Abstract As artificial intelligence (AI) Large Language Models (LLM) like ChatGPT become more common in healthcare, patients increasingly use them to find medical information. While ChatGPT may support health literacy, its readability and accuracy compared to established resources remain unclear. The purpose of this study is to evaluate ChatGPT-4 responses on femoroacetabular impingement (FAI) and its surgical management compared to AAOS OrthoInfo content. We hypothesize that ChatGPT may deliver medically accurate information, but its readability may fall short when compared to OrthoInfo. Nine questions based on the OrthoInfo FAI page were submitted to ChatGPT-4, with and without a readability prompt. Topics included anatomy, pathology, cause, symptoms, workup, imaging, treatment, role of hip arthroscopy, and outcomes. Readability was assessed using validated indices. Accuracy was independently rated using a 4-point scale. Statistical comparisons were made using t-tests and ANOVA (P < 0.01 threshold). OrthoInfo content had a mean reading grade level of 8.0 and a Flesch Reading Ease score of 60.7. Unprompted ChatGPT responses were significantly less readable (grade level 16.2; Flesch score 21.7; P < 0.001). Prompting for readability improved ChatGPT outputs (grade level 10.6; Flesch score 58.2), making them comparable to OrthoInfo (P < 0.09). Accuracy was high across all sources, though OrthoInfo's response on FAI causes scored slightly lower (3.5 versus 4.0; P < 0.46). ChatGPT provides accurate information on FAI. However, without prompting, its complexity may hinder patient understanding. Prompting for readability enables ChatGPT to match established resources like OrthoInfo. Tailored prompting is key to using LLM effectively in patient education and promoting health literacy.

The availability of health information through media has raised public awareness of health literacy (HL). HL is essential for medication adherence and self-management in individuals with chronic diseases, and for those without chronic conditions, HL is important for promoting health and engaging in preventive behaviors. This study examined the role of having a regular physician in improving HL among Korean adults, both with and without chronic diseases. We conducted a retrospective, cross-sectional analysis using data from 8,322 participants in the 2021 Korea Health Panel Study. HL was measured with the 16-item European Health Literacy Survey Questionnaire. To identify factors associated with HL categories and to calculate adjusted mean HL scores, we used multiple logistic regression and weighted linear regression. Among participants with chronic diseases (n=4,627), 56.6% reported having a regular physician, with the largest group (42.7%) showing inadequate HL. After adjustment, age 75 years or older and lower education were significantly linked to lower HL levels, regardless of chronic disease status. Having a regular physician was significantly associated with higher HL levels in participants with chronic diseases (adjusted odds ratio, 1.94; 95% confidence interval, 1.42-2.63), but not in those without chronic diseases. Participants with chronic diseases who had a regular physician showed higher mean HL scores across all HL competencies and domains. Although access to health information has increased, the risk of encountering conflicting or misleading content has grown. These findings emphasize the importance of regular physicians in guiding patients and improving HL, especially among individuals with chronic diseases.

Background Premature pregnancy among adolescents remains a critical public health challenge, particularly among ethnic populations in low-resource settings. Health literacy has been identified as a key determinant of reproductive decision-making and preventive behaviors. This study aims to assess the levels of health literacy and examine their association with pregnancy prevention behavior among ethnic students in northern Thailand. Methods A cross-sectional study was conducted with 128 in-school ethnic adolescent girls, using validated instruments to measure health literacy across three domains: basic, interactive, and critical health literacy, and pregnancy prevention behavior. Descriptive statistics, Pearson's correlation, and multiple linear regression were used to analyze the data. Results The participants exhibited moderate overall health literacy, with high scores in decision-making skills but relatively low scores in basic and interactive literacy. Pearson's correlation analysis revealed that critical literacy was positively associated with prevention behavior ( r = 0.336, p < 0.001), while interactive literacy showed a negative correlation ( r = −0.247, p < 0.001). Multiple regression analysis further confirmed these associations. Critical literacy significantly predicted pregnancy prevention behavior (β = 0.438, p < 0.001), whereas interactive literacy had a significant adverse effect (β = −0.568, p < 0.001). The model explained 17.8% of the variance in behavior ( R 2 = 0.178). Conclusion The findings underscore the importance of critical health literacy in fostering preventive behaviors among ethnic adolescents. Tailored interventions should emphasize evaluative and judgmental skills while addressing culturally rooted communication challenges. These insights may inform inclusive reproductive health policies in ethnic and underserved communities.

