Objective: Transgender and gender-diverse (TGD) individuals face significant discrimination in healthcare settings, often avoiding necessary care due to anticipated bias. To foster inclusive environments, initiatives such as providers wearing pronoun badges have been proposed. However, limited research exists on the impact that health care providers using pronoun badges has on patient and provider experiences. Furthermore, the attitudes of medical students, who will comprise a large part of the clinical workforce in the coming years, towards pronoun badges remain unclear. This study aimed to explore medical student experiences and perspectives on using pronoun badges for a year of clinical work. Setting/Methods: Pronoun badges were distributed to 132 medical students at Harvard Medical School and, after a year of clinical work, students were surveyed about their experiences using the badges. Results: Of 132 eligible students, 65 [49.2%] responded; most respondents (59 [90.8%]) obtained a pronoun badge, and 48 [81.3%] of those who obtained badges wore them consistently. Among badge wearers, 45 [93.8%] planned to continue. An inductive thematic analysis revealed three themes in the responses: reasons to use badges (signalling allyship); reasons to abstain (concerns about patient misunderstanding or personal comfort); and impacts of badge use (fostering conversation). While some negative feedback was reported, most students viewed pronoun badges as effective allyship tools. Conclusions: Pronoun badges were well-received by medical students, with most finding them to be a meaningful way to create affirming clinical environments. The badges served as conversation-starters, signalling inclusivity to patients and staff. However, non-use by both cisgender and TGD students highlighted the importance of personal agency and safety in pronoun disclosure and highlighted the complexity of identity and allyship in medical settings. We suggest that institutions should offer, but not mandate, pronoun badges. While pronoun badges provide an early step towards building TGD-inclusive clinical environments, they must be coupled with broader institutional support for LGBTQ+ inclusivity.

Objective: University students are highly sedentary, increasing their risk of poor health outcomes. This study aimed to co-design and pilot a behavioural gain-framed nudge-based intervention to reduce university students’ sedentary behaviour by breaking up long periods of sitting every 30 minutes. Methods: Experienced-based co-design was used to conduct three workshops with university students and staff ( n = 11) to develop and create the intervention (UC30). A mixed-methods pilot pre-post study investigated the effectiveness of the intervention in a university cohort ( n = 60) over one semester. Semi-structured interviews (staff, n = 6; students, n = 3) and student survey responses ( n = 43) were used to determine the primary outcomes of acceptability and feasibility. The secondary outcome measure was self-reported sedentary time (Past-day Adults’ Sedentary Time-University questionnaire, minutes/day). Results: Co-designed resources were simple to implement for staff and informative and influential for students. The qualitative analysis revealed three themes relevant to both students and staff: ‘delivery mode’, ‘academic engagement’ and ‘education and impact’. Total self-reported sedentary time did not decrease among students; however, there was a 51-minute daily reduction (95% confidence interval: −121, 19) in sitting-for-study post-intervention. Conclusion: Co-designed behavioural nudge-based resources as part of learning activities to reduce sedentary behaviour in university students may be effective in reducing sedentary time during study, improving health and learning outcomes, indicating a larger trial is warranted. Trial registration: Australia New Zealand Clinical Trials Register (ANZCTR): ACTRN126210006698971, https://www.anzctr.org.au/ACTRN12621000669897.aspx Registered 2 June 2021.

Background: Participatory research with children has been long-standing and has provided a space for researchers to understand the everyday lives of children, but also, and more importantly, has emphasised the significance of doing research with, rather than on or about, children and keeping them in the centre of our thinking and research. While this is true in many places around the world, doing research with children experiencing violence, uncertainty and political conflict – although crucial – becomes more complex in such challenging contexts. The voices of children in these settings are often silenced, and children are rarely given opportunities to communicate their needs and have a say in decisions and interventions that affect their lives, well-being and childhoods. Objective: This reflective paper aims to explore ethical and methodological challenges in conducting research with children in contexts of violence, uncertainty and political conflict. In exploring these challenges, the paper offers reflections on both the benefits and challenges of using participatory research with children by exploring meanings of voice, listening and silence in these contexts. Methods: The paper draws on a qualitative research study conducted with minority-Christian and Muslim Arab children in Jerusalem to understand the meanings they attach to being well in a context of violence and conflict. Findings: By providing some reflections on doing research in contexts affected by violence, conflict and uncertainty, this paper emphasises the importance of listening to children and the ways in which creative but flexible, contextual and adaptable research methods can enable researchers to listen to, and engage with, children in complex contexts and provide spaces which support children not only to experience voice, but to find that voice.

