Healthy Behaviors Research Articles

Teacher-Student Relationships and Coping Styles in Chinese Children: The Chain Mediating Role of Peer Relationships and Psychological Suzhi.

As age increases, children will face more and more adversity. How effectively they cope with stress and difficulties of life is of great significance to the development of children's mental health and academic achievement. However, few studies have explored how different interpersonal relationships and psychological suzhi work together to influence children's healthy behaviors, particularly healthy coping in adversity. Therefore, this research focused on the teacher-student relationships and coping styles, as well as the chain-mediated effects of peer relationships and psychological suzhi. A total of 688 children (360 boys, 52.3%; Mage = 10.98 and SD = 0.89) completed questionnaires that assessed using teacher-student relationships, peer relationships, psychological suzhi, and coping styles. The results indicated that teacher-student relationships correlated positively with coping styles, peer relationships, and psychological suzhi in children. Besides, teacher-student relationships positively affected coping styles through both the mediating roles of peer relationships and psychological suzhi. This research elucidated the extrinsic and intrinsic factors impacting the coping styles of children, thus providing empirical validation of existing theoretical frameworks. In China, interventions aimed at promoting Chinese children's positive coping could benefit from strategies focused on cultivating high-quality relationships and enhancing psychological suzhi.

From risk to reward: Japan’s potential for health and economic improvements

This study examines the relationship between risky consumption behaviors, non-communicable diseases (NCDs), and socioeconomic costs in Japan using the Preventable Risk Integrated ModEl (PRIME). We assess the potential impact of healthier lifestyle choices on NCD incidences and costs in 2019. Japan's rising healthcare expenditures threaten its economic future. Excessive intake of salt, tobacco, and alcohol, along with insufficient fiber and fruit consumption, significantly contribute to high NCD rates. Our analysis shows that healthier behaviors could have prevented 564,000 NCD cases, potentially saving $35 billion in health costs and economic losses in 2019. We consider scenarios where smokers switch to heated tobacco products (HTPs), applying conservative risk reduction estimates. Higher risk reduction levels could triple smoking-attributable savings. Projecting these savings over ten years would increase economic benefits tenfold. The study emphasizes the need for comprehensive public health strategies promoting healthier lifestyles. Targeted interventions, such as stricter regulation of high-risk products and incentives for healthier alternatives, could reduce NCD incidences and healthcare costs. While PRIME provides valuable insights, further research is needed to refine our understanding of risk factor-disease relationships.

Exploring the Impact of a Structured Educational Approach on Peristomal Skin Complications: An Interim Analysis.

This study, employing an interim analysis, investigates the effects of the Dermamecum protocol, a structured educational and tailored approach that stratifies ostomy patients into risk paths (green, yellow, red) based on pre-operative and post-operative characteristics. The green path indicates a low risk of peristomal skin complications (PSCs), focusing on sustaining healthy behaviours and basic stoma care. The yellow path represents a moderate risk, emphasizing the need for patients to self-monitor and recognize early signs of complications. The red path corresponds to high risk, requiring stringent monitoring and immediate access to healthcare support. The study aims to reduce PSCs and improve patient outcomes. Methods include the stratification of 226 patients, with significant differences in gender distribution, BMI categories, and stoma types across the paths. Results show an occurrence rate of PSCs of 5.9% in all risk paths (5.7% green path, 4.7% yellow path, and 7.9% red path, p = 0.685), significantly lower than the median rate of 35% reported in the literature. Multiple correspondence analysis validated the stratification, with distinct clusters for each path. Poisson regression models in the exploratory framework of an interim analysis identified male gender as the only significant predictor of PSCs, indicating the need for gender-specific interventions. The findings suggest that the Dermamecum protocol effectively reduces early PSCs, providing a foundation for further research.

To What Age Do Japanese People Wish to Live?: The Impact of Age Stereotypes.

