Health Self-efficacy Research Articles

Effectiveness of immersive technologies in oral health promotion and education: A systematic review

ObjectiveTo evaluate the effectiveness of immersive technologies in oral health promotion and education. MethodsAn extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. This study was systematically performed in six electronic databases (PubMed, Google Scholar, Web of Science, Cochrane, Scopus, and EBSCO). The risk of bias was assessed with the Cochrane tools using RoB 2.0 and ROBINS-I. ResultsPICOS criteria were formulated for study inclusion. The bibliographical search identified 10,074 articles, which were filtered subsequently. Finally, the most pertinent nine articles were included and scrutinized for data synthesis and analysis. This includes five randomized controlled trials and four non-randomized controlled trials in different countries that focused on children (33.3%), adolescents (11.1%), and adults (55.6%). The interventions used virtual reality (VR) and augmented reality (AR) to promote knowledge and attitudes towards oral care, improve toothbrushing performance, and smoking cessation, and reduce anxiety levels in oral health education. ConclusionThis systematic review demonstrates that immersive technologies, including VR and AR, significantly enhance oral health knowledge, attitudes, and self-efficacy, leading to improved health outcomes. Clinical significanceImmersive technologies such as VR and AR have the potential to provide innovative and effective methods for enhancing oral health promotion and education, while promoting positive health behaviours, which are crucial for improving overall oral health outcomes.

RESTART: a stepped-care approach to facilitate return to work for employees with psychological distress: design of a randomized controlled trial

BackgroundCommon mental health problems, such as stress, anxiety and depression, are highly prevalent among workers and often lead to long-term absenteeism and work disability. Effective elements found in previous researched interventions were to explicitly focus on return to work (RTW) and not solely on symptom reduction, to take into account the employees’ cognition towards RTW and to include the workplace environment. Based on these elements, a stepped-care approach was developed. The aim of this paper is to present the study design of a randomized controlled trial (RESTART), evaluating the effectiveness of the stepped-care approach on lasting RTW and the implementation process.MethodsRESTART is a randomized controlled trial with a 2 × 2 factorial design and a follow-up of one year. Employees eligible for this study are those who reported sick within 2 to 8 weeks with psychological distress based on a distress screener. Participants will be randomized to a group receiving a tailored e-Health app or usual care, as well as randomized to a group receiving a Participatory Approach (PA; conversational method) in the workplace or usual care. The PA will however only be provided in case of persistent sickness absence at 8 weeks. Measurements take place at baseline, after the e-Health intervention period (3 months), and after the PA intervention period (6 months) and 12 months. Primary outcome is lasting RTW, defined as full RTW in previous or equal work for at least four consecutive weeks. Secondary outcomes are (the severity of) stress-related symptoms, total number of sickness absence days, self-efficacy for RTW and self-reported health. A process evaluation including a realist evaluation will also be conducted.DiscussionEarly intervention that focuses on RTW, the cognition towards RTW despite symptoms and involves the workplace environment, plays a crucial role in managing sickness absence among employees with psychological distress. If effective, the stepped-care approach is relevant for employees, employers and society as a whole.Trial RegistrationISRCTN: 90663076. Registered on 5 October 2023.

Cross-Sectional Evaluation of Health Insurance Knowledge and Self-Efficacy in Adolescents and Young Adults with Inflammatory Bowel Disease

ObjectiveTo evaluate the status of health insurance knowledge and self-efficacy among adolescents and young adults with inflammatory bowel disease (AYA-IBD). Study designEnglish-proficient AYA-IBD >15 years receiving care at an academic pediatric practice were invited to perform the Kaiser Family Foundation survey on health information knowledge and the Health Insurance Literacy Measure. Analyses of responses by demographic factors were performed using nonparametric analyses and agreement analyses were performed to compare survey responses. ResultsFifty AYA-IBD (60% 15-17 years old; 54% male; 76% white; 32% Hispanic) completed the surveys. Most AYA-IBD (58%) answered less than half the health insurance knowledge questions correctly. Reported ability and confidence in choosing and using health insurance was slight to moderate (median 2.8 on Likert scale of 1[not at all confident] to 4 [very confident]). While health insurance knowledge scores did not vary by demographic factors, total health insurance self-efficacy increased with disease duration, and Hispanic participants reported reduced ability to select health insurance than non-Hispanic counterparts. ConclusionsAYA-IBD demonstrated suboptimal health insurance knowledge and self-efficacy. Our findings identify an important opportunity to provide health insurance education to help prepare all AYA-IBD to manage the costs of medical care during the transition process to adulthood

