Healthy Behaviors Research Articles

The efficacy of the TEACH e-Learning course at improving early childhood educators’ physical activity and sedentary behaviour self-efficacy, knowledge, intentions, and perceived behavioural control: a randomized controlled trial

BackgroundEarly childhood educators play a critical role in promoting physical activity and reducing sedentary time in childcare centres. However, early childhood educators receive limited specialised pre- and in-service learning opportunities relating to these behaviours and may lack the capacity to effectively engage children in healthy movement behaviours. This study aimed to examine the efficacy of an e-Learning course on increasing early childhood educators’ physical activity and sedentary behaviour-related capacities.MethodsA two-group parallel randomized controlled trial was conducted with early childhood educators in Canada (Mage = 41.78, 97% female). Participants randomized to the intervention group were asked to complete a physical activity and sedentary behaviour e-Learning course within a 4-week period. Participants randomized to the waitlist control condition were assigned to a waitlist to receive the intervention after the testing period. Participants reported on their self-efficacy, knowledge, intentions, and perceived behavioural control relating to physical activity and sedentary behaviours at baseline, post-intervention, and 3 months follow-up. Linear mixed effects models were estimated to determine difference in changes in outcomes from baseline to post-intervention, and follow-up.ResultsA total of 209 early childhood educators participated in the study (intervention n = 98; control n = 111). The TEACH e-Learning course was found to be efficacious at improving all of the examined outcomes, with standardized effect sizes ranging from d = 0.58 to d = 0.65 for self-efficacy outcomes, d = 0.66 to d = 1.20 for knowledge outcomes, d = 0.50 to d = 0.65 for intention outcomes, and d = 0.33 to d = 0.69 for perceived behavioural control outcomes post-intervention. The intervention effects were sustained at follow-up for all outcomes apart from perceived behavioural control to limit screen time. Additionally, the magnitude of the effect for knowledge outcomes decreased at follow-up, with standardized effect sizes ranging from d = 0.49 to d = 0.67.ConclusionsThe e-Learning course was highly successful at improving early childhood educators’ capacity pertaining to physical activity and sedentary behaviours. Providing training content through e-Learning may be an efficacious approach to providing continual professional learning opportunities relating to physical activity and sedentary time to early childhood educators on a large scale.

Lifestyle Behaviors and Needs After Breast Cancer Diagnosis: A Qualitative Assessment.

There is a need to gain a deeper understanding of facilitators and barriers involving lifestyle behaviors among newly diagnosed breast cancer patients. Design: Research team explored influences (e.g., social, cultural, environmental) for healthy lifestyle behaviors (nutrition, physical activity (PA), and self-care). One researcher conducted semi-structured interviews. Qualitative data were analyzed through content analysis. Demographic data were collected via survey, and descriptive statistics were generated. Patients were recruited, and interviews conducted via Zoom or phone. Twenty-eight newly diagnosed, treatment naïve breast cancer patients were interviewed, a majority were non-Hispanic White women (n=23; 82%) with invasive (n=14; 50%) breast cancer. Themes related to nutrition, PA, and self-care emerged, including influences (e.g., environmental, cultural, social), barriers, facilitators, and lived experiences. Most patients stressed the importance of maintaining healthy eating habits (n=23), and some were interested in understanding the relationship between nutrition and cancer (n=7). Sixteen reported sustaining their PA levels, while others (n=11) explained barriers, such as time, distance, and pain. All patients reported utilizing self-care strategies, and most reported increased engagement in self-care since being diagnosed (n=14). This study sheds light on factors influencing and hindering the adoption of healthy eating, PA, and self-care strategies among newly diagnosed breast cancer patients. The findings reflect the importance of healthy lifestyle behaviors as critical areas for upstream intervention.

