ABSTRACT Background Adults with spinal cord injury (SCI) often experience reduced cardiorespiratory fitness and physical inactivity, increasing their risk of secondary health complications and diminishing quality of life. Purpose This systematic review examined physical activity (PA) interventions aimed at improving cardiorespiratory fitness among individuals with SCI. Methods Five databases were systematically searched for randomized controlled trials published between 2014 and 2025. Eligible studies included adults with SCI, PA interventions lasting eight weeks or longer, and measured outcomes such as VO₂peak or VO₂max. Eleven studies met inclusion criteria and were assessed using a modified Jadad scale to evaluate methodological quality. Results Most interventions demonstrated significant improvements in cardiorespiratory fitness, with three reporting moderate effect sizes. Interventions were delivered across various settings, including laboratory, fitness facility, and home-based/virtual formats. Only two studies incorporated health behavior theory, and common limitations included small sample sizes, lack of fidelity assessments, and limited long-term follow-up. Discussion These findings support the utility of PA interventions in improving fitness outcomes for adults with SCI. Translation to Health Education Health educators can apply this evidence to develop accessible, theory-informed programs that reduce barriers, strengthen motivation, and promote long-term physical activity in rehabilitation and community settings.

ABSTRACT Background School-based physical fitness testing (SB-PFT), though widely utilized, continues to be a topic of debate over its utility and feasibility. Purpose A qualitative study among K-12 school personnel elicited information about challenges to and recommendations for SB-PFT implementation and explored perceptions of activity monitoring as an alternative or supplement to SB-PFT. Method Interviews conducted with 13 California public school personnel were transcribed and qualitatively analyzed to identify themes and select exemplary quotes. Results Whereas one-third of respondents were positively disposed toward SB-PFT, two-thirds were positively disposed toward activity monitoring. Thematic analysis yielded three benefits to SB-PFT and six challenges, compared to six benefits of activity monitoring and two challenges. The discrepancy was especially relevant to less active students. Discussion Participants were more optimistic about the use and importance of activity monitoring compared with SB-PFT. Activity monitoring as an alternative or supplement to SB-PFT deserves exploration. Translation into Health Education Practice This study yielded recommendations for implementing SB-PFT to promote youth physical activity. Recommendations include conducting multiple assessments during the school year, providing opportunities to practice the SB-PFT, and utilizing activity monitoring as an adjunct to SB-PFT. Teachers would benefit from clear guidelines for integrating physical activity monitoring into SB-PFT.

ABSTRACT Background Worksite health promotion programs may be helpful to modify lifestyles, particularly for staff working in stressful environments (e.g. hospitals). Purpose The present study aimed to assess the effects of a theory-based health education intervention to promote healthy lifestyles among hospital administrative staff. Methods A randomized controlled trial was conducted in which 70 administrative staff were randomly assigned to intervention and control groups. The intervention group participated in an educational program based on theory of planned behavior (TPB) principles over a 4-week period. At baseline and 1 and 3 months after the intervention, participant lifestyle was assessed. Results All lifestyle dimensions along with TPB constructs showed significant improvements from baseline to first or second follow-up in the intervention group. Adjustment of baseline differences in study variables showed significant improvements in both TPB constructs and lifestyle dimensions (4.1 < F < 26.1, p < .05) except for nutrition and spiritual growth at first follow-up and for physical activity and stress management at second follow-up. Discussion A TPB-based program may contribute to promoting a healthy lifestyle among hospital staff. Translation to Health Education Practice The study supports the constructive role for worksite health education specialists to direct and advocate for lifestyle changes among hospital administrative staff.

