PurposeThe South Carolina Choose Well contraceptive access initiative launched a statewide media campaign, No Drama, in 2018. We evaluated the reach and effectiveness of No Drama and provided recommendations for future campaigns.DesignA convergent mixed methods design triangulated data collected between 2018 and 2021 from (1) surveys of women of reproductive age seeking care at Choose Well-participating clinics in South Carolina (n = 908); (2) interviews with clinic staff (n = 100); and (3) metrics about statewide utilization of the campaign.SettingCommunity - No Drama was implemented in communities across South Carolina. Clinical - Research data were collected at family planning (health department and federally qualified health center) clinics.MeasuresExposure to and reported effectiveness of the campaign in encouraging contraceptive appointments and contraceptive use were examined. Clinic staff perceptions of campaign strengths and areas for improvement were also explored.AnalysisModified Poisson regression models with Generalized Estimating Equations, and inductive coding with content analysis, were used to analyze survey and interview data, respectively. Contraceptive appointments requested through No Drama were examined.ResultsNo Drama produced nearly 22000 contraceptive appointment requests between 2018 and 2021. One-third of reproductive-age patients at Choose Well-participating clinics reported exposure to the campaign. Exposure differed by race/ethnicity and educational attainment of patients. Nearly half (46%) of exposed patients found the campaign very effective at encouraging contraceptive appointments. Perceiving the campaign as very effective in encouraging contraceptive counseling appointments and encouraging contraceptive use was associated with the frequency of exposure. Clinic staff reported that the campaign had widespread visibility and connected patients to clinics.ConclusionNo Drama reached a portion of its intended audience and facilitated access to contraceptive care among exposed people. Future campaigns may consider increasing the rate of advertisements, ensuring clear messaging, involving community partners in campaign design, and diversifying campaign materials and locations.

PurposeExplore correlates of interest in and use of non-evidence-based practices (e.g., supplements, home remedies) and glucagon-like peptide-1 (GLP-1s) for weight loss.DesignOnline cross-sectional survey.SettingHealthcare patients of a large academic health system in the Southeast United States.SamplePatients (N = 190) with BMI ≥30kg/m2.MeasuresInterest in and past use of non-evidence-based practices and GLP-1s for obesity, and psychosocial factors, such as distrust in pharmaceutical corporations, preference for naturalness (i.e., favoring approaches described as natural over conventional medications), and expected weight loss were measured.AnalysisBivariate associations and multivariable regressions.ResultsInterest in non-evidence-based practices was greater among women and Black/African American patients (P < 0.05) and positively associated with perception of social norms for use (P < 0.01) and weight loss expectations with use (P < 0.05). Past use of non-evidence-based practices was associated with greater pharmaceutical distrust (P < 0.05). Interest in GLP-1s was associated with lower education (P < 0.05) and naturalness preference (P < 0.01), and greater social norms (P < 0.001), weight risk perceptions, and weight loss expectations (P < 0.05). Past use of GLP-1s was associated with lower expected weight loss with GLP-1s (P < 0.05).ConclusionFindings can inform patient education to help steer patients towards evidence-based treatments and away from ineffective approaches.

This article argues that clinicians and researchers must apply the same evidence-based medicine (EBM) hierarchy to digital health interventions that they use for traditional treatments. When comparing interventions for the same clinical indication, evidentiary standards should not change based on delivery method - whether pharmacotherapy, psychotherapy, or digital therapeutics. The manuscript outlines the spectrum of digital health tools (Digital Health, Digital Medicine, and Digital Therapeutics) and examines the rigorous FDA approval process for digital therapeutics, which requires Phase III randomized controlled trials comparable to pharmaceutical standards. Using substance use disorder treatment as a concrete example, the article demonstrates the "evidence gap" between FDA-approved digital therapeutics with robust clinical trial data and unvalidated commercial apps that rely on testimonials or no published research. The framework extends to emerging artificial intelligence applications in therapeutic spaces. Finally, the article addresses systemic implementation barriers - including reimbursement uncertainty, limited provider awareness, and clinical workflow integration challenges - and practical considerations clinicians face when selecting digital tools, including cost-access trade-offs, engagement metrics, and professional liability concerns.

Although strategic partnerships are vital to improving health equity in underserved communities, multiple challenges often arise when developing successful partnerships. This article features a proven and practical 5Ps partnership model, which was shown to be effective in the work of the Maryland Area Health Education Center (MAHEC) health workforce programs. This 5Ps model - Probe, Participate, Present, Partner, and Praise - centers around key strategies including trust, shared purpose, and mutual benefits. By following these 5Ps, organizations can develop successful partnerships as described in the case studies on AHEC Scholars, Community Health Workers, and Healing Together Consortium/Certified Peer Recovery Specialists.

