Implications For Health Education Research Articles

Young Black Men’s Information Seeking following Celebrity Depression Disclosure: Implications for Mental Health Communication

Celebrity health disclosures motivate people to seek information about various health topics. However, limited systematic evaluations exist on effects of celebrity disclosures of mental illness, despite observations that this is a growing phenomenon and have important implications for public health education. Further, research has rarely examined the impact of such disclosures on minority populations. This study sought to understand factors associated with young Black men’s information seeking following exposure to a depression disclosure by Scott Mescudi. Mescudi is a well-known Black male hip-hop artist who shared his depression diagnosis and subsequent treatment plans with his fans in October 2016. For this study, I surveyed 182 Black males aged 18–34, 1 month after the disclosure. Fifty percent sought general information about depression, and 16% sought information to ascertain whether they themselves were at risk for depression. Feeling emotional distress following the disclosure and having current depression symptoms were significantly associated with information seeking behaviors. Identification was indirectly related to information seeking through emotional distress. Thus, emotional distress appears to play an important role in information seeking behaviors following celebrity health disclosures. The findings suggest celebrity health disclosures are associated with proactive health behaviors among this sample. Implications of the results for theorization of celebrity health effects and research on mental health communication with young Black men are discussed.

"A tool doesn't add anything". The importance of added value: Use of observational pain tools with patients with advanced dementia approaching the end of life-a qualitative study of physician and nurse experiences and perspectives.

Observational pain tools (OPTs) are widely recommended in health care policies, clinical guidelines, and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. To explore hospice, secondary, and primary care physicians' and nurses' use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4), and nursing homes (n=10). Semistructured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim, and thematic analysis applied to identify core themes. Three key themes emerged: (1) use of OPTs in this vulnerable patient population, (2) barriers to the use of OPTs and lack of perceived "added value", and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for nonuse included perceived limitations of such tools, difficulties with their use and integration with existing practice, and lack of perceived added value. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice, and policy.

“We (Tong) Chinese”: Contemporary identity positioning through health management among Cantonese Chinese Americans

ABSTRACTThis paper explores discursive ways Chinese American older adults with type 2 diabetes mellitus (T2DM) take ownership of their health management. Fifteen patient stakeholders with T2DM took part in four focus group interviews. We used qualitiative discourse analysis to examine how participants used the phrase, “We (Tong) Chinese,” and variants, to index models of Chinese-living-in-the-U.S. personhoods, to incorporate “Chinese” and “western” ways of doing health management, to be Chinese American, and to interact with medical practitioners. We show how terms like “Tong” distinguish transnational boundaries and position participants in claiming “Chinese-in-America-ness” in relevant ways. Findings have implications for healthcare providers, health education, and intercultural communication.

The alcohol contexts of consent, wanted sex, sexual pleasure, and sexual assault: Results from a probability survey of undergraduate students

ABSTRACTObjective: To examine, in a probability sample of undergraduate students, characteristics of students’ most recent sexual experiences (including alcohol use) as well as their experiences with nonconsensual sex. Participants: In January and February 2015, 22,046 students were invited to participate in an anonymous, cross-sectional, Internet-based survey; 7,032 surveys were completed (31.9%). Methods: Measures included background characteristics (age, gender, sexual orientation), most recent sexual event items (sexual pleasure, wantedness, alcohol use), and experiences with nonconsensual sex (since college and lifetime). Results: Respondents reporting sober consensual sex were more likely to report higher levels of sexual pleasure and wantedness. Nonconsensual oral, vaginal, or anal penetration occurring during college were reported by 15.8% of women and 7.7% of men. Students more often told friends, partners, or family members and rarely disclosed to university faculty or police. Conclusions: Implications for campus policy and health education are addressed.

