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.

ABSTRACT Background Yoga is increasingly recognized for its benefits in enhancing mental health and learning outcomes in educational settings. However, a bibliometric understanding of this research field remains limited. Purpose This study aims to map global research trends in yoga interventions in education through a bibliometric lens. Methods A systematic search of the Scopus database yielded 30 experimental studies published between 2000 and May 2024. Using VOSviewer and Biblioshiny, analyses included keyword co-occurrence, co-citation, bibliographic coupling, and three-field plots. Results The field shows a 15.76% annual growth, with the U.S. leading in publications and citations. “Yoga” and “mindfulness” were the most frequent keywords, linked with mental health, education, and well-being. Major contributors included Boston University and Illinois State University. Research focused primarily on students, with limited studies on teachers and parents. Discussion The findings indicate increasing academic interest but also highlight geographic and demographic imbalances and methodological constraints. Translation to Health Education Practice These insights support integrating yoga into educational health programs. Educators and policymakers can leverage this research to design inclusive, evidence-based interventions promoting holistic student development.

ABSTRACT Background Community-based interventions address barriers to physical activity (PA) by leveraging local resources and familiar environments. Purpose Evaluate the influence of a community-based intervention on PA behaviors in youth. Methods Youth (n = 147) and PA educators (n = 15) from community settings participated in Rec-Connect™. A pre/post mixed-methods approach assessed PA behavior through surveys. Educators tracked the implementation with logs to evaluate process indicators. Descriptive statistics summarized PA behavior and implementation. Paired Wilcoxon signed rank tests examined behavior changes, and youth PA frequency was compared to state-level data. A qualitative analysis explored the process indicators. Results No statistically significant (p < .05) PA behavior changes occurred; however, some values showed potential for change. Youth PA frequency was similar to state-level data across groups. Primary themes from educators were as follows: 1) Educators influenced participants’ PA rates and intentions, 2) Positive feedback loops changed PA mind-sets, and 3) Community partners increased effectiveness. Fidelity was high (≥80%) for 5 of 7 implementation elements. Discussion Health education interventions must integrate educator support, social connections, and local resource access, to influence PA participation in youth. Translation to Health Education Practice This initiative aligns with health education competencies through collaborative program development, implementation, and evaluation.

ABSTRACT Background Self-management is a key element in the treatment of type 2 diabetes mellitus, yet culturally relevant educational resources remain limited in Indonesia. The EduDiaCare module was designed as a structured program for diabetes self-management, grounded in the AADE7 Self-Care Behaviors® framework and adapted to the Indonesian cultural and clinical context. Purpose This study aimed to examine the content validity and acceptability of EduDiaCare prior to large-scale application. Methods Content validity was assessed by a multidisciplinary panel of ten experts who evaluated each activity based on relevance (1–4 scale) and practical utility (0–2 scale). The Item-Level Content Validity Index (I-CVI) and Scale-Level Content Validity Index (S-CVI/Ave) were calculated. Acceptability was evaluated through questionnaires and open-ended responses from five participants after completing the intervention. Results Results indicated that most activities achieved an I-CVI of 1.00, with overall S-CVI/Ave scores of 0.98 for relevance and 0.95 for practical utility. Expert consensus confirmed the validity of all activities. Participants reported high levels of clarity, comfort, and applicability, highlighting the importance of therapeutic alliance, narrative flow, and visual materials. Discussion Findings support the feasibility of EduDiaCare as a culturally tailored, theory-based educational tool. Future studies should evaluate its effectiveness in improving self-management and quality of life outcomes. Translation to Health Education Practice EduDiaCare provides a culturally adapted, theory-based diabetes self-management education module that can be used by health educators and practitioners to support structured, patient-centered education for individuals with type 2 diabetes in Indonesia.

ABSTRACT Background US college general health and wellness classes (movement-based or lecture-based) are employed to increase physical activity (PA) levels among students; however, it is unclear whether mental health outcomes differ by class type across a semester. Purpose This study explored perceived depressive and stress symptoms in PA-based classes and lecture-based classes across a semester. Methods A volunteer sample of students enrolled in general health and wellness classes at a large northeastern US university completed an online survey. Demographics, class enrollment, depressive symptoms via Center for Epidemiological Studies Depression Scale short-form (CES-D-SF), and perceived stress via Perceived Stress Scale-10 (PSS-10) were self-reported. Results Overall (n = 6327), both perceived depressive and stress symptoms increased significantly across the semester regardless of class type and gender identity. Mann–Whitney U tests demonstrated significantly higher depressive symptoms among both men and women enrolled in lecture-based classes at the end of the semester. This effect was not observed for perceived stress among men or women. Conclusion PACs may be a viable component of US college health promotion initiatives to reduce later-life chronic mental illness. Translation to Health Education Practice Colleges are uniquely positioned to advocate for PA-based courses for general education requirements to promote health and well-being.

