Although existing literature has focused on the impact of racial/ethnic discrimination on Chinese American youth mental health during the pandemic, less attention has been paid to the protective family-level processes that can buffer against such mental health risks. Guided by the dual-factor model of mental health and family systems theory, this study aimed to explore the role of affirming family communication in Chinese American youth mental health in the midst of racial discrimination. Participants were 205 Chinese American youth and their parents, who completed an online survey in the spring of 2020 during the COVID-19 pandemic. By conducting a series of path analyses, we found that affirming family communication functions as a promotive factor that counteracts the negative impact of prepandemic peer discrimination on youth externalizing problems. However, the positive influences of affirming family communication on internalizing problems and subjective well-being were weakened when Chinese American youth faced high levels of COVID-19-related peer discrimination. The findings offer implications for school psychology practice by underscoring how to engage with families to promote youth mental health in the context of racial discrimination. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

To assess the perceived effectiveness of the school nurse services through students' responses and to examine whether there is a detectable relationship between the students' subjective health status and the school nurse's service delivery. We conducted our cross-sectional, quantitative research in the West Transdanubian region of Hungary using convenience sampling among high school students (n = 429). Given the non-probability sampling, the findings may not be generalizable to all student populations. Data were collected using standardized (SF-36, EQ-VAS, questions on the prevalence of subjective health complaints from the HBSC survey) and a self-developed questionnaire. Chi-square tests, correlation analyses and multivariable linear regression analyses were performed using SPSS Statistics 27.0 software. Students reported a higher level of health-related knowledge received from the school nurse, along with better perceived applicability of this knowledge in everyday life (p < 0.05). Nearly three quarters of respondents indicated that the school nurse's activities contributed to the development of their health-related attitudes and this perception showed a statistically significant association with both the quantitative and qualitative evaluation of the care provided (p < 0.05). Higher ratings of the perceived effectiveness of school nursing activities were associated with more favourable self-rated mental health and a lower level of reported health complaints; however, these associations were weak in magnitude. The results revealed statistically significant but weak associations between perceived school nurse services and selected indicators of students' self-rated health status. Due to the cross-sectional design and the use of self-reported data, causal inferences cannot be drawn. Nonetheless, the findings suggest that more favourable quantitative and qualitative evaluations of the care provided are linked to higher perceived effectiveness of school nurse activities. Further research on quality indicators of school nurse services and approaches tailored to students' needs may be warranted. The observed associations between students' perceptions of school nurse services and their health perceptions underscore the importance of continuous professional development for school nurses. This may include advanced training in health education and communication skills to further support the perceived effectiveness of their activities. What problem did the study address? We addressed the perceived effectiveness of school nurse services from the perspective of students and examined whether there is a detectable relationship between students' subjective health status and the services provided by school nurses. What were the main findings? The study found that higher levels of health-related knowledge reported as being provided by the school nurse were associated with more favourable student ratings of the applicability of this knowledge in everyday life. Students who reported more positive experiences with school nurse activities also tended to report more favourable health perceptions, which were reflected in the indicators used to evaluate the services. In addition, higher perceived effectiveness of school nurse services was associated with more favourable self-reported mental health and vitality, as well as a lower level of reported health complaints. Where and on whom will the research have an impact? The findings may be particularly relevant for school nurses, as they highlight the importance of their role and the potential need for continuous attention to service quality from the students' perspective. They may also be informative for students and school communities by underscoring that health education and services provided by school nurses are associated with more favourable self-reported health perceptions and overall well-being. No patients or members of the public were involved in the design, conduct, analysis, or reporting of this study beyond students' participation as anonymous questionnaire respondents.

