Delivery Of Advice Research Articles

Communications enhance sustainable intentions despite other ongoing crises

There is an ongoing trend toward more frequent and multiple crises. While there is a clear need for behaviors to become more sustainable to address the climate crisis, how to achieve this against the backdrop of other crises is unknown. Using a sample of 18,805 participants from the UK, we performed a survey experiment to investigate if communication messages provide a useful tool in nudging intentions toward improved sustainability in the context of the COVID-19 pandemic. We found that, despite the ongoing COVID-19 crisis, media messaging resulted in increases in sustainability-related intentions for all our communication messaging conditions. Specifically, after our communication was presented, (i) almost 80% of people who were not currently recycling their surgical masks reported their intention to do so; there was a > 70% increase in both (ii) the number of people likely to pick up face mask litter and (iii) the number of people willing to disinfect and reuse their filtering facepiece (FFP) masks 4–6 times, while (iv) there was an increase by 165% in those who would wash cloth masks at 60 °C. Our results highlight that communication messaging can play a useful role in minimizing the trade-offs between multiple crises, as well as maximizing any synergies. To support this, decision-makers and practitioners should encourage the delivery of sustainability advice via multiple sources and across different types of media, while taking steps to address potential misinformation.

63 General practitioners’ experience, attitudes and needs on providing advice on physical activity to people with chronic ischemic heart disease - A qualitative study (OptiCor study)

Abstract Purpose The German treatment guideline “chronic ischemic/coronary heart disease (IHD)” recommends that general practitioners (GPs) deliver advice on physical activity (PA) to IHD patients. However, the provision of PA advice is inadequately implemented in general practice in Germany. One reason is the lack of medical training in providing PA advice effectively and efficiently. International guidelines recommend such training for GPs. This study aims to explore needs, experiences, and attitudes including barriers and facilitators of GPs towards the routine delivery of PA advice to IHD patients, in order to adequately inform a customised development of such a training. Methods Over a period of four months (March – June 2023), 12 face-to-face problem centred interviews (n = 12; 5/12 females, age range: 35-73 years) and six focus group discussions (n = 37; 13/37 females, age range: 36-70 years) with GPs were conducted. Interview and discussion guides were developed and pilot tested by the multi-professional study team. Data were collected in an iterative process. Purposive sampling and techniques of maximal structural variation were applied (e.g., with regard to professional experience, interest in PA). Audio-recorded data were transcribed verbatim and analysed using a content structuring procedure (deductive and inductive approach). GPs were involved throughout the entire research process, e.g., in multi-professional analysis groups. Results Whereas GPs are mostly aware of the health benefits of PA for IHD patients, PA advice is not routinely provided. Conversations on PA tend to be unstructured and advice is often addressed more generally than customised to the patients’ needs and preferences. Priority is given to other lifestyle issues, such as smoking. The effectiveness of PA advice is perceived as less effective but time consuming. GPs mention frustration in this context. They express a need for communication strategies (structure and tools) to motivate patients to PA that can be integrated into everyday GP care. Conclusion The results provide relevant insights into the everyday practice of GPs, information on GPs’ needs and requirements and can thus contribute to a target group-specific development of a GP training on PA advice for patients with IHD in the OptiCor study. Funding German Ministry of Education and Research (01GY2103).

99 Delivery of advice on physical activity by general practitioners in Germany: a cross-sectional population survey in people with chronic ischemic heart disease (OptiCor study)

99 Delivery of advice on physical activity by general practitioners in Germany: a cross-sectional population survey in people with chronic ischemic heart disease (OptiCor study)

Knowledge, attitudes, and practices of Japanese physicians relating to climate change impacts on health, delivery of climate-specific advice, and advocacy for climate change policies

