Health Education Research Articles

Best Evidence Summary for Management of Older People With Type 2 Diabetes Mellitus Using 'Internet Plus Nursing Services'.

To evaluate and summarise the evidence for the management of older people with Type 2 diabetes mellitus (T2DM) using 'Internet Plus nursing services (IPNS)'. This study was conducted as an evidence summary, adhering strictly to the evidence summary reporting standards established by Fudan University Center for Evidence-based Nursing. We systematically searched for the best available evidence pertaining to the management of older people with T2DM using the IPNS. The literature types encompassed clinical guidelines, expert consensuses, systematic reviews, evidence summaries and original research studies. In order to gather pertinent information, we conducted a comprehensive search across various databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, PubMed, Web of Science, Yi Maitong Guidelines Network, SinoMed, CNKI, WanFang database, Chinese Biomedical Literature Database and China Science and Technology Journal Database. The search spanned from the inception of each database up to July 2023, ensuring an extensive coverage of relevant resources. After rigorous screening and evaluation, our study ultimately identified 19 articles with high-quality research outcomes. These articles consisted of three guidelines, two expert consensus documents, three systematic reviews and eleven original research studies. Through collaborative and in-depth discussions, we extracted and synthesised 27 pieces of evidence related to the application of the IPNS to enhance the T2DM management for older people. We categorised the evidence into five primary themes: mobile terminal design, team building, health education design, interaction and social support, and information feedback. In designing the IPNS for older people with T2DM, utmost attention should be paid to the intricacies of Internet module development preceded by comprehensive guidance. It is imperative to establish multidisciplinary teams to oversee the curation of patient educational content, ensuring its relevance and effectiveness. Leveraging Internet-based information feedback mechanisms is crucial for fostering peer support, assisting in blood glucose control, enhancing self-management capabilities and ultimately improving overall quality of life. Healthcare professionals are supposed to customise the IPNS for this vulnerable population, taking into account institutional resources and local contextual realities. It is highly recommended that clinical medical personnel worldwide adhere to the evidence-based recommendations for better care of older people with T2DM using the IPNS. No patient or public contribution was incorporated in this study. Our study provides structured ideas for the application of IPNS in T2DM management, provides practicable new ways for IPNS to improve self-management of older people with T2DM, and encourages the provision of Internet-based nursing services based on the needs and characteristics of older people, and jointly solves the challenges of T2DM management in order to enhance the effectiveness of nursing services.

Interdisciplinary Brain-based Learning Strategies in Addressing Liver Fluke Disease and Cultural Dietary Practices among Early Childhood Students

Liver fluke disease remains a critical public health issue in Southeast Asia, driven by cultural dietary practices involving raw or undercooked freshwater fish. This study evaluates the impact of an interdisciplinary brain-based learning intervention aimed at increasing awareness and modifying dietary behaviors among early childhood students in Central Northeast Thailand. A quasi-experimental design was employed, involving 122 students from four provinces. The intervention incorporated brain-based learning activities such as storytelling, songs, and visual aids to enhance engagement. Pre- and post-tests, behavioral observations, and attitudinal surveys were conducted to assess the program’s effectiveness. Post-intervention results indicated significant improvements in knowledge about liver fluke transmission, symptoms, and prevention, alongside positive changes in behavior, such as increased avoidance of raw fish consumption and improved hygiene practices. Attitudinal surveys showed a shift in preferences toward safer eating habits. These findings suggest integrating brain-based learning with culturally relevant health education can foster sustainable behavior change in early childhood populations. Further research is recommended to explore this approach’s long-term impacts and scalability.

Effect of lower-limb isokinetic muscle strengthening on knee function and joint contact force in knee osteoarthritis patients awaiting total knee arthroplasty: study protocol for a randomized controlled trial.