Subthreshold phototherapy use is common in infants with hyperbilirubinemia but leads to overtreatment of safe bilirubin levels. Coincident with publication of the 2022 American Academy of Pediatrics neonatal hyperbilirubinemia guidelines, we formed a quality improvement (QI) collaborative with the aim to reduce inpatient subthreshold phototherapy use to 10% of all phototherapy encounters over 12months. Our QI collaborative included 146 hospitals across North America. Sites submitted data from inpatient phototherapy encounters of newborns born at 35weeks' gestation or more between February 2022-January 2023 (baseline period; 6-month preguideline period, 6-month washout period) and February 2023-January 2024 (intervention period). Interventions included QI coaching, educational webinars, electronic health record tools, clinical algorithms, and communication resources. We analyzed the primary outcome with interrupted time series and balancing measures by statistical process control. Final analysis included 33 384 phototherapy encounters (20 018 baseline, 13 366 intervention) from 119 sites. The percentage of encounters initiated at subthreshold bilirubin levels decreased from 48.2% in the preguideline baseline period to 41.1% at the end of intervention. Overall phototherapy encounters demonstrated a relative decrease of 33.3%, with median encounters per site per month declining from 12 during the baseline period to 8 at the end of intervention. Modest increases were seen in percentage of encounters that met escalation-of-care threshold (5.73%-6.32%) and peak bilirubin greater than 25mg/dL (0.87%-2.12%). Although subthreshold phototherapy decreased, the chosen goal of reducing subthreshold encounters to 10% or less of all phototherapy encounters was not reached after 12months. Future work is needed to determine barriers to reducing unnecessary treatment for neonatal jaundice.

Risks posed by AI actants in human-AI health communication: AI health assistants facing HIV-related stigma inquiries.

Evidence-based nutrition guidance for female athletes remains limited relative to that available for males; in part, this has contributed to widespread reliance on social media for dietary information. Whilst social media can enhance health communication, it also facilitates the rapid dissemination of unverified, commercially driven nutrition claims. This narrative review critically synthesises the current scientific literature underpinning four prevalent claims targeting nutrition close to exercise for active females; (1) fasted training is harmful for all females, (2) menstrual cycle-related hormonal fluctuations require sex-specific hydration strategies, (3) carbohydrate differences by sex and menstrual cycle phase, and (4) precise protein timing is essential for optimal adaptation in females. Despite social media and 'influencer' claims of no evidence in humans for many of the claims, there is some, albeit limited, evidence. This review evaluates the available research and the evidence supporting these claims to provide practical advice for active females. Collectively, this review demonstrates that many widely circulated nutrition claims directed at active females lack robust scientific support. The findings emphasise the importance of individual context, including training load, energy availability, environmental conditions and total dietary intake, over rigid, sex-specific nutrition rules. Improved translation of female-specific sports nutrition research into accurate, accessible public messaging is urgently needed to counter persistent misinformation in digital media.

How effective are national tobacco prevention and cessation campaigns in reaching youth? Population assessment of tobacco and health, Wave 7 insights.

Social media platforms, such as Facebook and Instagram, play a pivotal role in shaping public opinion on health interventions, including community water fluoridation (CWF). Despite its recognition as a safe and effective public health measure, CWF remains a polarizing topic, with misinformation on these platforms contributing to public mistrust. This study collected 109,117 Facebook and Instagram posts from 2014 to 2023 to examine public sentiment surrounding CWF. The analysis revealed a mix of opinions, with 42.1% positive, 39.1% negative, and 18.8% neutral sentiments. Trends highlighted a surge in negative sentiment during 2017-2019, likely influenced by misinformation and significant public events, while positive sentiment has gradually regained ground in recent years. Key themes included health benefits, safety concerns, and government trust, with positive discussions emphasizing CWF's role in public health and negative discussions focusing on risks and chemical exposure. The study employed advanced sentiment analysis models to highlight the importance of monitoring public discourse and addressing misinformation, thereby promoting trust and support for evidence-based health policies, such as CWF. These findings offer digital data-driven insights for public health communication strategies, enhancing community understanding and acceptance of vital health interventions.Knowledge Transfer Statement:The findings of this study can inform public health agencies and policymakers about public concerns and support for water fluoridation. By identifying sentiment trends and misinformation on social media, communication strategies can be tailored to improve public understanding and acceptance of fluoridation as a preventive health measure.