The impact of public health policies on reducing tobacco and substance abuse among the community

Public health policies have significantly impacted the reduction of tobacco and substance abuse within communities. Legislative measures, including increased taxation on tobacco products, comprehensive smoking bans, and restrictions on advertising, have been instrumental in decreasing smoking rates and protecting non-smokers from second-hand smoke. Community-based interventions, such as school-based programs and peer-led initiatives, address the root causes of substance abuse by promoting education, social support, and healthy behaviors, tailored to meet the specific needs of local populations, ensuring their relevance and effectiveness. Public awareness campaigns leveraging mass media and educational efforts play a crucial role in changing social norms and attitudes towards tobacco and substance use. Campaigns like the "truth" campaign and programs such as life skills training (LST) have shown significant success in reducing smoking and substance use among adolescents and young adults. Integrating these campaigns with other strategies enhances their impact, creating a comprehensive approach to public health. A multifaceted strategy combining legislative action, community engagement, and public education is crucial for achieving sustained reductions in tobacco and substance abuse. Continued investment in these areas is necessary to address evolving challenges and ensure long-term public health benefits. Coordinated efforts involving diverse stakeholders, including policymakers, educators, healthcare providers, and community organizations, are essential for effectively combating tobacco and substance abuse. By fostering collaboration and leveraging local resources, communities can create supportive environments that discourage harmful behaviors and promote healthier lifestyles. These comprehensive strategies demonstrate that a well-rounded approach, incorporating legislative measures, community-based interventions, and public awareness campaigns, is effective in mitigating the prevalence of tobacco and substance abuse, ultimately contributing to improved public health outcomes.

How do emotions influence healthy food choice? Investigating an extended framework of the social-cognitive theory

PurposeThe purpose of this study was to investigate how and through which social-cognitive constructs, emotions influence healthy food shopping behaviors. Direct effects of those constructs, as well as indirect effects of consumer emotions are considered.Design/methodology/approachAn altered version of the Social Cognitive Theory, including intention, socio-structural factors, outcome expectancies and self-efficacy with the addition of consumer emotions was analyzed using structural equation modeling. Data of 1,181 volunteers were collected in Germany in 2021 through an online survey.FindingsIntention was the most important positive predictor of food choice, while socio-structural factors had the biggest impact on intentions. Those were mostly influenced by self-efficacy, which was strongly predicted by consumer emotions. Outcome expectancies did not influence the current model in any way. Consumer emotions did not directly influence intention, nor actual choice, however showed to be influencing those variables through indirect effects.Practical implicationsMarketers could benefit from these results by incorporating the current findings into existing marketing strategies through targeting a combination of social cognitive constructs, as well as consumer emotions to facilitate healthier food shopping behavior.Originality/valueAffect has received increasing attention in regards to its impact on healthy eating behaviors in recent years. Less attention has been paid to the mechanisms through which emotions influence healthy nutrition behavior, specifically how consumer emotions influence healthy food shopping behavior.

THE EFFECT OF HEALTHY LIFE STYLE BEHAVIOR ON PSYCHOLOGICAL RESILIENCE OF ASSOCIATE DEGREE STUDENTS RECEIVING HEALTH EDUCATION AFTER EARTHQUAKE

It was aimed to examine the effect of healthy lifestyle behavior on psychological resilience of associate degree students receiving health education after the earthquake. In line with the aim of the study, 428 people, who were determined by convenience sampling method among the students continuing their education and training at the university, constitute the sample of the study and the data were collected by applying an online questionnaire. In the study, "Personal Information Form", "Healthy Lifestyle Behavior Scale II" and "Brief Psychological Resilience Scale" were used. The data were analyzed with SPSS program. In addition, Pearson correlation and regression analyses were applied upon the determination that the data were normally distributed as an analysis method. As a result of the study, it was determined that there was a positive and significant relationship between healthy lifestyle behavior and its sub-dimensions and psychological resilience. In addition, it was determined that healthy lifestyle behavior has a positive and significant effect on psychological resilience. It is predicted that increasing the healthy lifestyle behavior of students after the earthquake will increase their psychological resilience against the disaster in a positive way.

Clinical Outcomes Among High-Risk Primary Care Patients With Diabetic Kidney Disease: Methodological Challenges and Results From the STOP-DKD Study.