Abstract Aim This study aimed to assess the knowledge, attitudes, and practices (KAP) of physicians in Japan toward climate change and health, their delivery of climate-specific advice to patients, and their advocacy for climate change policy. Subject and methods This cross-sectional study included licensed physicians active in clinical practice in Japan. Data were collected through a web-based platform from November 21 through November 27, 2023, using a 32-item self-administered questionnaire. Results A total of 1100 physicians with a mean age of 51.2 years (SD11.9) were included in the analysis. More than half (56.7%) agreed that physicians should advise their patients on the links climate change has on their health; however, less than half (32.6%) of the physicians responded that they do. Among the factors that reduced their action to deliver climate-specific health advice and advocacy were a lack of information/resources and knowledge. The multivariable logistic regression model showed that having prior climate change education or training, knowledge, and awareness is associated with physicians’ delivery of climate-specific advice to patients and advocating for climate change policy. Conclusion Many physicians recognize their responsibility to educate their patients on the impact climate change has on their health. There is a significant gap between the physicians’ willingness and what happens in practice. Among the main factors that reduce their action to engage in delivering climate-specific health advice and advocacy were a lack of information/resources and a lack of knowledge. Physicians need to be better equipped with the education, resources, and support to apply their expertise and influence to combat climate change.

Transformasi Tradisi Mangalehen Tuor dalam Upacara Perkawinan Mandailing Pasca Migrasi ke Kota Medan

This research examines the transformation of the Mangalehen Tuor tradition in Mandailing ethnic wedding ceremonies after migration to Medan City. This tradition has undergone significant adaptation in the context of rapid urbanization and intercultural interactions in urban environments. Changes in the implementation of traditions, such as adjustments to the time and place of implementation, as well as changes in participation and delivery of advice, are the main focus of this research. Factors influencing these changes, such as urbanization, intercultural interactions, the influence of the younger generation, economics, and technology, are analyzed to understand the dynamics of cultural adaptation in a broader context. Despite undergoing transformation, efforts to preserve Mandailing cultural values ??remain a priority, reflected in cultural education efforts, community activities and technology integration. This research provides insight into how ethnic communities manage and maintain their cultural identity amidst the ever-growing challenges of globalization and modernization.

UK midwives delivering physical activity advice; what are the challenges and possible solutions?

Despite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions. Ten UK midwives (mean work experience ± SD: 15.5 years ± 10.2) participated in semi-structured interviews between May and July 2023. Data were analysed using a deductive thematic approach following Braun and Clarke's six steps. Demographic data were collected by Microsoft Forms then summarised using Microsoft Excel. Six themes with 25 subthemes were identified as barriers and solutions in delivering PA advice. The role of midwives in providing PA advice during pregnancy; the role of midwives in providing PA advice postpartum; intrinsic barriers that limit PA advice provision (confidence, safety concerns, knowledge, and midwife's personal body habitus); extrinsic barriers that limit PA advice provision (lack of time, education, PA not a priority in care); solutions to allow midwives to promote PA (including formal PA education, and dissemination of resources); and optimising delivery of PA advice (personalized approach, interprofessional collaboration, and linking to mental health benefits). Midwives consider themselves ideally placed to provide PA advice to pregnant women, with many aware of the benefits PA provides. Despite this, there is a lack of PA advice provision and knowledge of PA guidelines. Postpartum PA advice appeared to be considered outside the remit of midwives, due to limited contact. Further research is needed to determine the current level of PA advice provision for pregnant and postpartum women and explore the role of other healthcare professionals involved in maternity care.

Health and lifestyle advice in community pharmacy for musculoskeletal conditions: a focused ethnography

