Health Education Sessions Research Articles

The effect of dietary carbohydrate and calorie restriction on weight and metabolic health in overweight/obese individuals: a multi-center randomized controlled trial

BackgroundBoth low‐carbohydrate (LC) and calorie-restricted (CR) diets have been shown to have metabolic benefits. However, the two regimens have yet to be thoroughly compared. We conducted a 12-week randomized trial to compare the effects of these diets separately and in combination on both weight loss and metabolic risk factors in overweight/obese individuals.MethodsA total of 302 participants were randomized to LC diet (n = 76), CR diet (n = 75), LC + CR diet (n = 76), or normal control (NC) diet (n = 75) using a computer-based random number generator. The primary outcome was the change in body mass index (BMI). The secondary outcomes included body weight, waist circumference, waist-to-hip ratio, body fat, and metabolic risk factors. All participants attended health education sessions during the trial.ResultsA total of 298 participants were analyzed. BMI change over 12 weeks was − 0.6 (95% CI, − 0.8 to − 0.3) kg/m2 in NC, − 1.3 (95% CI, − 1.5 to − 1.1) kg/m2 in CR, − 2.3 (95% CI, − 2.6 to − 2.1) kg/m2 in LC, and − 2.9 (95% CI, − 3.2 to − 2.6) kg/m2 in LC + CR. LC + CR diet was more effective than LC or CR diet alone at reducing BMI (P = 0.001 and P < 0.001, respectively). Furthermore, compared with the CR diet, the LC + CR diet and LC diet further reduced body weight, waist circumference, and body fat. Serum triglycerides were significantly reduced in the LC + CR diet group compared with the LC or CR diet alone. Plasma glucose, homeostasis model assessment of insulin resistance, and cholesterol concentrations (total, LDL, and HDL) did not change significantly between the groups during the 12-week intervention.ConclusionsThe reduction of carbohydrate intake without restricting caloric intake is more potent to achieve weight loss over 12 weeks when compared to a calorie-restricted diet in overweight/obese adults. The combination of restricting carbohydrate and total calorie intake may augment the beneficial effects of reducing BMI, body weight, and metabolic risk factors among overweight/obese individuals.Trial registrationThe study was approved by the institutional review board of Zhujiang Hospital of Southern Medical University and registered at the China Clinical Trial Registration Center (registration number: ChiCTR1800015156).

Medication Adherence and Its Associated Factors among Patients with Type 2 Diabetes Mellitus Attending Primary Health Centers of Eastern Province, Saudi Arabia.

Medication adherence by patients with diabetes is critical, as it plays a crucial role in individuals' long-term health and well-being. We evaluated the medication adherence, illness perception, diabetes knowledge, and associated factors among patients with type 2 diabetes mellitus (T2DM) attending primary health centers (PHCs) in the eastern province of the Kingdom of Saudi Arabia (KSA) using a validated Arabic version of a data collection form. In order to identify the variables that are associated with medication adherence, we applied a logistic regression analysis. Furthermore, we performed the Spearman test to find the correlation between medication adherence, illness perception, and diabetes knowledge. Of the 390 studied patients, 21.5% had low medication adherence, and it was significantly associated with gender (adjusted OR (AOR) = 1.89, 95% CI = 1.27-2.73, p = 0.003) and duration of diabetes (AOR = 0.83, 95% CI = 0.67-0.95, p = 0.017). Furthermore, we found a significant positive correlation between medication adherence and illness perception (rho = 0.217, p = 0.007) and knowledge of diabetes and medication adherence (rho = 0.425, p < 0.001). We recommend improving T2DM patients' knowledge about the importance of adherence to their medication regimen in several health education sessions at the PHCs. In addition, we recommend mixed-method medication adherence assessment surveys in different parts of the KSA.