Slowing the progression of diabetic kidney disease (DKD) is critical. We conducted a randomized controlled trial to target risk factors for DKD progression. We evaluated the effect of a pharmacist-led intervention focused on supporting healthy behaviors, medication management, and self-monitoring on decline in estimated glomerular filtration rate (eGFR) for 36 months compared with an educational control. We randomized 138 individuals to the intervention group and 143 to control. At baseline, mean (SD) eGFR was 80.7 (21.7) mL/min/1.73m 2 , 56% of participants had chronic kidney disease and a history of uncontrolled hypertension with a baseline SBP of 134.3mm Hg. The mean (SD) decline in eGFR by cystatin C from baseline to 36 months was 5.0 (19.6) and 5.9 (18.6) mL/min/1.73m 2 for the control and intervention groups, respectively, with no significant between-group difference ( P =0.75). We did not observe a significant difference in clinical outcomes by study arm. However, we showed that individuals with DKD will engage in a pharmacist-led intervention. The potential explanations for a lack of change in DKD risk factors can be attributed to 5 broad issues, challenges: (1) associated with enrolling patients with low eGFR and poor BP control; (2) implementing the intervention; (3) limited duration during which to observe any clinical benefit from the intervention; (4) potential co-intervention or contamination; and (5) low statistical power.

Impact of Healthy Lifestyle Factors on Life Expectancy and Lifetime Health Care Expenditure: Nationwide Cohort Study.

The association between lifestyle risk factors and the risk of mortality and chronic diseases has been established, while limited research has explored the impact of healthy lifestyle factors on lifetime health care expenditure using longitudinal individual data. We aimed to determine the individual and combined effects of 5 healthy lifestyle factors on life expectancy and lifetime health care expenditure in Taiwan. Using data from the National Health Interview Survey cohort, 5 healthy lifestyle behaviors were defined and analyzed: nonsmoking, avoiding excessive alcohol consumption, engaging in sufficient physical activity, ensuring sufficient fruit and vegetable intake, and maintaining a normal weight. We used a rolling extrapolation algorithm that incorporated inverse probability of treatment weighting to estimate the life expectancy and lifetime health care expenditure of the study populations with and without healthy lifestyle factors. A total of 19,893 participants aged ≥30 (mean age 48.8, SD 13.4) years were included, with 3815 deaths recorded during a median follow-up period of 15.6 years. The life expectancy and per capita estimated lifetime health care expenditures for the overall study population were 35.32 years and US $58,560, respectively. Multivariable-adjusted hazard ratios for all-cause mortality in participants adhering to all 5 healthy lifestyle factors, compared with those adhering to none, were 0.37 (95% CI 0.27-0.49). We found significant increases in life expectancy for nonsmokers (2.31 years; 95% CI 0.04-5.13; P=.03), those with sufficient physical activity (1.85 years; 95% CI 0.25-4.34; P=.02), and those with adequate fruit and vegetable intake (3.25 years; 95% CI 1.29-6.81; P=.01). In addition, nonsmokers experienced a significant reduction in annual health care expenditure (-9.78%; 95% CI -46.53% to -1.45%; P=.03), as did individuals maintaining optimal body weight (-18.36%; 95% CI -29.66% to -8.57%; P=.01). Overall, participants adhering to all 5 healthy lifestyle behaviors exhibited a life gain of 7.13 years (95% CI 1.33-11.11; P=.02) compared with those adhering to one or none, with a life expectancy of 29.19 years (95% CI 25.45-33.62). Furthermore, individuals adopting all 5 healthy lifestyle factors experienced an average annual health care expenditure reduction of 28.12% (95% CI 4.43%-57.61%; P=.02) compared with those adopting one or none. Adopting a healthy lifestyle is associated with a longer life expectancy and a reduction of health care expenditure in Taiwanese adults. This contributes to a more comprehensive understanding of the impact of healthy lifestyle factors on the overall health and economic burden.

From Likes to Lifestyle: Predicting the Impact of Following Fitness Influencers on the Adoption of Healthy Habits in Saudi Arabia.