Background: A growing body of research has indicated the importance of implementing community mental health initiatives in universities to promote student mental health and well-being. Designing and implementing community-based initiatives on campus can facilitate improved student well-being in a cost-effective way. Purpose: This paper provides a description of the implementation of a graduate-level university course grounded in a community mental health framework, which gave students the opportunity to become peer-mentors for other students within the university in exchange for course credit. Approach: The course took place over two semesters. In the first half of semester one, students engaged with theoretical and practical content that teaches them how to be a peer-mentor and support students’ needs. In the second half of the first semester, and over the course of the second semester, students used what they have learned to engage in experiential learning, where they acted as peer-mentors to their fellow university students. Conclusion: This university course provided mental health and well-being benefits to university students in a cost-effective manner while providing hands-on experience to students enrolled on the course to be peer-mentors. Implications: Experiential learning opportunities can be used to support student well-being while reducing the need for more specialist forms of mental health service provision.

Objectives: Although schools have an important role to play in preventing vape use, literature about teacher perceptions of vaping among students is limited. This study investigated teachers’ perceptions of student vaping in Australian secondary schools over a 12-month period. Design: Mixed methods design. Setting: Australian secondary schools. Method: We used quantitative survey data from secondary school teachers for three waves of the Generation Vape project from March–April 2022 to March–April 2023 ( n = 1,364), and qualitative focus group data from March–April 2023 ( n = 6 groups, n = 32 participants). Differences in survey data across time were tested using multinomial regression and linear regression, and common focus group data themes were identified. Results: Eighty-five percent of teachers were concerned or very concerned about vaping at school, with the proportion who were very concerned increasing from 43% to 55% over the 12 months. There was consistent and strong agreement that vape use is unsafe for young people and high agreement that vaping during adolescence can cause addiction. Focus group discussions provided context to survey findings: teachers’ awareness of and concern about vaping in schools, and the harms of vaping in students, which both then influenced school priorities for vaping management. Findings suggest inconsistent strategies to manage vaping in schools detract teachers from their core focus on teaching. Conclusion: Our study, the first to investigate teacher perceptions of vaping in Australian secondary schools across time, demonstrates increasing teacher concerns. As vaping is a community-wide problem, a coordinated response across government is required to support teachers in reducing student vape use at school.

Background: Full-Service Community Schools seek to integrate health, well-being, and academic services in schools by partnering with local community services. Establishing and maintaining community partnerships represents a significant operational challenge for schools. However, limited literature exists that explores the process of establishing a Full-Service Community School with community partners. Objectives: This paper explores the process of engaging with initial community partners to develop of Full-Service Community School through the perspective of the coordinator. Methods: Using an autoethnographic approach, the paper documents the learning process of the coordinator as they engaged with key health and education professionals as stakeholders in a Full-Service Community School. Data were analysed using reflexive thematic analysis and interpreted using social learning theory. Results: Four themes were developed: principles of Full-Service Community Schools are known and valued; integration in Full-Service Community Schools is challenging but critical; coordinators are needed to develop Full-Service Community Schools; developing a Full-Service Community School is a journey. Conclusion: While there may be shared enthusiasm among stakeholders for the potential of a Full-Service Community School, there are logistical matters to consider relating integration and coordination which need to be resolved. By focusing on the learning journey of one Full-Service Community School coordinator, insights can be gained for others wanting to implement this model in their school.