Magnitude and associated factors of Pityriasis Versicolor among patients attending Dermatovenereology Outpatient Department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Pityriasis versicolor (PV) is a chronic superficial fungal infection caused by Malassezia species. It is the most common dermatologic disorder in tropical countries including Ethiopia and skin discoloration is the principal morbidity resulting from pityriasis versicolor. Therefore, this study assess the prevalence and associated factors of PV among patients attending Dermatovenereology clinic at the University of Gondar Comprehensive Specialized Hospital. Hospital based cross sectional study design was employed. Systematic random sampling was used and a total of 406 participants who attended Dermatovenereology OPD were included in the study. Data were collected by interview and physical examination. Then it was checked, coded, entered into Epi-Info version 7 and analyzed using Stata version 14. Both bivariable and multivariable logistic regression were employed to identify factors associated with PV. Adjusted odds ratio with their corresponding 95% CI and P-value were calculated. A P-value less than 0.05 was used to declare statistically significant variables. The overall magnitude of PV among patients attending Dermatovenereology OPD at the UGCSH was 12.6% (95%CI; 9.2%, 15.0%).Those who had a diploma and above education [AOR: 95% CI; 4.67 (1.18, 18.47)], excessive sweating [AOR: 95% CI; 4.75 ( 1.92, 8.76)] being male [AOR: 95%CI; 4.19 (1.92, 9.14)], practicing regular exercise [AOR: 95% CI; 4.11 (1.93, 8.76)] and wearing heavy clothes [AOR: 95% CI; 2.53 (1.24, 5.15)] were found to be statistically significantly associated with PV. This study found that the magnitude of Pityriasis versicolor was relatively lower. The study revealed that educational status (diploma and above), male gender, habit of regular exercise, excessive sweating and wearing heavy cloths were significantly associated with Pityriasis Versicolor. It is recommended that high risk patients receive close follow up and health professionals should provide health education sessions in waiting rooms about the identified risk factors.

Effect of Behavior Change Communication on Self-Care Practices Among Adult Type-2 Diabetic Patients in a Semi-urban Community of South India: A Quasi-Experimental Study.

Diabetes mellitus is often termed the modern epidemic, and India ranks second afterChina in the global disease burden. Practice and adherence to essential self-care behaviors, positively correlated with good glycemic control and reduced complications in people with diabetes, have been inadequately understood, especially in a semi-urban setting. This community-based interventional study was done among 269 known adult type 2 diabetic patients from a semi-urban community in South India for three months. By simple random sampling, known diabetics identified in the health survey by the tertiary care teaching institute were considered for the study. Self-care practices in diabetes were recorded in the pre-test using a validated semi-structured questionnaire. Two health education sessions, each for 30 minutes, were conducted with 15-20 subjects in a group. Health education materials on self-care in diabetes, such as charts, handouts, video clippings, and PowerPoint presentations in the local language, were used. The self-care practices were re-recorded in the post-test after two months. Inferential statistics were carried out with a t-test, analysis of variance (ANOVA), and Pearson correlation coefficient, and a p-value less than 0.05 was considered statistically significant. Results: A total of 253 diabetic subjects were included in the final analysis, with an attrition rate of 6%. The mean age of participants was 56.5 ± 11.9 years. The mean score of self-care practices among diabetic subjects at the baseline was 14.6 ± 13.2. Illiteracy and smoking habit were significantly associated with lower self-care scores in the pre-test. In the post-test, after health education, there was a significant improvement in the mean self-care practices score and a reduction in the mean fasting blood sugar level. Also, a significant mild negative correlation between the self-care scores and blood sugar levels was seen (Pearson correlation coefficient = -0.21, p < 0.001). Self-care practices, which were not satisfactory in most diabetic participants, were found to be significantly impacted by the small group education. This stresses the need for effective health education sessionsas envisaged under the national program.

Validation of a Questionnaire on Sexual and Reproductive Health Among Immigrant Vocational Education Students in Portugal from São Tomé and Príncipe

Sexual and reproductive health interventions’ effectiveness should be evaluated using a valid instrument. This study aimed to validate a questionnaire on sexual and reproductive health in adolescents and young adults from São Tomé and Príncipe who voluntarily enrolled in a vocational school in Portugal to complete their 12th school year and obtain a professional card.A questionnaire consisting of perception and knowledge sections was adapted from previous questionnaires. We followed the steps of psychometric analysis. Firstly, we assessed face validity and content validity. We used factorial analysis to validate the perceptions section (which included Likert-type questions). For the knowledge section (which consisted of multiple-choice questions), we used the key check, discrimination index, and difficulty index. We evaluated internal consistency through Cronbach’s alpha for the perceptions section and the Kuder-Richardson score for the knowledge section.Out of 105 invited students, a total of ninety students were enrolled in this study, of whom 88 completed most of the questions. The exploratory analysis showed that most students agreed with the right to refuse intercourse. However, while approximately 23% disagreed that consensual sex among adult women or men is always wrong, around the same proportion agreed. A considerable number of students recognized condoms and pills as effective methods of contraception. However, most students were unfamiliar with other methods. Most knowledge questions showed acceptable difficulty levels, and the discrimination index varied among questions. The knowledge questions demonstrated good consistency levels. This study enabled us to develop an appropriate instrument for evaluating the effectiveness of public health interventions and identifying specific knowledge gaps in migrant populations from low-income countries. This will help prioritise topics to be addressed in sexual health education sessions.

Intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients

Background Hepatitis C virus (HCV) infection is the most challenging public health problem in Egypt where the prevalence is the highest in the world. Intrafamilial transmission of hepatitis C occurring between patients infected with HCV and their household members sharing the same house and living conditions. Preventive measures of hepatitis C are considered the first line of defense against HCV infection. Aim assess the intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients. Design A descriptive cross sectional research design was utilized. Setting The study was conducted at outpatient clinics of Liver Institute at Kafer-Elsheikh Governorate. Sample A simple random sample of 365 household contacts of hepatitis C patients was recruited for the current study. Tool Data was collected through one tool: A structured Interviewing Questionnaire for household contacts of hepatitis C patients which included three parts; part I-(a) Demographic data, (b) Medical history of household contacts, Part II (a) Household contacts knowledge about HCV (b) Hepatitis C risk factors, Part III: Preventive measures followed by household contact of hepatitis C patient: This part is self-reported practices. Results The study revealed that;56.7% of household contacts were males, 72.1% of them were living in rural areas, 75.60% were married, with a mean age ±SD 36.73±9.18 years old.44.1% obtained secondary education, 30.7% were employees, among this group hypertension and diabetes were the main chronic illness. 49.90% had moderate level of general knowledge about HCV infection, 71.50% had low level of knowledge about hepatitis C risk factors and 90.00% had a low level of preventive measures (self-reported practices) regarding HCV. There was no correlation between household contacts knowledge about HCV risk factors and their preventive measures(r=0.031 and P=0.549). Conclusion Almost half of household contacts mentioned that they knew intrafamilial risk factors while about half of this group have a misconception about intrafamilial risk factors, while majority of them stated that they knew sharing scissors and clippers as the main intrafamilial risk factors and less than one-fourth of them knew direct contact with infected blood and sharing of special equitoothbrushesth brushes. Household contacts applied some preventive measures such as; Cover the wound with a piece of cloth or gauze, disinfect the site with alcohol or antiseptic solution and frequent and proper hand washing. Recommendations Routine health assessment of household contacts knowledge regarding intrafamilial risk factors and preventive measures therefore health education sessions should be conducted to raise their awareness regarding HCV infection and further research should be conducted on larger samples of contacts.

An Exploratory Study of Healing Circles as a Strategy to Facilitate Resilience in an Undocumented Community.

Within the United States (U.S.), the COVID-19 pandemic highlighted critical inequalities affecting undocumented communities and resulting in particularly heightened stress for members of these communities. In addition to the stress associated to COVID-19, immigrants in the U.S. were more than ever subjected to a hostile anti-immigrant climate under Trump's administration. Given this compounded stress, the impact of the pandemic on mental health is likely to be disproportionately experienced by undocumented immigrants. In response, a group of psychologists partnered with a leading immigrant rights advocacy organization and formed a reciprocal collaboration to support undocumented communities. A major focus of the collaboration is to foster learning, supporting members of the immigrant community to contribute to their own well-being and others in the community. Accordingly, the collaborative developed and delivered a web-based mental health education session to the immigrant community and to practitioners serving this population. The session presented the use of healing circles as a strength-based approach to building resilience and also sought feedback regarding specific features of healing circles that can enhance their effectiveness in managing distress. Survey data and qualitative findings from this study show that those who participated in the web-based program perceived the session as validating and informative. Findings also underscored the need for creating safe spaces for community members to be vulnerable about their lived experiences while promoting ownership of their narratives. We discuss practical implications pertaining to the development and facilitation of social support groups for immigrants led by non-specialist community members trained for this role.

