Health-promoting Behaviors Research Articles

Mortality risk information and health-seeking behavior during an epidemic

In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic (Fig. 1 A), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions (Fig. 1 B) resulted in improved health behavior, including COVID-19 vaccine uptake (Fig. 1 C). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises-such as the COVID-19 pandemic-that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message.

Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

Self-assessment of health and care for health among employed men in Poland

Objectives. Self-assessment of health is one of the most important factors determining manifestations in care for health, expressed in health-promoting behaviours. The way a person takes care of their health affects not only their health but also their well-being, quality of life and work ability. This study aimed to present results regarding self-assessment of health and care for health and the relationship with work ability in a group of working men aged 20–65 years. Methods. The sample of 600 men were assessed using a survey. The work ability index was used to measure work ability. An original survey was developed, which included questions about self-assessment of health and taking care of health, motives for taking care of health, physical activity, healthy eating and smoking. Results. Most men rated their health well and declared that they took care of it. Low health scores were obtained among overweight men, men without physical activity, men with unhealthy nutrition and smokers. High self-rated health was associated with good work ability. Conclusions. There is a constant need to make men of all ages aware of the role of individual health care in maintaining good health and high work ability.

The Effects of Health Promotion Program on Healthy Aging, Wellbeing and Health Promoting Behaviour among Community Dwelling Older Adults

The Effects of Health Promotion Program on Healthy Aging, Wellbeing and Health Promoting Behaviour among Community Dwelling Older Adults

The effectiveness of exergames in improving physical activity behaviour and physical literacy domains in adolescents with developmental coordination disorder and cerebral palsy: A scoping review.

A large proportion of adolescents with developmental coordination disorder (DCD) are physically inactive. Physical literacy has been described as an important determinant in promoting health behaviours. The potential of exergames to improve physical literacy and activity has been recognized in typically developing children. The aim of the present scoping review was to identify and map the available evidence of this potential for adolescents with DCD. A scoping review was performed via a literature search in PubMed, Web of Science, Embase, ERIC and CINHAIL. From 2860 search records, six studies (two studies in DCD and four studies in cerebral palsy [CP]) assessed physical activity, 12 studies discussed exergame features and 16 studies assessed physical literacy domains. In DCD, one study showed positive effects of exergaming on physical activity and the other failed to show any significant effects of exergaming. In CP, all four studies demonstrated positive effects of exergaming on energy expenditure and daily physical activity. Furthermore, positive effects of exergames on the different physical literacy domains were shown, namely motor competence, self-concept and affect, motivation and social/experiential. Finally, exergame features including multiplayer modes, realism, game rewards, challenges and enjoyment were shown to have a significant effect on motivating and encouraging adolescents to exert more effort while playing. Based on the positive effects of exergaming on physical activity in other populations, more in-depth research in adolescents with DCD is warranted such that the decline in physical activity behaviour that is present in individuals with DCD can be counteracted. Physical literacy should be regarded as an important determinant in this regard.

Psychometric Testing of the Korean Version of the Self-Care of Coronary Heart Disease Inventory Version 3