Influencing Factors Attitude Health Workers in Patients Mental Disorders

The negative view experienced by individuals with mental disorders will have an impact on the attitude of health workers in providing services at health service facilities. The aim of this research is to identify the factors that influence the attitude of health workers towards patients with mental disorders. This quantitative research was conducted at the District Health Center. Fakfak-West Papua at 127 workers using a purposive sampling technique. Data collection used a self-developed attitude scale, the MHKQ and GSES scales. Data analysis uses multivariate tests using regression. The results of the research obtained significant values for the relationship between various health worker attitude factors, including: There is an influence between mental health literacy (P 0.048<0.005), self-efficacy (P0.001<0.005), R2=0.335. The research conclusion is that there is a significant influence of mental health literacy and self-efficacy on the attitude of health workers in patients with mental disorders, with an influence of 33.5%. It is hoped that the Health Service and Community Health Centers can pay attention to the factors that influence the attitude of Health workers in serving patients with mental disorders so that they can provide better services.

Effects of an Online Health Management Program for South Korean Adolescents with Complex Congenital Heart Disease during Their Transition to Adulthood: A Randomized Controlled Trial.

Adolescents with complex congenital heart disease (CHD) are at risk of experiencing complications later in life. The purpose of this study was to develop an online health management program for adolescents with complex CHD and to evaluate its effects on self-efficacy, health behavior, and health-related quality of life. A randomized controlled trial design was used. A total of 29 adolescents with complex CHD were divided into an experimental group of 15 and a control group of 14. Participants in the intervention group took part in the 4-week online health management program (weekly online group sessions, 1:1 phone coaching, dietary diary feedback, and provision of health information) developed based on self-efficacy theory, while those in the control group received standard medical follow-up. Data were collected from August 2021 to March 2022 using a questionnaire-including the Korean Self-Rated Abilities for Health Practices: Health Self-Efficacy Measure (K-SRAHP) and Pediatric Cardiac Quality of Life Inventory (PCQLI)-and an ActiGraph accelerometer to track physical activity and sleep. The intervention group showed significant improvements in health self-efficacy (p = 0.003), psychosocial impact (p = 0.013), daily step counts (p = 0.011), and moderate to vigorous-intensity physical activity (p = 0.027). Additionally, a decrease in weekend leisure time sedentary behavior (p = 0.035) was observed. However, there were no significant differences in sleep behavior between two groups. The online health management program significantly enhanced self-efficacy, health behavior, and psychosocial impact in adolescents with complex CHD. These findings will inform the development of policies for transitional medical care tailored to adolescents with complex CHD.

Good therapeutic connections and patient psychological safety: A qualitative survey study.

Therapeutic connections (TCs) between patients and care providers are important for achieving desired patient outcomes. For patients, TC is associated with greater health self-efficacy, better health status, mental health status, and higher satisfaction with providers. The aim of the study was to examine patients' descriptions of what signals to them they have a TC with their care provider. We conducted an online survey of patients with a recent health care visit ( n = 1,766). This study analyzed the results of an open-ended question that asked how patients know they have a good TC with their care provider. Data were analyzed using framework analysis to determine the extent to which patient responses indicated TC dimensions. A thematic content analysis identified emergent themes. Of the TC dimensions, words associated with Shared Deliberation were mentioned by 60% of respondents. Other dimension mentions ranged between 14% (Shared Mind) and 2% (Bond). Thematic content analysis revealed that patient psychological safety seems to be required for many patients to feel connected. A majority of patients indicated that good TCs happen when they feel seen and heard by providers. However, it appears that prior to feeling a strong TC, patients need to feel safe to be fully welcome into the encounter. Health care organizations need to give care providers the uninterrupted time and space they need to fully connect with patients. Training about how to create a psychologically safe environment for patients should be tailored for practicing providers, leaders, and students in health care fields.