Knee osteoarthritis (OA) is a common and serious joint disease and patients mainly suffer from knee pain and dysfunction, significantly impacting their quality of life and daily activities. Non-pharmacological treatments and total knee arthroplasty (TKA) are the two major treatments for knee OA. TKA is the primary treatment for severe knee OA patients, however, the postoperative rehabilitation results are not entirely satisfactory. To enhance postoperative rehabilitation outcomes, preoperative lower-limb muscle strengthening has aroused attention and demonstrated significant results on functional recovery after TKA. Specifically, isokinetic muscle strengthening (IMS) has been highly anticipated as an efficient training method. Nevertheless, its effects in perioperative and long-term periods of TKA require further investigation. This study aims to evaluate the impact of preoperative lower-limb IMS during the 4weeks before TKA on the perioperative and postoperative outcomes, with particular attention on knee function, pain, and inflammatory response. In this study, 104 patients awaiting TKA will be randomized to 2 groups: the IMS and health education groups. All patients will be evaluated at baseline, post-intervention, discharge day, and postoperative day 14, with follow-up assessments at 6weeks, 3, 6, and 12months after discharge. The primary outcome will be the Knee Injury and Osteoarthritis Outcome Score 3months after TKA and the medial-to-lateral knee contact force ratio. The secondary outcomes will be changes in lower-limb muscle strength, knee pain, inflammation response, active range of motion, performance-based function (5-times Sit-to-Stand Test, Time Up-and-Go Test, 3m walking speed), Berg Balance Scale, and surgical need. Lower-limb IMS can improve muscle strength, pain, and function for early knee OA patients. However, the effects of different doses of IMS on perioperative and postoperative knee pain, inflammation response, and function after TKA are inconclusive. This study will provide high-quality evidence to assess the efficacy of IMS in end-stage patients who will undergo TKA. Understanding IMS in end-stage knee OA patients will help guide future surgical management for this population. Trial Registration Chinese Clinical Trial Registry ChiCTR2400088136.

Dental Health Education at Aisyiyah Kindergarten, Kalitengah Village

Dental and oral health is an important part of overall body health. Problems with teeth and mouth can negatively impact body health and interfere with daily activities, especially in children. Dental health education at Aisyiyah Kindergarten in Kalitengah Village is crucial for raising children's awareness of the importance of oral hygiene. This educational activity includes outreach on proper tooth brushing techniques, understanding the significance of dental health, and providing information on foods that are beneficial or harmful to teeth. Through a fun and interactive approach, children are encouraged to actively participate in tooth brushing practices and selecting healthy foods. The results of this activity indicate an increase in children's understanding of dental health, which is expected to foster good habits from an early age to maintain their dental health in the future

Determinants of maternal adherence to child vaccination in jordan: A cross-sectional study

In the past few years, a significant decline in vaccination coverage has been noted, leading to measles outbreaks. Mothers’ adherence or reluctance to undergo childhood immunization is a major contributing factor to a substantial population of children who remain unvaccinated or inadequately vaccinated. This study aimed to investigate adherence to children’s vaccination by investigating mothers’ personal and contextual factors in addition to knowledge and attitudes scores. A cross-sectional analytical design was employed, and data were collected from a sample of 533 mothers in Jordan between May and July 2023. The statistical analysis included descriptive analysis, t-test, ANOVA, and Pearson r correlation. The results demonstrated that adherence to vaccination was associated with several factors, including knowledge score (r = 0.33, p < 0.01), the ability to access and understand health information (r = 0.16, p < 0.01), income level (F = 11.88, p < 0.01), education level (F = 5.71, p < 0.01), employment (t = 2.41, p < 0.05), and working in a medical field (t = 4.5, p < 0.01). Scheffe post hoc analysis was performed to evaluate adherence outcomes according to the different categories of education and income levels. Mothers’ adherence to vaccination needs improvement, with special attention given to contributing factors. Strategies should be developed to target mothers with low incomes and educational levels and limited ability to access and understand health information to enhance maternal knowledge and eventually adherence to children’s vaccination.

Amphimeriasis in Ecuador-Prevalence, Knowledge, and Socio-Cultural Practices Among Indigenous Chachi and Montubios Populations: A Mixed-Methods Cross-Sectional Study.