Exploring the effect of disease explanations of chronic pain on stigma.

This study summarised the global epidemiology, prevention policies, and public health communication strategies related to infant botulism and exposure to honey. A narrative review of epidemiological data was carried out from 1976 to 2024, using surveillance reports, national health agency documents, and peer-reviewed literature. Cases were rare, but honey was the only consistently confirmed dietary source of infant botulism. The median age at onset was 3-4 months, and mortality was below 1% if the infants received intensive care support and specific therapy with human botulism immune globulin. A global review from 2007 to 2021 reported that the USA had approximately 130 cases of infant botulism per year, while Europe, Canada, Japan, and Australia reported markedly lower incidences. Italy had 36 cases between 2001-2020, which represented 8% of all confirmed botulism cases in the country during that period. We found that health authorities uniformly advised against consuming honey before 12 months of age, but warning labels remained voluntary in many regions, and caregiver awareness varied. Strengthened paediatric counselling, harmonised labelling policies, and culturally tailored communication strategies are needed to reduce infant botulism by preventing infants under 12 months of age from consuming honey.

Acute flaccid paralysis (AFP) surveillance in Ethiopia remains limited due to hard-to-reach populations, restricted healthcare access, low public awareness, and persistent underreporting within community-based surveillance (CBS) systems. Contributing to this are inadequate training of community reporters, communication barriers, and cultural beliefs and misinformation that further hinder timely case detection. Here, AFP Assistant, a multilingual large language model powered chatbot, is developed to strengthen CBS through improved health communication and real-time reporting. The system supports Amharic, Afaan Oromo, and English to enhance accessibility and inclusivity. A curated dataset derived from literature, guidelines, and community interviews was translated and validated by experts to ensure clinical and cultural accuracy. The system integrates supervised fine-tuning with retrieval-augmented generation (RAG) to deliver accurate, context-aware responses. Trained on 468 question-answer pairs using pretrained Gemini 2.5-flash, the model achieved an accuracy of 0.90 and a loss of 0.31. The RAG framework improved retrieval relevance, grounding, and response efficiency. Evaluation through in-house testing and human annotation using a structured rubric demonstrated robust performance across tasks and languages, while user feedback confirmed usability and relevance. These findings highlight the potential of AI-driven chatbots to enhance AFP surveillance and equitable health communication in low-resource settings.

Sexual decision-making and sexually transmitted infection (STI) prevention are influenced not only by individuals' characteristics but also by those of their partners and their relationship with each other. To inform STI prevention and understand transmission dynamics, we aimed to understand sexual partnership demographic assortativity, sexual behaviour, communication and concurrency among UK-resident gay, bisexual and other men who have sex with men (GBMSM). With community members and organisations, we codesigned a sexual partnerships module for an annual online cross-sectional community-based survey of UK-resident GBMSM (cisgender/trans/non-binary assigned-male-at-birth) undertaken November-December 2023. We collected data about ≤3 most recent male sex partners since August 2023 and analysed variations in relative demographic characteristics (age, ethnicity), sexual behaviours (practices, condom use, HIV-pre-exposure prophylaxis (HIV-PrEP use)) and sexual health communication by partner type (one-time, established, casual and uncertain). 1106 participants described 2342 partners: 12.5%, 20.4%, 9.9% and 57.1% reporting 0, 1, 2 and 3 partners, respectively, of varying combinations. Casual partner types were most reported (43.2%) versus one-time (36.1%), established (13.9%) and uncertain partnerships (6.8%). Concurrency was common with the mean number of ongoing partnerships >1 (1.23, 95% CI 1.17 to 1.30). Age-mixing varied by partner type, from median 2 (established partners) to 10 (one-time partners) years difference.Sexual health communication was highest among established partners. It was two times as common to be unaware of one-time partners' HIV status (66.8%) and not to have discussed sexual health (65.7%) compared with casual partners (30.0% and 27.2%, respectively). Condom use was low across partner types. HIV-PrEP was always used by HIV-negative participants in two times as many one-time, causal and uncertain partnerships (49.2%, 50.0%, 42.0%) compared with established partnerships (23.3%) involving condomless anal intercourse. UK-resident GBMSM have diverse types of male sexual partners, varying in their demographic mixing, sexual behaviour and communication, which should be reflected in sexual health promotion and transmission dynamics analyses.