Quantifying Disparities in COVID-19 Vaccination Rates by Rural and Urban Areas: Cross-Sectional Observational Study.

Vaccination plays an important role in preventing COVID-19 infection and reducing the severity of the disease. There are usually differences in vaccination rates between urban and rural areas. Measuring these differences can aid in developing more coordinated and sustainable solutions. This information also serves as a reference for the prevention and control of emerging infectious diseases in the future. This study aims to assess the current coverage rate and influencing factors of COVID-19 (second booster) vaccination among Chinese residents, as well as the disparities between urban and rural areas in China. This cross-sectional study used a stratified random sampling approach to select representative samples from 11 communities and 10 villages in eastern (Changzhou), central (Zhengzhou), western (Xining), and northeast (Mudanjiang) Mainland China from February 1 to February 18, 2023. The questionnaires were developed by experienced epidemiologists and contained the following: sociodemographic information, health conditions, vaccine-related information, information related to the Protective Motivation Theory (PMT), and the level of trust in the health care system. Vaccination rates among the participants were evaluated based on self-reported information provided. Binary logistic regression models were performed to explore influencing factors of vaccination among urban and rural participants. Urban-rural disparities in the vaccination rate were assessed using propensity score matching (PSM). A total of 5780 participants were included, with 53.04% (3066/5780) being female. The vaccination rate was 12.18% (704/5780; 95% CI 11.34-13.02) in the total sample, 13.76% (341/2478; 95% CI 12.40-15.12) among the rural participants, and 10.99% (363/3302; 95% CI 9.93-12.06) among the urban participants. For rural participants, self-reported health condition, self-efficacy, educational level, vaccine knowledge, susceptibility, benefits, and trust in the health care system were independent factors associated with vaccination (all P＜.05). For urban participants, chronic conditions, COVID-19 infection, subjective community level, vaccine knowledge, self-efficacy, and trust in the health care system were independent factors associated with vaccination (all P＜.05). PSM analysis uncovered a 3.42% difference in vaccination rates between urban and rural participants. The fourth COVID-19 vaccination coverage rate (second booster) among the Chinese population was extremely low, significantly lower than the previous vaccine coverage rate. Given that COVID-19 infection is still prevalent at low levels, efforts should focus on enhancing self-efficacy to expand the vaccine coverage rate among the Chinese population. For rural residents, building awareness of the vaccine's benefits and improving their overall health status should be prioritized. In urban areas, a larger proportion of people with COVID-19 and patients with chronic illness should be vaccinated.

Interest in and Willingness to Use PrEP: A Cross-Sectional Study of Individuals with Problematic Substance Use Residing in a High HIV Prevalence Jurisdiction

Although it is an effective HIV prevention method, pre-exposure prophylaxis (PrEP) is underutilized in the Southern US. Many people who use drugs (PWUD) have increased susceptibility to HIV which could be lessened by using PrEP. Potential barriers to PrEP use include lack of awareness of PrEP, low knowledge about HIV prevention, low self-efficacy for HIV prevention, inaccurate risk perceptions, and anticipated stigma. The current study examined predisposing, enabling, and reinforcing factors that may predict interest in PrEP. The purpose of the current study was to explore factors associated with interest in and willingness to use daily oral and long acting injectable PrEP among sexually active adult PWUD. The data were collected from adult participants (n = 270) residing in Harris County, TX, who self-reported problematic substance use and who reported oral, anal, or vaginal sex in the six months prior to completing the survey. The survey was distributed and completed online via Qualtrics Panels in March of 2022 and included measures of PrEP and HIV knowledge, PrEP stigma, sexual health self-efficacy, experiences of discrimination, health literacy, and medical mistrust. The majority of participants reported circumstances or behaviors that increased their susceptibility to HIV. Findings indicated that PrEP user stereotypes and PrEP anticipated disapproval by others were associated with interest in using daily oral PrEP and willingness to use long acting injectable PrEP. These results provide insight into reasons for low PrEP uptake among PWUD who live in a high HIV prevalence jurisdiction. Implications for HIV prevention intervention are discussed.