Effect of Multimedia E-Book Use on the Information Literacy of Nursing Students and Health Communication in Student-Led Large- and Small-Group Community Health Education Sessions

The integration of digital technology into healthcare is critical for health communication. This study analyzed a group of nursing students who applied multimedia health education e-books to different groups of varying sizes to explore the efficiency of implementing health communication and nursing information literacy in the nursing industry. If medical personnel can make appropriate use of technology, combine medical operations with information systems, and disseminate the purpose of health to groups of different sizes properly, the quality of patient care will improve. Thirty-two junior nursing students at the college level were divided into three groups, each subject to a 3-week internship. After the internship, a questionnaire survey was conducted. Additionally, nine nursing students were interviewed in a 45-min semistructured format. Regarding the effectiveness of nursing students using multimedia e-books to implement health communication and the development of nursing information literacy, the statistical analysis results demonstrated no significant differences between large groups and small groups. However, their 5-point Likert scale average values were all greater than 4, indicating that regardless of group size, their feedback on using e-books was positive. This means multimedia e-books can effectively help nursing students practice health communication application effectiveness and develop nursing information literacy.

Impact of oral intervention on the oral and overall health of children living with HIV in Cambodia: a randomized controlled trial

BackgroundMaintaining oral health is essential for improving overall health of children living with HIV. Therefore, we evaluated the effectiveness of an oral health intervention for improving their oral and overall health. In addition, we examined their longitudinal association between changes in oral and overall health.MethodsWe conducted a 2-year randomized controlled trial involving children living with HIV in Cambodia. Children aged 3–15 years and their caregivers were randomly allocated either to the intervention (group A) or control (group B) arm. A second control arm (group C) included children without HIV. The group A children received oral health education sessions and practiced home-based daily care.ResultsIn the baseline survey, 482 children participated (group A: n = 160, group B: n = 168, group C: n = 154), and 350 completed the endline survey. An interaction effect in teeth brushing duration was observed in children in group A relative to group B (AOR = 2.69, 95% CI: 1.37–5.31) and group C (AOR = 3.78, 95% CI: 1.70–8.40). Longitudinal associations were observed between changes in oral hygiene and overall health, as presented by alterations in dental caries in permanent teeth with viral load detection (adjusted odds ratio = 3.58, 95% CI: 1.10 − 11.73), in salivary flow quantity with the overall quality of life (β = 0.07, 95% CI: < 0.01 − 0.13), as well as in dental caries, salivary pH, debris index with body mass index for age among group A children.ConclusionsOral health intervention may improve oral care behaviors and potentially enhance overall health among children living with HIV in antiretroviral therapy in a resource-constrained setting.Trial registrationISRCTN 15177479.

Effects of 12 weeks of Tai Chi on neuromuscular responses and postural control in elderly patients with sarcopenia: a randomized controlled trial.

To explore the effect of 12 weeks of Tai Chi on neuromuscular responses and postural control in elderly patients with sarcopenia. One hundred and twenty-four elderly patients with sarcopenia from ZheJiang Hospital and surrounding communities were selected, however, 64 were later disqualified. Sixty elderly patients with sarcopenia were randomly assigned to the Tai Chi group (n = 30) and the control group (n = 30). Both groups received 45-min health education sessions once every 2 weeks for 12 weeks, and the Tai Chi group engaged in 40-min simplified eight-style Tai Chi exercise sessions 3 times per week for 12 weeks. Two assessors who had received professional training and were unaware of the intervention allocation assessed the subjects within 3 days prior to the intervention and within 3 days after completion of the intervention. They chose the unstable platform provided by the dynamic stability test module in ProKin 254 to evaluate the patient's postural control ability. Meanwhile, surface EMG was utilized to assess the neuromuscular response during this period. After 12 weeks of intervention, the Tai Chi group showed a significant decrease in neuromuscular response times of the rectus femoris, semitendinosus, anterior tibialis, and gastrocnemius and overall stability index (OSI) compared to before the intervention (p < 0.05), while there was no significant difference in the control group for these indicators before and after intervention (p > 0.05). In addition, these indicators in the Tai Chi group were significantly lower than those in the control group (p < 0.05). The changes in neuromuscular response times of the rectus femoris, semitendinosus, anterior tibialis, and gastrocnemius were positively correlated with the changes in OSI (p < 0.05) in the Tai Chi group, but there were no significant correlations between changes in neuromuscular response times of the aforementioned muscles and changes in OSI in the control group (p < 0.05). Twelve-weeks of Tai Chi exercise can improve the neuromuscular response of the lower extremities in elderly patients with sarcopenia, shorten their neuromuscular response time when balance is endangered, enhance their dynamic posture control ability, and ultimately reduce the risk of falls.

The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women

BackgroundThe present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women.MethodThis RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5–7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests.ResultsThe mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05).ConclusionThe results of this research indicated that CBT and sexual health education are effective in improving women’s sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women.Trial registrationIranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir.