The images we have concerning aging and older people influence our health, well-being, and longevity; however, we do not know which of its aspects (e.g., health, appearance, and personality) positively or negatively affect us. Therefore, to clarify the impact of images of aging on our desire to live long, which impacts our healthy behavior, we conducted an internet survey targeting 1,000 people aged between 30 and 75 years old in Japan in 2018. We tested the following five hypotheses: 1) Respondents who are interested in interacting with older people wish to live longer than those who do not; 2) Respondents who have a positive stereotype about physiological traits of older people wish to live longer than those who do not; 3) Respondents who have a positive stereotype about social relations among older people wish to live longer than those who do not; 4) Respondents who have a positive stereotype about the functioning of older people wish to live longer than those who do not; 5) Respondents who have a positive stereotype about the functioning of older people are likely to engage in healthy behavior and perceive better subjective health than those who do not, which positively affects the age they wish to live to. As a result, we found that only 70-75-year-old participants who had positive images of social relations in old age tended to express a wish to live longer. However, other aspects of images of aging such as appearance, personality, and biological traits did not affect such desire. We conclude that the influence of aging images on the desire to live long may be less apparent among Japanese than other cultures. It is possible that Japanese people are less likely to internalize aging images regarding old age.

Analysis of diarrhea incidence based on demographic characteristics and hygiene behavior of adults in Indonesia and Taiwan

Diarrhea is a common manifestation of gastroenteritis, affecting both children and adults globally. Subsequently, gastroenteritis is particularly prevalent in developing countries such as Indonesia and Taiwan. This research aimed to analyze the incidence of diarrhea based on socio-demographics and personal hygiene in Indonesia and Taiwan.The method used in this research was a quantitative design with a cross-sectional approach, and the data collection involved interviews with adults, using a structured questionnaire. The primary goal of the analysis was to examine the bivariate relationships between each variable and the incidence of diarrhea, and the logistic regression test was applied for the multivariate test.A result from Taiwan respondents, the statistical tests showed significant relationships with age with a p-value of 0.009, education with a p-value =0.010, and personal hygiene with a p-value =0.010. Factors that influenced diarrhea in Indonesia were education with a p-value =0.038 and income with a p-value =0.08.In summary, several socio-demographics and personal hygiene practices played a significant role in the incidence of diarrhea. The differences in results obtained from Taiwan and Indonesia were attributed to differing respondent characteristics, emphasizing the importance of promoting clean and healthy behaviors, including handwashing with soap before eating and maintaining a clean environment, as effective measures to prevent diarrhea.

Built environment and childhood obesity.

Childhood obesity, an escalating global health challenge, is intricately linked to the built environment in which children live, learn, and play. This review and perspective examined the multifaceted relationship between the built environment and childhood obesity, offering insights into potential interventions for prevention. Factors such as urbanization, access to unhealthy food options, sedentary behaviors, and socioeconomic disparities are critical contributors to this complex epidemic. Built environment encompasses the human-modified spaces such as homes, schools, workplaces, and urban areas. These settings can influence children's physical activity levels, dietary habits, and overall health. The built environment can be modified to prevent childhood obesity by enhancing active transportation through the development of safe walking and cycling routes, creating accessible and inviting green spaces and play areas, and promoting healthy food environments by regulating fast-food outlet density. School design is another area for intervention, with a focus on integrating outdoor spaces and facilities that promote physical activity and healthy eating. Community engagement and education in reinforcing healthy behaviors is necessary, alongside the potential of technology and innovation in encouraging physical activity among children. Policy and legislative support are crucial for sustaining these efforts. In conclusion, addressing the built environment in the fight against childhood obesity requires the need for a comprehensive, multipronged approach that leverages the built environment as a tool for promoting healthier lifestyles among children, ultimately paving the way for a healthier, more active future generation.

Unconscious Drivers of Consumer Behavior: An Examination of the Effect of Nature-Nurture Interactions on Product Desire.

Both biological and environmental factors can affect consumer behavior. Consumer behavior can also be a product of an interaction between one's evolved biology and environmental factors. If marketers aim to increase healthy consumption behavior and decrease unhealthy behavior, they need to identify whether the behavior is a product of one's evolved biology or environmental factors acting in isolation, or if the behavior is a product of a biology-environment interaction. Therefore, the purpose of this study is to examine the effect of biology-environment interactions on product desire. This study comprises two experiments that used a repeated-measures design. The first experiment included 315 females and examined the effect of perceived physical safety, economic well-being, and social support on the desire for beautifying and wealth-signalling products. The second experiment included 314 men and examined the effect of perceived physical safety, economic well-being, and social support on the desire for products that are used to signal wealth and toughness. The results showed that under harsh economic conditions, product desire generally decreased. However, there were significant differences in the amount of decrease between product categories in different environmental conditions.