Falls are a major public health concern among older adults and contribute substantially to disability, reduced quality of life, and increased healthcare burden. Fall prevention-related health literacy practices, reflecting the application of health literacy skills in daily life, may influence an individual's ability to recognize risk factors and adopt appropriate preventive behaviors. This study aimed to examine factors associated with fall prevention-related health literacy practices among community-dwelling older adults in Northern Thailand. A community-based cross-sectional study was conducted among 415 older adults residing in Chiang Rai Province, Thailand, between February to May 2025. Participants were selected using a multi-stage stratified sampling approach. Data were collected through structured questionnaires assessing sociodemographic characteristics, fear of falling, and fall prevention-related health literacy. Functional mobility was evaluated using the Timed Up and Go (TUG) test. Data were analyzed using IBM SPSS Statistics for Windows, Version 29.0 (IBM Corp., Armonk, NY, USA). Multivariable logistic regression analyses were performed to identify factors independently associated with adequate fall prevention-related health literacy and its subdomains. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Most participants were female (58.3%), and 61.9% were aged 60-69 years. Overall, 88.70% demonstrated inadequate fall prevention-related health literacy. Housing characteristics (AOR = 3.166, 95% CI: 1.505-6.660) and TUG performance (AOR = 0.352, 95% CI: 0.163-0.761) were significantly associated with adequate fall prevention-related health literacy. Housing characteristics were consistently associated with access (AOR = 1.959, 95% CI: 1.168-3.284), cognitive (AOR = 2.055, 95% CI: 1.203-3.511), communication (AOR = 2.125, 95% CI: 1.233-3.665), and self-management skills (AOR = 1.830, 95% CI: 1.095-3.059). TUG performance was significantly associated with access and cognitive literacy. Additionally, cognitive literacy was significantly associated with marital status and fear of falling, while education level was significantly associated with self-management (AOR = 0.504, 95% CI: 0.296-0.861) and media literacy (AOR = 0.342, 95% CI: 0.211-0.556). A substantial proportion of community-dwelling older adults had inadequate fall prevention-related health literacy. Environmental and functional factors were consistently associated with health literacy across multiple domains, with additional associations for marital status, educational attainment, and fear of falling. These findings highlight the need for community-based fall prevention strategies incorporating adapted health communication, environmental modification, mobility assessment, and targeted interventions to strengthen preventive capacity among older adults. Not applicable.

Beyond one-size-fits-all: Personalising health communication to drive real behaviour change.

Health misinformation undermines public well-being, yet most research conceptualizes fact-checking as an external intervention targeting false messages only. This obscures the effects of counter-messages on initially truthful statements and diverts attention from fact-checking as a user-driven practice. This study advances misinformation research by examining fact-checking as a spontaneous, naturalistic user behavior, captured via indirect behavioral indicators of external verification, and by testing its predictors and consequences for accuracy in a large-scale online experiment (N = 1,843). Participants evaluated the veracity of health-related statements and could verify information externally; in one condition, an accuracy-based financial incentive was introduced to model motivational stakes. Using Bayesian structural equation modeling, we show that greater fact-checking effort is associated with higher classification accuracy. However, its effectiveness varies by expertise: media professionals benefited more from verification than laypeople, whereas effects for medical professionals were inconsistent. These findings challenge assumptions about domain expertise as a universal safeguard against misinformation and point to the importance of transferable verification routines. Importantly, motivational incentives did not increase either fact-checking effort or accuracy, suggesting that motivational engagement in online verification may be difficult to induce, thereby limiting the feasibility of widespread routine fact-checking by users. Overall, resilience to misinformation appears to depend on the interaction between user-driven verification practices and forms of expertise. Interventions may therefore benefit from combining verification skill training with context-sensitive cues that help users identify high-risk informational situations worthy of fact-checking, rather than relying solely on domain knowledge or external fact-checking institutions.