PurposeThis methodological study evaluated the psychometric properties of the Self-Care of Coronary Heart Disease Inventory version 3 (SC-CHDI v3) in a Korean context. MethodsThe SC-CHDI v3 was translated into Korean following a rigorous translation process. Participants were 452 patients who had experienced coronary heart disease (CHD), all recruited from a tertiary hospital in Korea. Exploratory and confirmatory factor analyses were performed to test construct validity. Concurrent validity was examined by correlating scores from the Korean version of the SC-CHDI v3 with those from the Cardiac Self-Efficacy Scale. Internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega. ResultsThe Korean version of the SC-CHDI v3 consists of 21 items, excluding two from the original instrument. The self-care maintenance subscale identified a two-factor structure: “treatment adherence” and “health-promoting behaviors.” The goodness-of-fit indices were satisfied: χ2 = 18.19, p = .110, comparative fit index (CFI) = .97, Tucker-Lewis Index (TLI) = .95, and standardized root mean square residual (SRMR) = .04. The self-care monitoring subscale consisted of a one-dimensional structure (“monitoring behaviors”) and the goodness-of-fit indices were satisfied: χ2 = 19.19, p = .059, CFI = .99, TLI = .99, and SRMR = .04. The self-care management subscales had a two-factor structure of “consulting behaviors” and “problem-solving behaviors.” The goodness-of-fit indices were satisfied: χ2 = 16.44, p = .037, CFI = .99, TLI = .98, and SRMR = .03. Scores from the Cardiac Self-Efficacy Scale showed a positive correlation with the Korean version of SC-CHDI v3 subscales. Reliability estimates were ≥ .80 for all subscales except for the self-care maintenance subscale. ConclusionsThe Korean version of the SC-CHDI v3 consists of 21 items in 3 subscales and is a valid and reliable instrument. Therefore, healthcare providers can effectively utilize it to assess the self-care levels of patients with CHD.

The Moderating Effect of Social Networks on Health-Promoting Behaviors Among Korean Older Adults

The Moderating Effect of Social Networks on Health-Promoting Behaviors Among Korean Older Adults

Just-in-time adaptive interventions for adolescent and young adult health and well-being: protocol for a systematic review

IntroductionHealth behaviours such as exercise and diet strongly influence well-being and disease risk, providing the opportunity for interventions tailored to diverse individual contexts. Precise behaviour interventions are critical during adolescence...

Mapping regional implementation of ‘Making Every Contact Count’: mixed-methods evaluation of implementation stage, strategies, barriers and facilitators of implementation

BackgroundThe Making Every Contact Count (MECC) programme provides training and materials to support public-facing workers to encourage health-promoting behaviour change by using the day-to-day interactions between organisations and individuals. This...

Genetikai alapú személyre szabott táplálkozás és az étrend-kiegészítő fogyasztás kapcsolata a magyar lakosság körében

Genetic-based personalised nutrition is a concept that adapts diets, foods and nutrients to a person's individual needs (genetic, lifestyle and environmental), of which the use of supplements can be an integral part. Personalised nutrition, as a new technology and nutritional principle, could be a good way to improve the objective health status of the population in a meaningful way. However, previous research has shown that Hungarian consumers are distrustful and uncertain about this new technology, despite its obvious benefits. My main objective is to identify the attitudes towards nutrigenomics in relation to dietary supplement consumer behaviour. My quantitative analysis was carried out on a nationally representative sample of 1000 people. In the present study, I describe the clusters of the Hungarian population based on their dietary supplement consumption behaviour. Each cluster has different opinions on who they perceive as having an advantage in the applicability of genetic-based tests and to what extent they expect consensus among experts on genetic-based tests. Clusters show characteristic differences in openness to innovation and attitudes towards genetically personalised nutrition. I complemented my results with a qualitative study, which I conducted in the form of a netnographic survey. Through content analysis on social media, I identified the most common themes and consumer reactions to personalised nutrition on social media sites. Overall, it was found that dietary supplement consumption and the adoption of genetic-based tests show synergies in the manifestation of openness to novelty, health promotion behaviours, social norms, and positive attitudes.JEL Codes: A13, I12, P46

노마드 융합프로그램이 참가 대학생의 건강지각, 건강증진행동 및삶의 질에 미치는 영향

This study aims to analyze how the nomad convergence program affects collegestudents' health perception, health promotion behavior, and quality of life. The researchmethod was divided into a participating group and a non-participating group for comparativeanalysis, and the nomad convergence program was operated for 8 sessions. the results are asfollow. First, the nomad participating group showed higher levels of present health, futurehealth, and resistance than the non-participating group, and lower health concerns. Second, theNomad participating group showed higher levels of physical strength promotion activities,health promotion activities, and internal and external relationships than the non-participatinggroup. Third, the nomad participating group had better social relationships and livingconditions than the non-participating group. It appeared high in the health area. Through this,the Nomad convergence program can be said to be effective in improving mental andemotional health and quality of life beyond just physical health.