Relevance of Dipo Womanhood Rites as a Social Control Mechanism Among People of Yilo-Krobo in the Eastern Region of Ghana

This study based on Dipo rites was carried out in Yilo-Krobo Municipality in the Eastern region of Ghana among 350 young people aged 15–24, using mixed methods. The findings show that girls who have not done Dipo are less likely than their initiated counterparts to have sex before marriage. The study also shows that although Dipo is an old custom, it still influences sexual behaviours among young people in the study area. The study concludes that Dipo contributes positively to maintaining young people’s healthy sexual behaviour. It is suggested awareness-raising, and sensitization efforts be intensified in light of this.

Educating adolescents on preventing substance use: The role of 24-h movement behaviors ─ data from 2021 Youth Risk Behavior Surveillance

BackgroundLittle is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents. MethodsData from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association. ResultsOnly 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]). ConclusionsAdhering to 24-h MB guidelines may reduce adolescents’ alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.

Trauma-Informed Development and Education: Turning the TIDE on Transition to Practice.

Transition to practice (TTP), the first year of a nurse's career postlicensure, is widely recognized as a stressful time. Previous trauma exposure and additional workplace trauma exacerbate the stress of this transitional period. Trauma-informed environments are associated with clinician wellness and engagement. Because workforce training for leaders is a necessary precursor to developing supportive environments, we studied changes in trauma knowledge, awareness, and attitudes among TTP leaders. Our mixed methods study included administering the Attitudes Related to Trauma-Informed Care Scale (ARTIC) pre- and post-training, with additional open-ended questions about the impact of training. Paired data from participants showed overall mean improvement that was statistically significant, with a large effect size. Statistically significant knowledge gains related to trauma recognition and safety, how to respond to trauma, and how to promote healthy behaviors. Our study underscores the importance of trauma education, which not only increased awareness but also prompted nurse leaders to reflect on enhanced support for early nursing professionals. [J Contin Educ Nurs. 2024;55(10):501-508.].

The SMILE scale: a wellness behavioral tool for patients with cancer.

As cancer survivorship increases, there is a need for simple tools to measure and promote healthy behaviors. We created a wellness behavioral tool (the SMILE Scale) to encourage self-monitoring of wellness behaviors. This study aimed to determine the feasibility of collecting daily self-reported SMILE Scale data and weekly quality of life data among patients with cancer. We also aimed to measure the association between SMILE Scale responses and validated health-related quality of life (HRQOL) tools (PROMIS-29 + 2 and SymTrak-8) as a pilot test of the hypothesis that increased wellness behaviors may impact quality of life. We surveyed 100 patients with cancer at the Indiana University Simon Comprehensive Cancer Center. Participants were asked to complete daily SMILE Scale assessments over a two-week period, as well as weekly PROMIS-29 + 2 and SymTrak-8 surveys. The primary endpoint was the SMILE Scale completion rate. Secondary endpoints in this single-arm pilot study included correlations between the SMILE Scale and other HRQOL tools. Daily completion rate of the SMILE Scale ranged from 57% to 65% of participants over a 14-day period. Among the 61% of participants who completed SMILE on day 1, 87% completed SMILE on 10 of 14 days. By end of study, participants who self-reported more wellness behaviors (i.e., higher daily SMILE scores) demonstrated significantly higher PROMIS physical health (p = 0.003), higher PROMIS mental health (p = 0.008), and lower (better) SymTrak total symptom burden (p = 0.006). Further, among those who completed at least 1 of 14 daily SMILE assessments, quality of life significantly improved over the two-week period for PROMIS mental health (p = 0.018) and SymTrak total symptom burden (p = 0.014). The SMILE Scale completion rate did not satisfy our pre-planned ≥70% threshold for feasibility; however, the rate for completing SMILE at least once during the 14 days (77%) met this threshold. Participants with higher average daily SMILE scores had significantly better scores across other validated HRQOL tools. While these results may be correlative and not causative, this suggests a potential physical and mental health benefit for delivering the SMILE Scale in clinical practice to help encourage healthy behaviors and warrants testing the SMILE Scale's impact in future studies.