ObjectiveThe systematic review examined the efficacy of theory-based and culturally tailored physical activity (PA) interventions for Hispanic adults.Data SourceA systematic search of Medline, PubMed, ERIC, CINAHL, APA PsychInfo, and SPORTDiscus.Study Inclusion and Exclusion CriteriaStudies published between May 2018 and May 2023 were included if they targeted Hispanic adults, incorporated PA as a primary outcome, and were conducted in the United States.MethodsScreening followed PRISMA guidelines and protocol is registered in PROSPERO (CRD42025630372). Titles and abstracts were reviewed independently by two researchers. Full-text review and data extraction captured sample characteristics, theoretical frameworks, intervention strategies, PA outcomes, and measurement tools.Data Extraction1139 articles were scrutinized, and 21 studies met the inclusion criteria.Data SynthesisExtracted variables included demographic characteristics, theoretical frameworks, intervention strategies, physical activity outcomes, and measurement tools.ResultsOf the 21 included studies, 13 reported statistically significant increases in physical activity, often ranging from 54 to 146 additional minutes of moderate-to-vigorous physical activity per week. Interventions guided by theoretical frameworks, such as Social Cognitive Theory and the Transtheoretical Model, were more likely to demonstrate efficacy. Promotor-led and community-based programs yielded high engagement and improved outcomes, with some studies achieving step count increases of up to 9000 steps/day and 47% of participants meeting national PA guidelines. In contrast, 4 of the 6 studies lacking a theoretical framework showed no significant improvements. Common barriers included cultural norms, time constraints, and access limitations.ConclusionCulturally tailored and theory-based interventions, particularly those using promotores and community collaboration, are effective in increasing PA among Hispanic adults. Future research should prioritize larger sample sizes, integrate mixed assessment methods, recruit men and the elderly, and explore long-term sustainability. Expanding culturally relevant strategies can help reduce health disparities and improve outcomes in this growing demographic.

PurposeAmerican Indian and Alaska Native (AI/AN) peoples face disproportionate health risks. Understanding how AI/ANs seek out information can inform effective campaigns design that can help address these risks. We investigate preferred communication sources, health information seeking behavior (HISB), self-efficacy, perceived importance of health information, and prevention orientation of American Indians and Alaska Natives (AI/ANs).DesignWe administered a survey at 3 cultural events.SettingThe National Tribal Health Conference in Bellevue, the University of Washington Winter and Spring Powwows in Seattle.SubjectsParticipants (N = 344) of the survey included people from tribes throughout the US, particularly from northwestern tribes.AnalysisIndependent samples t-tests and ANOVAs examined differences in HISB. Frequency analyses identified preferred health information. PROCESS tested the relationship between perceived importance and HISB, and moderation from prevention orientation and self-efficacy.ResultsPreferred health information source were doctor (M = 3.5), the internet (M = 3.32) and friends/relatives (M = 3.11). Females demonstrated more HISB than males (P < .01). Individuals with a college degree or higher showed greater HISB (P < .001). AI/ANs living on reservations (M = 2.34, SD = 1.53) preferred newspapers for health information more than those in metropolitan (M = 1.64, SD = .13) or rural areas (M = 1.45, SD = .16, P < .05). Perceived importance is a robust positive factor that predicts HISB (b = .48, t(315) = 9.67, P < .001).ConclusionThis study offers advice for scholars and practitioners to design messages to increase accessibility of health information.

PurposeBowel cancer screening (BCS) is a critical preventive health measure. However, participation in BCS remains suboptimal in some populations. We aimed to examine the association between psychosocial factors and participation in bowel cancer screening among adults aged 45years and above in Australia.DesignProspective cohort study.Setting and sampleOur study utilised longitudinal data from four waves of the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, comprising 29 334 person-year observations from 11 315 individuals.MeasuresWe employed social connection, social isolation, and community membership as proxies for psychosocial factors and explored their relationship with bowel cancer screening participation.AnalysisWe performed descriptive statistics and random-effects logistic regression. The relationships were also stratified by age groups and gender to highlight heterogeneous effects.ResultsAfter adjusting for various confounding factors, our findings demonstrated that high social connection (adjusted Odds Ratio [aOR]): 1.14, 95% CI: 1.06-1.22) and community membership (aOR: 1.23, 95% CI: 1.15-1.32) were significantly and positively associated with participation in bowel cancer screening. Further stratified analysis revealed that this association was heterogeneous; the link between high social connection was significant for men (aOR: 1.17, 95% CI: 1.06-1.30) but not for women. Additionally, while community membership served as a significant predictor across all age groups, the positive association with social connection was evident in adults aged 45 to 59 (aOR: 1.13, 95% CI: 1.01-1.27) and those aged 60 to 74 years (aOR: 1.13, 95% CI: 1.09-1.36).ConclusionOur study highlighted the role of psychosocial factors in influencing participation in bowel cancer screening. Our results suggest that public health policies should prioritise initiatives that promote social engagement and strengthen community ties.

PurposeThis study aimed to examine physical activity levels, sleep quality, and musculoskeletal discomfort in university students during the academic and exam periods.Approach or DesignA cross-sectional comparative design was used.SettingThe study was conducted at a University.ParticipantsA total of 227 (n = 199 female) undergraduate students participated.MethodData were collected face-to-face using the Cornell Musculoskeletal Discomfort Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire-Short Form (IPAQ-SF) during both periods. Daily sitting durations and preferred study postures were also recorded. Data were analyzed using paired t-tests, with significance set at P < 0.05.ResultsDuring the exam period, musculoskeletal discomfort was highest in the back, lower back, and neck regions. PSQI scores showed worse subjective sleep quality, longer sleep latency, shorter duration, and increased disturbances during exams (P < 0.05). IPAQ-SF results indicated reduced physical activity and significantly increased daily sitting time in the exam period (P < 0.05).ConclusionUniversity students experience more musculoskeletal discomfort, poorer sleep quality, and decreased physical activity during exams. These findings highlight the need for preventive strategies during high-stress academic periods.