Amphimerus, a liver fluke, is the causative agent of amphimeriasis, a foodborne disease acquired thought the consumption of infected raw or undercooked river fish-a practice embedded in traditional culinary customs. Amphimeriasis represents a significant public health issue and has been endemic in Ecuador since 2011, particularly among the Chachi Amerindians and Montubios populations residing in tropical ecoregions. By employing a mixed-methods research design, we conducted a community-based, cross-sectional study. A survey comprising of 63 questions on KAP was administrated in person to community members, health personnel, and academic staff in the two populations. Additionally, 67 semi-structured interviews were performed. Microscopy was achieved on 273 human and 80 dog fecal samples to detect Amphimerus eggs. A total of 86 questionnaires (54 Chachi) and 67 interviews (44 Chachi), out of 300 residents, were completed. Among the respondents, 31.4% were aware of Amphimerus, locally referred to as "liver worm". Although 79.1% reported not consuming raw fish, most admitted eating raw fish with lime juice and salt, a preparation known as "curtido", and 59.3% reported consuming smoked fish. Here, 86.1% of participants considered "liver worm" a serious disease, and 55.8% recognized raw or marinated fish as a potential transmission route. The Chachi showed a preference for smoked fish, whereas the Montubios favoured "curtido". The prevalence of Amphimerus infection was 23% in humans and 16.2% in dogs. Differences in KAP were observed between infected and non-infected individuals. Local health and academic personnel demonstrated insufficient knowledge about amphimeriasis. Some religious individuals refrained from participating, stating that they were "with God". Despite the high prevalence of Amphimerus infection in both humans and dogs, knowledge about the parasite, the disease, and its transmission routes remains limited. Health education initiatives should be designed to modify the population's KAP. It is crucial for national and local health authorities, as well as religious leaders, to be informed and actively involved in the prevention and control of amphimeriasis.

Assessment of Knowledge, Attitudes, and Practices towards Sexual and Reproductive Health among Secondary School Students in Kicukiro District, Rwanda

Sexual and reproductive health (SRH) is intricately connected to a variety of factors, including cultural norms, psychological influences, and individual experiences. This study explores the experiences of late adolescents regarding SRH, focusing on their knowledge, attitudes, and practices in Kicukiro District, Rwanda. Despite government efforts to educate youth on SRH, many secondary school students remain vulnerable to issues like unplanned pregnancies and sexually transmitted infections (STIs). To evaluate the knowledge, attitudes, and practices regarding sexual and reproductive health among secondary school students in Kicukiro District, Rwanda. The study targeted secondary school students from two schools: Groupe Scolaire Saint Vincent Pillotie Gikondo (urban) and EFOTEK (rural). Using Fisher’s formula, a sample size of 423 respondents was determined through stratified random sampling. Data were collected via structured questionnaires and analyzed using SPSS and descriptive statistics, including frequency, percentages, means, and standard deviations. The findings revealed that 88% of students were aware of puberty and pregnancy processes, while 78.7% were knowledgeable about contraceptive methods, particularly condoms and oral contraceptives. Positive attitudes towards SRH were noted, with a mean score of 4.00 for pre-marital relationships, but significant misconceptions existed, such as 11% of respondents lacking knowledge on HIV protection. The overall mean for practices related to SRH was 3.98 for seeking medical check-ups, indicating a willingness to engage with health services. However, practices promoting healthy lifestyles received a lower mean of 3.25, suggesting areas needing improvement. The study highlights the need for enhanced sexual and reproductive health education among secondary school students in Kicukiro District. While students demonstrate good knowledge and positive attitudes toward SRH, targeted interventions are necessary to address misconceptions and promote healthier practices, particularly in areas related to lifestyle and open communication.

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Prescribing Hydroxyurea in Sickle Cell Disease Patients: The Pattern and Association with Co-Prescribed Medications Used to Manage the Disease Complications.