Affective-Sexual Behaviors in Youth: Analysis of a Public Health Survey in the School Setting.

Adolescence is a critical period for the development of affectivity and sexuality. Adolescents begin to explore their sexual identities, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the fourth year of ESO, identifying risk factors, comparing their behaviors and risks, monitoring these behaviors, analyzing their pornography consumption, and evaluating the use of the internet as a source of sexual information. Descriptive cross-sectional study using questionnaires. Participants are fourth-year ESO students from a school in the Baix Llobregat province (Catalonia), aged between 14 and 18 years. Descriptive and bivariate statistical analyses are conducted using the chi-square test and p-value calculations with the R Project software. Frequency and percentage analyses are also used to describe the health behaviors of the participants. The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use management vary between the genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in terms of the age of initiation and frequency between boys and girls. This study on adolescent affectivity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors within municipal public health.

Predicting oral hygiene practices through health behavior, perceived stress and self-efficacy in undergraduate dental students of Pakistan: a national survey

BackgroundDental students face the rigorous demands of coursework, which can lead to feelings of inadequacy and stress. These pressures can negatively influence self-efficacy and cause neglect in practicing healthy behaviors that encompass oral health. Identifying the associations of these variables with oral hygiene practices can help in the formulation of interventions tailored toward supporting young students. Therefore, this study aimed to investigate the impact of health behaviors, perceived stress and self-efficacy on oral hygiene practices among undergraduate dental students in Pakistan.MethodsA national online survey was carried out among 904 students across the dental colleges of Pakistan. The survey assessed general health behaviors such as tobacco use, sleep, and exercise, among other demographic variables. Perceived stress was evaluated via the Perceived Stress Scale (PSS-10), and self-efficacy was evaluated via the General Self-Efficacy Scale (GSES). Twice daily brushing, brushing for 2 min, and changing toothbrushes after 3 months informed oral hygiene practice of the participants.ResultsThe students experienced moderate perceived stress (20.82 ± 5.92) and high self-efficacy (29.19 ± 5.43). The majority of participants were in their third year (31.9%), were female (65.9%), and resided in home during their studies (64.4%). Perceived stress was observed to have no significant effect on the oral practice of participants. Female gender, non tobacco user, regular exercise, frequent dental visits and higher self-efficacy were associated with good oral hygiene practices.ConclusionsThe results highlight the importance of addressing stress, enhancing self-efficacy and encouraging healthy behaviors among dental students to improve their oral health, which could be reflected in their professional practice and personal well-being. This study contributes to the understanding of behavioral determinants and emphasizes the need for supportive measures to foster better health behaviors in future dental professionals.

Análisis crítico de las nuevas directrices de la OMS sobre alimentación complementaria en el lactante de 6 a 23 meses de edad

Introduction: the World Health Organization (WHO) has issued new recommendations on complementary feeding (CF) in 2023. The introduction of CF takes place with the period of greatest nutritional risk for the toddler. Inadequate CF increases risk for altered physical and cognitive development and the risk of chronic non-communicable diseases. The WHO sets out seven main recommendations based on the review of the available evidence. Objective: present a critical review of the new WHO guidelines on CF. Methods: the analysis has been carried out by the Spanish Group of Gastroenterology and Nutrition of the Spanish Association of Primary Care Paediatrics and has included an exhaustive review of the WHO guidelines and documents of particular relevance in infant feeding from scientific societies of our environment in order to adapt them to our environment. Results: the certainty of the scientific evidence is low or very low for six of the seven recommendations. There is a lack of randomized clinical trials to provide certainty in decision-making and to define health outcomes for each recommendation. The absence of specific recommendations on new trends in food and allergenic foods as well as adaptation to first world countries is noteworthy. Conclusions: the start of adequate CF is key for health in early life. In line with WHO, we conclude that breastfeeding should be promoted as the exclusive food for the first 6 months of life, especially in low resource areas. The introduction of CF should take place around 180 days of life through a diversified and adequate diet. CF involves the acquisition of healthy feeding behaviour. Adaptation of the recommendations to our environment is necessary, in addition to other aspects not considered by the WHO guidelines.