Factors effecting on health-promoting behaviors in iranian pregnant women and their husbands: the actor-partner interdependence model (APIM)

IntroductionPregnancy is an important period of life for women and their husbands as the couple’s health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM).Materials and methodsThis descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier’s Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker’s Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM.ResultsThe pregnant women’s marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491–0.998, p < 0.001) and their husbands’ (β = 0.210, 95% Cl: 0.030–0.726, p = 0.048). Pregnant woman’s depressive symptoms also negatively affected their health-promoting behaviors (β=-0.088, 95% Cl: -0.974–0.074, P = 0.236) and their husbands’ health-promoting behaviors (β=-0.177, 95% Cl: -0.281 – -0.975, P = 0.011). Furthermore, the husband’s marital adjustment only positively affected his studied behaviors (β = 0.323, 95% Cl: 0.0303–0.895, P < 0.001) but did not affect the pregnant woman’s health behaviors. The husband’s depressive symptoms had a negative impact on his studied behaviors (β = 0.219, 95% Cl: -0.122 – -0.917, P = 0.001) and did not affect the pregnant woman’s depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman’s marital adjustment scores positively affected her studied behaviors and her husband (β = 0.071, 95% Cl: 0.042–0.278, P = 0.015) by decreasing her depression score. Therefore, the husband’s marital adjustment score positively affected his studied behaviors by decreasing his depression score (β = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife’s health-promoting behaviors.Discussion and conclusionThese findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands’ symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.

The Feasibility and Impact of an Asynchronous Interprofessional Well-Being Course on Burnout in Health Care Professionals.

Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs. The Health Care Professional Well-Being course is 4.5 hours of interactive online education that explores personal well-being, promoters and detractors of well-being, and systemic factors that influence the overall impact of well-being in health care systems. Participants were recruited through institutional members of the Academic Consortium for Integrative Medicine and Health and were randomized to either active or waitlist control groups. Assessments were taken pre-course, 1-month post-course, and 6-months post-course in the areas of burnout, compassion, resiliency, and lifestyle behaviors. Burnout measures of depersonalization and emotional exhaustion showed a significant improvement amongst active participants, sustained for 6 months after the course. However, no significant improvement in either the resiliency or the compassion measurements was noted for the active group. Initially, the active group showed improvement in personal accomplishment; however, both groups showed a decline overall. Most noteworthy, a large number of active participants demonstrated adoption of new health-promoting behavior; 95% incorporated at least 1 new lifestyle behavior learned from the course. This study of a brief, asynchronous, online well-being course with interprofessional HCPs, demonstrates that the course is associated with improvement in individual burnout measures and can educate HCPs about healthy behaviors and a framework for professional engagement.

Promoting the empowerment and emancipation of community-dwelling older adults with chronic multimorbidity through a home visiting programme: a hermeneutical study

IntroductionNurse-led preventive home visiting programmes can improve health-related outcomes in community-dwelling older adults, but they have not proven to be cost-effective. Home visiting programmes led by nursing students could be a viable alternative. However, we do not know how community-dwelling older adults with chronic multimorbidity experience home visiting programmes in which nursing students carry out health promotion activities. The aim of the study is to understand how community-dwelling older adults with chronic multimorbidity experience a home visiting programme led by nursing students.MethodsA qualitative study based on Gadamer’s hermeneutics. Thirty-one community-dwelling older adults with chronic multimorbidity were interviewed in-depth. Fleming’s method for conducting hermeneutic, Gadamerian-based studies was followed and ATLAS.ti software was used for data analysis.ResultsTwo main themes were generated: (1) ‘The empowering experience of a personalised health-promoting intervention’, and (2) ‘The emancipatory effect of going beyond standardised self-care education’.ConclusionsThe home visiting programme contributed to the community-dwelling older adults feeling more empowered to engage in health-promoting self-care behaviours. It also improved the older adults’ sense of autonomy and self-efficacy, while reducing their loneliness and addressing some perceived shortcomings of the healthcare system.Clinical relevanceOlder adults participating in a home visiting programme led by nursing students feel empowered to implement self-care behaviours, which has a positive impact on their perceived health status. Nurse leaders and nursing regulatory bodies could collaborate with nursing faculties to integrate preventive home visiting programmes led by nursing students into the services offered to community-dwelling older adults with chronic multimorbidity.

