Development Of Health Promotion Programs Research Articles

Impact of breastfeeding on ICU admissions and need for mechanical ventilation in infants younger than 6 months with RSV+ bronchiolitis. An observational study.

This work aimed to analyze whether breastfeeding is a predictive factor for admission to ICU or needing mechanical ventilation in children under 6 months with RSV+ respiratory infection. A retrospective cohort study was performed in three hospitals. Binary and multiple logistic regression analyses were performed to evaluate the association of variables with admission to the ICU or receiving mechanical ventilation. We analyzed 414 admissions, of which 293 (70.8%) had received breastfeeding, 43 (8.1%) were admitted to the ICU, and 26 (5.4%) required mechanical ventilation. Bivariate analysis showed that breastfeeding for at least 15 days and a longer duration of breastfeeding were associated with a lower risk of admission to the ICU and requiring mechanical ventilation. Multivariate analysis showed that not having been breastfed for at least 1 month was predictive of ICU admission; not having been breastfed for at least 2 months was predictive of needing mechanical ventilation. Breastfeeding for as little as 15-28 days could be associated with a lower risk of ICU admission and requiring mechanical ventilation in infants younger than 6 months admitted for RSV+ bronchiolitis. Since breastfeeding is one of the few protective factors that can be promoted, this finding is relevant for current clinical practice and the development of health promotion programs. Future studies can compare their results to ours.

Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan.

The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors. Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05). The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.

Research Centers Collaborative Network Workshop on Digital Health Approaches to Research in Aging.

Digital health technologies are ubiquitous in the healthcare landscape. Older adults represent an important user group who may benefit from improved monitoring of physical and cognitive health and in-home access to care, but there remain many barriers to widespread use of digital health technologies in gerontology and geriatric medicine. The National Institute on Aging Research Centers Collaborative Network convened a workshop wherein geriatricians and gerontological researchers with expertise related to mHealth and digital health applications shared opportunities and challenges in the application of digital health technologies in aging. Discussion broadly centered on 2 themes: promises and challenges in (i) the use of ecological momentary assessment methodologies in gerontology and geriatric medicine, and (ii) the development of health promotion programs delivered via digital health technologies. Herein, we summarize this discussion and outline several promising areas for future research.

Oral health promotion for rural adolescents: A process evaluation of a co-designed pilot program.

Adolescents living in rural areas are more likely to have poorer oral health compared with their metropolitan counterparts. Co-design is emerging as an effective method for developing health promotion programs that meets the needs of stakeholders; however, little evidence exists to inform successful co-designed oral health promotion programs for rural adolescents. The aim of this study is to understand the value of a co-designed oral health promotion program undertaken with rural adolescents in northeast Victoria with objectives to: Co-design an oral health promotion program with rural adolescents. Evaluate the program for appropriateness, acceptability, and feasibility. Make recommendations for program refinement and scalability. Study participants included year 11 and 12 students in a rural secondary school in Northern Victoria (n=2), who collaboratively along with schoolteachers, and the local health service staff led by an oral health therapist, co-designed, and delivered an oral gealth promotion program in their schools. This qualitative study used semi-structured group interviews (n = 8) to evaluate the co-design process and impact. Audio-recorded interviews were transcribed and thematically analysed using a co-design evaluation toolkit as a framework for analysis. Qualitative inductive analysis revealed three main thematic categories around participant benefits (intended and unintended learning outcomes; interpersonal skills), the quality of the process (value of co-design, qualities of facilitators, and engagement); and scalability and replicability. The study indicates that co-design was both acceptable and appropriate for designing an oral health promotion program for rural adolescents delivering unexpected benefits. Building the capacity of schoolteachers could offer sustainable and cost-effective solutions for scalability.