Abstract Introduction Musculoskeletal health conditions are common, painful, and disabling, and often occur alongside other long-term conditions. Around a third of the UK population live with a musculoskeletal condition placing a huge burden on health and social care resources, accounting for 1 in 7 general practitioner consultations.[1] Primary care often focuses on using safe but less effective pharmacological approaches (e.g., paracetamol) despite evidence-based recommendations for self-management and lifestyle support being more effective, particularly in the context of pain management. However, access to such support is not always available or adequate. Community pharmacy is recognised for its important and well positioned setting for the delivery of public health promotion, supporting people to improve their health and live well through the Healthy Living Pharmacy Framework. Despite policy recommendations for an extended role in supporting people to self-manage long-term conditions and to adopt healthier behaviours, we currently do not know how community pharmacy manages and supports lifestyle advice in practice, particularly in relation to musculoskeletal health. Aim To gain an in-depth insight into community pharmacy daily practice in relation to the delivery of health and lifestyle advice, in order to examine community pharmacy’s current and future potential for supporting musculoskeletal health conditions. Methods An in-depth multi-site ethnographic approach was used across four community pharmacies differing in geographical and socioeconomic areas in England (April 2023 – October 2023). Data included 92 hours of observations within community pharmacies observing everyday practice and customer interactions, and 19 in-person semi-structured interviews (participants included counter assistants, dispensers, technicians and pharmacists). Results were analysed iteratively using analytic induction.[2] Results The provision of lifestyle advice was seen as awkward by staff members and problematic in consultations where advice was deemed unsolicited by customers, particularly in relation to sensitive topics such as weight or alcohol use. Pharmacists were generally more confident including lifestyle advice within appointments in the consultation room, and embedding behaviour change messages within an overall health check. Nevertheless, they lacked knowledge and training with regards to support and lifestyle advice specific for musculoskeletal health conditions. Observed over-the-counter interactions with customers were often complicated in terms of opportunities for staff to offer lifestyle advice, with encounters concerning pain relief medication at times resulting in tense and arduous consultations. Staff often found the experience of trying to offer lifestyle advice uncomfortable and challenging, leaving many feeling demotivated and lacking in confidence and as a result avoid introducing lifestyle advice into conversations. Conclusion Community pharmacy staff recognised the importance of the provision of lifestyle advice but experienced many barriers to its delivery. Increasing demands on community pharmacy with new services have implications with regards to capacity, time and skills development to effectively imbed lifestyle advice into everyday practice. Pharmacy staff may benefit from enhanced support and training to increase confidence and motivation in providing lifestyle advice, particularly relating to understanding musculoskeletal health and effective self-management strategies.

Exploring the Role of ChatGPT in Cardiology: A Systematic Review of the Current Literature.

Chat Generative Pre-Trained Transformer (ChatGPT) is a chatbot based on a large language model that has gained public interest since its release in November 2022. This systematic review examines the current literature on the potential applications of ChatGPT in cardiology. A systematic literature search was conducted to retrieve all publications on ChatGPT in PubMed, Scopus, MedRxiv, and the Cochrane Library published on or before September 30, 2023. Search terms relating to ChatGPT and cardiology were used. Publications without relevance to ChatGPT and cardiology were excluded. The included publications were divided into cohorts. Cohort A examined ChatGPT's role in improving patient health literacy. Cohort B explored ChatGPT's role in clinical care. Cohort C examined ChatGPT's role in future literature and research. Cohort D included case reports that used ChatGPT. A total of 115 publications were found across all databases. Twenty-four publications met the inclusion criteria and were included in the review. Cohort A-C included a total of 14 records comprised of editorials/letters to the editor (29%), research letters/correspondence (21%), review papers (21%), observational studies (7%), research studies (7%), and short reports (7%). Cohort D included 10 case reports. No relevant systematic literature reviews, meta-analyses, or randomized controlled trials were identified in the search. Based on this review of the literature, ChatGPT has the potential to enhance patient education, support clinicians providing clinical care, and enhance the development of future literature. However, further studies are needed to understand the potential applications of ChatGPT in cardiology and to address ethical concerns regarding the delivery of medical advice and the authoring of manuscripts.