Examining Heterosexual Women’s Anal Sexual Health Knowledge and Product Use

Prevalence rates indicate that receptive anal sex is increasingly part of heterosexual women’s sexual repertoire. However, there is a body of literature linking this behavior to risk for adverse sexual health outcomes. Women’s anal sexual health knowledge and awareness of behaviors associated with elevated risk have received less attention in the research literature. The aim of the current study was to examine anal sexual health knowledge and product use among heterosexual women aged 18 to 30 years. A total of 33 self-identified heterosexual women recruited from the general population participated in one of six focus groups. The results suggest that knowledge was variable. Salient sexual health themes centered on risks of human immunodeficiency virus/sexually transmitted infections (HIV/STIs), other infections, and physical harm/damage. Product-use themes included cleanliness/hygiene, comfort, and product safety. Participants expressed the desire for anal sexual health education. The results have implications for sexual health research, education, and clinical practice.

Self-Disclosure among Men and Women of Arab Descent: Implications for Group-Based Health Education

Arab American gender norms may affect female participation in group-delivered health education settings. Our objective was to examine gender-specific participation in Arab American group interactions. This study was conducted to inform the necessity of gender-specific groups in a subsequent diabetes prevention intervention. Self-identified Arabs or Arab Americans ≥ 30 years and without diabetes were randomly recruited. Participants were randomly assigned to male-only, female-only, or mixed-gender focus groups. A trained Arabic-speaking moderator facilitated 90-minute sessions using a standardized guide. Interviews were digitally recorded and transcribed verbatim. A self-disclosure survey immediately followed sessions. Turn-taking, verbosity, and survey responses were compared between males and females in gender-specific and mixed-gender group settings. Twenty-nine individuals participated: male-only (8), female-only (12), and mixed-gender (9). Males took more turns and spoke with more utterances than females during gender-specific and mixed-gender groups. Fewer men reported keeping comments to themselves relative to women. Group-formatted educational interventions in Arab Americans should take self-disclosure into consideration and efforts should be made to identify females who prefer participating in a gender-specific group.

Multilevel Analysis of Factors associated with Subjective Weight Perception among Normal Body Weight Adolescents based on the 2017 Korean Youth's Risk Behavior Survey (KYRBS)

Purpose: The present study is focused on understanding weight perception related with individual- and school-level multifactorial origins, underestimated and overestimated respectively, in normal body weight adolescents. Methods: Using the 2017 Korea Youth Risk Behavior Web-based Survey data of 45,902 students from 799 secondary schools, a multilevel multinomial logistic regression analysis was performed where adolescents (level1) were nested within schools (level 2). Results: At the school level, the average school body mass index (BMI, kg/m2) and physical education were associated with weight perception among both boys and girls. In boys, geographic areas were associated with weight underestimation. At the individual level, perceived economic status, weekly allowance, BMI (kg/m2), smartphone usage time (hrs/day) and perceived stress were associated with weight perception among both boys and girls. Age, paternal education, academic achievement and alcohol use were associated with weight perception among girls, while part-time job and physical activity were associated with weight perception among boys. Conclusion: Our findings underscore the importance of individual- and school-level environments in developing correct weight perception and have implications for school health education to establish healthy lifestyle behaviors for all adolescents.

How does patient-centered communication improve emotional health? An exploratory study in China

ABSTRACTIn China, people’s emotional health is concerning. The patient-centered communication during medical consultations may play an important role in improving people’s emotional well-being. However, the relationship between communication and health is one of the least developed areas in communication research. This study empirically tested a pathway linking communication to health. Based on survey data collected from 483 Chinese patients, the results showed that patient-centered communication directly improved emotional health. Also, patient-centered communication had an indirect effect on emotional health through uncertainty management skill. In addition, patient trust positively moderated the effects of patient-centered communication on uncertainty management skill and emotional health. Also, one’s Internet health information seeking positively moderated the effect of communication on health. The findings have significant theoretical and practical implications for health education and promotion in the context of China.