Introduction The college period represents a pivotal stage for establishing long-term health behaviors. Grounded in the COM-B (Capability, Opportunity, Motivation—Behavior) model, this study constructs a comprehensive behavioral explanatory framework: positioning eHealth literacy as Capability, social support as Opportunity, and social responsibility as core Motivation to predict healthy lifestyles (Behavior). It further examines how this mechanism is moderated by major, mental health, and sense of hope. Methods From May to June 2022, a cross-sectional survey was conducted involving 4,036 students recruited from six universities in Shandong Province, China, using stratified cluster sampling. Validated scales were administered to assess healthy lifestyle, eHealth literacy, social support, social responsibility, mental health, and sense of hope. Multiple linear regression combined with the Bootstrap method was used to explore variable mediation, and Bootstrap was further applied to test moderation effects. Results A total of 4,036 participants were included in this study, among whom 1,811 were male (44.9%) and 2,225 were female (55.1%). In terms of grade distribution, there were 2,216 lower-grade students (55.0%) and 1,820 upper-grade students (45.0%). The mean score for healthy lifestyles was 3.95 (±0.74). Social responsibility emerged as the strongest predictor ( β = 0.449, 95%CI [0.413, 0.466]) and was found to partially mediate the relationships of both eHealth literacy and social support with healthy lifestyles. Furthermore, major negatively moderated the relationship between eHealth literacy and healthy lifestyles ( β = −0.127, p < 0.001), while mental health status negatively moderated the relationship between social support and healthy lifestyles ( β = −0.087, p < 0.001). In contrast, sense of hope positively moderated the relationship between social responsibility and healthy lifestyles (β = 0.040, p < 0.001). Discussion Social responsibility is not only related to the healthy lifestyle of college students, but also plays a mediating role between electronic health literacy, social support, and healthy lifestyle. Therefore, colleges and universities should focus on cultivating students’ sense of social responsibility, systematically improve their health literacy, create a supportive campus environment, and enhance students’ psychological capital and sense of hope. These multi-level measures, when working together, will help to establish a sustainable mechanism for promoting a healthy lifestyle among college students.

Socioeconomic disparities in hospice care access are well recognized, but their structural drivers remain underexplored. Low-income patients with cancer often face compounded informational, psychosocial, and financial barriers at the end of life. To examine how limited cultural capital, disease-related stigma, and class-based disadvantage may be jointly associated with hospice care access among low-income patients with cancer in China. This descriptive qualitative study was conducted at a tertiary hospital in southwestern China from July 2024 to July 2025. Adult patients with advanced cancer receiving government social assistance were purposively sampled. Semistructured in-depth interviews were conducted, transcribed verbatim, and thematically analyzed using a 6-phase approach. Two researchers independently coded transcripts, with analytic consensus achieved through iterative discussion. NVivo 12 software was used for data management. Analysis occurred from August to October 2025. Among 16 adults with advanced cancer (median [range] age, 55 years [late 30s to early 70s]; 9 men [56.2%]), 4 themes emerged: (1) Limited cultural capital was associated with cognitive and communicative barriers, including low health literacy, reliance on informal sources, and poor digital navigation. (2) Stigma surrounding cancer and death was associated with moral dilemmas and inhibition of open discussion of hospice. (3) Economic deprivation was associated with restricted care options, reinforced curative treatment priorities, and weakened access to social support. (4) Patients and families used resilience strategies, including peer networks, communication tactics, and value redefinition. These domains interacted synergistically; poverty was associated with reduced access to education and digital literacy, with exacerbated stigma internalization and discouraged care-seeking. This study found that cultural capital deficits, stigma, and socioeconomic hardship were jointly associated with a self-reinforcing cycle of hospice exclusion. These outcomes suggest that interventions must address these factors simultaneously by improving health literacy, reducing stigma, and expanding financial and systemic support.