Exploring timing and delivery of lifestyle advice following an acute cardiac event hospitalization: The cardiac patient’s perspective

ObjectiveTo explore the perspective of cardiac patients regarding the timing and manner of delivering lifestyle advice following an acute cardiac event hospitalization. MethodsDutch cardiac patients who experienced a cardiac event hospitalization participated in a semi-structured interview (n = 14) or a cross-sectional survey study (n = 119). ResultsOur findings indicate that cardiac patients are receptive to lifestyle advice throughout the care trajectory. Advice delivered by a cardiologist had the highest self-reported impact. Furthermore, receiving advice at multiple phases during the care trajectory was associated with a greater intention to change lifestyle (B = 0.37, CI = 0.17 – 0.57). Patients favored clear-cut, feasible, and friendly but confronting advice. Moreover, they stressed the importance of advice being aligned with their identity and beliefs about the causes of their disease. ConclusionThe period following an acute cardiac event provides a unique opportunity to offer tailored and patient-centered lifestyle advice. This “teachable window” for lifestyle change, when used wisely, may improve health outcomes for cardiac patients. Practice ImplicationsHealthcare professionals should initiate lifestyle advice already during hospitalization and continue during follow-up appointments and cardiac rehabilitation. Advice should be feasible and empathy-based, as well as tailored to the patient’s needs, values, and perceptions of the causes of their cardiovascular disease.

‘Just Like Pandemic Prevention’: The Semiotic Flow That Interweaves Multimodality, Metaphor, and Narrativity

ABSTRACT This study investigates how COVID-19 advice is creatively delivered in a one-minute video produced by the Taiwan Centers for Disease Control in February 2022. It examines metaphors in verbal, visual, and multimodal modes, and illustrates how such metaphors interact with multimodal narrativity. Drawing on the insights of studies on multimodal metaphors, this paper seeks to identify which are the most pervasive metaphors or what dominant metaphor, if any, is used in the video. It finds that the metaphorical mappings between coping with the covid pandemic and handling olympic weightlifting are represented across modes and that the creative delivery of COVID-19 advice is woven from a warp of metaphors in various modes and a weft of narrativity across modes. Such metaphorical creativity is underpinned by the semiotic flow that features four interconnected configurations: moving between metaphorization, literalization, and re-metaphorization; somehow blurring the source-target boundary; expanding the range of functions that the multimodal representation can serve; and initiating a metaphorical thought from one or more contextual factors.

Factors influencing the intention of young adults to adopt genotype-based personalised advice on diet and physical activity according to perceived weight status.

Genotype-based dietary and physical activity advice can be delivered to young adults before unhealthy lifestyle behaviours or metabolic and physiological conditions have developed. The aim of the present study was to investigate the factors that influence the intention to adopt genotype-based personalised advice on diet and physical activity in young adults who perceive themselves to be a healthy weight versus those who perceive themselves to be overweight or obese. An online survey of 396 young adults (18-25 years) evaluated background factors (participant characteristics (including perception of body weight), psychological factors, belief composites) and constructs of the Theory of Planned Behaviour (TPB) related to the adoption of genotype-based personalised advice. The association between background factors and TPB constructs was assessed using multiple linear regression. The constructs of TPB predicted intention to adopt genotype-based personalised nutrition (P < 0.001, adj. R 2 = 0.54; attitude: B = 0.24, subjective norm: B = 0.25, PBC: B = 0.45). Background factors including belief composites, health locus of control, gender, physical activity, and food choice motives of 'health', 'price', 'familiarity', 'weight control', and 'convenience' significantly added to models of TPB constructs related to the intention to adopt personalised advice (P < 0.05). The influence of background factors varied between TPB constructs and differed based on participants perception of their body weight. The study provides support for the use of the TPB in understanding the intention of young adults to adopt gene-based advice for dietary and physical activity behaviour. In addition to perceived body weight, the background factors identified should help to inform and modify the delivery of advice in behaviour change interventions that seek to use genotype-based personalised advice in young adult populations.

Driving Safety Education for Bus Drivers During Christmas and New Year 2023-2024 at Mengwi Terminal

Traffic and Road Transport Safety is a condition where everyone is protected from the risk of accidents during traffic caused by humans, road vehicles and/or the environment. The importance of safety when driving must be a common awareness of both the general public, drivers, operators and the government. Mengwi Terminal is the only Type A terminal in Bali Province which is located on the Mengwi-Mengwitani road, Mengwitani Village, Mengwi District, Badung Regency. Mengwi Terminal is a center for public transportation activities, especially inter-city, inter-provincial (AKAP) transportation routes. The aim of this Community Service in the form of counseling on driving safety for bus drivers is to provide information and advice to bus drivers so that driving is safer, namely driving the vehicle carefully, maintaining a safe distance, not using a mobile phone (HP) while driving, get enough rest, speed at safe limits or in accordance with the information on the signs, use a safety belt and always ensure that the vehicle is in a roadworthy condition. Counseling is carried out directly by conveying driving safety issues to several bus drivers operating at the Mengwi Terminal. This outreach activity was successfully carried out with the delivery of information and advice regarding driving safety to bus drivers at several operating bus companies.

Can Telehealth Improve Access to Dietary Management in Patients Receiving Dialysis? Insights from Consumers.

Timely, effective, and individualised dietary interventions are essential for patients undergoing dialysis. However, delivery of dietary advice is challenging due to limited access to renal dietitians, as well as logistic and scheduling difficulties for patients receiving dialysis. The objectives of this study were to explore consumer perspectives regarding dietary advice utilising telehealth technology. Twenty-two participants (seventeen patients receiving dialysis, five caregivers) were purposively recruited from a local dialysis centre and participated in one of three focus groups. Each focus group was recorded, transcribed, and analysed using inductive thematic analysis. One overarching theme: "a desire to learn" was apparent. The four themes that facilitated this process are herein described: Meaningful communication-a need for improved and individualised communication about diet using positively framed messages with consistency among clinicians. Conducive information-a preference for tailored, current, and clear dietary information (plain language was preferred, with practical advice on making dietary changes). Appropriate timing-health advice at the right time (consumers felt overwhelmed, not supported enough with timely advice, and experienced difficulty attending appointments in addition to dialysis treatments). Contemporary modalities-delivering information using different technologies (consumers preferred a combination of delivery methods for dietetic advice including text/SMS/App messages as an adjunct to face-to-face care). The results showed that consumers believe that telehealth options are an acceptable adjunct to receive dietary advice in a timely manner, and feedback from patients and caregivers has informed the design of a clinical trial to incorporate the use of telehealth to improve the management of serum phosphate.

STRATEGI GURU DALAM PEMBENTUKAN KARAKTER SANTRI PONDOK PESANTREN AL-UM BENGKULU UTARA

This research aims to identify the strategies used by teachers in shaping the character of students al the al-um islamic boarding school. The main aim of this relligious education instution is deal with moral and character issues. The research apprach applied is a desriptive method, using tool such as observation, interviwes annd documentation. The results show that the teacher use several strategies, including : 1, role models, 2. Habituation, 3. Delivery of advice.

Alcohol Prevention in Urgent and Emergency Care (APUEC): Development and Evaluation of Workforce Digital Training on Screening, Brief Intervention, and Referral for Treatment.

Excessive alcohol consumption carries a significant health, social and economic burden. Screening, brief intervention and referral to treatment (SBIRT) is one approach to identifying patients with excessive alcohol consumption and providing interventions to help them reduce their drinking. However, healthcare workers in urgent and emergency care settings do not routinely integrate SBIRT into clinical practice and raise a lack of training as a barrier to SBIRT delivery. Therefore, "Alcohol Prevention in Urgent and Emergency Care" (APUEC) training was developed, delivered, and evaluated. APUEC is a brief, stand-alone, multimedia, interactive digital training package for healthcare workers. The aim of APUEC is to increase positive attitudes, knowledge, confidence and skills related to SBIRT through the provision of (a) education on the impact of alcohol and the role of urgent and emergency care in alcohol prevention, and (b) practical guidance on patient assessment, delivery of brief advice and making referral decisions. Development involved collaborative-participatory design approaches and a rigorous six-step ASPIRE methodology (involving n = 28 contributors). APUEC was delivered to healthcare workers who completed an online survey (n = 18) and then participated in individual qualitative interviews (n = 15). Analysis of data was aligned with Levels 1-3 of the Kirkpatrick Model of Training Evaluation. Survey data showed that all participants (100%) found the training useful and would recommend it to others. Insights from the qualitative data showed that APUEC digital training increases healthcare workers' perceived knowledge, confidence and skills related to alcohol prevention in urgent and emergency care settings. Participants viewed APUEC to be engaging and relevant to urgent and emergency care workers. This digital training was perceived to be useful for workforce skills development and supporting the implementation of SBIRT in clinical practice. While the impact of APUEC on clinician behaviour and patient outcomes is yet to be tested, APUEC digital training could easily be embedded within education and continuing professional development programmes for healthcare workers and healthcare trainees of any discipline. Ultimately, this may facilitate the integration of SBIRT into routine care and contribute to population health improvement.