ABSTRACT Background Psychological well-being is a state of mental and emotional health where people feel happy, fulfilled, and satisfied with their lives. Social media addiction refers to compulsive and excessive usage of social media platforms to the point where it impairs a person’s relationships, everyday functioning, and general well-being. Purpose This study aims to understand the relationship of social media addiction with psychological well-being. Methodology Three hundred twenty-one college students were included in the cross-sectional descriptive study. The tool included three sections: demographic data, the Bergen Social Media Addiction Scale, and Ryff’s Psychological Well-Being Scale. Result Our results indicate that 6.2% of participants had high social media addiction and 19.6% had good psychological well-being. We identified a statistically significant inverse relationship between social media addiction and psychological well-being. Type of family was identified as a significant predictor of social media addiction. Discussion As social media addiction increases, psychological well-being decreases. Excessive use of social media should be managed to improve psychological well-being. Translation to Health Education Practice Proactive nursing interventions such as early detection and community education can help young individuals to reduce social media addiction.

ABSTRACT Purpose This study aimed to evaluate the effectiveness of an intervention based on health education in improving glycated hemoglobin (HbA1c) levels and anthropometric parameters in T2DM individuals. Methods This pilot study was conducted from February to May 2023 in a basic health unit (BHU) in Brazil. 15 participants with T2DM participated in the study. The participants received health education as part of the intervention. HbA1c, capillary glucose, and body composition parameters were measured. The chi-square and t-test were used for statistical analysis. Results The educational intervention reduced HbA1c levels and fat mass and increased lean mass. However, no significant differences were detected in the other variables. Discussion These findings highlight the positive impact of the intervention on the metabolic and cardiovascular health of the participants. Translation to Health Education Practice This study follows the competencies of the National Commission for Health Education Credentialing (NCHEC). The health education, with illustrative materials, and team training could be applied in other locations as an alternative to avoid complications and worsening of the DM2.

ABSTRACT Background U.S. adults with disabilities face higher mental health challenges and barriers to care. Limited evidence exists on how treatment, unmet needs, and barriers intersect. Purpose To identify factors associated with mental health treatment, unmet needs, and barriers to care among U.S. adults with disabilities. Methods Data from the 2015–2019 National Survey on Drug Use and Health (n = 37,214; weighted N = 48.7 million) were analyzed. Multivariable logistic regression models examined correlates of past-year mental health treatment utilization and unmet needs. Barriers were analyzed descriptively among those reporting unmet need (n = 6,923). Results Among individuals with disabilities, 28.9% reported receiving treatment in the past year, and 12.1% reported unmet needs. Women (AOR = 1.54), young adults aged 18–25 (AOR = 4.35), those with depression (AOR = 4.73), and alcohol abuse (AOR = 1.43) had greater odds of treatment receipt; similar patterns were seen for unmet need (all p’s < .05). Cost (47.2%) was the most reported barrier. Discussion Disparities in mental health care persist among minoritized racial/ethnic groups, younger individuals, and individuals with mental health or substance use disorders. Translation to Health Education Practice Health educators can address disparities by promoting affordable care, supporting service navigation, and designing culturally responsive, literacy-informed interventions. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI).http://portal.shapeamerica.org/trn-Webinars

ABSTRACT Although programs such as the National Diabetes Prevention Program (NDPP) have been implemented nationwide, participation rates remain low among many population groups. This commentary addresses this issue by applying the Purnell Model for Cultural Competence to examine practical barriers and opportunities for improving engagement in diabetes prevention. Using the model’s 12 domains, we explore ways to improve program relevance and accessibility. Key considerations involve showing respect for health-related beliefs, recognizing heterogeneity within and across groups, and considering the overarching factors that shape behavior. To strengthen the impact and reach of programs like the NDPP, we recommend tailoring educational materials to meet the needs of specific populations, partnering with community organizations, and building a public health workforce that is well-prepared and drawn from the communities it serves.