BackgroundThis study assessed hypertensive health literacy and its association with achieving blood pressure goals at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.MethodA cross-sectional study was conducted with 393 hypertensive patients from September 1 to October 30, 2024, selected through simple random sampling. Data were analyzed using t-tests, one-way ANOVA, and logistic regression, with p < 0.05 considered significant.ResultAmong the 393 participants, only 40.2% of participant achieved their blood pressure goal. Only 15% and 30.8% had high hypertensive health literacy and adherence levels, respectively. Participants living in an urban area (AOR = 5.1, 95% CI: 2.74–9.17, p < 0.001), with higher education (AOR = 2.7, 95% CI: 1.15–6.75, p < 0.023), living with hypertension for more than 10 years (AOR = 3.4, 95% CI: 1.54–7.58, p < 0.002), using three or more antihypertensive drugs (AOR = 0.3, 95% CI: 0.13–0.95, p < 0.041), adhering to treatment (AOR = 2.7, 95% CI: 1.34–5.55, p < 0.005), and having high hypertension health literacy (AOR = 3.8, 95% CI: 1.36–10.90, p < 0.011) were more likely to achieve blood pressure goal. Variables like residence (p < 0.001), marital status (p < 0.004), educational status (p < 0.013), occupation (p < 0.013), number of antihypertensive medications (p < 0.001), and presence of complication (p < 0.002) showed a significantly mean difference in hypertension health literacy score. There is a significant association between hypertensive health literacy and medication adherence with a p-value of < 0.001.ConclusionMost participants did not achieve their target blood pressure goals. Hypertensive health literacy and medication adherence were significantly associated with blood pressure goals. To improve these outcomes, health policies should focus on creating community-based educational programs that empower patients with a better understanding of their condition and the importance of following their treatment plans. Additionally, increasing access to healthcare resources and support can provide the guidance patients need to manage their hypertension effectively. By strengthening these initiatives, we can help more individuals take control of their health and achieve better blood pressure management.

Chronic liver disease (CLD) poses a growing public health burden in India, with hepatitis B virus (HBV) remaining a preventable contributor despite the nation's expanding immunization and screening frameworks. This narrative review critically appraises programme-level preventive strategies for HBV-related CLD in India, structured across three tiers of prevention: public awareness, vaccination and screening. Evidence was synthesized from 26 eligible studies, incorporating national surveys, cohort studies, policy reports and qualitative analyses. Findings reveal substantial deficits in HBV-related knowledge, particularly among socio-economically disadvantaged and rural populations, where stigma, mis-information and poor health literacy impede timely diagnosis and care-seeking. Although hepatitis B vaccination is part of India's Universal Immunization Programme, birth-dose coverage remains sub-optimal due to labor-room workflow challenges, cold chain fragility and provider hesitancy, especially in high-fertility states. Uptake among healthcare workers and medical students is also inconsistent, highlighting gaps between theoretical knowledge and preventive behavior. Screening efforts, primarily through the National Viral Hepatitis Control Programme, remain fragmented, with significant inter-state disparities in antenatal HBsAg testing and limited penetration in tribal and remote regions. While decentralized, community-led models have shown promise; broader scale-up is hampered by logistical and infrastructural constraints. The review underscores the urgent need for culturally tailored awareness campaigns, cold chain automation, subsidized adult vaccination and robust digital linkage-to-care models. Generating rural-specific cost-of-illness and willingness-to-pay data will be vital for evidence-informed policymaking. A life-course approach anchored in equity, digital health and decentralization is essential to achieving HBV elimination goals and reducing the burden of chronic liver disease in India.