Transition from child to adult health services for young people with cerebral palsy in Ireland; implications from a mixed-methods study

Background Poor transition from child- to adult-oriented healthcare may lead to negative outcomes and dissatisfaction with services in adulthood. The aim of the study was to examine how transition is provided to and experienced by young people with CP in Ireland. This report provides integrated quantitative and qualitative findings and implications based on the totality of knowledge generated. Methods A convergent parallel mixed-methods study was conducted. Data were collected from people with CP aged 16-22 years, parents, and health professionals using surveys and semi-structured interviews, informed by a framework of nine key transition practices. Quantitative and qualitative findings were integrated at the interpretation stage of the research using integration through joint displays. Implications were developed through discussions with health professionals, young people, and parents. Results Surveys were completed by 75 young people/parents and 108 health professionals. Interviews were conducted with 13 young people, 14 parents, and 27 health professionals. There was complementarity between quantitative and qualitative findings indicating lack of a named worker, limited information provision, insufficient self-management support, no opportunity to meet the adult team, limited contact with the GP, and no opportunity for attending formal life skills training. There was dissonance between quantitative and qualitative findings regarding appropriate level of parental involvement. There was silence between quantitative and qualitative findings for promotion of health self-efficacy and senior manager responsible for transition, with quantitative findings indicating these were not present for most young people, but qualitative findings not describing these practices Conclusion Implications of integrated findings include the need for a standardised transition pathway, intentional actions to enable parents and young people to adapt to changing roles, provision of information in a collaborative and phased approach, a common understanding of self-management between young people, parents and health professionals, and the need to involve adults’ services and GPs in transition.

Effect of self-efficacy among persons who inject drugs treated with direct-acting antivirals on Hepatitis C treatment initiation, duration, completion, adherence, and cure

BackgroundSelf-efficacy, a patient-level factor, has been shown to facilitate patient engagement in treatment and optimize treatment-related outcomes in various health contexts. Research on interventions supporting hepatitis C virus (HCV) direct-acting antiviral (DAA) treatment uptake and adherence among persons who inject drugs (PWID) is needed, but whether self-efficacy factors influence DAA treatment cascade outcomes in this population has been less studied. MethodsUsing the HERO study data, we analyzed a subset of participants with any general health self-efficacy data (n=708) measured at baseline and end-of-treatment time points using a 5-items instrument (facets: ‘goal setting', ‘goal attainment', ‘having a positive effect', ‘being in control', and ‘working to improve’). The cascade outcomes included DAA treatment initiation, duration, adherence, completion, and sustained virologic response (SVR). The effect of baseline and change (Δ) scores for composite and item-level self-efficacy on the cascade outcomes was assessed using logistic regression and generalized linear models. ResultsHigher baseline composite self-efficacy [adjusted odds ratio (95 % confidence interval) =1.57 (1.07, 2.29)], ‘goal attainment’ [1.31 (1.03, 1.67)] and ‘having a positive effect’ [1.33 (1.03, 1.74)] were associated with greater likelihood of treatment initiation. ‘Δ Goal attainment’ was significantly associated with SVR [1.63 (1.04, 2.53)]. ‘Δ Being in control’ and ‘Δ working to improve’ were associated with treatment adherence and duration, respectively. ConclusionsGeneral health self-efficacy positively influences DAA treatment initiation among PWID. ‘Goal attainment’ facilitates the achievement of DAA treatment-related outcomes. Further studies should assess the effect of self-efficacy related to performing healthcare tasks specific to DAAs on the treatment-related outcomes.