Community Health Needs Assessment of Primary Healthcare in Saudi Arabia: A Cross-Sectional Study

ABSTRACT Introduction Continuous assessment of community health needs is essential to predict, recognize, and act on healthcare issues. Conducting community health needs assessments (CHNAs) in Saudi Arabia has become a priority to overcome the current healthcare challenges and keep pace with the Saudi Arabia 2030 vision. Studies reporting community health needs in Saudi Arabia regions are limited despite the high incidence of chronic diseases. This study aims to understand the community’s health problems and the range of healthy behaviors and determine the priority health problems. Methods We conducted a cross-sectional study based on the adults in Primary Health Care Centers in Hail, Northern Saudi Arabia, by using the CHNA standard questionnaire. In addition to the demographic information, the questionnaire collects data on personal health status, the health status of adults and children, health facilities access information, receiving of healthcare procedures, traveling for healthcare, source of medical information, safety measures and behaviors, health problems, childcare (special needs), and perceived community problems. Results In all, 336 individuals were approached to participate in this study; 303 agreed to participate (response rate: 90%). The analysis comprised 276 individuals after eliminating 27 who did not fulfill the age inclusion criteria or had missing gender data. Of these, 107 (38.8%) were men and 169 (61.2%) were women. Our data revealed that almost half of the participants, 135 (52.9%) constantly or 107 (42%) occasionally, were able to visit the doctors when needed. Conclusion Our findings reported positive health behaviors and good accessibility to healthcare services when needed. However, the study findings also revealed healthcare challenges that required urgent action from Hail healthcare leaders. Developing healthcare strategies, screening/prevention programs, and changing healthcare policies in the Hail region are needed to control and prevent health problems and improve the population’s health.

Household Latrine Utilization Behavioral Model as an Effort to Improve Open Defecation-Free Program

Background: Healthy latrine-using behavior indicates healthy behavior. However, many people still practice open defecation, which can cause illness and increase death risk. Self-efficacy is a dominant predictor of health behavior change. Aims: The study aims to develop a household latrine utilization behavior model based on self-efficacy to improve an open defecation-free (ODF) program. Method: The study was a descriptive-analytic with a cross-sectional design. The sample size was 138 respondents with cluster random sampling. The study variables were endogenous (household latrine utilization), exogenous (predisposing, enabling, and reinforcing factors), and intervening variables (self-efficacy). Data were collected by questionnaire and analyzed using SEM-PLS. Result: The household latrine utilization behavior-based self-efficacy model is fit (SRMR=0.098; NFI= 0.910; Q2=0.334). Valid and reliable indicators were education (predisposing), clean water availability and latrine maintenance (enabling), and health worker and family support (reinforcing). Path analysis showed exogenous factors, directly and indirectly, influence latrine utilization behavior through self-efficacy. Predisposing and reinforcing factors had a direct and significant effect (p = 0.025; p = 0.001) while enabling factors were insignificant (p = 0.438). Enabling and reinforcing factors indirectly and significantly affected latrine utilization behavior through self-efficacy (p = 0.033; p = 0.004), while predisposing factors were insignificant (p = 0.141). Self-efficacy significantly influenced latrine-using behavior (p = 0.023). Conclusion: The household latrine utilization behavior-based self-efficacy model is a fit model with good predictive relevance in predicting household latrine use behavior. Health workers can use the model to enhance household latrine utilization behavior and improve the ODF program and public health status.

The Best Practices for Designing Built Environments to Promote Healthy Food Access and Dietary Behaviors in Low-Income and Underserved Communities

Background: The built environment can influence health outcomes, including access to good dietary options. Aims: The current study intends to thoroughly evaluate the literature on best practices for building environments that promote healthy food access and nutritional behaviors in low-income and underserved communities in Indonesia. Method: To discover relevant studies on this topic, a thorough literature review was done using databases from PubMed, Web of Science, and Scopus extracting. Result: The final analysis included 32 studies after removing duplicates and applying inclusion and exclusion criteria. Extracting and assessing data from the chosen research and thematic synthesis was applied. The data was extracted and processed into a detailed narrative that provided an overview of the best practices. Conclusion: According to the findings of the literature study, built environment design can have a considerable impact on healthy food availability and eating patterns in Indonesian communities. It might be possible to develop effective interventions that enhance health outcomes for all Indonesians by addressing these gaps in the evidence.