A Nature-Based Intervention for Promoting Physical Activity in Older Adults: A Qualitative Study Using the COM-B Model.

Physical inactivity contributes to over 800,000 deaths annually. Numerous non-pharmacological interventions provide a route to address this behavioural risk factor linked to the growth of non-communicable diseases. Here, we consider a nature-based intervention, specifically group outdoor health walks (GOHW), as a non-pharmacological intervention to increase physical activity and contribute to health and quality of life amongst older adults. We used the theoretically grounded Capability, Opportunity, Motivation, and Behaviour (COM-B) model as a lens to examine interviews with participants in a GOHW with an activity tracker and signposted by health clinics in Scotland, UK. Analysis identified capabilities, opportunities, and motivations, their impact on behaviour, and perceived physical and mental health. The application of the COM-B model to intervention evaluation allowed us to examine two separate behaviours, that of (i) engaging with the intervention itself, and (ii) incorporating the behaviour into one's life that the intervention targets. Analysis identified emerging capabilities, opportunities, and motivations that supported additional health-promoting behaviours, including increased time outdoors in nature and leadership to self-organise continued group walks. We offer insight into the design of nature-based interventions to effectively engage older adults with chronic health conditions and foster personal behaviour change for health and well-being.

The Relationship Between Self-care Ability and Health-Promoting Behaviors of Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic disease. Familiarity and awareness of self-care conditions and health-promoting behaviors contribute to patients’ self-efficacy. Objectives: This study examines the relationship between self-care ability and health-promoting behaviors in patients with Multiple Sclerosis. Methods: This descriptive-analytical study involved 112 MS patients from the MS Society of Khuzestan province, selected through convenience sampling. Data were collected using a demographic form, Weaver’s Self-Care Inventory (SCI), and Walker’s Health-Promoting Lifestyle Profile (HPLP), then analyzed with SPSS software at a significance level of 0.05. Results: The mean self-care ability score was 104.49 ± 12.72 (range 40 - 240), and the mean health-promoting behavior score was 132.52 ± 12.72 (range 50 - 208), indicating overall poor health-promoting behaviors. Self-care ability was significantly related to health-promoting behaviors in MS patients (P &lt; 0.01). Age (P = 0.001), education (P = 0.002), and job type (P = 0.017) showed significant relationships with self-care ability. However, there was no significant relationship between demographic variables and health-promoting behaviors (P &lt; 0.05). Conclusions: Multiple sclerosis patients exhibit poor health-promoting behaviors and self-care ability. Improving self-care ability and health-promoting behaviors requires ongoing education and culturalization. The MS Society can design and implement structured training programs by understanding the self-efficacy needs and abilities of patients and collaborating with other therapy group members.

Barriers and enablers to promoting grandchildren’s physical activity and reducing screen time: a qualitative study with Australian grandparents

BackgroundWith an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children’s engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children’s physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children’s physical activity and reducing screen time. The present study sought to explore these perceptions.MethodsSemi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis.ResultsKey reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents’ age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children’s fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view).ConclusionsFindings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents’ age and health status, as well as any environmental barriers, are likely to be well-received.

Relationships among health promotion behaviors, patient engagement, and the nurse practitioner-patient partnership.