Objectives: Existing youth mental health services are unable to meet a rising demand for care. Changes are required to align care with young people’s needs and priorities. In this paper, we present a case study examining the developmental stages of a community-based participatory research project in which young people and professional stakeholders co-designed a youth mental health service blueprint in Southern England. Methods: We took a reflexive approach to critique, appraise and evaluate how our subjectivity – as embedded researchers – influenced the research process. Findings: In this paper, we reflect on (1) the impact of an immersive approach on the development of trust with stakeholders and participants; (2) our methodology for developing and implementing community-based research and (3) the ways in which the complexity and the fragmentation of youth mental health services affected the research process. Conclusion: A participatory approach can be complex and challenging; however, we argue that by engaging with communities and building relationships and trust, researchers can develop a deeper and more nuanced understanding of how to create and shape services that better reflect local needs and priorities.

Objective: This study investigated the impact of an online postural education programme on primary school teachers’ knowledge regarding back care and low back pain (LBP) prevention. Design: This investigation was nested within a randomised controlled trial. Setting: A total of 61 teachers participated, divided into an experimental group ( n = 32) and a control group ( n = 29). Method: The intervention consisted of online training sessions focusing on back care and LBP prevention. Knowledge acquisition was measured using the Low Back Pain Knowledge Questionnaire (LKQ) and the COSACUES-AEF questionnaire, administered before and after the intervention. Results: Results indicated significant improvements in the experimental group’s knowledge compared to the control group. Specifically, the experimental group showed a mean increase in total LKQ scores of 2.22 points ( p = .020), highlighting the effectiveness of the online programme. The findings underscore the importance of integrating health education into teachers’ professional development, leveraging digital platforms to enhance accessibility and engagement. Conclusion: The study concludes that online postural education can significantly improve teachers’ knowledge about back care and LBP prevention, which is crucial for promoting health literacy and better health practices in educational settings.

Objectives and Setting: Schools are becoming more and more complex work environments, in turn impacting teachers’ well-being. This study aimed to better understand how one teacher’s well-being could be impacted when offered consistent opportunities to attend to their own personal wellness during school hours through monthly ‘unstructured wellness time’. Design and Methods: Using autoethnography, the research is an account of first author’s personal experiences as an educator. Data collection and analysis was an iterative and holistic examination of critical incidents, reflective journal entries and photographs to allow for ‘meaning-making’ and to convey the first author’s personal experiences throughout the ‘unstructured wellness times’. A Comprehensive School Health framework was also used to reflect on and interpret data throughout this study. Results: Findings showed that being offered consistent time throughout the school year to attend to teacher wellness led to an increase in feeling that first author’s health was of more value within the workplace. Conclusion: Key conclusions drawn from the study contribute to the growing amount of literature on teacher well-being and identify that with the proper supports in place, the concept of ‘unstructured wellness time’ could be an effective tool to improving teachers’ health within school workplace settings.

Objective: Children’s lifestyle behaviours significantly affect childhood obesity. The impact of a body mass index reduction intervention applied to secondary school students on their eating behaviour, physical activity, sleep quality and obesity was in the focus of this research. Method: A quasi-experimental pre–post design was employed. The research was conducted with sixth-grade students (age 10) studying at two public schools in a province in the east of Türkiye, selected by simple random sampling. The research was carried out with 155 students ( n = 84 experimental and n = 71 controls). A body mass index reduction education programme was provided to the intervention group. The training consisted of six modules, each module delivered in one or two sessions lasting an average of 40 minutes. Data were collected using a Socio-Demographic Data Form, CTFEQ, PAQ-C and SQS. The statistical analysis of the data was conducted using IBM SPSS Statistics 24.0. Results: The post-intervention body mass index values of the students in the intervention and control groups did not differ statistically significantly ( p > 0.05). Students’ mean scores on the total eating behaviour scale differed statistically significantly for group and group*time interaction ( p < 0.05). In addition, the mean physical activity questionnaire and sleep quality scale scores differed statistically significantly in terms of group, time and group*time interaction ( p < 0.05). Results showed that the effect size was large for all variables according to the time*group interaction. Conclusion: The results of this study show that education on obesity was not effective in reducing body mass index values. However, it effectively increased students’ mean physical activity, sleep quality scores and positive eating behaviours.