Abstract P251: Using Art to Mitigate Psychosocial Stress and Blood Pressure Among Black Women: A Pilot Trial

Background: Black women demonstrate higher levels of stress over the life course compared to Black men, White men, and White women, which may help to explain their higher cardiovascular disease (CVD) morbidity and mortality. Despite implications for primary and secondary CVD prevention and racial disparities, few interventions have targeted psychosocial stress to improve blood pressure (BP) levels among Black women. Objective: To test whether a theory-driven, culturally tailored, community intervention focused on the stress experiences of Black women improves psychological outcomes and BP levels. Methods: The “Art for Hearts” pilot trial sought to examine the feasibility, acceptability, and preliminary efficacy of a novel intervention encouraging creative self-expression. This individual level, single-arm pilot trial recruited self-identified Black women ≥18 years. Women participated in an 8-week program, including 4 art sessions with a community artist (a self-identified Black woman) accompanied by a moderated focus group discussion and 4 heart health education sessions (facilitated by a Black woman researcher) on home BP monitoring, stress management techniques, diet/physical activity, and patient-clinician communication. All sessions were conducted in-person in a community space. Participants completed a survey including self-rated stress (scale of 0 to 7), perceived stress (PSS-10), depressive symptoms (PHQ-8), and anxiety symptoms (GAD-7) at baseline and 8 weeks. BP was measured by a trained assessor at baseline and 8 weeks as well as before and after each session. We examined within-participant changes in psychological measures as well as mean systolic and diastolic BP from baseline to 8 weeks. Results: The study included 18 Black women with a mean age of 44.1 (SD=15.4) years. Women were highly educated (36.8% with a graduate/professional degree) and 11.1% earned an income of ≥$100,000. Mean systolic BP was 114 mmHg and mean diastolic BP was 66 mmHg at baseline. From baseline to 8 weeks, self-rated stress level decreased by 1-point (from 4.36 to 3.18; p=0.005) (scale range: 0 -7). Perceived stress (-1.08; p=0.58) and anxiety (-1.33; p=0.09) decreased from baseline to 8 weeks; however, these changes did not achieve statistical significance. Depressive symptoms significantly improved from baseline to 8 weeks (19.13 to 13.38; p=0.044). There were no differences in systolic or diastolic BP from baseline to follow-up. The intervention was deemed feasible and acceptable with an attendance rate of &gt;80%; participants expressed high overall satisfaction with the intervention. Conclusion: A tailored 8-week pilot intervention using painting self-expression demonstrated feasibility, acceptability, and preliminary efficacy for improving self-rated stress and depressive symptoms. No effects were demonstrated on BP in this sample.

Exploring the benefits and challenges of being a consumer educator in nursing education: A scoping review.

WHAT IS KNOWN ON THE SUBJECT?: The mental health needs of individuals are increasing following the COVID-19 pandemic, with a need to focus on the education of nurses to be equipped to respond. Stigma around mental health still exists for nursing students, with the implementation of mental health education by an individual with lived experience having a known positive effect on stigmatizing attitudes. Research on consumer involvement in nursing education identifies that the consumer role is often varied and casual, with no existing review on the consumer experience. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study emphasizes the importance of consumer involvement in nursing education. Alongside the literature focussing on the student benefits, this review highlights both the benefits of being an educator, and the challenges of being an educator from the consumer's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE: The knowledge around the consumer perspective mapped in this review has the potential to impact and transform education protocols for consumer involvement in education. This can maximize on the meaningful contribution that lived experience has within mental health nursing education. This review enforces the need for an awareness of the challenges consumers face in their role as an educator, and highlights the need for further understanding of how to overcome these challenges. There is also an opportunity to capitalize on the benefits identified by consumers in their role within nursing education and sharing their lived experience. ABSTRACT: Introduction While the mental health needs of populations are increasing, the targeted training of mental health professionals, specifically nurses, is required. Stigma surrounding mental health from nursing students exists, highlighting educational gaps. To address this, the involvement of consumers in undergraduate education has resulted in a positive effect on the stigmatizing attitudes of nursing students. There is still a limited understanding, however, of the consumers experience in this process. Aim To explore the experiences of individuals living with mental illness in educating nursing students. Methods The Joanna Brigg's Institute's (JBI) methodology for scoping reviews was used to search CINAHL, Medline, PsychInfo, Web of Science and Scopus including grey literature. The eligibility criteria for participants included individuals (a) diagnosed with a mental illness; (b) over 18 years of age; and (c) who participated in the educating of nursing students surrounding mental health in any context. Articles were only considered that were in the English language, and no time constraint was enforced during the search strategy for article selection. The search yielded 2640 results, of which 26 articles were included. Results Results found two prominent categories, including both benefits and challenges of being the educator from the consumer perspective. The benefits included: (a) the person behind the diagnosis; (b) reciprocal relationships; (c) positive effects on well-being; (d) unique contribution; and (e) purpose in storytelling. Challenges identified included: (a) vulnerability; (b) voyeuristic; (c) lack of preparation; (d) negative effects on well-being; (e) support; (f) not a real consumer; (g) variation of involvement; and (h) acknowledging consumer perspective. Discussion As consumer-led education for mental health nursing curriculum becomes mandated, amplifying the voice of the consumer in nursing education is crucial. While the benefits and challenges voiced by consumers in their involvement in mental health nursing education have been outlined here, further knowledge focussed on the consumer's experience as an educator outside the classroom setting, and in clinical practicum, alongside consumer involvement in specialized mental health education sessions, could aid in transforming consumer involvement. Implications for practice This review offers an incentive for nurse educators to capitalize on the benefits of educating for consumers to promote a meaningful contribution, while also practicing with an awareness of voiced challenges.