Background and Objectives: Hydroxyurea (HU) is an effective medication used to reduce the frequency of painful crises associated with sickle cell disease (SCD). However, data describing its prevalence among SCD patients in the Eastern Region of Saudi Arabia are scarce. This is a multi-center, retrospective, cross-sectional study that aims to investigate the pattern of prescribing HU in SCD patients and to determine the association between prescribing HU and other co-prescribed medications used to manage SCD complications. Methods: Data were collected from patients who visited the hematology clinics of Al-Qatif Central Hospital (QCH) and King Fahad Hospital in Hofuf (KFHH) between June 2021 to May 2023. The data included demographics, prescribed medications, and recent laboratory test results, all of which were collected from patients' medical records. Descriptive statistics were utilized to assess the difference between HU users vs. non-users. A binary logistic regression model was used to determine the association between prescribing HU and co-prescribed medications used to manage SCD complications. The results are presented as the odds ratio (OR) and 95% confidence interval (95% CI). Results: This study included 2816 SCD patients with a 56% prevalence of HU prescription. HU was prescribed for young age groups more often compared to old age group patients. Young males were more likely to be prescribed with HU compared to females, and it becomes dominant in females after the age of 36. HU users were more likely to have paracetamol (69% vs. 53%, OR = 1.9, 95% CI 1.6-2.2), NSAIDs (50% vs. 35%, OR = 1.7, 95% CI 1.5-2), and opioids (41% vs. 37%, OR = 1.3, 95% CI 1.1-1.6) co-prescribed, and less often to have laxatives (8% vs. 5%, OR = 0.66, 95% CI 0.48-0.9) and anticoagulants (22% vs. 15%, OR = 0.56, 95% CI 0.46-0.68) co-prescribed compared to non-users. Conclusions: The pattern of prescribing HU, supported by the association findings, raises concerns about patients' compliance and adherence to HU therapy. Early health education, specifically to young female SCD patients, is warranted to increase the success rate of HU therapy.

Advocacy Skill Development in Public Health Education Curriculum: A Pilot Study.

The National Commission for Health Education Credentialing (NCHEC) released updated Responsibilities and Competencies for Health Education Specialists based on the 2020 HESPA II. For the first time, advocacy is a standalone area of responsibility (Area V: Advocacy) for health education specialists. Although this is exciting for the field of health education, there is limited consensus on how to effectively teach advocacy or what content and skills to include. Furthermore, while the HESPA II was updated, the Council on Education for Public Health (CEPH) criteria for advocacy have not been. This pilot study examined how CEPH-accredited programs in the United States are addressing the profession-wide advocacy competency in their health education curricula. A cross-sectional research design with single-point data collection was used to assess how CEPH-accredited university programs (including Standalone Baccalaureate Programs, Public Health Programs, and Schools of Public Health) are preparing health education students to meet the national advocacy responsibility. The survey included items from the Advocacy Area of Responsibility and potential barriers for faculty teaching advocacy. Results indicate that most programs are teaching something about advocacy, but there is no program teaching all listed sub-competencies. Barriers to including all components of the advocacy responsibility were largely related to faculty motivation, knowledge, and time. With a full responsibility area devoted to advocacy, it is reasonable to expect that programs will adjust with the profession. However, program administrators must be catalysts for these changes in their individual programs.

The Effectiveness of Dental Health Education Programs in Reducing Dental Caries Prevalence among Indonesian Adolescents

Dental caries is a significant public health issue among adolescents in Indonesia, exacerbated by limited access to preventive dental care and oral health education. This study aims to assess the effectiveness of Dental Health Education (DHE) programs in reducing the prevalence of dental caries among Indonesian adolescents. Using a qualitative research approach with secondary data analysis, the study reviews findings from existing literature and reports. The findings indicate that well-implemented DHE programs can reduce dental caries prevalence by 30% to 35%, with significant improvements in oral hygiene behaviors. However, factors such as geographic location, socioeconomic status, and cultural beliefs impact the success or failure of these programs. Rural and low-income communities face additional challenges in accessing dental care and educational resources. Technological innovations, including mobile health platforms, interactive apps, and SMS reminders, have shown promise in enhancing the delivery and effectiveness of DHE programs by making them more accessible and engaging. In conclusion, the success of DHE programs depends on addressing contextual barriers and incorporating technological solutions to improve reach and sustainability.

The Impact of Ecological Footprint, Urbanization, Education, Health Expenditure, and Industrialization on Child Mortality: Insights for Environment and Public Health in Eastern Europe.

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality.