Preference for cesarean section in young nulligravid women in eight OECD countries and implications for reproductive health education

BackgroundEfforts to reduce unnecessary Cesarean sections (CS) in high and middle income countries have focused on changing hospital cultures and policies, care provider attitudes and behaviors, and increasing women’s knowledge about the benefits of vaginal birth. These strategies have been largely ineffective. Despite evidence that women have well-developed preferences for mode of delivery prior to conceiving their first child, few studies and no interventions have targeted the next generation of maternity care consumers. The objectives of the study were to identify how many women prefer Cesarean section in a hypothetical healthy pregnancy, why they prefer CS and whether women report knowledge gaps about pregnancy and childbirth that can inform educational interventions.MethodsData was collected via an online survey at colleges and universities in 8 OECD countries (Australia, Canada, Chile, England, Germany, Iceland, New Zealand, United States) in 2014/2015. Childless young men and women between 18 and 40 years of age who planned to have at least one child in the future were eligible to participate. The current analysis is focused on the attitudes of women (n = 3616); rates of CS preference across countries are compared, using a standardized cohort of women aged 18–25 years, who were born in the survey country and did not study health sciences (n = 1390).ResultsOne in ten young women in our study preferred CS, ranging from 7.6% in Iceland to 18.4% in Australia. Fear of uncontrollable labor pain and fear of physical damage were primary reasons for preferring a CS. Both fear of childbirth and preferences for CS declined as the level of confidence in women’s knowledge of pregnancy and birth increased.ConclusionEducation sessions delivered online, through social media, and face-to-face using drama and stories told by peers (young women who have recently had babies) or celebrities could be designed to maximize young women’s capacity to understand the physiology of labor and birth, and the range of methods available to support them in coping with labor pain and to minimize invasive procedures, therefore reducing fear of pain, bodily damage, and loss of control. The most efficacious designs and content for such education for young women and girls remains to be tested in future studies.

Predictors of Adults' Knowledge and Awareness of HPV, HPV-Associated Cancers, and the HPV Vaccine: Implications for Health Education.

High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified sociodemographic characteristics associated with HPV knowledge at the population level. Data from adult men ( n = 1,197) and women ( n = 1,906) who participated in the National Cancer Institute's 2014 Health Information National Trends Survey were analyzed. Multivariable regression was used to identify predictors of four HPV knowledge categories: (1) general knowledge, (2) cervical cancer knowledge, (3) "other" cancer knowledge (i.e., anal, oral, penile), and (4) vaccine knowledge. Significant gender differences in awareness and knowledge of HPV and the HPV vaccine were revealed. Most participants (>70%) knew that HPV could cause cervical cancer, but fewer (14.9% to 31.5%) knew of the association between HPV and "other" cancers. Women were more likely to report that a health care provider recommended vaccination. Significant predictors of general HPV and HPV vaccine knowledge included gender, education, income, race, and other sociodemographic characteristics. Age and income predicted cervical cancer knowledge. Knowledge of "other" HPV-associated cancers was predicted by having a child under 18 years in the household and relationship status. HPV knowledge appears to be socially patterned. Low HPV knowledge among men and some racial minorities suggests a need for further intervention. Health education should emphasize risks of noncervical HPV-associated cancers. Patient-provider communication that includes education, counseling, and clear recommendations favoring vaccination may improve uptake.

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado. Semi-structured qualitative interviews. Denver, CO, USA. Thirty-two young adults (aged 18-26years) who used tobacco/marijuana/vaporizers. Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products. Young adults evaluated harms and benefits using five dimensions: (1) combustion-smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency-edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals-products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction-participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge-personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits. Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading.

A Parental Health Education Model of Children’s Food Consumption: Influence on Children’s Attitudes, Intention, and Consumption of Healthy and Unhealthy Foods

This study proposes that parental mediation of television advertising and parental guidance of food consumption differentially influence children’s attitude, intention, and behavior toward the consumption of healthy and unhealthy foods. Structural equation modeling based on a survey of 1,119 children aged 9–12 supported our model, revealing that parental education strategies influence children’s food consumption in a complex manner that is highly context-dependent. Parental guidance of food consumption enhanced children’s healthy food attitude and intention to consume, while reducing the intention to consume unhealthy food. However, parental mediation of television advertising influenced unhealthy food attitude to a greater extent than healthy food attitude. Implications for health promotion and education, as well as parents and policy makers are discussed.