Electronic Health Literacy as a Source of Self-Efficacy Among Community-Dwelling Older Adults

ABSTRACT Objectives Health-related factors, such as health status, health anxiety, and health literacy, are established contributors to self-efficacy. However, the relationship between electronic health literacy and self-efficacy is less known. The present study examined the role of electronic health literacy in relation to self-efficacy among community-dwelling older adults. Methods Cross-sectional survey data were collected in the United States between September 2022 and March 2023. The survey dataset consisted of 191 responses from individuals in the United States who were ages 65 or older. It provided information about survey respondents’ sociodemographic status, perceived health status, health anxiety, electronic health literacy, and self-efficacy. Hierarchical linear regression was conducted to analyze the data. Results Electronic health literacy was positively related to self-efficacy, and health anxiety was negatively related to self-efficacy, with sociodemographic status and perceived health status controlled. Conclusions The results indicate that electronic health literacy can be a source of self-efficacy among community-dwelling older adults. Clinical Implications Improving older adults’ electronic health literacy may help them maintain self-efficacy, and the improvement should be made, especially in the domains of evaluating health information found on the internet and making decisions based on the information.

Behavioral Engagement and Activation Model Study (BEAMS): A latent class analysis of adopters and non-adopters of digital health technologies among people with Type 2 diabetes.

Many people with Type 2 diabetes (T2D) who could benefit from digital health technologies (DHTs) are either not using DHTs or do use them, but not for long enough to reach their behavioral or metabolic goals. We aimed to identify subgroups within DHT adopters and non-adopters and describe their unique profiles to better understand the type of tailored support needed to promote effective and sustained DHT use across a diverse T2D population. We conducted latent class analysis of a sample of adults with T2D who responded to an internet survey between December 2021 and March 2022. We describe the clinical and psychological characteristics of DHT adopters and non-adopters, and their attitudes toward DHTs. A total of 633 individuals were characterized as either DHT "Adopters" (n = 376 reporting any use of DHT) or "Non-Adopters" (n = 257 reporting never using any DHT). Within Adopters, three subgroups were identified: 21% (79/376) were "Self-managing Adopters," who reported high health activation and self-efficacy for diabetes management, 42% (158/376) were "Activated Adopters with dropout risk," and 37% (139/376) were "Non-Activated Adopters with dropout risk." The latter two subgroups reported barriers to using DHTs and lower rates of intended future use. Within Non-Adopters, two subgroups were identified: 31% (79/257) were "Activated Non-Adopters," and 69% (178/257) were "Non-Adopters with barriers," and were similarly distinguished by health activation and barriers to using DHTs. Beyond demographic characteristics, psychological, and clinical factors may help identify different subgroups of Adopters and Non-Adopters.

Analysis Of Factors Affecting Stroke Patients' Adherence To Treatment Programmes

Stroke occupies the first place as the deadliest disease in Indonesia. Data on the number of ischaemia stroke patients is 1117 patients. There are approximately 104 patients who do not make a return visit after being discharged from the hospital. The purpose of this study was to determine the factors that influence patient compliance with the treatment programme in outpatients with stroke. This study is a quantitative study with a crosectional research design. The sample determination in this study used total sampling of the average number of patient visits for 3 months. The number of samples taken was 63 patients. Statistical tests used in this study were chi square test and logistic regression test. Based on the results of the multivariate test, the variables that influence compliance with the treatment program for patients with ischaemia stroke are trust in health workers with a p-value of 0.000, family support with a p-value of 0.000, and self-efficacy with a p-value of 0.001. The conclusion of this study is that trust in health workers, family support and self-efficacy greatly affect the treatment program of patients with ischaemia stroke. The author hopes that families and health workers can provide good support and understanding to patients in following the existing treatment programme

Principal Work Stress and its Relationship with Mental Health, Sleep Quality, and Leadership Self-Efficacy: An Exploratory Mixed-Methods Approach

ABSTRACT Principals are critical for school improvement, but work-related stress threatens leadership sustainability. While stress is increasingly examined among principals, the impacts on indicators of health such as anxiety, depression, and sleep are under-explored. In other fields, these factors are implicated in long-term health effects and negative occupational outcomes. This mixed-methods study explores principals’ overall health, sleep quality using actigraphy watches, and perceptions of leadership self-efficacy in eight principals. Findings show principals struggled with health issues and disrupted sleep patterns which affected their leadership self-efficacy and intentions to stay in their professions. Recommendations for practice, policy, and future directions are included.