The increasing popularity of fitness influencers on social media has the potential to significantly impact public health by promoting healthy behaviors. Understanding how these influencers affect the adoption of healthy habits among Saudi residents can provide insights into effective public health strategies. This study aims to quantitatively assess the influence of following fitness influencers on social media on adopting healthy behaviors among Saudi residents, focusing on socio-demographic factors, characteristics of influencers, and participants' perceptions. A descriptive, cross-sectional study with an analytical component was carried out from March 25, 2023, to August 15, 2023. The study included Saudi residents aged 18 and older who actively follow fitness influencers. Data was gathered through an online questionnaire and analyzed using descriptive statistics, Pearson's chi-square test, and logistic regression analyses to identify factors associated with positive health outcomes. The study included 561 participants, revealing that marital status and residential region significantly influenced the adoption of healthy habits, with married participants and those from the Southern and Central regions more likely to report positive outcomes. Notably, engagement in physical activity more than three times a week and adherence to a healthy diet were strongly associated with positive health outcomes (p<0.05). Analysis of influencer characteristics showed that following fewer than 10 influencers and being unaware of their follower count were predictors of positive results with p<0.05. Specifically, 76.6% of participants experienced positive results after following health advice from social media, highlighting the impactful yet complex role of influencers in shaping health behaviors. Logistic regression analyses underscored the significance of socio-demographic factors, influencer characteristics, and participant perceptions in predicting the likelihood of experiencing positive health outcomes. Following fitness influencers on social media can positively impact the adoption of healthy habits, moderated by socio-demographic factors and influencer characteristics.

Heart health champions: how to develop student nurses as role models for cardiovascular health

Abstract Background Nurses as health promotors are optimally placed to identify cardiovascular disease risk factors and discuss behaviour change strategies for modifiable risk factors, but most undergraduate curriculums lack detailed content regarding these topics. Unfortunately evidence indicates that student nurses often demonstrate risky behaviours such as smoking, physical inactivity, excessive alcohol consumption and poor nutritional choices. As nursing is a pressurised career with long shifts and often challenging emotional encounters, it can be easy to overlook personal health behaviours. Purpose Given that nursing students are our potential health promotors of the future, we aimed to enhance cardiovascular knowledge and behaviour change awareness in their undergraduate education by implementing a co-designed digital educational resource - ASMOSUS. It sought to embed knowledge and risk assessment of cardiovascular disease risk factors, while motivating and sustaining behaviour change within undergraduates, facilitating them to make healthier lifestyle choices themselves and act as role models for patients. We developed roles of ‘Heart Health Champions’ within university and clinical placements, which is novel for both clinical practice and Higher Education Institutes. Methods Any nursing student who had received the ASMOSUS digital educational resource in the first semester of their undergraduate program and had an interest in further knowledge acquisition and health promotion amongst their peers were invited to become a Heart Health Champion. Alongside the recruitment of Heart Health Champions the cohort received cardiovascular risk factor specific educational sessions on physical exercise, smoking and vaping cessation, nutrition and alcohol consumption. Results We recruited 9 Heart Health Champions from the cohort representing all fields of undergraduate nursing. These students have undertaken 30 hours of required participation, leading to a university recognised qualification- FutureReady on graduation. This included attending cardiac risk and prevention training with cardiac rehabilitation nurses. They have taken the initiative to plan activities such as a sponsored walk, a ‘dancercise' class and support for their peers in harnessing healthy lifestyle behaviours through role modelling and motivational interviewing techniques. Results demonstrate that these sessions and student led activities are well attended and positively evaluated, which shows that including cardiovascular prevention techniques in undergraduates is feasible and acceptable. Conclusion Heart Health Champions are a valuable asset and can promote modifiable risk factor change amongst their peers and may help to maintain a healthy lifestyle. Further Heart Health Champions will be recruited over the next undergraduate nursing cohorts with a planned study to explore their effectiveness.