This study examines the development of health marketing communications research through a bibliometric analysis of 171 articles indexed in Scopus within the Business, Management, and Accounting domain. Using Bibliometrix and Biblioshiny, the study maps publication trends, influential sources, collaboration patterns, and thematic development. The findings show that the field is anchored in health communication, health marketing, and social marketing, while stronger thematic streams have emerged around persuasion, message framing, prevention-oriented communication, and co-design. The study also highlights underdeveloped areas related to digital health, cultural context, and health equity, offering a foundation for future research in health marketing communications.

Excessive sugar consumption is a public health problem because it can increase the risk of non-communicable diseases, especially diabetes mellitus. In Bengkulu City, diabetes remains an important health issue, so health communication is needed not only to provide information but also to improve public health literacy and encourage healthier behavior. This study aims to formulate a community development communication model based on digital campaigns to improve health literacy about sugar consumption in Bengkulu City. This study uses a descriptive qualitative approach with content analysis of digital campaign materials published by the Bengkulu City Health Office, Bengkulu City Media Center, community health centers, and the Ministry of Health of the Republic of Indonesia. The results show that local digital campaigns mostly focus on health checks, screening, and healthy lifestyle messages. Meanwhile, national campaigns are stronger in explaining sugar consumption limits, diabetes risks, and education about sugar, salt, and fat. This study produces a communication model that integrates digital media, health messages, community health centers, Posbindu, health cadres, and community participation. This model places digital campaigns as a medium for awareness, education, empowerment, and behavior change in controlling sugar consumption.

Evaluating AI-assisted sign language recognition as a digital health intervention to improve communication access for people who are deaf.

The World Health Organization has declared mpox a Public Health Emergency of International Concern twice. In China, public health professionals (PHPs) involved in infectious disease prevention and control are responsible for mpox control, case reporting, and health communications during outbreaks. This study aimed to assess mpox knowledge and factors associated with sufficient mpox knowledge among PHPs in China. This study analyzed PHPs involved in infectious disease prevention and control from a large-scale online cross-sectional survey of healthcare workers conducted through a nationwide platform. An e-questionnaire was used to collect data on demographic and institutional characteristics, attention to mpox, mpox information sources, training history and 37 mpox knowledge items covering etiology, clinical features, transmission, and prevention. Univariable and multivariable logistic regression analyses were performed to identify factors associated with sufficient mpox knowledge. A total of 1,601 PHPs from 28 of 31 provincial-level regions in China completed the survey, and 1,568 valid responses were included. Among the 1,568 PHPs, 91.3% (1,432/1,568) were aware of mpox, and 61.7% (967/1,568, 95% CI: 59.3%-64.1%) had sufficient mpox knowledge. 44.6% (95% CI: 42.1%-47.0%), 74.2% (95%CI: 72.1%-76.4%) and 47.0% (95% CI: 44.5%-49.5%) PHPs aware of mpox had sufficient knowledge regarding etiology, clinical features and transmission and prevention, respectively. Multivariable logistic regression analysis showed that the associated factors with sufficient mpox knowledge included gender (female: OR = 1.34, 95% CI: 1.03-1.74), professional title (intermediate: OR = 1.85, 95% CI: 1.40-2.45, senior: OR = 2.05, 95% CI: 1.44-2.91), institution (CDC: OR = 2.07, 95% CI: 1.60-2.67), attention toward mpox (occasional: OR = 2.59, 95% CI: 1.72-3.90; daily/frequent: OR = 3.70, 95% CI: 2.39-5.73), mpox information sources (two sources: OR = 1.51, 95% CI: 1.14-2.00; three or more sources: OR = 1.77, 95% CI: 1.31-2.39), and training (OR = 2.44, 95% CI: 1.89-3.15). This study found insufficient mpox knowledge among the surveyed PHPs involved in infectious disease prevention and control across multiple regions of China, especially among males, those with junior professional titles, limited information access, low attention to mpox, no prior training, and hospital-based staff. Targeted training, continuing education, and multi-channel information dissemination should be strengthened to support mpox preparedness among frontline PHPs.