Exploring health professionals' viewpoint of provision of nutrition advice for women with endometrial cancer.

The aim of this study was to explore barriers and facilitators to delivery and uptake of nutrition advice to women diagnosed with endometrial cancer from a health professionals' viewpoint. Fifteen semi-structured interviews with health professionals with experience in providing healthcare to women diagnosed with endometrial cancer were audio-recorded and transcribed. Interviews were analysed using reflexive thematic analysis. Topics included high weight as a risk factor for endometrial cancer, nutrition information sources, and barriers and facilitators to delivering nutrition advice in clinical care. Four themes were identified. The first three exist as barriers to women receiving nutrition advice-how to navigate conversations about high weight, access to limited resourcing and health professionals feeling powerless to overcome system influences. The fourth theme identified a community approach need to facilitate a supportive environment and share knowledge. This study, through the lens of health professionals, highlights barriers to the delivery and uptake of nutrition advice at the patient, community and system levels. Enhancing survivorship for women after the diagnosis of endometrial cancer may be enabled by further understanding of how to overcome barriers and promote facilitators. Communication and partnership with women are imperative to achieving this.

Exploring the gut microbiota: lifestyle choices, disease associations, and personal genomics.

The gut microbiota is a rich and dynamic ecosystem that actively interacts with the human body, playing a significant role in the state of health and disease of the host. Diet, exercise, mental health, and other factors have exhibited the ability to influence the gut bacterial composition, leading to changes that can prevent and improve, or favor and worsen, both intestinal and extra-intestinal conditions. Altered gut microbial states, or 'dysbiosis', associated with conditions and diseases are often characterized by shifts in bacterial abundance and diversity, including an impaired Firmicutes to Bacteroidetes ratio. By understanding the effect of lifestyle on the gut microbiota, personalized advice can be generated to suit each individual profile and foster the adoption of lifestyle changes that can both prevent and ameliorate dysbiosis. The delivery of effective and reliable advice, however, depends not only on the available research and current understanding of the topic, but also on the methods used to assess individuals and to discover the associations, which can introduce bias at multiple stages. The aim of this review is to summarize how human gut microbial variability is defined and what lifestyle choices and diseases have shown association with gut bacterial composition. Furthermore, popular methods to investigate the human gut microbiota are outlined, with a focus on the possible bias caused by the lack of use of standardized methods. Finally, an overview of the current state of personalized advice based on gut microbiota testing is presented, underlining its power and limitations.

What happens after an NHS Health Check? A survey and realist review.