Evaluation of the quality of oral hygiene mobile apps for children using the mobile app rating scale

BackgroundWith the increased use of smartphones, mobile applications (apps) aimed at promoting healthy behaviors have experienced exponential growth. ObjectivesThis study aimed to provide an overview of mobile apps that use gamification to motivate children to maintain optimal oral hygiene and to evaluate the quality of the oral hygiene apps for children (OHACs) available in the Turkish Google Play Store and the Apple Store. MethodsBetween January 20 and February 2, 2024, OHACs were searched in the Turkish Google Play Store and the Apple Store. Seven apps were assessed using the Mobile Application Rating Scale (MARS) and evidence-based dentistry criteria (EBD). We used Microsoft Office Professional 2016 (Microsoft Excel 2016; Microsoft Corp, Redmond, WA, USA) and IBM SPSS Statistics version 29 for Windows (IBM Corp, Armonk, NY, USA) for all the data analyses and visualizations. ResultsThe best overall MARS scores were obtained for Diş Doktoru: Dentist (3.53 ± 0.15) and Diş Hekimi Oyunları: Dentist Game (3.72 ± 0.33). The worst overall MARS scores were obtained for Truthbrush (2.76 ± 0.06) and Mimizaur (2.85 ± 0.09). Hayvan Diş Hekimi: Animal Dentist, Diş Hekimi Oyunları, and the Brush Teeth Game: Kids Dentist included the most evidence-based content. ConclusionMost OHACs achieved moderate MARS scores for promoting oral hygiene habits among children. Improving the quality and educational content of OHACs could increase personal oral care motivation in children. More research is required to determine the long-term effects of the apps and whether they align with oral hygiene guidance.

Supportive Workplace Wellness Cultures and Mattering Are Associated With Less Burnout and Mental Health Issues in Nurse Managers.

The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. A cross-sectional, descriptive correlational design was used. The Florida Organization for Nursing Leadership enabled distribution of a wellness survey to nurse managers. There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout. Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers.

Strengthening Community Healthy Behavior to Support Tourism Area

Kenjeran Beach Amusement Park is one of the beaches with a strategic area bordering the Madura Strait. In addition, Kenjeran Beach Amusement Park also provides several facilities that can be enjoyed by tourists. The results of observations, still found low personal hygiene of food vendors, not all food vendors provide trash bins, and tourists are still seen littering. Based on the results of the problem situation analysis, it is necessary to strengthen healthy behavior in the community around the tourist area. The targets of the activity were elementary school students around the Kenjeran beach tourism area in Surabaya City 113 students and food and beverage vendors in the Kenjeran beach tourism area 20 in number, using total sampling. The purpose of community service activities carried out to strengthen community healthy living behavior to support tourism areas in the Kenjeran Beach area, Surabaya. The implementation that has been carried out in this community service are education to elementary school children, education to food vendors, observation of the cleanliness of the tourist area observation of how to serve snacks and laboratory tests of microbial contamination in food/beverage snacks. Then to evaluate understanding after education by analyzing the mean value of pre-test and post-test. The results of this activity have provided education for elementary school students regarding clean and healthy living behavior in the area even though the average pre-test score of 6.15 decreased to 6.07 during the post-test. The socialization of safe and healthy snacks for food vendors in THP Kenjeran Lama has also been carried out with the pre-test score having an average of 5.2 then increased to 8.7 at the time of the post-test. Laboratory test results showed a very alarming condition, namely 88.89% of food-beverage samples were contaminated with microbes with various types of bacteria. Suggestions from the results of this activity are still the need for more intensive education to school children about the selection of snacks and diseases transmitted through food and beverages. There is still a need for assistance from food vendors in processing and serving food and drinks by sanitary hygiene standards.