Conversational artificial intelligence (AI) technologies are increasingly positioned as a response to social isolation, loneliness, and unmet psychosocial needs across health and care contexts. Non-embodied AI-based digital companions have attracted growing attention for their potential to support companionship, social interaction, communication, and psychosocial well-being among older adults, including people living with dementia. However, the evidence base remains underexplored. Terminology is inconsistently applied, systems are variably defined, and studies are distributed across disciplinary silos, limiting critical investigation of how these technologies are conceptualized, designed, and evaluated. This study aims to map and critically synthesize the existing literature on non-embodied AI-based digital companions for older adults in aging, health, and care contexts. The review seeks to describe digital companions, examine methodological approaches, and identify research gaps. This protocol follows the Joanna Briggs Institute methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines). A comprehensive search will be conducted across multiple electronic databases, including MEDLINE, APA PsycINFO, CINAHL, Scopus, Web of Science, IEEE Xplore, and ACM Digital Library, as well as selected gray literature sources. The search strategy combined terms related to digital companions, conversational AI, aging, and care contexts, including concepts related to companionship, social interaction, communication, loneliness, and psychosocial support., Eligible studies will include empirical studies involving older adults that examine non-embodied AI-based digital companions designed primarily to support companionship, social interaction, communication, or related psychosocial support in aging, health, and care contexts. Two reviewers (YC and MG) will independently conduct study selection and data charting. Data will be synthesized using descriptive statistics and narrative analysis. This protocol outlines a systematic approach to identifying, selecting, and synthesizing the existing evidence on non-embodied AI-based digital companions. A preliminary PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-style search flow for the revised database searches identified 2289 records from MEDLINE, CINAHL, and APA PsycINFO. After duplicate removal and eligibility-based removals before screening, 1978 records remained available for title and abstract screening. The full scoping review will summarize study characteristics, populations, contexts, digital companion features, and methodological trends using descriptive tables and narrative synthesis. As of June 2026, the revised database searches had been completed for MEDLINE, CINAHL, and APA PsycINFO, and title and abstract screening was underway. The full scoping review results are expected to be submitted for publication after screening, data charting, and synthesis are completed. This scoping review is expected to clarify conceptual boundaries, map the scope of current research, and identify knowledge gaps related to non-embodied AI-based digital companions in health, aging, and care contexts. The findings will inform future research, design, and implementation of non-embodied AI-based digital companions.

ABSTRACT Although health messaging by social media influencers (SMIs) may have positive effects such as promoting awareness and decreasing stigma, concerns have been raised that influencer narratives may lack comprehensive or balanced information and may evidence a disconnect with accepted clinical guidelines, especially when it comes to mental health. The purpose of this scoping review was to describe the state of research on both content of and audience response to SMI mental health communication. A total of 2,746 records were retrieved from searches, among which 23 studies met the inclusion criteria. Studies have investigated a range of influencer types, mental illnesses, and social media platforms. Research on this topic is nascent, with the majority of studies having been published in 2024 or later. Across methodologies, the focus was on mapping the existing situation, analyzing SMI personal narratives of mental illness, identifying dialectical tensions for both SMI content creators and followers, and describing ethical dilemmas of SMIs. Few studies were theoretically based, and few of the concerns raised in the previous literature regarding either problematic content or negative behavioral impacts of SMI mental health messaging were empirically investigated. Thoughtfully designed longitudinal designs of key issues of concern articulated in the previous literature, as well as testing and development of appropriate theories, are needed going forward.