This study identified barriers to and facilitators of human papillomavirus (HPV) vaccination for adolescent boys and their parents in high-income countries using a social-ecological model (SEM) to inform future health education strategies. A scoping review was conducted in accordance with Joanna Briggs Institute guidelines, Arksey and O'Malley's framework, and Levac's recommendations. Six databases were searched in March and December 2024, with Covidence used for screening. The identified factors were categorized into four levels: intrapersonal, interpersonal, community, and policy. A total of 78 studies were included. Amongst these, 54 facilitators and 120 barriers were identified. Common facilitators included health protection for individuals and their future partners, whilst key barriers were concerns regarding vaccine safety and side effects. Perceptions of risks and benefits emerged as central themes in both categories. Most reported factors were at the intrapersonal (n = 75, 96.2%) and interpersonal (n = 52, 66.7%) levels, with found at the community (n = 27, 38.5%) and policy (n = 28, 35.9%) levels. It is important to emphasize the safety and significance of the HPV vaccine, which should be provided through tailored health education programmes in schools or clinics. This review suggests that future education studies should comprise each domain of the SEM to successfully implement HPV vaccination in adolescent boys. Registration: Open Science Framework (https://doi.org/10.17605/OSF.IO/AWRX6).

A diet self-management plan aligning with patients' culture, beliefs, and values is essential to the success of diabetes self-management education (DSME), which requires candid communication between patients and providers. However, in a Confucianism-dominated culture, the emphasis on social hierarchy, respect for authority, and harmony may hinder patients from communicating openly with healthcare teams. This qualitative study was conducted in accordance with the guidelines of the Consolidated Criteria for Reporting Qualitative Research to explore the experiences of participants with poor diabetes control, focusing on the challenges they face in diet self-management and how they communicate these challenges to their providers during DSME encounters. The present study revealed that the 'fear of being judged' reflects the Confucian culture, which inhibits open dialogue between patients and healthcare teams about the difficulties patients face in managing their diet. Given the high prevalence of poor diabetes control in Confucianism-dominated societies, it is strongly recommended to modify the approach of DSME, such as using patients' food diary as the base for the DSME discussion to avoid requiring patients to ask questions to the healthcare team, to fit the Confucian culture dominating in Eastern Asian societies.

Several school-based physical activity interventions have been developed to address the critical public health concern that children are not meeting the recommended daily moderate-to-vigorous physical activity (MVPA). However, less is known about implementation fidelity and its impact on programme efficacy. This study examined process evaluation findings of a school-based physical education (PE) intervention and its impact on MVPA among 3rd and 4th-grade children. Four fidelity components (adherence, dose, quality of delivery, and participant responsiveness) were assessed through weekly, unannounced direct observations of intervention classrooms. MVPA was assessed using accelerometry at baseline and post-intervention. Multilevel modelling was used to assess the effect of implementation fidelity on child MVPA. Overall fidelity score of our intervention was high (76.4%), although participant responsiveness (82.4%) and quality of delivery (77.8%) were implemented more successfully than dose (65.8%) and adherence (52%). Participant responsiveness was a statistically significant predictor of change in student MVPA (β = 26.14, 95% CI: 2.68, 49.60). Adherence, dose, quality of delivery, and overall fidelity were not significant predictors of student outcomes. Participant responsiveness is an important aspect of fidelity. School-based PE interventions should focus on enhancing student engagement for successful impact. Further investigation is needed to identify factors that enhance child responsiveness.

Tobacco use has detrimental effects on women's reproductive health and is associated with poor pregnancy outcomes. Antenatal care (ANC) check-ups provide health professionals with a unique opportunity to screen and counsel pregnant tobacco users to quit. Currently, in India, pregnant women are not being screened for tobacco use during antenatal care visits and healthcare providers lack formal training to provide tobacco cessation advice. This article describes the designing and development of a tailored behaviour change intervention (BCI) module for tobacco cessation and its delivery to pregnant women attending antenatal clinics. The BCI module was designed to incorporate the components of the Capability, Opportunity and Motivation Model and the Behaviour Change Wheel guide. The development was done in three steps-understanding the behaviour, developing intervention model, and identifying implementation options along with monitoring and evaluation strategies. The module has three tools-counselling flipbook for healthcare provider, take home pamphlets, and information posters for patient waiting areas. A gender- and culture-specific BCI module was developed and implemented to screen and counsel 105 pregnant tobacco users during antenatal visits, leading to high self-reported tobacco quit rate (69%) which corroborated with urine cotinine levels at baseline and end line.