“Augmenting the referral pathway for retinal services among diabetic patients at Reiyukai Eiko Masunaga Eye Hospital, Nepal: a non-randomized, pre-post intervention study”

BackgroundDiabetic Retinopathy (DR) is an important public health issue in Nepal. Despite the availability of retinal services, people may not access them because of the lack of knowledge about DR and poor referral systems. DR screening uptake was low at Reiyukai Eiko Masunaga Eye Hospital(REMEH) since retina services were started. Scheer Memorial Hospital is a multispeciality hospital near to REMEH. It has no eye department but has been running a regular diabetic clinic. This was a site for referring diabetic patients for DR screening. Improving DR awareness among general physicians has the potential to address these challenges.MethodsThe aim of our study was to investigate the effectiveness of providing health education to selected health personnel and establish a referral pathway on the attendance of diabetic patients for retinal screening at REMEH. This was a non-randomized, pre-post intervention study design. Total of three health education sessions were provided to the health care professionals of Scheer on diabetic retinopathy using Power Point presentations, posters, pamphlets and videos. The study period was 16 months (2020 June –2021 September) and divided into 8 months pre-intervention(baseline data collection) and 8 months post intervention period. The proportional increase in number of diabetes attendance pre and post intervention was calculated by Z test. The change in knowledge of health care personnels pre and post intervention was scored and evaluated through a questionnaire and calculated by paired- t test. Data was analyzed using Excel and Epi Info 7.The Protocol was published on August 21, 2021, in JMIR Publications.ResultsThe proportional increase in number of referrals of diabetes attendance post intervention increased from 50 to 95% and was statistically significant (p < 0.001, 95% CI: 0.214–0.688). The mean score of knowledge gained by physicians on DR awareness was more at post intervention (8.8 ± 1.32) than pre intervention (6.4 ± 1.51). It was statistically significant (p < 0.001).ConclusionThis study shows that a well-planned health education intervention changes the knowledge in physicians about DR. There is an increase in the number of referrals and attendance of patients for DR screening with the change in knowledge and referral mechanism.Trial RegistrationClinical Trials.gov NCT04829084; https://clinicaltrials.gov/ct2/show/NCT04829084:02/04/2021.

Addressing immediate public health needs as part of Afghan evacuees’ resettlement to the United States during the COVID-19 pandemic