ABSTRACT Background Cervical cancer is among the most prevalent cancers in women, and improving health literacy is key to prevention. However, a validated, disease-specific assessment tool for cervical cancer literacy in Persian has been lacking. Purpose To evaluate the psychometric properties of the Persian version of C-CLAT. Methods This methodological study was conducted in 2025 with 400 women in Tehran. Following translation and back-translation, content and face validity were assessed. Construct validity was examined via Exploratory and Confirmatory Factor Analyses (EFA, CFA) and known-groups comparison. EFA used the Scree plot, Kaiser criterion, parallel analysis, and Principal Component Analysis (PCA) with varimax rotation. Reliability was evaluated using Cronbach’s alpha and the Intra-class Correlation Coefficient (ICC). Data were analyzed using SPSS v16 and EQS v6.4. Results The mean CVI was 0.95 and all CVR values exceeded 0.62. EFA revealed a three-factor structure – prevention/control, screening/knowledge, and awareness – explaining 45.36% of variance, confirmed by CFA (e.g. RMSEA = 0.05, CFI = 0.91). No significant age-related differences emerged, but scores varied by education. The tool showed strong reliability (Cronbach’s alpha = 0.81; ICC = 0.97). Discussion The Persian C-CLAT is a valid and reliable instrument for assessing cervical cancer literacy in Iranian women, supporting its use in educational planning and health promotion initiatives. Translation to Health Education Practice Assessment of cervical cancer literacy is a critical component of primary prevention and plays an essential role in designing and implementing intervention for mitigating the rising absolute burden of the disease. Focusing on the first domain of health education specialists’ responsibilities, this study develops and validates a reliable instrument to serve this purpose.

ABSTRACT Background US adults with disabilities report elevated rates of depression and chronic health conditions influenced by biopsychosocial factors. Purpose To examine how body mass index (BMI), chronic health conditions, and sociodemographic factors influence depression among US adults with disabilities. Methods Data from the 2020–2023 Behavioral Risk Factor Surveillance System (N = 305,633) were analyzed using logistic regression, moderated mediation, and machine learning to evaluate predictors of depression. Results Logistic regression showed increased depression odds associated with higher BMI categories (OR = 1.084–1.497), asthma (OR = 1.567), angina (OR = 1.148), heart attack (OR = 1.067), cognitive disability (OR = 4.089), and female sex (OR = 1.799). Conversely, older age (OR = 0.473), higher income (OR = 0.904), and self-employment (OR = 0.895) were associated with lower odds of depression. Moderated mediation showed significant BMI effects on depression mediated by chronic health conditions, with more substantial effects among females. The machine learning identified cognitive disability (66.7%) and age (15.0%) as leading predictors. Discussion Biopsychosocial factors influence depression, with cognitive impairments and socioeconomic disadvantage further compounding vulnerability. Translation to Health Education Practice Health education interventions must integrate obesity management, chronic health care, sex disparities, and disability accommodations to mitigate depression.

ABSTRACT Background Telehealth is a transformative tool for expanding healthcare access, yet population-level data on its use among people with disabilities are limited. Purpose To examine the national prevalence, associated factors, and motivations for telehealth utilization among U.S. adults with disabilities. Methods Data was drawn from the 2024 Health Information National TrendsSurvey (HINTS 7; n = 6,854). Multivariable logistic regression assessed associations between disability type, sociodemographics, healthcare-related factors, and substance use and telehealth utilization. Self-reported reasons for choosing telehealth were also examined descriptively. Results 27.1% of U.S. adults reported at least one disability, including 5.7% with hearing, 7.3% with vision, 12.7% with mobility, and 18.0% with chronic pain-related disabilities. 44.5% of adults with disabilities reported past-year telehealth utilization, with higher rates across all disability types except hearing. Utilization was positively associated with higher education, sexual minoritized identity, internet use, and electronic cigarette use. Common motivations included provider recommendation (27.6%) and convenience (19.1%). Discussion Findings highlight variation in telehealth utilization by disability type, structural and behavioral factors, and the critical role of healthcare providers. Translation to Health Education Practice Health educators should incorporate disability-specific needs and tailored strategies into educational initiatives and service delivery to advance equitable telehealth for individuals with disabilities. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars.