Individual Health Behaviors Research Articles

Understanding cultural perceptions of sexuality in China and their influence on human papillomavirus vaccine hesitancy

IntroductionThe human papillomavirus (HPV) vaccine prevents infections that may result in precancerous lesions, cervical cancers, genital warts, and many other diseases. However, its uptake rate in China is 2.24%, and HPV vaccine hesitancy is widespread. This study aimed to identify whether cultural perceptions of sexuality in China influence HPV vaccine hesitancy and explore the correlation between sexual attitudes, sexual morality, and HPV hesitancy in Chinese.MethodsBetween January and April 2024, we adopted a qualitative approach and conducted in-depth, one-on-one, semi-structured interviews with 15 young female Chinese university students of sexual maturity.ResultsAlthough all college students exhibited vaccine hesitancy, their perceptions of vaccines and reasons for hesitation varied. This study classified hesitancy into three types: individuals hesitant owing to cultural conservatism and stigmatization, individuals with positive intentions but delayed vaccination, and overconfident individuals who disregarded vaccines. The reasons for vaccine hesitancy are linked to China’s conservative culture of sexuality, and Chinese sexual attitudes and morality have complex mechanisms that influence vaccination. Social taboos on sexual topics lead to inadequate sources of information regarding the HPV vaccine. Sexual morality is internalized into an individual’s subconscious, influencing the cognition of the vaccine. Negative associations and stigmatization of the vaccine further discourage vaccination.DiscussionVaccine hesitancy is not solely a medical or political-economic issue but also a deep-seated cultural issue. Culture significantly affects individual health behaviors, and ignoring socio-cultural factors can exacerbate public health problems. Future research should investigate the political-economic and socio-cultural factors to address geographic differences in vaccine hesitancy.

Incentives, Health, and Retirement: Evidence From a Finnish Pension Reform

ABSTRACTThis paper examines, using exogenous variation generated by a Finnish pension reform implemented in 2005, the interplay between health and financial incentives to postpone retirement. Based on detailed administrative data on individual health and retirement behavior, we focus on whether individual reactions to incentives vary according to health status and analyze whether individuals with ill health are also able to take advantage of the potential monetary benefits of delayed retirement created by the reform. We find that on average, individuals react to the financial incentives created by the reform as expected. This result holds for most of the health‐related subgroups we analyze. However, those with a long period of sickness absence are less likely to respond to changes in the financial incentives to postpone retirement.

Investigating the Impact of Health-Protective Behaviors on Morbidity and non-Morbidity COVID-19 among Workers in Oil Refining Industry Using Machine Learning algorithms

Introduction: The prevalence of COVID-19 has significantly impacted work environments and the workforce. Therefore, identifying the most important preventive and control strategies, as well as assessing their effectiveness, is of paramount importance. Various studies have shown that machine learning algorithms can be used to predict complex and nonlinear issues, including predicting the behavior of various diseases such as COVID-19 and the parameters affecting it, and can be beneficial. The purpose of this study has been to examine the importance of preventive measures and hygiene behaviors in preventing COVID-19 in the oil refining industry using various machine learning models. Material and Methods: For this purpose, demographic information and health behaviors of individuals were collected. Subsequently, a multi-layer perceptron (MLP), radial basis function (RBF), and support vector machine (SVM) models were compared to enhance the analysis of the effects of preventive measures on COVID-19 infection. Finally, the most influential factors affecting the likelihood of COVID-19 infection were determined using sensitivity analysis. Results: The results showed that the accuracies achieved in predicting the impact of preventive measures and health behaviors on COVID-19 in occupational settings were 78.1%, 81.2%, and 78.1% by MLP, RBF, and SVM respectively. The RBF model was identified as the most accurate model for predicting the impact of health behaviors on COVID-19 disease Additionally, the level of social distancing with customers, handwashing frequency and disinfection, the availability of cleansing and disinfecting agents for hands and surfaces in the workplace, and gatherings for eating meals and snacks were identified as the most significant health behaviors influencing the prevalence of COVID-19 in the workplace. Conclusion: Studies of this nature can underscore the importance of attention to preventive measures and health behaviors in unprecedented circumstances. Furthermore, the utilization of artificial intelligence models and tools such as DSS (Decision Support Systems) can serve as powerful tools for optimizing control measures in work environments.

De-normalizing sugar-sweetened beverage consumption: effects of tax measures on social norms and attitudes in the California Bay Area

BackgroundSocial norms can influence individual health behaviors. Shifts in social norms for smoking were critical for the effectiveness of tobacco control efforts such as excise taxes. Sugar-sweetened beverage (SSB) excise taxes have been implemented in municipalities across the United States to reduce SSB intake and improve health. We sought to identify trends in social norms and attitudes about healthfulness of sugar-sweetened beverage (SSB) consumption in the California Bay Area and examine whether social norms and attitudes changed following SSB taxes.MethodsData came from annual (2016–2019, 2021) cross-sectional surveys (n = 9128) in lower-income neighborhoods in Oakland, San Francisco, Berkeley, and Richmond. We assessed overall trends and compared pre-post tax changes in Oakland and San Francisco with comparison cities.ResultsWe observed a 28% reduction in social norms for SSB consumption (people’s perceptions of peers’ consumption) and variable reductions in attitudes about the healthfulness of SSBs. Relative to comparison cities, post-tax, perceptions of peers’ consumption of sports drinks declined in Oakland; attitudes about the healthfulness of sugar-sweetened fruit drinks declined in San Francisco.ConclusionsAmong lower-income populations, social norms and attitudes towards the healthfulness of SSBs meaningfully declined over time, with smaller tax-related effects. SSB taxes as well as the local media attention they generate appear to affect people’s perceptions of SSBs. Pairing SSB taxes with messaging campaigns may be more effective in de-normalizing SSB consumption.

Analysis of the Influence of Personality Traits on the Level of Knowledge and Health Behaviours of Cardiac Patients.

Background/Objectives: Numerous risk factors of cardiac diseases are influenced by health behaviours. An individual's health behaviours, somatic symptoms and even cardiac outcomes can be influenced by their personality. The aim of this study was to analyse the influence of personality traits on the knowledge and health behaviour of cardiac patients. Methods: The study was conducted at the Independent Public Voivodship Hospital in Szczecin on 180 patients in the invasive cardiology wards and the intensive cardiac care unit between July and September 2019. A self-developed questionnaire and the NEO-Five-Factor Inventory-3 (NEO-FFI) and Health Behaviour Inventory (HBI) standardised tools were used. Results: Respondents mostly linked the occurrence of cardiovascular disease with smoking (87.22%) and hypertension (85.56%). A large majority of the respondents (68.44%) knew the correct recommended values for blood pressure. This was also the case for total cholesterol-only 20.56% of the patients did not know the correct levels. Respondents experienced more difficulty in adhering to preventive measures-only 27.22% followed a low-fat diet and only half controlled their weight. The overall HBI scale score was 5.93 sten, which indicates an average score. The most intense personality trait among the respondents was extraversion (5.79), while the least intense was agreeableness (4.12). Neuroticism was found to be negatively correlated (p < 0.05) with healthy eating habits and a positive mental attitude. Extroverts, on the other hand, are more likely to take preventive action. Older and non-working individuals are more likely to exhibit health-promoting behaviours in all HBI categories (p < 0.05). Conclusions: The personality traits that have the greatest impact on health behaviour are extraversion, agreeableness and conscientiousness. Health practises also depend on gender, age and work activity. Further research on more diverse groups is needed.

The impact of safety leadership on safety behaviors of aircraft rescue and firefighting personnel during the COVID-19 pandemic

Objectives. Facing risk of contracting COVID-19, adopting individual health and safety behaviors to prevent infection was critical for first responders to ensure personal and public safety. This study assessed direct and indirect relationships between safety leadership, safety behaviors and the effect of risk perceptions on these relationships among aircraft rescue and firefighting (ARFF) personnel during the COVID-19 pandemic. Method. A total of 127 ARFF frontline personnel participated in an online survey. COVID-19-specific constructs of safety leadership, safety behaviors and risk perceptions were assessed using a structural model with moderation and serial mediation analysis using the mixed-model method. Results. Safety leadership had significant direct effects on safety compliance and indirect effects on safety participation and mask use. ARFF personnel’s perceived severity of the virus had significant direct effects on mask use and indirect effects on safety compliance and participation behaviors. The interaction of safety leadership and perceived susceptibility to the virus had significant direct effects on safety compliance behaviors and indirect effects on safety participation and mask use. Conclusion. There are practical implications to strengthen safety compliance behaviors through leadership. This study contributes to the literature on leadership and safety behaviors among ARFF personnel during exceptional circumstances and times of crisis.

Uptake of Digital Health Interventions for Cardiometabolic Disease in British South Asian Individuals: Think Aloud Study.

Digital health interventions (DHIs) could support prevention and management of cardiometabolic disease. However, those who may benefit most often experience barriers to awareness and adoption of these interventions. Among South Asian individuals, we evaluated user experience of DHIs for prevention and management of cardiometabolic disease, aiming to understand barriers and facilitators to initial and ongoing use. Among South Asian individuals recruited via primary care, community organizations, and snowball methods (n=18), we conducted "think-aloud" interviews using a reflective and reactive approach. Participants included nonusers, as well as those that used a range of DHIs as part of monitoring and improving their health. Participants were asked to think aloud while completing a task they routinely do in a familiar DHI, as well as while setting up and completing a search task in a novel DHI; they were encouraged to behave as if unobserved. Lack of cultural specificity was highlighted as reducing relevance and usability, particularly relating to dietary change. Preferred features reflected individual health beliefs and behaviors, digital skills, and trust in DHIs. For example, tracking blood glucose was considered by some to be positive, while for others it caused distress and anxiety. Similarly, some users found the novel DHI to be extremely simple to set up and use, and others grew frustrated navigating through initial interfaces. Many participants raised concerns about data privacy and needing to agree to terms and conditions that they did not understand. Participants expressed that with information and support from trusted sources, they would be interested in using DHIs as part of self-management. DHIs may support South Asians to prevent and manage cardiometabolic disease, but it is important to consider the needs of specific user groups in DHI development, design, and implementation. Despite motivation to make health changes, digital barriers are common. Cultural appropriateness and trusted sources (such as health care providers and community organizations) have roles in increasing awareness and enabling individuals to access and use DHIs.

Health Coaching Impacts Stage-Specific Transitions in Multiple Health Behaviors for Patients at High Risk for Coronary Heart Disease and Type 2 Diabetes: A Multigroup Latent Transition Analysis.

Multiple behavior change interventions have gained traction in the behavioral health space. Yet, previous studies on health coaching (HC) focused on testing its effect on stages of change for individual health behaviors. The purpose of this study was to examine the effects of HC on stages of change across multiple health behavior domains among patients at high risk of coronary heart disease and type 2 diabetes. This secondary analysis of a randomized clinical trial included 200 primary care patients (mean age of 47.7 years, 49.0% women, 60.5% Whites) who completed transtheoretical model-based questionnaires related to weight reduction, exercise, healthier eating, and stress management. Multigroup latent transition analysis was used to compare the stage of change distributions and transitions over time between HC and controls at baseline, midpoint of the intervention (3 months), and postintervention (6 months). Three distinct categories of behavior change were identified ("Contemplation," "Preparation to Action," and "Action"), and membership in these categories changed over time as a function of intervention exposure. Both groups exhibited positive transitions through stages of change from baseline to 3 months. Pronounced intervention effects emerged from 3 to 6 months, revealing larger differences in transition probabilities between the groups. In particular, HC increased patients' likelihood of transitioning from "Contemplation" to both "Preparation for Action" and "Action," as well as from "Preparation for Action" to "Action." The control group remained stagnant during the same period. Although HC produces changes across multiple behavioral domains, it was most effective for patients who were reluctant or ambivalent about changing their behaviors.

Peer effects of health behaviors and the moderating role of Internet use among middle-aged and older adults: a nationally representative cross-sectional survey in China.

This study investigates peer effects on the health behaviors of middle-aged and older adult people in China and examines the moderating role of Internet use. A total of 16,188 respondents were selected from the China Health and Retirement Longitudinal Study (CHARLS) 2020 data set. Ordinary Least Squares and Quantile Regression were used to validate the peer effect of health behaviors on middle-aged and older adults, and a moderating effects model was used to test the moderating roles of Internet use and Internet proficiency. Finally, the peer effect was analyzed for heterogeneity according to Internet use preferences. The peer effect had a positive influence on the individual health behaviors of middle-aged and older adult people in China (β = 0.5341, p < 0.001). Middle-aged and older adult people were more sensitive to the average health behavior level of the community when they lived in rural communities and/or had a low level of education. Internet use positively moderated the health behavior peer effect in the older adult population (β = 0.0094, p < 0.1), and Internet proficiency negatively moderated the peer effect of the health behaviors of the middle-aged population (β = 0.1589, p < 0.1). According to the magnitude of the influence of peer effect, the Internet preference type can be ranked from social and entertainment (β = 0.6250, p < 0.01), to cultural and entertainment (β = 0.5835, p < 0.01), to comprehensive (β = 0.4622, p < 0.01). There is a peer effect on the health behaviors of middle-aged and old-aged individuals, in which Internet use plays a moderating role. The construction of healthy communities should be promoted, giving full play to the community's active role in health promotion. Attention should be paid to the health-enabling function of the Internet, encouraging middle-aged and older adult people to use the Internet actively, moderately, and diversely, and making full use of the advantages of short videos for online health education.

The link between fear of disease progression and health promotion behaviors in patients with obstructive sleep apnea hypoventilation syndrome (OSAHS): the mediating role of social support

ObjectiveThis study aims to assess the levels of social support, fear of disease progression (FOP) and health promotion behaviors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to examine the associations between FOP, social support, and health promotion behaviors in OSAHS patients, with a focus on exploring the mediating role of social support. The findings aim to provide insights for enhancing health promotion behaviors among OSAHS patients in China and to offer a theoretical foundation for healthcare professionals in devising intervention strategies to promote health behaviors in individuals with OSAHS.MethodsThis cross-sectional study included 307 patients diagnosed with OSAHS in Jinzhou City, Liaoning province. The survey instruments utilized included the Demographic Characteristics Questionnaire, Social Support Rating Scale (SSRS), Fear of Disease Progression Scale (Fop-Q-SF), and Health-Promoting Lifestyle Scale (HPLP II). Pearson correlation analysis was employed to assess correlations, while multiple linear regression and structural equation modeling were utilized to explore potential mediation effects.ResultsIn the OSAHS patient population, FOP (r=-0.55, p<0.001) and social support (r = 0.60, p<0.001) were found to be significantly correlated with health promotion behaviors. In the mediated effects model, social support was identified as a partial mediator in the association between FOP and health promotion behaviors among OSAHS patients, accounting for 59.00% of the total effect.ConclusionFOP demonstrates a direct relationship with health promotion behaviors in patients with OSAHS, with social support playing a mediating role in this connection. Healthcare professionals are advised to underscore the significance of social support in promoting the health of OSAHS patients to mitigate FOP and consequently improve health promotion behaviors.

Bridging the gap: Political engagement and trust as mediators of racial health inequities and vaccine reluctance

This paper investigates how political engagement and trust can reduce health disparities in the context of COVID-19 vaccine hesitancy. It posits that active participation in the political process and trust in political institutions enable communities, especially marginalized ones, to advocate for equitable health policies, leading to more inclusive healthcare services. The study employs a multidisciplinary approach to understand how politics influence individual and collective health behaviors and decision-making. The research uses t-tests and logistic regression to analyze the relationship between political factors (like interest and participation) and trust in political and federal systems on COVID-19 vaccine hesitancy. The t-test examines disparities in vaccine hesitancy across racial groups, revealing significant differences and emphasizing the impact of race on health behaviors. Logistic regression, controlling for variables such as partisanship and media influence, further explores these relationships, showing a consistent negative correlation between trust in federal institutions and vaccine hesitancy across racial groups. The study also finds that this correlation varies by race, with trust in the political system and political participation influencing vaccine hesitancy to different degrees among racial groups. These findings underscore the complex interplay between political engagement, trust, and health behaviors, highlighting the role of politics in shaping public health outcomes.

Adaptation of the health literacy survey19-Europe-Q12 into Turkish culture: A psychometric study.