ObjectivesSince the removal of US troops from Afghanistan in 2021, the United States welcomed Afghan evacuees through Operation Allies Welcome. Using cell phone accessibility, the CDC Foundation worked with public-private partners to protect evacuees from the spread of COVID-19 and provide accessibility to resources. Study designThis was a mixed methods study. MethodsThe CDC Foundation activated its Emergency Response Fund to accelerate public health components of Operation Allies Welcome, including testing, vaccination, and COVID-19 mitigation and prevention. The CDC Foundation began the provision of cell phones to evacuees to ensure access to public health and resettlement resources. ResultsThe provision of cell phones provided connections between individuals and access to public health resources. Cell phones provided means to supplement in-person health education sessions, capture and store medical records, maintain official resettlement documents, and assist in registration for state-administered benefits. ConclusionsPhones provided necessary connectivity to friends and family for displaced Afghan evacuees and higher accessibility to public health and resettlement resources. As many evacuees did not have access to US-based phone services upon entry, provision of cell phones and plans for a fixed amount of service time provided a helpful start in resettlement while also being a mechanism to easily share resources. Such connectivity solutions helped to minimize disparities among Afghan evacuees seeking asylum in the United States. Provision of cell phones by public health or governmental agencies can help to provide equitable resources to evacuees entering the United States for social connection, healthcare resources, and resources to assist in the process of resettlement. Further research is needed to understand the generalizability of these findings to other displaced populations.

Impact of reproductive and sexual health education on late adolescent girls in an urban slum

Background: Menstruation, although, a natural process, may result in adverse health outcomes. Adolescents having a better knowledge regarding menstrual hygiene and safe menstrual practices are less vulnerable to reproductive tract infections and its consequences. Aim and Objectives were to study the socio-demographic profile of late adolescent girls in an urban slum. To determine the baseline knowledge of girls regarding reproductive and sexual health and menstrual hygiene. To estimate the impact of reproductive and sexual health education on the existing knowledge. Methods: This study was done among late adolescent girls to assess the impact of health education on their knowledge, attitude and practices regarding menstruation and puberty, conception, contraception, RTI, STI, HIV and AIDS. After collecting sociodemographic details and baseline knowledge, health education session was conducted, which was followed by checking their, post-test knowledge Follow up session was also conducted after a month. Results: Most of the girls were 16 years old, Hindus and from nuclear families. The baseline knowledge about puberty, menstruation, conception, contraception, RTI, STD, HIV, AIDS was not good. The knowledge increased immediately after the first session, but after the second session, the knowledge was not retained. The menstrual hygiene practices increased after the health education session. Conclusions: The study stresses the importance of imparting knowledge about menstruation, hygiene during the periods, to the adolescent girls and having a regular revision session so as to have good menstrual hygiene practices.

Parents’ A priori Expectations of an Obesity Focused Intervention and What They Found Valuable from its Health Education Webinars

ABSTRACT&#x0D; Purpose: Explore parents with obesity’s: (1) a priori expectations of what they wanted to gain from participating in an obesity-focused intervention compared to (2) post-participation views of what was valuable from the webinar-based health education sessions.&#x0D; Design: A before and after descriptive study, baseline interviews gleaned parents’ motivations for program participation. Following 6 webinar-based health education sessions focused on physical activity (PA) and nutrition in the family unit, parents’ perceptions of what was valuable were collected.&#x0D; Setting: Community-dwelling members in southwestern Ontario.&#x0D; Participants: “Parents” (N=50) were adults with a body mass index of 25+ kg/m2 and had a child of any body composition, aged 2.5 – 10.&#x0D; Methods: Inductive content analyses were employed on semi-structured qualitative interview transcripts and written responses to open-ended questions.&#x0D; Results: Wanting to provide a healthier life for their children was a prominent finding from parents’ baseline interviews. From the webinars, information on local PA resources and on creating positive food environments were especially valuable. In total, there were 7 themes and 4 sub-themes from the baseline interviews; 7 themes and 7 sub-themes from the PA webinars; and 7 themes and 11 sub-themes from the nutrition webinars.&#x0D; Conclusions: Parents found the webinars addressed various concepts they hoped to gain from their participation in the intervention. Results from these webinars can inform other parent-focused family interventions on important components when crafting future webinars.&#x0D; Keywords: parents, health education, obesity, overweight

Parents’ A priori Expectations of an Obesity Focused Intervention and What They Found Valuable from its Health Education Webinars