Individuals adopting health promotion behaviors benefit from improved health and reduced risk of chronic diseases. Patient engagement and a strong provider-patient partnership may play a role in health promotion. This study examined the relationships between patient engagement, the nurse practitioner-patient partnership and health promotion behaviors among adults in a primary care setting. A descriptive correlational study using convenience sampling to recruit 85 participants from a nurse practitioner primary care practice. Participants completed questionnaires measuring health promotion behaviors (Health Promoting Lifestyle Profile II), the quality of the nurse practitioner-patient partnership (Patient Reactions Assessment), and a person's capacity to engage in their health care (Person Engagement Index). Moderate to strong correlations were found among the main study variables. Multiple regression analysis found a person's capacity to engage in health care significantly predicted health promotion behaviors (R2 = 0.362, p < .001) and explained 36.2% of the variance in health promotion behaviors. Patient engagement is a significant predictor of health promotion behaviors. The interactive care model can serve as a framework for nurse practitioners to build partnerships and facilitate patient engagement. Nurse practitioners can serve as a coach, navigator, collaborator, and trusted health care partner with their patients. Nurse practitioners in primary care may need to restructure the health care encounter to allow for adequate time to communicate, listen, educate, and enlist patients in the shared decision-making process. Nurse practitioners can provide the support patients need to engage in their health care as they accept greater responsibility for their health.

Counseling lifestyle medicine in oncology: A qualitative analysis of interprofessional patient-nurse-physician interactions

ObjectivesCounseling plays a key role in promoting health behaviors, providing evidence-based information, and supporting patients with cancer during and after treatment. This study aimed to evaluate an interprofessional counseling service on Complementary and Integrative Health (CIH) for patients being treated at Comprehensive Cancer Centers (CCCs) in Southern Germany. MethodsPatients participating in the CCC-Integrativ study received three CIH counseling sessions within three months in addition to their conventional cancer treatment. Medical and nursing staff participated in a study-specific blended learning training program before conducting the counseling. As part of the process evaluation, 30 audio-recorded counseling sessions were transcribed verbatim and analyzed by conducting a content analysis using MAXQDA 2020. ResultsThroughout the counseling, patients were conceded to address various health issues, which mainly revolved around symptom management interlaced with the areas of nutrition, exercise, and relaxation. The interprofessional teams conducted the counseling in a structured and patient-oriented manner. They worked together to motivate the patients to apply procedures from the CIH field independently, even if patients sometimes experienced difficulties in implementation. ConclusionsInterprofessional collaboration improved healthcare quality, as patients received comprehensive and evidence-based advice on their supportive needs and lifestyle issues. Both professions could equally contribute their areas of knowledge and expertise and apply them to the benefit of the patients. Practice implicationsProviding an integrative counseling service and adequate training on interpersonal communication and CIH for healthcare professionals will improve patient-centered care.

Does health-related college major have an effect on health-promoting behaviors? Evidence from Iranian‘s staff

BackgroundHealth-promoting behaviors and lifestyle changes can reduce the cost of health services, stress, and disease complications. This study examined the status of health-promoting behaviors and its influencing factors. MethodsThis cross-sectional study was conducted on 171 staff members of Zanjan University of Medical Sciences, Iran, in 2023. The Persian version of the health-promoting lifestyle profile II questionnaire was used. Analyzes were performed in R 4.3.2 software. ResultsMean ± SD age was 37.67 ± 7.58 years. 83 % had the low levels of health-promoting behaviors, while 17.0 % had moderate levels. The physical activity and interpersonal relation had the lowest and highest scores. The most significant strong and weekly correlations was between health responsibility and physical activity with total score of health-promoting behavior scores (r = 0.81, r = 0.66). Staff with health-related college major performed better in the areas of nutrition, stress management, spiritual growth. ConclusionHealth-related college major is the most important factor affecting health-promoting behaviors. Also, health responsibility is most related to these behaviors. Educational interventions should be done at the community level, regardless of people’s field of study, to increase people’s knowledge and awareness about risk factors and improve the level of health.