The National Health Service Health Check in England aims to provide adults aged 40 to 74 with an assessment of their risk of developing cardiovascular disease and to offer advice to help manage and reduce this risk. The programme is commissioned by local authorities and delivered by a range of providers in different settings, although primarily in general practices. This project focused on variation in the advice, onward referrals and prescriptions offered to attendees following their health check. (1) Map recent programme delivery across England via a survey of local authorities; (2) conduct a realist review to enable understanding of how the National Health Service Health Check programme works in different settings, for different groups; (3) provide recommendations to improve delivery. Survey of local authorities and realist review of the literature. Realist review is a theory-driven, interpretive approach to evidence synthesis that seeks to explain why, when and for whom outcomes occur. We gathered published research and grey literature (including local evaluation documents and conference materials) via searching and supplementary methods. Extracted data were synthesised using a realist logic of analysis to develop an understanding of important contexts that affect the delivery of National Health Service Health Checks, and underlying mechanisms that produce outcomes related to our project focus. Our findings highlight the variation in National Health Service Health Check delivery models across England. Commissioners, providers and attendees understand the programme's purpose in different ways. When understood primarily as an opportunity to screen for disease, responsibility for delivery and outcomes rests with primary care, and there is an emphasis on volume of checks delivered, gathering essential data and communicating risk. When understood as an opportunity to prompt and support behaviour change, more emphasis is placed on delivery of advice and referrals to 'lifestyle services'. Practical constraints limit what can be delivered within the programme's remit. Public health funding restricts delivery options and links with onward services, while providers may struggle to deliver effective checks when faced with competing priorities. Attendees' responses to the programme are affected by features of delivery models and the constraints they face within their own lives. Survey response rate lower than anticipated; review findings limited by the availability and quality of the literature. The purpose and remit of the National Health Service Health Check programme should be clarified, considering prevailing attitudes about its value (especially among providers) and what can be delivered within existing resources. Some variation in delivery is likely to be appropriate to meet local population needs, but lack of clarity for the programme contributes to a 'postcode lottery' effect in the support offered to attendees after a check. Our findings raise important questions about whether the programme itself and services that it may feed into are adequately resourced to achieve positive outcomes for attendees, and whether current delivery models may produce inequitable outcomes. Policy-makers and commissioners should consider the implications of the findings of this project; future research should address the relative scarcity of studies focused on the end of the National Health Service Health Check pathway. PROSPERO registration CRD42020163822. This project was funded by the National Institute for Health and Care Research (NIHR) Health Services and Delivery Research programme (NIHR129209).

Differences in health care provider advice on abstaining from tobacco use: Findings from the 2020 National Youth Tobacco Survey

BackgroundHealth care providers’ (HCP) advice on tobacco prevention and cessation is critical in addressing the tobacco use epidemic among adolescents. However, examination of whether receiving advice from HCPs differs by adolescent sociodemographic characteristics and tobacco use is limited. MethodsHCP advice to abstain from using tobacco was examined using the 2020 National Youth Tobacco Survey (N = 12,483). Sociodemographic (age, sex, sexual orientation, race/ethnicity, and region) and tobacco use (non-current, sole, dual/poly) differences by HCP advice were evaluated using adjusted logistic regression models. ResultsAmong the sample, 37.26% of adolescents received HCP advice to abstain from using tobacco products, and 31.35% received HCP advice to abstain from using e-cigarettes specifically. Adolescents who were non-Hispanic Black (vs. non-Hispanic White) were more likely not to receive HCP advice to abstain from all tobacco products (OR = 1.31, 95% CI: 1.08–1.59). Adolescents who were non-Hispanic Black (vs. non-Hispanic White) (OR = 1.41, 95% CI: 1.16–1.73) or sexual minority (vs. heterosexual) (OR = 1.16, 95% CI: 1.02–1.33) were more likely not to receive HCP advice to abstain from e-cigarettes. Adolescents who were aged 16–18 (vs. aged 9–12) (OR = 0.68, 95% CI: 0.56–0.83) or currently use dual/poly tobacco products (vs. adolescents who do not currently use tobacco) (OR = 0.56, 95% CI: 0.43–0.74) were more likely to receive HCP advice to abstain from using e-cigarettes). ConclusionsMany U.S. adolescents do not receive HCP advice to abstain from using tobacco. HCPs should increase tobacco prevention and cessation advice across adolescent groups, particularly racial/ethnic and sexual minorities. HCP training and public health policies that improve delivery of e-cigarette advice to adolescents are essential.

UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study

ObjectivesDespite the known health benefits of physical activity (PA), PA levels are in decline. Healthcare professionals, including physiotherapists, have been identified as ideal conduits to promote PA, yet their knowledge...