ABSTRACT&#x0D; Purpose: Explore parents with obesity’s: (1) a priori expectations of what they wanted to gain from participating in an obesity-focused intervention compared to (2) post-participation views of what was valuable from the webinar-based health education sessions.&#x0D; Design: A before and after descriptive study, baseline interviews gleaned parents’ motivations for program participation. Following 6 webinar-based health education sessions focused on physical activity (PA) and nutrition in the family unit, parents’ perceptions of what was valuable were collected.&#x0D; Setting: Community-dwelling members in southwestern Ontario.&#x0D; Participants: “Parents” (N=50) were adults with a body mass index of 25+ kg/m2 and had a child of any body composition, aged 2.5 – 10.&#x0D; Methods: Inductive content analyses were employed on semi-structured qualitative interview transcripts and written responses to open-ended questions.&#x0D; Results: Wanting to provide a healthier life for their children was a prominent finding from parents’ baseline interviews. From the webinars, information on local PA resources and on creating positive food environments were especially valuable. In total, there were 7 themes and 4 sub-themes from the baseline interviews; 7 themes and 7 sub-themes from the PA webinars; and 7 themes and 11 sub-themes from the nutrition webinars.&#x0D; Conclusions: Parents found the webinars addressed various concepts they hoped to gain from their participation in the intervention. Results from these webinars can inform other parent-focused family interventions on important components when crafting future webinars.&#x0D; Keywords: parents, health education, obesity, overweight

The Level of School Teachers' Knowledge About First-Aid Management and Control of Epistaxis in Qassim Region, Saudi Arabia.

Epistaxis is an acute episode of nasal bleeding commonlycaused in children bytraumatic injuriesin aschool setting.It is one of thecommonear, nose, and throat emergencies, which should be managed with first-aid measures.To the best ofour knowledge, no studieshave been conductedamong school teachers in the Qassim regionofSaudi Arabiaregarding this information. Thisstudythusaimed to assess levelsof knowledge about first-aid management and control of epistaxis among school teachers intheQassim region, Saudi Arabia. A cross-sectional study using avalidatedonline questionnaire was distributed via social media platforms. Informationwas collectedregarding sociodemographic characteristics, and eight items assessed participants'knowledgeaboutepistaxis and its management. Univariate, bivariate, and multivariable analyses were conducted to assess the factors associated with good levelsof knowledge. The study had atotal of 1,152 participants, of which 69.7% were female. The mean of knowledge was 3.29 (SD=1.39, range: 0-7). Only 19.4% of participants had a good level of knowledge. In multivariate analysis, females and those whohadreceived informationon firstaid to stop nose-bleedswere significantly associated with good knowledgelevels(adjusted odds ratio {AOR}: 1.72, 95% CI: 1.18-2.51,p=0.005; and AOR: 3.38, 95% CI: 2.47-4.64, p<0.001, respectively). Less thanone-quarter of participants had good knowledgelevels. Health education sessions for teachers are highly recommendedand should specifically targetmale teachers.

The efficacy of maternal health education and maternal screening on knowledge and the uptake of infant screening for sickle cell disease in Dar-Es-Salaam, Tanzania; a quasi experimental study

BackgroundGlobally, Sickle cell disease (SCD) is one of the most common genetic disease with high childhood mortality. Early identification of babies with SCD through newborn screening (NBS) and linking them to care are among the recommended interventions. The purpose of this study was to assess the efficacy of maternal health education and maternal screening for SCD on knowledge and the uptake of infant screening for SCD among mother-infant pairs attending antenatal clinics at Government health facilities in Dar-es-salaam, Tanzania. MethodsThis study was a pre-test post-test, quasi-experimental which involved pregnant women attending antenatal clinics at three hospitals; Mbagala hospital, Sinza hospital and Buguruni health center in Dar Es Salaam. A structured questionnaire was used in data collection. Knowledge on SCD was assessed for all participants before and after two sessions of health education. Participants in Mbagala and Buguruni were also screened for SCD using Sickle SCAN point-of-care test (BioMedomics Inc, USA). The efficacy for health education intervention was computed as the post-intervention minus baseline knowledge score. For proportions, a two-sample z-test was used. Univariate and multivariate logistic regression were used to analyze the efficacy of health education intervention and also predictors of infant diagnosis. ResultsFor two sessions of health education intervention, a total of 467 pregnant women completed the sessions. During antenatal visits, a total of 218 were screened for SCD. The proportion of participants with good knowledge of SCD had significantly increased to 85.9% from 12.4% at baseline following the education intervention. In multivariate analysis, sharing the received education on SCD was an independent predictor of the efficacy of health education intervention. Maternal occupation, maternal SCD status as well as sharing the received education on SCD were independent predictors of the uptake of SCD infant diagnosis.ConclusionThis study has demonstrated that maternal health education and maternal screening for SCD are feasible and efficacious interventions in raising knowledge and improving the uptake of infant diagnosis for SCD. These interventions are strongly recommended to be included in the comprehensive care package for pregnant women attending antenatal clinics, particularly in areas with a high burden of SCD.