A Structural Equation Model on Health Status in Delivery Workers: Based on the Theory of Salutogenesis

Purpose: This study aimed to develop and test a structural equation model on health status of delivery workers. The conceptual model was based on the theory of salutogenesis. Methods: Data were collected from 262 delivery workers working in D and K cities from August 2 to August 27, 2021. The structural equation model was used to assess the relationships among the variables. The model comprised three exogenous variables (working environment, social support, health promotion activities) and two endogenous variables (sense of coherence, health status). The data were analyzed using SPSS 23.0 and AMOS 22.0. Results: The hypothetical model showed a good fit to the data: χ&lt;sup&gt;2&lt;/sup&gt;/df=2.38, TLI=.91, CFI=.93, SRMR=.08, RMSEA=.07. Out of 10 research hypotheses, 10 were supported, and explained 62.3% of the variance in the health status of delivery workers. The model confirmed that sense of coherence was the most important factor. Health status is directly affected by working environment, social support, and health promotion activities. Health status is indirectly affected by working environment, social support, and health promotion activities through mediation of sense of coherence. Conclusion: The theory of salutogenesis is adequate to use for developing health promotion programs for delivery workers. There is a need to develop a customized program to increase health status of delivery workers by enhancing sense of coherence.

O.1.3-6 Using a socio-ecological approach to explore healthy lifestyle in elite sport: perspectives of athletes, coaches and managers

Abstract Purpose Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the individual factors related to risky behaviors and disorders in elite sport contexts, and have provided prevention programs, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviors of elite athletes are still poorly explored. Based on the socioecological model of health, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Methods Semi-structured interviews were conducted with 45 participants: athletes (N = 32; Mage=20.1, SD = 4.4), their coaches (N = 6; Mage=45.3, SD = 6.4) and managers of elite sport centers (N = 7; Mage=52.0, SD = 7.0). Interviews were audio recorded and transcribed verbatim. Both deductive and inductive thematic analyses were performed. This study was approved by the local Ethic Committee of the University. Results Our results highlight the different levels of factors related to the health-related lifestyle of elite athletes, using the socioecological model, as perceived by athletes themselves, coaches, and managers. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors to influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches were considered as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centers were key factors in supporting the athletes’ healthy lifestyle. Similarities and specificities of the views of the different actors have been identified. Conclusion These results show the interest of the application of the socioecological model in the elite sport domain. They encourage the development of health-promotion programs at different levels of intervention of the socioecological model, beyond traditional health prevention programs. In addition, this study suggests to consider the different perspectives of each actor to co-construct health promotion programs.

Using a socioecological approach to explore healthy lifestyle in elite sport: a qualitative study of French athletes’, coaches’, and managers’ perspectives

ABSTRACT Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the individual factors related to risky behaviours and disorders in elite sport contexts, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviours of elite athletes are still poorly explored. Based on the socioecological model, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Semi-structured interviews were conducted with 45 participants: athletes (N = 32), their coaches (N = 6) and the managers of elite sport centres (N = 7). Both deductive and inductive thematic analyses were performed. Our results highlight the views of the actors. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors in influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches emerged as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centres were key factors in supporting the athletes’ healthy lifestyle. These results encourage the development of health promotion programs at different levels of intervention.

Health-related quality of life in older women with injuries: a nationwide study.

This study aims to describe the health-related quality of life (HRQoL) and influencing factors of older women who experienced injuries. This study is a secondary analysis of data from 4,217 women aged 65 years or older sampled from the Korea National Health and Nutrition Examination Survey (KNHANES) (2016-2020) database. Two-way analysis of variance was used to analyze the data. The mean HRQoL scores of older women with and without injuries were 0.81 ± 0.19 (n = 328) and 0.85 ± 0.17 (n = 3,889), respectively, which were significantly different (p < 0.001). The results of multiple regression analysis revealed that working, physical activity, BMI, osteoarthritis, stress, and subjective health status significantly affected the HRQoL of older women with injuries, and the explanatory power of the model was 29%. The results of this study on factors affecting HRQoL can contribute to the understanding of the experience of older women with injuries and can be used as a reference to develop health promotion programs.

The Correlation between Adolescent Daily Breakfast Consumption and Socio-Demographic: Trends in 23 European Countries Participating in the Health Behaviour in School-Aged Children Study (2002-2018).