Misinformation can lead to adverse outcomes on the health beliefs and behaviors of individuals. Therefore, health literacy skills are needed as a central competency to recognize the trustfulness of health-related knowledge in any resources. To ensure this, a time-efficient, skill-oriented psychometric tools are needed to measure the comprehensive general health literacy level of communities. This research was conducted to evaluate the psychometric properties of the 12-item Health Literacy Survey-Europe (HLS19-Q12) regarding Turkish culture. A methodological design was adopted. The population consisted of adult individuals registered to two family health centers in Ankara. The sample was determined based on 5-10 times the number of scale items rule (ntotal = 192). A questionnaire and Health Literacy Survey-Europe-Q12 were used to collect data. Language, content and construct validities and internal consistency reliability tests were performed through IBM-SPSS 25.0 and AMOS 24.0 programs. The content validity was determined via the Davis technique. The construct validity was examined by exploratory (EFA) (n1 = 120) and confirmatory factor analysis (CFA) (n2 = 72). Internal consistency was evaluated using Cronbach's alpha coefficient. Time invariance was evaluated by test-retest method (nretest = 32) 4 weeks later. The mean age was 30.17 ± 10.37 (min. 18-max. 61). The Kaiser-Meyer Olkin test result was 0.898, and the Bartlett's Test of Sphericity result was 604.889 (p < 0.001). The model-fit indices showed good fit. The difference between the first and the second measurements was statistically insignificant (t = -1.659, p = 0.107). The Cronbach's alpha was 0.88. The HLS19-Q12-TR was a valid and reliable measurement tool in determining the health literacy level of the Turkish adult population. As one of the social determinants of health, easy measurement and generating a general health literacy map of the population is considered a necessity.

Reassessing Cervical Cancer Prevention: Evaluating the NHS Cervical Cancer Screening Programme Through the Health Belief Model and Global Health Promotion Strategies

Cervical cancer remains a significant public health issue in the United Kingdom, with disparities in screening coverage and outcomes persisting despite robust national programs. This critical analysis evaluates the NHS Cervical Screening Programme (CSP) through the lens of the Health Belief Model (HBM) and global health promotion strategies, such as those outlined in the Ottawa Charter. The analysis explores how individual beliefs about susceptibility, severity, benefits, and barriers influence participation in cervical screening, while also critiquing the CSP's reliance on these factors to the potential exclusion of broader social determinants of health. Key findings reveal that while the HBM provides a valuable framework for understanding individual health behaviors, its emphasis on personal responsibility may overlook significant socioeconomic and cultural barriers, leading to inequities in screening uptake. Furthermore, the CSP's approach, though well-intentioned, may inadvertently undermine patient autonomy by promoting a top-down model of health promotion. The analysis is supported by data from the 2022-2023 Cervical Screening Standards Data Report and other contemporary sources, highlighting the need for more culturally sensitive and equitable strategies. Recommendations for policymakers include the enhancement of targeted interventions for high-risk groups, improved communication strategies, and the integration of a social model of health that considers the broader determinants of health. Future studies are encouraged to explore the sociocultural factors influencing screening behaviors and to evaluate the effectiveness of new screening technologies and integrated HPV vaccination programs. This analysis underscores the importance of rethinking cervical cancer prevention strategies to ensure they are inclusive, equitable, and aligned with the principles of health promotion.

Association between beliefs in medical conspiracy theories and health behaviors among medical and healthcare students. Implications for professional practice.

While conspiracy theories cover many different themes, medical conspiracy theories (MCTs) have become particularly prevalent in modern societies. As beliefs in MCTs can become a source of "infodemics", influence individual health behaviors and cause distrust in medical institutions and personnel, healthcare workers must find ways to overturn patients' conspiracy thinking. However, as the medical world is not free of these beliefs, in this study, we investigated beliefs in MCTs among medical and health science students and their association with reported health behaviors. Our sample was derived from a self-administered, anonymized, computer-assisted web survey conducted among 1,175 medical and health science students enrolled at the Poznan University of Medical Sciences, Poland. From a set of twenty different MCTs, one-third of students rejected all of them, 18% believed in one, 15% in two, 10% in three, and 24% supported four or more conspiracy theories. In addition, many students were hesitant or unsure about MCTs. We also found that nursing and midwifery students were the most likely to believe in MCTs, while medical and dental students were the least supportive. Support for MCTs was higher among students in the early years of their studies and who declared themselves religious and conservative. This study also highlights the association between students' support for MCTs and their reported health behaviors, including avoiding vaccinations, using alternative medicine, taking vitamin C, or using social media as an essential source of health information. As medical and health science students are prone to conspiratorial thinking, they should be trained to act as a trusted and reliable source of medical information, to mitigate conspiratorial beliefs, and to act as role models for their patients and society, effectively shaping health behaviors in the population.