Cultural competence is widely recognized as a core component of equity in healthcare. However, little is known about how healthcare professionals in Greece, a frontline country for displaced populations, develop and implement cultural competence in refugee healthcare. This study explores the experiences, training needs, challenges, and strategies of Greek healthcare professionals for delivering culturally competent care to refugees and asylum seekers. Twelve healthcare professionals from various Greek healthcare settings participated in semi-structured interviews. Data were analysed using reflexive thematic analysis within an interpretive description framework, appropriate for applied health research. Three themes were developed: (i) developing cultural competence through cross-cultural engagement; (ii) finding a balance: dilemmas and complexity in refugee healthcare; and (iii) caring in isolation: refugee care in unsupportive environments. Systemic constraints and patient–provider challenges limited participants’ efforts, despite their demonstrated adaptability and commitment, which sometimes resulted in emotional exhaustion or disengagement. Findings highlight the need for multilevel interventions, combining structural competence, advocacy, and reflective supervision, to support uninterrupted, culturally responsive care and promote healthcare providers’ well-being.

This is a systematic review and meta-analysis of preoperative patient education interventions used in vascular surgery and their impact on patient knowledge. Embase, PubMed, and Ovid were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For inclusion, studies involved an educational intervention for a vascular surgery procedure and patient knowledge was an outcome. Using mean knowledge scores (defined as the percentage of correct responses on knowledge assessments) pre and post education intervention for experimental groups, a forest plot with standardized mean difference (SMD) was generated. Subgroup analyses were performed for abdominal aortic aneurysm (AAA) repair and decision aids. Six studies (654 patients) met inclusion criteria (five randomized controlled trials, one prospective cohort study). Procedures included AAA repair, femoral-popliteal artery bypass, carotid surgery, and endovenous thermal vein ablation. Education interventions included informed consent discussions, decision aids, virtual reality displays, and videos. The pooled SMD was 0.64 (95% confidence interval [CI], 0.48-0.79), suggesting a significant positive effect of education interventions on patient knowledge. For AAA repair and decision aid subgroups (four papers each), the SMD was 0.58 (95% CI, 0.42-0.75) and 0.62 (95% CI, 0.45-0.79), respectively. Preoperative patient education enhances understanding of vascular surgery procedures. Developing procedure-specific and patient-oriented education interventions will help address knowledge gaps among patients with vascular disease.

This manuscript aims to describe the development and evaluation of a lung cancer education and navigation program utilizing Lay Health Navigators (LHNs) to navigate members of at-risk communities to low-dose computed tomography (LDCT) screening. Given observed higher lung cancer incidence and mortality rates among people of colour in the U.S., we utilized and built upon previous cancer education efforts to develop an educational presentation specific to lung cancer. Recognizing the potential for navigation using community members, we trained and evaluated culturally- and linguistically-representative student volunteers as LHNs to address nonclinical barriers to screening, such as a lack of transportation funds. We observed statistically significant improvements in LHNs' cancer knowledge (P < 0.01) and self-evaluated confidence in helping others access health services (P < 0.05). From July 2022 to November 2023, we held 41 lung cancer educational presentations with 1966 community members in New York City. Twenty community members were confirmed to be eligible for screening, and 57% were successfully navigated into LDCT screening by LHNs. This program provides support for existing research on the potential for lay patient navigation to address present disparities in cancer screening using non-healthcare professionals.

This study investigated how life skills-based health education influences early childhood educators' cognition, attitudes, and teaching confidence, using a quasi-experimental, parallel mixed-methods design. A total of 65 in-service students were assigned to an experimental (n= 33) or control group (n= 32). Quantitative measures assessed pre- and post-intervention changes, while qualitative data from open-ended reflections were analysed thematically. Statistical results revealed significant improvements in all three dimensions for the experimental group. Generalized Estimating Equation analyses confirmed significant group × time interaction effects for attitudes (B = 4.64, P< .001) and confidence (B = 19.69, P< .001), with no interaction for cognition (P= .078), suggesting knowledge consolidation rather than new learning. Qualitative findings clarified the mechanisms of change: simulations and collaborative tasks enhanced students' critical reflection, situational adaptability, and real-world application of health teaching strategies. By answering both what changed and how it changed, this study supports integrating life skills and simulation into health education curricula to build sustainable teaching capacity. Future studies should extend follow-up duration and expand contextual diversity to evaluate long-term impact and generalizability.

The present study investigated the effect of the lifestyle-based health promotion intervention on health behaviour, irrational health beliefs, and eating behaviour of patients with type 2 diabetes. For this purpose, 90 patients with type 2 diabetes were selected by convenience sampling and randomly assigned to experimental and control groups, each comprising 45 patients. The experimental group received eight 90-min sessions of lifestyle-based health promotion intervention, while the control group received no treatment. The data were collected by the Health-Promoting Lifestyle Profile, Irrational Health Belief Scale, and the Dutch Eating Behaviour Questionnaire, administered to the participants at the pre-test, post-test, and 3-month follow-up phases and analysed by the analysis of variance. The results indicated that the mean score of health behaviours of the experimental group improved. In contrast, the mean scores of their eating behaviour and irrational health beliefs decreased compared with the control group (P < .01). The findings of this study underscore the significant impact of lifestyle-based health promotion interventions on patients with type 2 diabetes. Consequently, practitioners and healthcare professionals might include lifestyle-based health promotion interventions in the standard treatment programs for patients with type 2 diabetes to promote their health and treatment outcomes.