Given the global demographic shifts and rapid digitalization, digital engagement has emerged as a critical determinant of healthy aging. While previous research has linked digital engagement to cognitive outcomes, the underlying mechanisms remain underexplored among Chinese older adults. This study aimed to analyze the relationships between digital engagement and cognitive function among older adults in China through a moderated mediation model guided by the technological reserve hypothesis, with digital health literacy (DHL) and social support as mediators and living arrangements as a moderator. We conducted a cross-sectional questionnaire survey using stratified multistage sampling from June to November 2024, including 8123 participants aged 55 years and older. Digital engagement, defined as older adults' use of contemporary digital technologies to support routine daily activities, autonomy, independence, and social inclusion, was assessed using a multidimensional questionnaire. The Chinese eHealth Literacy Scale, the 3-item short version of the Perceived Social Support Scale, and the Mini-Cog test were used to assess DHL, social support, and cognitive function. Guided by a directed acyclic graph based on the technological reserve hypothesis, mediation and moderated mediation analyses were performed using the PROCESS macro in SPSS (IBM Corp) with 5000 bootstrap resamples. Digital engagement was positively associated with cognitive function among older adults (β=0.241, 95% CI 0.216-0.265). This association was partially mediated by DHL (β=0.059, 95% CI 0.049-0.069) and social support (β=0.012, 95% CI 0.008-0.016), with the combined indirect effects accounting for 29.5% of the total effect (β=0.071, 95% CI 0.061-0.082). Additionally, living arrangements significantly moderated the associations between digital engagement and cognitive function (β=0.109, 95% CI 0.052-0.166), digital engagement and DHL (β=0.063, 95% CI 0.014-0.112), and digital engagement and social support (β=0.151, 95% CI 0.089-0.212). These effects were stronger among older adults living alone. This study contributes to the understanding of cognitive aging in the digital environment from the perspective of the technological reserve hypothesis and digital engagement. Digital engagement influenced cognitive function via DHL and social support, and these associations of digital engagement with cognitive function, DHL, and social support were stronger among older adults living alone. Digital health interventions and public health policies should target both DHL and social support among older populations and prioritize older adults living alone.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with epilepsy with an incidence of 1:1000. The primary risk factors for SUDEP are generalized or focal to bilateral tonic-clonic seizures. Preventive measures like nighttime monitoring devices and resuscitation training address modifiable risk factors. Nevertheless, SUDEP awareness remains insufficient. This study aimed to analyze risk awareness and behavior and to evaluate the impact of a questionnaire. In a monocentric cross-sectional pediatric study, routinely used questionnaires were analyzed retrospectively regarding SUDEP awareness rates and monitor ownership. A total of 498 patient families completed the questionnaire between December 2023 and July 2024. At the time of the survey, 58% recalled having been informed about SUDEP before the questionnaire. The SUDEP questionnaire led to an education in the following outpatient clinic in 25%. A further 9% had been counseled within the following 6 months, leading to an education rate of 92%. Monitoring devices were used in 46% of patients, with nocturnal monitoring being most frequently used in children <4 years. Among those who did not use a monitor and provided reasons against monitoring, half had SUDEP risk factors. Additionally, one third of the responders reported not using their seizure detecting device, with false alarms (28%) being the most frequently cited reason. All patients with epilepsy should be counseled about epilepsy-related risks and preventive measures. Our study highlights SUDEP education gaps and the need for targeted counseling strategies to contribute to SUDEP prevention. The findings show that a structured questionnaire can effectively identify education gaps, enhance counseling efforts, and improve health literacy. Furthermore, there is a need for the development of novel, reliable seizure detection devices. Sudden unexpected death in epilepsy (SUDEP) remains the most common cause of death in people with epilepsy. That is why it is important to take steps to prevent it. We still do not fully understand why SUDEP occurs and how it can be completely prevented. But it is very important to be aware of the risk. This enables those affected and their families to take measures to reduce the danger. This text explains how to inform more people about SUDEP. It also shows a possible role of nighttime monitoring devices in the prevention of SUDEP.

Abstract Background In prostate cancer care, artificial intelligence (AI) models are increasingly used to generate personalized risk predictions by analyzing diverse data inputs, including clinical variables, imaging findings, and genomic indicators such as polygenic risk scores. However, effectively communicating these complex AI-derived risk estimates to patients presents significant challenges. Patients often struggle to understand probabilistic risk information, particularly when advanced algorithms generate it. Traditional cancer risk communication methods might not consider the complexities of AI outputs or differences in patient health literacy and numeracy. We propose a conceptual framework to guide patient-centered communication of AI-driven risk predictions. Methods We reviewed the existing literature on AI-based risk modeling, health risk communication, numeracy, dual-process information processing, and related theories to develop a communication framework designed explicitly for AI-based prostate cancer risk prediction tools. Results The proposed framework emphasizes clear, patient-specific risk communication strategies to enhance understanding and foster trust. It highlights a dual-process approach: offering intuitive visual aids and narrative explanations for quick, instinctive understanding, while also providing accurate statistics and explanations of the AI model’s reasoning for more deliberate processing. By addressing various patient numeracy levels and clearly explaining the AI model’s inputs, assumptions, and uncertainty in plain language, the framework aims to improve understanding and trust in AI-generated risk estimates. Additionally, to promote equity, it includes culturally responsive and accessible communication strategies tailored to patients’ linguistic, literacy, and cultural backgrounds. Conclusion This conceptual framework offers guidance on integrating AI-based risk prediction tools into prostate cancer consultations in a manner that is patient-friendly. By enhancing patients’ understanding of personalized risk information, building greater trust in AI-driven predictions, and addressing various communication needs, the framework helps facilitate more informed decision-making. Ultimately, patient-focused communication can help reduce disparities and promote more equity in prostate cancer care. Citation Format: Tingyu Zou, Folakemi Odedina. A Conceptual Framework for Communicating AI-Based Prostate Cancer Risk Predictions [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Innovations in Prostate Cancer Research and Treatment; 2026 Jan 20-22; Philadelphia PA. Philadelphia (PA): AACR; Cancer Res 2026;86(2_Suppl):Abstract nr A083.