Impact of a Health Promotion Program on Knowledge, Physical Health, Mental Health, and Social Health Behaviors in Individuals at Risk for Colorectal Cancer

Impact of a Health Promotion Program on Knowledge, Physical Health, Mental Health, and Social Health Behaviors in Individuals at Risk for Colorectal Cancer

Do Children's Health Behaviors Buffer the Impact of Cumulative Environmental Stress on Emerging Cardiometabolic Risk?

Previous studies have found that exposure to childhood environmental stress is associated with cardiometabolic risk. However, it is not known whether individual health behaviors disrupt this relationship. This study prospectively evaluated the relationship between cumulative environmental stress in a low-income sample and cardiometabolic risk in middle childhood and examined whether child health behaviors attenuated this relationship. In a cohort of children (n=338; 57% Hispanic children; 25% Black children), environmental stressors (family and neighborhood factors representing disadvantage/deprivation) and child health behaviors (accelerometry measured physical activity; parent-reported screen time and diet recalls) were measured over 5 time points beginning when children were aged 2 to 4 years and ending when they were aged 7 to 11 years. Children's cardiometabolic risk factors (body mass index, blood pressure, triglyceride/high-density lipoprotein ratio, glucose, hemoglobin A1c, C-reactive protein) were measured at 7 to 11 years. Emerging cardiometabolic risk was defined as having ≥1 elevations that exceeded clinical thresholds. In adjusted path analyses, greater cumulative environmental stress was associated with higher likelihood of emerging cardiometabolic risk in middle childhood (P<0.001). Higher levels of moderate to vigorous physical activity and fewer sedentary minutes attenuated the positive relationship between stress and cardiometabolic risk (P<0.05). Children with >2 hours of average daily screen time had a higher likelihood of elevated cardiometabolic risk (P<0.01), but screen time did not moderate the stress-cardiometabolic risk relationship. Dietary intake was not related to cardiometabolic risk. Interventions that promote moderate to vigorous physical activity and limit sedentary behavior may have particular importance for the cardiometabolic health of children exposed to high levels of cumulative environmental stress.

Effectiveness of receiving cardiovascular disease genetic risk information on health behaviors, psychological responses, and associated risk factor modification in individuals: a systematic review protocol.

This review aims to assess the effectiveness of receiving cardiovascular disease (CVD) genetic risk information on individual health behaviors, psychological responses, and risk factor modification. Advancements in genomics have identified strong genetic predispositions for CVD, leading to the development of CVD genetic risk information. Integrating genetic risk information into clinical practice shows promise in predicting CVD risk and facilitating multifactorial management. This review will focus on randomized controlled trials assessing individual responses to CVD genetic risk information. Participants will be adults aged 18 or older, either with or without CVD. The review will compare the effectiveness of receiving genetic risk information with receiving traditional risk information or no risk information, assessing outcomes such as health behaviors, psychological responses, and risk factor modification. Cochrane CENTRAL, MEDLINE, Embase, and Emcare will be searched for relevant studies. Current or unpublished trials will be searched for in ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform. Articles will be screened and assessed for inclusion by 2 independent reviewers. Methodological quality will be assessed using the standardized instrument from JBI. Data will be extracted and synthesized according to the objectives of the review. If data are sufficient, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. PROSPERO CRD42023390876.

Effect of information-motivation-behavioral skills model based perioperative nursing on pain in patients with gallstones.

