaction terms. Results About 10.7% reported having diabetes. Diabetes was least prevalent among food-secure, physically active adults. Food-secure but insufficiently active adults had lower odds of diabetes than those who were both food-insecure and insufficiently active. However, the interaction between food security and physical activity was not statistically significant. Discussion Joint exposure highlights the compounded burden when insecurity co-occurs with low PA. However, meeting PA guidelines is linked to lower odds of diabetes, while household food security status has no significant interaction effect. Translation to Health Education Practice Pairing food insecurity screening and referrals with PA promotion and counseling can be integrated into clinical and community programs to minimize diabetes risk.

ABSTRACT Background Few studies compare instructional modalities’ effectiveness in identical health education programs. Purpose To compare the effectiveness of text message and in-person delivery of the Whole Body Approach (WBA) program in improving eating competence, physical activity motives, and self-efficacy for fruit and vegetable consumption among food pantry clients. Methods A non-experimental, comparative design was used to evaluate the WBA program. Convenience samples of Northern Illinois Food Bank clients included 147 text message group (TMG) participants recruited from My Pantry Express (2021), and 14 in-person group (IPG) participants recruited from the Winnebago Community Market (2022). Both 10-week programs addressed stress management, mindful eating, healthy body image, and enjoyable movement. The text message program was delivered from February to April 2021, and the in-person program was delivered from February to April 2022. Independent and Paired samples t-tests compared post-intervention outcomes for participants completing pre- and post-surveys. Results IPG showed significantly better outcomes than TMG in eating competence (p < .05) and physical activity motives (p = .004). No significant differences were observed in fruit and vegetable self-efficacy. Discussion In-person delivery yielded superior outcomes for eating competence and physical activity. Future research could explore hybrid delivery models. Translation to Health Education Practice This study informs health educators on how to design, implement, and evaluate health promotion programs in the community settings, emphasizing how the mode of program delivery can influence outcomes.

ABSTRACT Background In older adults with type 2 diabetes (T2DM), a decline in oral function can cause frailty and other issues, such as poor mental health and cognition. An intervention strategy that promotes oral self-care behaviors is needed to maintain oral function. Purpose This study aimed to examine the effects of an oral self-care education program on older adults with T2DM. Methods Sixty older adults aged 65 years or older with T2DM were included. The program included an oral health lecture and oral exercises held monthly for three months. The effects were evaluated one month after program completion. Results Frailty, oral dryness, oral diadochokinesis, dental floss use, and cognitive function improved significantly at follow-up compared with those at baseline. Multivariate logistic regression analysis revealed that poor adherence to oral exercise daily at home was significantly associated with frailty. Discussion The program had a positive effect on the oral condition and changes in the frailty status in older adults with T2DM. In addition, the program may contribute to better oral self-care behaviors and cognitive function. Translation to Health Education Practice Health educators need to understand the effect of oral function on older adults with T2DM and support participation in appropriate self-management behaviors.

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.