This community service programme was implemented in the coastal community of Padelegan Village, Pademawu Subdistrict, Pamekasan Regency, with a focus on strengthening health literacy and behaviour-based disease prevention at the household level. The background of the activity is based on the vulnerability of coastal communities to health problems related to hygiene, household drinking water management, and environmental cleanliness, as well as the need for an approach that not only increases knowledge but also encourages consistent preventive practices. The programme aims to improve residents' ability to understand and use health information in an applicable manner, while strengthening key disease prevention behaviours through education and mentoring. The activity will be carried out from February to April 2025 with a behaviour-based education design combined with practice demonstrations and community mentoring, involving 48 participants (40 residents/households and 8 posyandu/PKK cadres). The stages included initial assessment, development of KIE media (brief modules and leaflets/posters), two education-demonstration sessions, two home mentoring sessions, and final evaluation. The evaluation was conducted using pre-post knowledge, attitude, and practice (KAP) assessments and practice observation through a checklist. The results showed an increase in health literacy and improved consistency in preventive behaviour; knowledge increased from 5.4 to 7.8, and compliance with hand washing at critical times increased from 41.7% to 72.9%. Programme outputs included an information, education and communication (IEC) package, a household monitoring checklist, and capacity building for cadres as local facilitators. It was concluded that the integration of participatory education, practical demonstrations and cadre mentoring has the potential to be effective in encouraging preventive behavioural change in coastal communities, with recommendations for integrating monitoring into the routine agenda of integrated health service posts (posyandu) and community empowerment groups (PKK) and for follow-up monitoring for 3–6 months to maintain the sustainability of practices.

Healthy behavior has long been linked to mental health outcomes. However, the role of artificial intelligence (AI) literacy in shaping healthy behaviors and its potential impact on mental health remains underexplored. This paper presents a scoping review offering a novel perspective on the intersection of healthy behaviors, mental health, and AI literacy. By examining how individuals’ understanding of AI influences their choices regarding nutrition and their susceptibility to mental health issues, the current study explores emerging trends in health behavior decision-making. This emphasizes the need for integrating AI literacy into mental health and health behaviors education, as well as the development of AI-driven tools to support healthier behavior choices. It highlights that individuals with low AI literacy may misinterpret or overly depend on AI guidance, resulting in maladaptive health choices, while those with high AI literacy may be more likely to engage reflectively and sustain positive behaviors. The paper outlines the importance of inclusive education, user-centered design, and community-based support systems to enhance AI literacy for digitally marginalized groups. AI literacy may be positioned as a key determinant of health equity, better allowing for interdisciplinary strategies that empower individuals to make informed, autonomous decisions that promote both physical and mental health.

Despite the rapid rise of short-video platforms as health information sources, the informational quality of robotic-surgery videos-an area requiring precise clinical explanation-remains insufficiently studied. To compare the quality and reliability of robotic-surgery videos on TikTok and Bilibili and determine how platform features and uploader identity shape content quality. We conducted a cross-sectional analysis of 200 videos (100 per platform) scored using the Global Quality Score (GQS) and modified DISCERN (mDISCERN). Videos were coded by uploader type and theme, and group differences and predictors were examined with nonparametric tests and multivariable regression. TikTok videos drew more engagement, but Bilibili posts were longer and scored higher on GQS and mDISCERN. Professional uploaders produced the most reliable content. Engagement metrics correlated with each other yet did not predict quality in regression. On short-video platforms, visibility and scientific accuracy diverge-highlighting the need for professional involvement, quality-sensitive governance, and stronger public digital health literacy.

BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels. AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders, providing a scientific, comprehensive, and reliable tool for the monitoring and intervention of mental health literacy of such patients. METHODS From December 2022 to June 2023, the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews, semi-structured interviews, expert letter consultations, and the analytic hierarchy process. Based on this index system, a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system. RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators, 10 second-level indicators, and 52 third-level indicators. The overall Cronbach’s α coefficient of the index system was 0.957, with a partial reliability of 0.826 and a content validity index of 0.975. The cumulative variance contribution rate of 10 common factors was 66.491%. The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724, while the correlation coefficients in each dimension ranged from 0.389 to 0.705. CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders, developed in this study, demonstrated notable reliability and validity, making it a valuable tool for evaluating mental health literacy in this population.