Breakfast is often considered the most important meal of the day and can benefit adolescent health in several ways. The aims of the present study were (1) to identify adolescents' socio-demographic (sex, family affluence and family structure) determinants of daily breakfast consumption (DBC) and (2) to describe trends in DBC among adolescents across 23 countries. Cross-sectional surveys of nationally representative samples of adolescents (aged 11, 13, and 15 years) (n = 589,737) participating in the Health Behaviour in School-aged Children (HBSC) survey from 2002 to 2018 were used. Multilevel logistic regression analyses modeled DBC over time, adjusted for family affluence, family structure and year of survey. Four countries showed an increased trend in DBC (the Netherlands, Macedonia, Slovenia, and England). A significant decrease in DBC was observed in 15 countries (Belgium-Fr, France, Germany, Croatia, Portugal, Spain, Hungary, Poland, Russian Federation, Ukraine, Denmark, Finland, Latvia, Lithuania and Sweden). In 4 countries no significant change was observed (Czech Republic, Scotland, Ireland and Norway). In most of the countries (n = 19), DBC was higher among the adolescents from high-affluence homes. In all the countries analysed, the adolescents living in two-parent households report higher DBC use than those in single-parent households. More than half of the countries showed a decrease in DBC. There is a need to implement key interventions by developing different strategies (education, incorporating educational curriculum and counselling programmes) to increase DBC. Comparing DBC patterns across HBSC countries is important for understanding regional and global trends, monitoring strategies, and developing health promotion programmes.

Factors correlating with self-care behaviors among patients with coronary artery disease: a cross-sectional study

Background: In Palestine, there is a lack of studies that examined self-care behaviors among patients with coronary artery disease in outpatient clinics. Objective: This study purposed to evaluate self-care behaviors, examine the relationship between self-care behaviors and selected sociodemographic and psychosocial factors (e.g. depression, anxiety, stress, and social support), and self-efficacy, and determine predictors of self-care behaviors among patients with coronary artery disease in outpatient clinics in the West Bank/Palestine. Design: A cross-sectional study was conducted. Methods: A total of 430 Palestinian adult patients suffering from coronary artery disease attended outpatient clinics were recruited. A self-reported questionnaire consisting of the following tools: Depression, Anxiety, Stress Scale 21, Sullivian’s Self-efficacy scale, and Multidimensional Social Support Scale was used to collect data during the period from the beginning of April to the beginning of July 2022. Descriptive and inferential statistics (Pearson’s and Point-biserial correlation tests and multiple linear regression) were used for analyzing data. Results: The patients reported low self-care behaviors levels and high self-efficacy levels. The psychosocial reactions endorsed by the patients were 86.3% for depression, 76.3% for anxiety, 43.3% for stress, and 98.6% had moderate and normal social support. A positive correlation was found between self-care behaviors and age (r = 0.160, p < 0.01), duration of disease (r = 0.095, p < 0.05), self-efficacy (r = 0.443, p < 0.01), and social support (r = 0.266, p < 0.01). Self-efficacy (B = 0.401, p < 0.01), social support (B = 0.160, p < 0.01), and age (B = 0.109, p < 0.05) were significant predictors of self-care behaviors in those patients. Conclusion: Low self-care behaviors were a significant issue among patients with coronary artery disease in outpatient clinics. This study may help healthcare professionals develop health promotion programs for patients with coronary artery disease to improve self-care behaviors.

Determinants of Health Protocols Compliance on Office Workers

Abstract. The high number of Covid-19 cases contributed to office clusters. To reduce the spread of Covid-19, the government has implemented the 5M health protocol. However many people, especially office workers, violate this health protocol. One of the available approaches to analyze non-compliance behavior is by using the Health Belief Model (HBM). This study aims to determine the factors affecting office workers' compliance with the Covid-19 preventive health protocol, explained bythe Health BeliefModel (HBM) theory to develop health promotion programs which may contribute to the compliance level of the office workers. This research is a correlational quantitative study with a sample of 357 office workers in the Surakarta residency. The data were collected online by usings six scales uploaded in the Google Form, consisting of the perceived susceptibility scale, perceived severity scale, perceived barriers scale, perceived benefits scale, self-efficacy scale, and the Covid-19 prevention protocol compliance scale. The path analysis was carried out by using JASP 14.1 to analyze the collected data. The result shows that health protocols are greatly helped for workers by many cues/stimuli that will appear with the many perceived barriers in implementing health protocols but will increase with relevant facts. Self-efficacy plays a vital role in influencing health protocol compliance in office workers. Providing more intense education that focuses on providing solutions that workers can take when facing difficulties in implementing health protocols can be one way to further increase confidence in workers in implementing health protocols.Keywords: compliance; health belief model; health protocol; office worker