Feasibility and effectiveness of cardiac telerehabilitation for older adults with coronary heart disease patients: a pilot randomized controlled trial

Abstract Background Cardiac rehabilitation is a standard and multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person CR, however, older adults are under-reported with effectiveness, feasibility, and usability of CTR for this population remains unclear . Purpose This study investigates the effects, usability, and feasibility of 12-week CTR on health outcomes of older people with CHD. Design A pilot randomized controlled trial with qualitative process evaluation. Methods The study randomized 43 older adults with CHD to the 12-week CTR intervention or usual care. Guided by Social Cognitive Theory, intervention group participants received individualized in-person assessment and orientation session, followed by CTR usage at home. Participants were encouraged to visit the CR website for self-learning and data uploading, use the pedometer for daily step tracking, and chat with peers and CR nurse via social media for problem-solving and mutual support. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). Results Participants in the CTR intervention group showed significant improvement in daily steps (T1: β=4126.58, p=0.001; T2: β=5285, p=0.01) and health-promoting lifestyle profile (T1: β= 23.26, p&amp;lt;.001; T2: β=12.18, p=0.008) across study endpoints. No significant difference was observed regarding self-efficacy, quality of life, psychological symptoms, and body weight and blood pressure. Twenty participants completed the intervention, with 100% used social media for tele-consultation, 90% used the pedometer for tele-monitoring, 40% (n=8) used the website. Improving awareness on rehabilitation and a clear action focus were considered as key enablers while physical discomforts and difficulties in using the technology were described as main barriers. Conclusions The CTR is effective in improving physical activity and healthy behaviors for older adults. Considering the variation in individual cardiovascular risk factors, full-scale RCT with larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life. Strategies to improve user intervention usage is needed.

Trends and factors influencing the mental health of college students in the post-pandemic: four consecutive cross-sectional surveys.

The long-term impact of COVID-19 on the mental health and well-being of college students, specifically trends over time after full removal of COVID-19 restrictions, has not been well-studied. Four consecutive cross-sectional surveys were conducted in December 2022 (N = 689), March 2023 (N = 456), June 2023 (N = 300), and November 2023 (N = 601) at a university in Sichuan Province, China. The proportion of students with COVID-19 panic decreased from 95.1 to 77.3% (p < 0.001). The prevalence of moderate anxiety and above decreased from 18 to 13.6% (p < 0.001), and the prevalence of moderate and above depression decreased from 33.1 to 28.1% (p < 0.001), while the prevalence of post-traumatic stress disorder (PTSD) increased from 21.5 to 29.6% (p < 0.005). Further, the proportion of suicidal thoughts increased from 7.7 to 14.8% (p < 0.001). Suicidal thoughts and self-injuries were significantly associated with COVID-19 panic, depression, anxiety, and PTSD. Students who reported being in close contact with COVID-19 patients in the past were more likely to develop PTSD. Further, COVID-19-induced panic was a risk factor for self-injury. One year after the COVID-19 pandemic, the overall mental health of college students was not optimal. Hence, we can conclude that the long-term impacts of COVID-19 on the mental health of college students may have already occurred. To mitigate this impact and prepare for the next major public health event, strengthening college students' mental health curricula and promoting healthy behaviors among college students should be a priority for universities and education authorities.

Creating a community advisory board for pediatric bladder health.

Pediatric lower urinary tract symptoms (LUTS) are highly prevalent in neurologically healthy school-aged children. However, no evidence-based programs exist to prevent or treat LUTS in the community setting. To address this, we established the first community advisory board (CAB) that aims to identify individual and societal structures impacting pediatric bladder health in Northern California's Bay Area and co-design culturally relevant bladder health interventions. Probability and non-probability sampling methods were used to recruit community stakeholders to the CAB. Our final CAB comprised of two parents, two community health workers, one educator, one pediatric urology registered nurse, and one pediatrician. The CAB met quarterly during the 1-year study period. Bi-directional feedback identified community-level barriers to bladder health, particularly in the school environment, and the need for tailored resources to teach children and families about healthy bladder behaviors. The CAB co-designed school-based bladder health interventions, including bladder health posters, and provided feedback on three school-based research study proposals. The CAB will continue to guide and inform future community-engaged research efforts.