Restless sleep is associated with increased anxiety in physical therapy students: a cross sectional survey study

BackgroundSleep and mental health are intimately related and shown to impact graduate students enrolled in health sciences programs, including physical therapy education. Doctorate of Physical Therapy (DPT) students’ attitudes and behaviors surrounding sleep and whether these factors are associated with mental health are unknown. This study aimed to describe sleep behaviors and attitudes of entry-level DPT students and to explore the relationship between subjectively reported sleep quality and self-reported symptoms of anxiety in these students.MethodsA cross-sectional online survey consisting of the Sleep Practices and Attitudes Questionnaire (SPAQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and demographic questions were used. Analyses investigated sleep behaviors and attitudes, along with the relationship (unadjusted odds ratio) between restless sleep and anxiety in DPT students in hybrid and traditional DPT programs across the United States (US).ResultsA total of 271 DPT students completed the survey. A majority of students reported feeling tired during most days (80.8%, n = 219), a quarter of participants (24.7%) reported having a history of trouble sleeping and four (1.5%) reported being diagnosed with a sleep disorder. Of those who reported their sleep duration, participants slept an average of 6.86 h. The mean GAD-7 score was 7.68 (SD = 4.90), suggestive of mild anxiety. Sixty-seven (24.7%) reported having a diagnosed anxiety disorder, with generalized anxiety being the most common diagnosis. Those who reported having restless sleep were 4.09 times more likely to have moderate to severe anxiety [unadjusted odds ratio = 4.09 (95% CI 2.27,7.35; p < 0.001)] compared to those who reported restful sleep.ConclusionsDPT students who rated sleep as restless exhibit signs of poor subjective sleep quality associated with an increased risk of experiencing moderate to severe anxiety compared to students who had restful sleep. Students reported behaviors surrounding sleep that may contribute to anxiety. These findings have implications for including sleep and mental health education and practices within DPT programs.

Inadequacy of antenatal care attendance and its determinants amongst pregnant women in Ethiopia based on the 2019 Mini-Ethiopian demographic health survey: secondary data analysis

BackgroundInadequacy of antenatal care (ANC) utilization is a prominent public health problem, causing poor pregnancy outcomes. In developing countries, including Ethiopia, having ANC coverage, many pregnant women do not achieve the first ANC visits in the first trimester and receive at least four ANC visits. Therefore, this study aimed to examine the magnitude and identify determinants of inadequacy of antenatal care attendance amongst pregnant women in Ethiopia.MethodsInadequate ANC attendance was defined as combining starting ANC visits after the first trimester and having fewer than four visits together. The study used secondary data from the 2019 mini-demographic and health survey. A weighted sample of 3927 pregnant women was included in this study. Data management and further analysis were performed using STATA 14 software. A multivariable generalized estimating equation analysis was used to identify determinants associated with inadequacy of antenatal care attendance. The Adjusted odds ratio with a 95% confidence interval was used to identify significant variables for inadequate antenatal care visits.ResultOverall, 78.5% of pregnant women did not attend adequate antenatal care visits during pregnancy. In multivariable generalized estimating equation analysis, women aged 25 to 34 years (AOR = 0.77, 95% CI: 0.61–0.95), being educated (AOR = 0.31; 95% CI: 0.22–0.45), and being wealthier index (AOR = 0.67, 95% CI: 0.51–0.88) were less likely to inadequate antenatal care attendance. Whereas being rural residents (AOR = 1.49; 95% CI:1.08–2.07), no television exposure (AOR = 1.51; 95% CI:1.1–2.06), having more family members in the household (AOR = 1.81; 95% CI: 1.11–2.95), and women from semi-peripheral region (AOR = 1.92; 95% CI: 1.42–2.59) were higher odds of being associated with inadequacy of antenatal care attendance.ConclusionsThe prevalence of Inadequate antenatal care attendance amongst pregnant women in Ethiopia is still High. The study identifies significant variables that could be positively and negatively associated with inadequate antenatal care visits. Health education interventions should target uneducated, poorer, and rural women to attend early antenatal care and use at least four antenatal care utilization for early detection of complications during pregnancy and delivery.