Student engagement in health education and scientific dissemination initiatives can foster critical thinking, leadership, and collaboration skills. The Long COVID Brazilian Congress represented an innovative academic initiative aimed at disseminating updated scientific knowledge about post-COVID-19 conditions to diverse audiences while promoting student involvement in scientific communication. Our aim was to assess the self-perceptions of health science students regarding skills and lessons learned from their experience organizing a conference dedicated to disseminating the latest scientific insights on COVID-19 and long COVID. A cross-sectional study employing a mixed-methods approach assessed the self-perception of all 17 students who were part of the organizing committee of the Third Brazilian Congress on Clinical Evidence in COVID-19, using a questionnaire on Google Forms®. Students reported significant learning gains in scientific communication, teamwork, and social responsibility. They recognized the challenge of simplifying scientific language for a lay audience while maintaining accuracy, which strengthened their ability to mediate between research and society. The experience fostered empathy toward patients with long COVID and expanded their understanding of the broader social implications of the pandemic. Participants emphasized that the Congress provided a unique opportunity for interprofessional collaboration and promoted a sense of purpose in addressing contemporary public health challenges. In conclusion, the initiative demonstrates that engaging students in scientific dissemination projects can enhance professional development and strengthen the link between universities and communities. This educational model may serve as a replicable strategy to promote health literacy and civic engagement in future health professionals.

Health Literacy by Hispanic Ethnicity and its Association with Healthcare Experiences, Self-rated Health, and Quality of Life.

BackgroundSocial media has revolutionized healthcare communication, giving nurses unprecedented visibility and influence in shaping public perceptions of health and professionalism. Among these emerging figures are "nurse digital content creators"-nurses who use social platforms to communicate health information, advocate for the profession, and engage with large online audiences. Yet, their online presence challenges traditional ethical frameworks and professional boundaries.AimThis study explores how Italian nurse digital content creators perceive and negotiate ethical and professional boundaries in digital environments, focusing on their motivations, challenges, and the implications for nursing ethics and public health.Research designA qualitative reflexive thematic analysis was used to capture the lived experiences of four Italian nurse digital content creators.Participants and research contextParticipants were purposively selected based on defined criteria and interviewed through semi-structured video calls. Data were transcribed verbatim and analyzed using Braun and Clarke's six-step thematic analysis. Rigor was achieved through member checking, peer debriefing, and transparent coding.Ethical considerationsEthical approval was obtained. Participants provided informed consent electronically. All data were anonymized during the analysis.ResultsFive interrelated themes emerged: (1) Professional Purpose and Digital Advocacy; (2) Ethical Boundaries and Institutional Silence; (3) Privacy, Confidentiality, and Self-Protection; (4) Emotional Labour and Public Exposure; and (5) Health Misinformation and Moral Duty. Participants viewed digital communication as an ethical extension of care but struggled with ambiguous institutional guidance, fear of reputational risk, and the emotional toll of constant visibility.ConclusionNurse digital content creators play a crucial role in improving health literacy and reshaping the image of nursing in society. However, their engagement raises ethical questions that demand updated professional guidelines and institutional recognition. Integrating digital ethics and social media communication into nursing curricula and institutional policies is essential to safeguard professional integrity and enhance the educational potential of online engagement.

Utilization of patient-reported outcome measures for women with low health literacy in gynecologic oncology - A mixed-methods study.

Persistent income-related inequalities in cancer screening utilisation in South Korea: Evidence from repeated cross-sectional data, 2013-2023.

Throughout the COVID-19 pandemic, correctional officers not only experienced high rates of COVID-19 infection but concomitantly demonstrated low vaccine uptake and high government mistrust, placing correctional staff and the incarcerated at risk for viral transmission. To support behavioral change, a multi-pronged dialogic health education intervention was developed for correctional officers in a New York county jail. One-hour facilitated discussions took place during mandatory training days. The research team collected pre- and post-surveys to assess whether the sessions impacted intention to change COVID-19 preventive behaviors, perceived effectiveness of behaviors recommended by public health professionals, and overall health literacy. Participants were also invited to participate in an interview 3-7 months after the session regarding behavior change and perceived effectiveness of the dialogic approach. Surveys were analyzed for pre-post changes, and interview notes were analyzed using thematic content analysis. The data indicate that officers were more likely to demonstrate increased health literacy and an intention to improve or maintain their non-pharmacological health behaviors following participation in a dialogue-based health information session. Outcomes suggest that when delivering sensitive health information to populations often mistrustful of governmental initiatives, information sessions that employ discussion strategies, facilitated by credible messengers, are likely to be the most effective in improving health-related knowledge and attitudes; further study is needed to understand these strategies' effect on behavioral change.