Exploring food consumption patterns in the province of Kenitra, Northwest of Morocco

BackgroundMorocco is currently undergoing rapid changes in diets and lifestyles, influenced by globalization and urbanization, leading to a shift away from the Mediterranean diet (MedDiet) toward Western diets.ObjectiveDescribe and explore the food consumption patterns of the population of Kenitra province and their adherence to the MedDiet using a validated survey.MethodThe current cross-sectional study involved 442 respondents from Kenitra province, comprising individuals aged 18 and above. The survey included a combination of closed and open-ended questions regarding food consumption patterns and socio-demographic characteristics. Adherence to the MedDiet was assessed using the Panagiotakos method to calculate the MedDiet score (MDS). Additionally, each participant’s adherence to the MedDiet was evaluated using a method based on Martínez-González’s approach.ResultsThe results indicate that 31% of the participants eat vegetables, 28% eat fruits, and 19% eat wholegrain bread daily. Furthermore, 58% regularly use olive oil in their cooking. Eating out of home (OOH) was high, with popular places being restaurants and cafes (70%), fast food outlets (20%), and workplace canteens (7%). Overall, participants showed moderate adherence to the MedDiet, with a mean MDS of 36.3 ± 19.7.ConclusionsPromoting healthy eating habits is crucial in Kenitra. With moderate consumption of nutrient-dense foods and the popularity of the MedDiet, targeted interventions and educational initiatives can promote healthy dietary behaviors, improving overall public health.

Planning healthy food environments: An analysis of local government municipal public health and wellbeing policy in regional Victoria.

While there has been an increased focus on how local governments can support the creation of healthy food environments through healthy public policy, little is known about how this is reflected in public health policy in regional areas. The aim of this study was to understand how improvements to the food environment are prioritised, implemented and evaluated by local governments in regional Victoria. Using a qualitative descriptive approach, content analysis was undertaken of Municipal Public Health and Wellbeing Plans and Council Plans from 10 regional local governments in Victoria, Australia. Seventeen policy documents were analysed including 10 Council Plans, 6 Municipal Public Health and Wellbeing Plans and 1 Food Systems Strategy. Findings highlight regional public health and wellbeing plans have very few concrete actions in place to improve food environments. There is an opportunity for Australian regional local governments to include in their public health and wellbeing plans a greater emphasis on supporting healthy food behaviours, and therefore seeking opportunities to improve food environments through clearly aligned priorities, objectives, actions and measures of success. SO WHAT?: Improving the quality of public health and wellbeing plans can support local government to use policy to drive improvements in food environments leading to improved health and wellbeing for regional communities.

The strongest predictors of compliance with health protocols among marketers and guilds based on the transtheoretical model

BackgroundGlobal communication, an integral part of modern life, increases the risk of transmitting infectious diseases to individuals. Based on the transtheoretical model (TTM), this study aimed to identify the most effective factors in adherence to health protocols among marketers and guilds.MethodsThis cross-sectional study was conducted among 400 market sellers and guilds of Ardabil City, Iran, in 2023. The TTM questionnaire was distributed among the participants which included four sub-constructs: (1) stages of change, (2) process of change, (3) self-efficacy, and (4) decisional balance. The data were analyzed using SPSS version 20. One-way ANOVA and linear regression tests were employed to evaluate the prediction of effective factors of the stage transition.ResultsMost participants (63.5%) were between 21 and 40. Most participants (65.5%) were in the passive stages of change (precontemplation, contemplation, and preparation). Pros (β = 0.133, P < 0.001) and behavioral processes of change (β = 0.058, P < 0.001) were the strongest predictors of the stage of change or improvement of stages of participants’ willingness to follow health protocols.ConclusionA correct understanding of the stages of behavior change can strengthen strategies for promoting healthy behaviors. Also, understanding the benefits of healthy behavior means compliance with health protocols and behavioral processes such as stimulus control, reinforcement management, counterconditioning, and self-liberation, along with high self-efficacy, have an impact on improving the stages of behavior change.

Effectiveness of a Community Pharmacy-Based Health Promotion Program on Hypertension in Bangladesh and Pakistan: Study Protocol for a Cluster-Randomized Controlled Trial.