Determinants of medication non-adherence among patients with chronic diseases at community pharmacy settings in South Gondar Zone, Northwest Ethiopia: a multicenter cross-sectional study

BackgroundMedication non-adherence is a significant public health concern in managing patients with chronic diseases, and community pharmacists are on the frontline in the management of chronic medications. Chronic diseases require lifelong pharmacotherapy and understanding the determinants of medication adherence has paramount importance to develop strategies that improve medication adherence and treatment outcomes. Thus, this study aimed to assess the magnitude of medication non-adherence and its contributing factors among patients with chronic diseases attending community pharmacies in South Gondar Zone, Northwest Ethiopia.MethodsA multicenter cross-sectional study was conducted at community pharmacies in South Gondar Zone from September 01 to October 30, 2023. Medication adherence was assessed using a structured questionnaire using the Adherence in Chronic Diseases Scale (ACDS). Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Association between the outcome variable and independent variables was performed using binary logistic regression and a p-value of &amp;lt;0.05 was considered statistically significant.ResultsAmong three hundred and eighty six (386) study participants recruited in this study, more than half of them 222 (57.51%, 95%CI: 52.4% - 62.5%) were low adherent to their medications. Concerning determinants of medication non-adherence; the presence of side effects (AOR =2.1, 95%CI=1.33-3.29), unable to get ever counseling from community pharmacists (AOR=2.3, 95%CI= 1.46-3.58), and poor about their medications (AOR=3.1, 95% CI= 1.96-4.82) were significantly associated with patients’ non-adherence to medications.ConclusionThe medication adherence level in this study was suboptimal, with a significant proportion of the patients being non-adherent to their medications. The presence of side effects, unable to get ever counseling, and poor knowledge about their medications were statistically significant factors of poorer medication adherence. Hence, healthcare professionals, especially community pharmacists, have a crucial role in designing the schedule for health education concerning the needs of these patients in community pharmacy settings.

Perspective of Midwives in Turkey Regarding Sexual Health Literacy and Sexual Healthcare Services.

This study aimed to examine the factors associated with the level of sexual health literacy of midwives and their views on sexual healthcare. This is a descriptive and correlational study. A total of 324 midwives with at least 1 year of professional experience and at least a bachelor's degree participated in the study. Data were collected with the "Midwife Information Form" and "Sexual Health Literacy Scale." The professional work experience, marital status, and education related to sexual health did not affect the sexual health literacy of midwives. Age, educational status, and voluntary choice of the profession willingly affected sexual health literacy. The sexual health literacy of midwives who hold positive views on sexuality and sexual healthcare services is higher. The midwives' perspectives on sexual health, their level of knowledge, and the sexual health education they receive impact the quality of care they provide. Sexual and reproductive health should be emphasized within the scope of midwifery education.

Dual HIV risk and vulnerabilities among people who inject drugs in Iran: Findings from a nationwide study in 2020

IntroductionPeople who inject drugs (PWID) are a key population at risk of HIV in Iran. We measured the prevalence and covariates of HIV-related risk behaviours among PWID in Iran.MethodsWe conducted a respondent-driven bio-behavioural surveillance survey among PWID from July 2019 to March 2020 in 11 major cities. We assessed PWID’s recent (i.e., last three months) HIV-related risk behaviours using a four-level categorical variable: Only unsafe injection (i.e., sharing needles/syringes or injecting equipment), only unsafe sex (i.e., unprotected sex), dual HIV risk (i.e., both unsafe injection and unprotected sex), and safe injection and sex. Data were summarized using RDS-weighted analysis. Multinomial logistic regression models were built to characterize HIV-related risk behaviours and relative risk ratio (RRR) with 95% confidence interval (CI) were reported.ResultsOverall, 2562 men who inject drugs (MWID) were included in the regression analysis. The RDS-weighted prevalence of dual HIV risk was 1.3% (95% CI: 0.8, 1.9), only unsafe injection was 4.5%, and only unsafe sex was 11.8%. Compared to the safe injection and sex group, dual HIV risk was significantly and positively associated with multiple partnership (RRR = 15.06; 3.30, 68.73). Only unsafe injection was significantly associated with homelessness in the last 12 months (RRR: 3.02; 95% CI: 1.34, 6.80). Only unsafe sex was significantly associated with multiple partnership (RRR = 6.66; 4.27, 10.38), receiving free condoms (RRR = 1.71; 1.01, 2.89), receiving free needles (RRR = 2.18; 1.22, 3.90), and self-received risk for HIV (RRR = 2.51; 1.36, 4.66). Moreover, history of HIV-testing in the last three months was significantly associated with only unsafe injection (RRR = 2.71; 1.84, 3.80). Among the 90 women who injected drugs, none reported dual HIV risk behaviours.Discussion and conclusionsWhile the low prevalence of dual HIV risk among PWID is encouraging, unprotected sexual practices among PWID is concerning. Expanding sexual health education and care services as well as tailored interventions aimed at reducing high-risk sexual activities among PWID are warranted. Additionally, tackling potential misperceptions about risk of HIV transmission among PWID in Iran is warranted.