Factors Predicting Caregiver Contributions to Self-care in Patients with Heart Failure

Introduction Caregivers play an important role in contributing to self-care in patients with heart failure (HF). To date, knowledge regarding factors associated with caregiver contributions to self-care remains limited, particularly in Thai patients with HF. Objective This study aimed to 1) describe caregiver contributions to self-care, and 2) examine factors predicting caregiver contributions (self-care maintenance, symptom perception, self-care management) of patients with HF. Design This correlational predictive study was guided by a situation-specific theory of caregiver contributions to heart failure self-care. Methodology The study included 128 caregivers of patients with heart failure, who were purposively selected based on the following inclusion criteria: aged at least 18 years, unpaid for their caregiving tasks, and living with the patients who attended the heart failure clinic and general internal medicine clinic at an outpatient department of a super-tertiary hospital from April to August 2023. Data collection was conducted using questionnaires and record forms, and the data were analyzed using descriptive statistics, simple linear regression, and multiple linear regression. Results The majority of the participants were female (75.78%), with an average age of 46.10 years (SD = 13.74). Caregiver contributions (CC) to symptom perception and self-care maintenance were found to be adequate, with means of 73.38 (SD = 14.83) and 72.72 (SD = 13.75), respectively. In contrast, self-care management was deemed inadequate, with a mean of 68.83 (SD = 16.56). Multiple linear regression analysis revealed that health perception and self-efficacy together predicted CC for symptom perception, explaining 35.20% of the variance. Health perception, self-efficacy, and positive aspects of caregiving together predicted CC to self-care maintenance, explaining 31.50% of variance. Self-efficacy and comorbidities in patients together predicted CC to self-care management, explaining 21.20% of variance. While the status of caregivers to patients was not a statistically significant predictor of all three dimensions of CC to self-care in the patients with HF in this study. Recommendation The results of this study can be utilized to develop specific programs aimed at enhancing caregiver contributions to the self-care of patients with HF, particularly in promoting self-efficacy, positive aspects of caregiving, caregivers’ health perception, and managing the comorbidities of the patients.

Student acceptance towards AsepticTech VR: a teaching and learning tool for cell and tissue culture aseptic techniques

The high cost of establishing a cell and tissue culture facility has denied students an opportunity to practice proper aseptic techniques during their studies. An in-house application named AsepticTech Virtual Reality (VR) was developed to simulate a cell and tissue culture facility for students to train their aseptic techniques virtually. However, the performance gain associated with the application will be limited by the student’s willingness to use the application. Therefore, this study aims to investigate the driving factors behind students’ intention to use AsepticTech VR. A total of 55 biomedical undergraduates were granted access to AsepticTech VR. After using the application, the students completed a Technology Acceptance Model (TAM) questionnaire. It measures seven latent constructs that are believed to influence the students’ behavioral intention to use the application, namely Perceived Usefulness (PU), Perceived Ease of Use (PEU), Attitude Towards Use (ATU), Behavioral Intention (BI), Perceived Enjoyment (PENJ), Perceived Health Risk (PHR) and Self-Efficacy (SE). The questionnaire was preliminarily evaluated on its validity and reliability using Confirmatory Factor Analysis (CFA), Average Variance Extracted (AVE), Composite Reliability (CR), and Cronbach’s alpha. Subsequently, the interactions between the seven latent variables were analyzed via path analysis. Findings of the path analysis suggested that ATU is the most influential factor on BI, followed by PENJ and SE. In turn, ATU was positively and significantly influenced by PENJ, whereas PHR exerted a significant negative influence on ATU. This study revealed that enjoyment and comfort are the principal factors influencing students’ acceptance of AsepticTech VR. This study also identifies other determinants that influence users’ acceptance of AsepticTech VR and paves guidance for the future development of the application.

Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system.

Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

Diet quality, Self-efficacy and Health Literacy in Adults with Chronic Kidney Disease: A Cross-Sectional Study

ObjectiveAdherence to high quality dietary patterns is associated with lower risk of disease progression and all-cause mortality in chronic kidney disease (CKD). Self-efficacy and health literacy are recognised as factors that may lead to better adherence to high quality diets. However, these associations are not well studied in CKD. This study aims to explore the relationship between health literacy, self-efficacy, and diet quality in CKD. MethodsParticipants with CKD stages 3a-5 recruited from three large tertiary hospitals were assessed using the Self-Efficacy for Managing Chronic Disease 6-item scale (SEMCD-6), the Health Literacy Questionnaire (HLQ) and the Australian Eating Survey (AES) Food Frequency Questionnaire. Diet quality was measured using the Australian Recommended Food Score (ARFS). Associations were examined using multivariable linear regression models, adjusted for sex and type 2 diabetes (T2D) diagnosis. ResultsSixty participants were included in the analysis. Mean age of participants was 74.5 years old and 58% were male. The mean ARFS was poor (Mean=29.9±9.1/73) and characterised by high intake of processed foods and animal protein, and low intake of fruit and vegetables. Mean SEMCD-6 was high (7.12±2.07/10). Self-efficacy and health literacy domains 6 - Actively engage with healthcare providers and 7 - Navigating healthcare system independently predicted diet quality in the adjusted model for sex and T2D. ConclusionAdults with CKD report suboptimal diet quality. The results suggest that self-efficacy and aspects of health literacy should be considered when designing interventions aimed at improving diet quality in people with CKD.

Working together with people with intellectual disability to make a difference: a protocol for a mixed-method co-production study to address inequities in cervical screening participation

IntroductionCervical cancer is one of the most preventable cancers yet remains a disease of inequity for people with intellectual disability, in part due to low screening rates. The ScreenEQUAL project will use an integrated knowledge translation (iKT) model to co-produce and evaluate accessible cervical screening resources with and for this group.MethodsStage 1 will qualitatively explore facilitators and barriers to screening participation for people with intellectual disability, families and support people, healthcare providers and disability sector stakeholders (n ≈ 20 in each group). An accessible multimodal screening resource, accompanying supporting materials for families and support people, and trauma-informed healthcare provider training materials will then be co-produced through a series of workshops. Stage 2 will recruit people with intellectual disability aged 25 to 74 who are due or overdue for screening into a single-arm trial (n = 48). Trained support people will provide them with the co-produced resource in accessible workshops (intervention) and support them in completing pre-post questions to assess informed decision-making. A subset will participate in qualitative post-intervention interviews including optional body-mapping (n ≈ 20). Screening uptake in the 9-months following the intervention will be measured through data linkage. Family members and support people (n = 48) and healthcare providers (n = 433) will be recruited into single-arm sub-studies. Over a 4-month period they will, respectively, receive the accompanying supporting materials, and the trauma-informed training materials. Both groups will complete pre-post online surveys. A subset of each group (n ≈ 20) will be invited to participate in post-intervention semi-structured interviews.Outcomes and analysisOur primary outcome is a change in informed decision-making by people with intellectual disability across the domains of knowledge, attitudes, and screening intention. Secondary outcomes include: (i) uptake of screening in the 9-months following the intervention workshops, (ii) changes in health literacy, attitudes and self-efficacy of family members and support people, and (iii) changes in knowledge, attitudes, self-efficacy and preparedness of screening providers. Each participant group will evaluate acceptability, feasibility and usability of the resources.DiscussionIf found to be effective and acceptable, the co-produced cervical screening resources and training materials will be made freely available through the ScreenEQUAL website to support national, and potentially international, scale-up.

Occupational Health and Safety Self-Efficacy’s Impact on The Quality of Work Life Among Teachers in Educational Organizations: A Cross-Sectional Study in Konya, Turkey

Occupational Health and Safety Self-Efficacy’s Impact on The Quality of Work Life Among Teachers in Educational Organizations: A Cross-Sectional Study in Konya, Turkey