The incidence of cholecystolithiasis is on the rise. Use of information, motivation, and behavioral skills can play a positive role in promoting changes in individual health behaviors. However, reports on the effects of information-motivation-behavioral (IMB) skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent. To explore the application of IMB skills model based high-quality nursing in patients with gallstones. Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control, high-quality, and combined nursing groups, with 72 patients in each group. The control, high-quality, and combination groups received conventional, high-quality, and IMB skills model based perioperative nursing services, respectively. Differences in clinical indicators, stress levels, degree of pain, emotional state, and quality of life were observed, and complications and nursing satisfaction among the three groups were evaluated. After nursing, the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group, with the recovery of gastrointestinal function being the fastest in the combined nursing group (P < 0.05). After nursing intervention, cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery, with the combined nursing group having the closest to normal levels (P < 0.05). After 3 and 7 d of intervention, the patients' pain significantly improved, which was more prominent in the high-quality and combination groups. Meanwhile, the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups (P < 0.05). After nursing intervention, the emotional states of all patients improved, and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups. The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group, with the combined nursing group having the highest quality of life score. After intervention, the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group (P < 0.05), but the difference between the combination and high-quality nursing groups was not significant. Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group, with the nursing satisfaction being the highest in the combination group (P < 0.05). IMB skills model based nursing can improve surgical stress levels, degrees of pain, emotional state, quality of life, and nursing satisfaction of patients with gallstones and reduce the incidence of complications.

The mediating effect of e-health literacy on social support and behavioral decision-making on glycemic management in pregnant women with gestational diabetes: a cross-sectional study.

Social support and e-health literacy are closely related to individual health behaviors, while behavior is premised on decision-making. Few studies have identified the relationships among social support, e-health literacy, and behavioral decision-making, and the nature of these relationships among pregnant women with gestational diabetes remains unclear. Therefore, this study aimed to investigate relationships among social support, e-health literacy, and glycemic management behavioral decisions in pregnant women with gestational diabetes. Using continuous sampling, an online cross-sectional survey was conducted among pregnant women with gestational diabetes who met the inclusion and exclusion criteria at four Class 3 hospitals in Fujian Province from October to December 2023. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social support, e-health literacy, and behavioral decision-making regarding glycemic management. Descriptive statistical analyses, correlation analyses, and mediation effects were used to assess associations. A total of 219 pregnant women with gestational diabetes participated, and 217 valid results were obtained. The level of glycemic management behavior decision-making in women with gestational diabetes was positively correlated with e-health literacy (r = 0.741, p < 0.01) and with perceived social support (r = 0.755, p < 0.01). E-health literacy was positively correlated with perceived social support (r = 0.694, p < 0.01). The indirect effect of perceived social support on glycemic management behavior decisions through e-health literacy (a*b) was 0.153, accounting for 38% of the total effect. Social support and e-health literacy in pregnant women with gestational diabetes are related to behavioral decision-making in glycemic management. The results of this study provide a reference for developing targeted measures to improve glycemic management behaviors in pregnant women with gestational diabetes, which is crucial for achieving sustainable glycemic management.

Health behavior and psychological treatment utilization in adults with avoidant/restrictive food intake disorder symptoms

BackgroundAvoidant/restrictive food intake disorder (ARFID), an eating disorder not associated with weight and shape concerns, results in nutrient or energy deficiencies related with further health consequences and a pronounced need for specialized treatment. These interventions need to be tailored to individual health behavior. However, research about health behavior and treatment utilization in ARFID is scarce, particularly in adults, as ARFID is more common in children despite occurring across the lifespan. One important aspect of health behavior is the individual’s health regulatory focus (i.e., health prevention and health promotion). Additionally, symptoms of eating disorders have generally been associated with various health risk behaviors, such as smoking, drinking, or unhealthy physical (in)activity. Therefore, the present study aimed to investigate health behavior and psychological treatment utilization in adults with symptoms of ARFID.MethodsA representative adult population sample (N = 2415) completed several self-report questionnaires assessing symptoms of eating disorders and health behavior. Differences between groups (symptoms of ARFID vs. no symptoms of ARFID) were tested with analysis of variance, Mann-Whitney-U-tests, and binary logistic regression.ResultsIndividuals with symptoms of ARFID (n = 20) did not differ in their health regulatory focus, smoking status, physical activity or psychological treatment utilization from individuals without symptoms of ARFID (n = 2395). However, they reported higher alcohol misuse than individuals without symptoms of ARFID.ConclusionThe findings suggest a relevance of further exploration of the relationship between alcohol misuse and ARFID, given the preliminary nature of these results. This exploration could inform treatment strategies for addressing potential comorbid substance misuse. Furthermore, the low psychological treatment utilization in adults with symptoms of ARFID suggest a need for more specialized psychological treatment services, public education about ARFID being an indication for psychological treatment, and further research about treatment barriers.