Interventions for Preventing Tobacco Uptake among Adolescents within School Setting in South-East Asia region: A Systematic Review

Abstract Background Tobacco users disproportionately reside in lower-and-middle income countries, with many people beginning consumption of tobacco in adolescence. Countries employ interventions in schools as a means of providing health education thereby creating mass awareness among them. However, research has mostly restricted to developed nations. Objective To examine the impact of interventions implemented in preventing tobacco uptake among adolescents in school setting in South-East Asia region. Method The protocol was registered prospectively on PROSPERO (CRD42022337341). Systematic search was conducted on 6 databases: PubMed, Embase, Scopus, CINAHL, ProQuest and Web of Science. Randomized Control Trials (RCT) and Cluster RCT conducted in school set-up in South-East Asia among adolescents below 18 years’ age were included. Articles between timeline 2002–2022 were considered. Results From a total of 963 articles, total of 13 studies were included. Four were RCT, while nine were Cluster RCT. Most of the studies were targeted at change in prevalence, followed change in knowledge and attitude towards tobacco and impact on susceptibility to use tobacco. Nine studies had interventions based on Health Promoting School Framework, three were Peer-led Interventions and one was Counsellor-centred Intervention. Risk of Bias assessment revealed eight studies had low risk of bias, two had some concerns while three were high risk studies. Conclusion Interventions that focus on building a holistic environment and go beyond the usual classroom environment have primarily been implemented and found to be effective in this region. There is a need for strong, high-quality RCT studies with standardised evaluation techniques to combat tobacco use among adolescents.

Sex Educators' Strategies for Building Student Trust.

Although clinicians have been the focus of research on trust in health care, much of the health guidance Americans receive occurs outside clinical settings. School-based health education is one such setting. Given the importance of interpersonal dynamics to clinicians' work, trust likely features heavily in achieving health educators' outcomes. This study asks: How do health educators approach building trust with students? In interviews with 39 sexual health educators in Ohio and Illinois, I find that educators report several strategies that they use in their attempt to build student trust: They use personal anecdotes and informality to distinguish themselves from teachers; adjust their approach based on their race, gender, or age if they perceive these identities impede trust; and emphasize lessons are factual when facing pushback. My findings reveal key differences in how clinicians and nonclinical professionals approach trust and more broadly, how organizational factors impact health professionals' approach to trust.

The Effect of Cervical Cancer and Human Papillomavirus Vaccine Education on Vaccination Perception in University Students: A Quasi-Experimental Controlled Educational Intervention.

Purpose: The study investigated the impact of cervical cancer and human papillomavirus (HPV) vaccine education on university students' vaccination perceptions. Methods: This research was conducted with pre- posttest and quasi-experimental design with students enrolled in the department of health services of a university. The sample of the study consisted of 87 students (n = 43 in the intervention group, n = 44 in the control group). Research data were collected between June 29 and July 22, 2022, using the Introductory Information Form and HPV Information Scale. An informative training program about cervical cancer and HPV was applied to the intervention group. This training program was carried out in two separate sessions. In the first session, information was given about the prevalence, pathology, and risk factors of cervical cancer. In the second session, general information about HPV, details about the vaccine, and vaccination programs were given. Training sessions are organized as small group discussions and seminars covering relevant topics. Results: In our study, the average age of our students was 20.7 ± 2.5 years, and in both groups, the proportion of students who did not know about HPV, which can cause cervical cancer, was quite high (74.4%, 68.2%). The majority of the control and intervention groups needed health education about STDs. There were statistically significant differences between the control and intervention groups in terms of the pre-test and posttest Knowledge of HPV Scale scores (p < 0.05). Conclusion: It was found that the education on cervical cancer and HPV positively affected the perspectives of the students on vaccination. Interactive and group-oriented education increases knowledge sharing by encouraging interaction among students. In this way, a broader knowledge base about cervical cancer and HPV can be created, and misinformation can be corrected.