ABSTRACT Social media platforms have become central to health communication, influencing how individuals access and interpret medical information. A notable innovation in this space is the emergence of medical avatars which are digital personas representing clinicians, patients, or AI-driven agents that deliver health-related content. These avatars leverage visual storytelling and interactivity to simplify complex concepts, foster trust, and enhance engagement, offering scalable solutions for health education and chronic disease support. However, their growing influence raises significant concerns regarding misinformation, ethical transparency, and data privacy. This commentary critically examines the opportunities and risks associated with avatar-led health communication across major platforms, including YouTube, TikTok, Instagram, Facebook, and X. It explores how avatars shape health literacy, patient expectations, and clinical encounters, while highlighting ethical challenges such as credential disclosure and informed consent. The paper also discusses implications for clinical practice, policy development, and research, emphasizing the need for evidence-based design and governance frameworks. Future directions include longitudinal studies to assess avatar efficacy, integration of clinical guidelines into avatar-friendly formats, and interdisciplinary collaboration to ensure equitable and trustworthy digital health communication. By addressing these complexities, medical avatars can advance health equity and informed decision-making in the digital age.

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.

ABSTRACT Background Food security (FS) is a major problem for colleges, with food insecurity averaging 20–40% among United States (US) college students. Yet few studies have explored campus food environments and their relationship with FS. Purpose This study assessed satisfaction of a medium-sized, southern US university’s students with the food environment on all 3 campuses, comparing FS status with satisfaction with the environment. Methods Food environment and FS surveys were emailed to all students. Satisfaction with aspects of campus food environments (accessibility of food; accessibility of healthy food; affordability; cultural acceptability) were evaluated using one-way ANOVA. FS status and its relation to satisfaction were explored. Factors impacting food selection were ranked. Results were shared with stakeholders. Results Among 617 students responding, students on the suburban campus reported greater satisfaction compared to smaller, urban campuses (p < .001 for both). Students with very low FS had overall lower satisfaction (p = .009). Stakeholder discussions led to developing potential policies and implementation of additional food options on campus. Discussion Smaller campuses may struggle more with making healthy, affordable food available to students. Working with stakeholders can improve campus food environments. Translation to Health Education Practice Health educators in higher education should work with stakeholders to promote availability and consumption of healthful foods. 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 March 2020 saw colleges and universities close their doors during the nationwide lockdown in response to the virus, SARS-CoV-2. Strategies to educate students while mitigating viral spread were utmost among stakeholders at universities. Purpose This study explores attitudes, behavior and communal responsibility related to mitigating COVID-19 spread on a university campus, using the Health Belief Model. Method A survey was randomly distributed to students and employees at a university campus using repeated cross-sectional design to compare COVID-19 attitudes, mitigating behaviors and communal responsibility. Results The study found that age, gender and race were factors in perceived severity and cues to action. Communal responsibility and higher perceived susceptibility and perceived severity increased the likelihood of engaging in mitigating practices. Discussion Mitigating behaviors were less practiced among those who had a need for social engagement, believed that infection was inevitable, or had pandemic fatigue. Translation to Health Education Practice A multi-pronged approach to health education in a pandemic should incorporate theoretical perspectives to understand motivators to prevent the spread of infections such as perceived susceptibility, perceived severity, cues to action, and communal responsibility. Such motivators are especially important for communities reliant on shared resources and social interactions, such as university settings.

ABSTRACT Background Subjective social status (SSS) and hopelessness are linked to anxiety and depression, yet research among undergraduates – particularly considering the COVID-19 pandemic – is limited. This study examined associations among SSS, hopelessness, depression, and anxiety during and after the pandemic. Methods Cross-sectional surveys were conducted at a Southeastern U.S. university in 2021 (N = 1,602) and 2024 (N = 972). Measures included anxiety (GAD-7), depression (PHQ-9), SSS (MacArthur Scale), and hopelessness (Brief-H-Neg). Higher scores indicated greater distress, social status, or hopelessness. Linear regression models assessed associations. Results In 2021, 82.3% reported moderate to severe depression and 63.0% anxiety. By 2024, depression rose slightly (83.0%) and anxiety increased to 70.3%. Mean depression scores increased (p <.0001), anxiety remained stable (p = .7712), hopelessness declined (p <.0001), and SSS improved (p <.0001). Hopelessness correlated positively with anxiety (r = 0.60) and depression (r = 0.53), while SSS correlated negatively with both (p <.001). Regression analyses confirmed that lower SSS and higher hopelessness predicted greater distress. Female and lower-income students reported higher distress. Translation to Health Education Practice Despite improvements in hopelessness and SSS, mental health concerns remain widespread, highlighting the need for targeted prevention and treatment strategies in university settings.