Patterns and Determinants of Weight Gain among People Who Use Drugs Undergoing Treatment for Recovery in Lebanon

Substance use disorder compromises the nutritional status and the eating habits of drug users, often leading to malnutrition. Once referred for treatment, hyperphagia and poor lifestyle practices leading to weight gain are observed. This study aimed to examine the patterns and extent of weight change as well as the determinants of weight gain in a sample of drug users who were receiving treatment in Lebanon. A total of 172 male participants undergoing either rehabilitation or opioid substitution treatment (OST) were included. Multivariate regression analysis was applied to assess the effect of different variables on weight gain while adjusting for potentially confounding variables. Approximately two-thirds (65.1%) of the participants gained weight (OST: 54.3%, rehabilitation: 78.2%; p < 0.05). The mean weight gain was 5.9 kg and was mainly reported among participants in the underweight, normal, and overweight pre-treatment categories and accentuated in the rehabilitation group (OST: 2 kg, Rehabilitation: 10.6 kg). Around half of the participants moved from the normal weight category to the overweight and obese categories during treatment. Weight gain was negatively associated with the number of previous treatment attempts (Odds Ratio = 0.86; Confidence Interval: 0.74-0.99), duration of current treatment (Odds Ratio = 0.98; Confidence Interval: 0.96-0.99), and pre-treatment body mass index (BMI) (Odds Ratio = 0.88; Confidence Interval: 0.80-0.96). Investigating other nutrition and lifestyle practices, neither nutrition knowledge, food addiction, physical activity level, nor sleep quality were associated with weight gain. Treatment through drug use was associated with meaningful weight gain that might lead to health risk factors. Developing health promotion programs is crucial to enhance treatment and decrease the risk of relapse.

From self-care behaviours to cardiometabolic risks prevention for the health of farmers: Nursing implications.

The study aimed to explore farmers' self-care behaviours including oral hygiene, remaining natural teeth, cardiometabolic risks, hepatitis, risk of stroke and their determinant factors. This cross-sectional study was conducted between June 2020 and March 2021 in the south-western remote areas of Taiwan. We recruited current farmers who participated in an annual community health screening conducted by a collaborated local hospital. Data were collected through face-to-face interviews using a semi-structured questionnaire. Blood samples were drawn and stored in the central laboratory of the cooperating hospital. The study outcomes included cardiometabolic risks, the remaining natural teeth, and farmers' self-care behaviours including oral hygiene, adopting a healthy diet and substance use. Overall, 183 current farmers (55.2% women, aged 66.9 ± 11.7 years) were enrolled. Abnormal blood pressure, high risk of stroke, metabolic syndrome and hepatitis C virus infection were found among the participants. The average remaining teeth were 12.1, 73.2% of participants had <20 teeth; 90.2% and 71% did not undergo regular dental check-ups and scaling or use dental floss, respectively. The determinant factors associated with the remaining teeth included a high risk of stroke, teeth scaling and dental floss use. Although only 3.8% felt mentally distressed, many farmers were unaware of having potential cardiometabolic diseases and curable viral hepatitis, and only two had received antiviral treatment. The farmers in this study had a high prevalence of cardiometabolic risks, a high probability of stroke, inadequate number of remaining teeth and poor oral hygiene behaviours. These findings can provide evidence to develop health promotion programmes for farmers. This study demonstrates the health needs of farmers. We strongly recommend that community nurses empower farmers to engage in self-care behaviours through tailored health promotion programmes. For instance, by discussing cardiometabolic risk prevention from the farmers' perspectives to improve their health literacy.

Sexualized Images on Social Media and Adolescent Girls' Mental Health: Qualitative Insights from Parents, School Support Service Staff and Youth Mental Health Service Providers.

This research explored adults' perceptions of how sexualized images typically found on social media might influence adolescent girls' mental health, what support girls might need should they experience mental health difficulties, and how such difficulties could be prevented or reduced. Qualitative data were collected using semi-structured in-depth interviews with parents of adolescent girls (n = 11) and those who provide support to them: school support service staff (n = 7) and youth mental health service providers (n = 10) located in Perth, Western Australia. All three participant groups perceived sexualized images typically found on social media as exacerbating poor mental health among adolescent girls. Two interrelated themes, emerged with participants describing the 'potential for comparison' and 'pressure to conform' they believed girls encounter on social media that influences their mental health. Participants also explained how they perceived 'counteracting negative influences' related to sexualized images on social media could prevent or reduce the potential for mental health harms among girls, and the importance of adults and services 'keeping up to date' and being 'approachable and trustworthy' when describing the support they believed girls might need. The findings of this study have important implications for the development of health promotion programs focused on social media use and mental health among adolescent girls.