The aim of this multi-country, cluster-randomized trial is to test the impact of pharmacy-based health promotion to reduce the blood pressure of individuals with hypertension over a 12-month period in Bangladesh and Pakistan. The trial will be implemented with two arms. In Bangladesh, the estimated sample size is around 3600 hypertensive patients. In Pakistan, we will select samples equivalent to 10% of the participants from Bangladesh, comprising 360 hypertensive patients from four pharmacies. Community pharmacies will be randomized into one of two parallel groups (allocation ratio 1:1). Pharmacy professionals in the treatment arm will provide their patients with educational training and counseling, as well as phone calls/mobile text messages and care coordination in the health sector, as part of the intervention. The study will be conducted in three phases: a baseline survey with intervention, a midline survey with intervention and follow-up, and an endline survey with impact evaluation. The primary outcome of the study will be BP. The secondary outcomes will be BP controlled to target, treatment adherence, quality of life, mortality or hospital admission rates resulting from hypertension and its related complications, incremental cost per health-related quality of life gained, knowledge on healthy lifestyle and dietary behavior, and change in the prevalence of current smoking status.

The Relationship between Self-Efficacy and Recognizing and Practicing Healthy Relationship and Consensual Behaviors

Sexual assault and relationship violence are a public health issue on college campuses. In order to prevent gender-based violence, it is important to understand the multiple protective factors that could be utilized in university prevention programming. Self-efficacy has not been thoroughly explored as a factor that could influence whether people recognize healthy romantic and sex relationship behaviors. The purpose of this study was to examine whether self-efficacy has a significant relationship with recognizing consent and healthy relationships and whether it impacts a person’s likelihood to practice active consent. The results of this study demonstrated that self-efficacy has a significant relationship with a person’s confidence in their ability to recognize consent behaviors, practice consent behaviors, and recognize when they are in a healthy relationship. Future research should further explore how self-efficacy can be a protective factor in preventing sex and relationship violence.

An app promoting weight gain prevention via healthy behaviours amongst young women with a family history of breast cancer: Acceptability and usability assessment.

Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk. The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18-35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures. Both recruitment methods were successful. Thirty-five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2-34.5) years, the majority (94.1%) were of White ethnicity. Thirty-four participants were included in the analyses, of which 94% downloaded the app. Median self-monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8-28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1-5). Eighty-nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period. This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing.

The effect of multiple nursing interventions on physical activity and health promotion in the elderly: A randomized controlled trial

Health promotion and physical activity practices for the elderly are important but still not sufficient. This study aimed to determine if the effects of education through home visit, mobile application (Google Fit), group walking, and phone reminder interventions on health promotion and physical activity in the elderly. The study has a randomized controlled design with pretest-posttest interventions and a control group. The study sample consisted of 66 elderly individuals, 33 of whom were assigned to the intervention group and 33 to the control group by randomization. Multiple nursing interventions, including education through home visit, mobile application (Google Fit) use, group walking, and phone reminder messages, were implemented by the researcher in line with Pender's Health Promotion Model. The first month score of the intervention group participants on the healthy lifestyle habits subscale was higher than that of the control group participants (all p-values < 0.05). The effect size was 0.577 (high effect size) and the confidence interval was 0.085-1.07. It can be recommended that interventions with reminders and repetitions regarding healthy lifestyle behaviors to health promotion in the elderly be planned.

Social contagion on higher-order networks: The effect of relationship strengths

We study the role and impact of interpersonal relationships on the dissemination of information, emotions, and behaviors through social higher-order networks. Namely, we introduce a novel model that explicitly accounts for strong and weak relationships on social contagion, and that integrates binary and ternary interactions among individuals. The model captures the dynamics of complex group interactions, and the differential impact that these relationship strengths have on the spread of contagion within various network structures. Our study reveals that in non-preferential structures, strong relationships significantly accelerate contagion, enhancing infection rates especially when weak relationship infection rates are low. Conversely, in preferential and mixed structures, the influence of strong relationships is more subdued, with network architecture playing a more dominant role in contagion dynamics. Our results thus offer various hints for managing social contagion. For instance, enhancing positive interactions within specific network structures, such as increasing connectivity in preferential networks or stabilizing influential nodes in non-preferential networks, can significantly promote a rapid spread of positive information and healthy behaviors.