Family caregivers' perspectives of cultural beliefs and practices towards mental illness in Zambia: an interview-based qualitative study.

Many elements of mental illness, including accessibility and utilization of mental health care, are influenced by societal cultural ideas. In Zambia, for example, traditional healers are not recognized, yet a large segment of the population continues to use their services due to their conviction. Despite this, studies on cultural beliefs and practices regarding mental illness in Zambia are scarce. Thus, this study is contextualized in Lusaka, Zambia, with the goal of filling a gap in the knowledge by exploring the cultural beliefs and practices surrounding mental illness as experienced by family caregivers caring for a next-of-kin with mental illness. Using a qualitative exploratory design, a purposeful sample of 15 family caregivers of next-of-kins diagnosed with mental illness were recruited. Data were collected via individual interviews, and analyzed using qualitative thematic analysis. The analysis revealed four main themes: (1) prevailing beliefs on cause of mental illness; (2) encountering social support and neglect; (3) recognizing the need of professional help; and (4) seeking culturally influenced help. Findings show that traditional attributions (for example, being bewitched, demon possession and sexual relations with uncleansed widows) are deeply embedded in beliefs and descriptions of what causes mental illness. These beliefs were found to influence not only help-seeking practices but also how people perceived and related to families. Given that beliefs influence caregiver help-seeking, these findings have implications for culturally sensitive practice. The study recommends that public health practitioners consider cultural beliefs and practices when developing health promotion programs, and public health messages.

“It just Sends the Message that you’re Nothing but your body” a Qualitative Exploration of Adolescent Girls’ Perceptions of Sexualized Images on Social Media

This qualitative study used in-depth interviews to explore adolescent girls’ perceptions of sexualized images they typically find when using social media. Twenty-four participants aged 14–17 years described sexualized images of females as normalized on social media. The interplay between gendered and social norms that endorsed and rewarded girls for posting sexualized images was seen to influence an expectation for girls to conform with their peers and post such images of themselves. They indicated sexualized images emphasize personal value on appearance and rejected this notion. However, participants also believed girls should be able to post sexualized images of themselves if they wanted to. There were tensions between whether girls’ sharing of sexualized images of themselves on social media would be interpreted as a display of confidence (socially acceptable) or attention seeking (socially unacceptable). Findings provide guidance for the development of health promotion programs to reduce potential harm from social media use by adolescent girls.

Relationship Between Individual Factors of Empowerment and General Health in Older Adults Attending Neighborhood Houses in Tehran, Iran

Objectives By the rapid growth of the elderly population, the need to pay attention to this group becomes more obvious. General self-efficacy, self-control and self-esteem are the effective individual factors for the empowerment of the elderly. This study aims to examine the relationship between these individual aspects of empowerment and general health in older adults attending neighborhood houses in Tehran, Iran. Methods &amp; Materials In this descriptive-analytical study with cross-sectional study design, 320 older men and women over 60 years of age participated who were selected by a cluster sampling method. Data were collected using a demographic form, the 28-item general health questionaire, 10-item general self-efficacy scale, Rosenberg self-esteem scale, and Tangney’s brief self-control scale. Data was described using mean and standard deviation, and analyzed using chi-square test, Spearman correlation test, one-way-ANOVA, and linear regression in SPSS sofwtare, version 22. Results The mean age of the elderly was 68.42±8.3 years. Their mean score of general health was 21.95±13.4. A significant negative correlation was found between general health, general self-efficacy, self-esteem and self-control (P&lt;0.001). Their general health had a significant relationship with their educational level (P&lt;0.001), years of employment (P=0.002) and housing status (P&lt;0.001). The multivariate regression results showed that housing status (P=0.156), self-esteem (P&lt;0.001), self-control (P&lt;0.001), and general self-efficacy (P&lt;0.001) were the significant predictors of general health in the elderly. Conclusion There is a relationship between general health, general self-efficacy, self-esteem, and self-control of the elderly in Tehran. Their general health is related to their educational level, years of employment, and housing status. Housing status, self-esteem, self-control and general self-efficacy are predictors of their general health. Attention should be paid to these factors in developing health promotion programs for the elderly.

Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women.

This study aimed to determine the effects of health coaching on reducing menopausal symptoms in postmenopausal and perimenopausal women. This randomized controlled study was performed on 94 postmenopausal and perimenopausal women aged 45 to 55 years. The participants were randomly divided into intervention and control groups. In the intervention group, health coaching was performed in five coaching sessions biweekly (30-45 minutes each) by a midwifery coach. The primary outcome of this study was the menopausal score based on the modified Kupperman Index at 4 months after randomization. Depression (based on Zung's Self-Rating Depression Scale), physical activity (based on the International Physical Activity Questionnaire), quality of life (based on the 12-Item Short-Form Survey), smoking, alcohol intake, and anthropometric indices were also evaluated as secondary outcomes. There was a significant mean difference between the coaching and control groups in terms of change in the scores of menopausal symptoms from baseline (T0) to 4 months after the intervention (T1; -12.51; 95% confidence interval [CI], -10.59 to -14.42; P = 0.001). Moreover, a significant mean difference was observed between the two groups in terms of change in depression symptoms from T0 to T1 (-5.72; 95% CI, -7.61 to -3.83; P < 0.001) and in terms of quality of life (4.13; 95% CI, 2.95 to 5.31; P < 0.001). Health coaching, however, had no effects on the physical activity of the participants. Based on the present results, the coaching intervention is a suitable method to improve quality of life by reducing weight, waist circumference, body mass index, depression, and menopausal symptoms in postmenopausal and perimenopausal women. It can have important effects on the development of health promotion programs to reduce menopausal symptoms in menopause clinics.

“Why don’t I look like her?” How adolescent girls view social media and its connection to body image

BackgroundAdolescent girls appear more vulnerable to experiencing mental health difficulties from social media use than boys. The presence of sexualized images online is thought to contribute, through increasing body dissatisfaction among adolescent girls. Sexual objectification through images may reinforce to adolescent girls that their value is based on their appearance. This study explored how sexualized images typically found on social media might influence adolescent girls’ mental health, in positive and/or negative ways.MethodsIn-depth interviews were conducted with girls aged 14–17 years (n = 24) in Perth, Western Australia. Data were analyzed using thematic analysis.ResultsParticipants identified body image as a major concern, reporting negative appearance comparisons when viewing images on social media. Appearance comparisons were perceived to exacerbate adolescent girls’ appearance-based concerns. Comparisons also influenced adolescent girls’ efforts to change their appearance and seek validation on social media. The importance of awareness and education from a younger age about social media and its influence on body image was emphasized, as was the need for strategies to promote positive body image and counteract negative body image.ConclusionThe findings of this study have important implications for professionals working with adolescent girls and for the development of health promotion programs addressing social media use and body image concerns.

Co-creating with families and healthcare professionals: shaping a context-sensitive health promotion intervention 'Face-it'.

Participatory methodologies have become imperative when developing health promotion programmes. However, the concrete adoption of co-creation and its implications for intervention development are less reported. This article aims to convey how fidelity and adaptation were balanced in a structured intervention design by co-creating intervention components with various stakeholders. The intervention was part of the Face-it programme, which was initiated to prevent diabetes and increase the quality of life in women with prior diabetes during pregnancy by supporting the entire family's health practices. We relied on participatory methods, e.g. workshops using design games, role play and family interviews, as well as ethnographic fieldwork. Stakeholders comprised women with prior gestational diabetes mellitus and their families as intervention receivers and healthcare professionals, e.g. obstetricians, midwives and health visitors as potential intervention deliverers to shape intervention content. We used Bammer's stakeholder participation spectrum in research to describe how different stakeholders were engaged and with what implications for the intervention components. This article shows how an iterative co-creation process was (i) achieved through diverse involvement practices across stakeholder groups; and (ii) upheld both premises of the structured design (fidelity) and flexibility (adaptation) in developing intervention content and delivery. When adopting co-creation as a strategy for intervention development, we recommend using various engagement practices according to the role of stakeholders in the intervention and available resources to create ownership and sustainable intervention content.