First Semester College Students’ Definitions of and Expectations for Engaging in Hookups

Our study was guided by a developmental lens (emerging adulthood) and the theory of symbolic interaction as we attended to the meanings and definitions that contextualize expectations for engaging in hookups while attending college. Using a directed approach to qualitative content analysis, we examined first semester college men’s and women’s ( N = 253) responses to a series of open-ended questions focused on definitions of and expectations for hooking up. Six definitional variations of hooking up emerged from these responses: (a) “sex” left undefined, (b) making out, (c) a range of sexual activities, (d) “sex” defined as intercourse, (e) the “all but sex” continuum, and (f) hanging out or going on a date. Chi-square analyses indicated no proportional differences in these definitions based on participant gender. Characteristics of hookup partners were also identified in participant responses. Whereas a greater proportion of men identified physical appearance as a necessary attribute of a potential hookup partner, a greater proportion of women discussed (a) familiarity with a hookup partner and (b) hookups as occurring between noncommitted individuals. Also, a greater proportion of men than women indicated expectations to hookup while attending college. Implications for research, relationship and sexual health education, and policy are discussed.

Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood “safer sex,” the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.

Midwives’ provision of antimalaria services to pregnant women in Uganda

Objectivesmalaria causes complications during 80% of all pregnancies in Uganda. However, only 48% of Ugandan pregnant women took one dose of intermittent preventive therapy while merely 27% took the second dose during 2011. This study investigated midwives’ provision of anti-malaria services in the Buikwe District of Uganda. Designa quantitative exploratory descriptive design was used. Settingprenatal clinics (n=16) in the Buikwe District of Uganda Respondentsquestionnaires were completed by 40 (out of a population of 45) midwives. Findingsmidwives’ provision of malaria-preventive services to pregnant women were associated with the midwives’ education level and professional experience as well as by the availability of safe drinking water and drugs for intermittent preventive treatment. Midwives who provided frequent health education to pregnant women, cooperated with village health team members and received in-service training were likely to provide effective anti-malaria services to pregnant women. Key conclusionsregular audits of midwives’ records should identify strengths and weaknesses related to the prevention of malaria during pregnancy. Relevant in- service education should be provided. Drugs for intermittent preventive therapy and clean drinking water must be available at all prenatal clinics so that pregnant women can take these drugs under direct observation of the midwives. Implications for practicemalaria-related health education should be provided during every prenatal clinic visit, and every pregnant women should take two doses of intermittent preventive therapy drugs during every pregnancy (as prescribed by Uganda's Ministry of Health) in order to reduce the reported impact of malaria on 80% of pregnancies in Uganda.

The Relationship Between Cognitive Ability and Experiences of Vaginal, Oral, and Anal Sex in the United States

Few studies have investigated the sexual development of populations with low cognitive abilities in the United States. This article examines the relationship between cognitive ability and various sexual experiences from adolescence (ages 12 to 18) to early adulthood (ages 28 to 34). Data were from 13,845 respondents interviewed at Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a probability sample of adolescents in the United States followed from adolescence to adulthood. Adjusted logistic regression models were used to study relationships between cognitive ability, approximated by the Add Health Picture Vocabulary Test (AHPVT), and experiences of vaginal, oral, and anal sex. After controlling for biological sex, age, race/ethnicity, and socioeconomic status (SES), individuals in the lowest cognitive ability group had significantly lower odds of experiencing each type of sex than those in the average ability group. Although individuals in the highest cognitive ability group had significantly lower odds of experiencing vaginal intercourse than those in the average ability group, this association did not remain significant when analyses were stratified by biological sex. These differences in experiences have implications for future health and warrant further study to understand policy implications for sexual health services and education.

Knowledge of metabolic syndrome in Chinese adults: Implications for health education

Objective: The objective of this study was to assess knowledge of metabolic syndrome (MS) among Chinese adults and provide directions for designing healthcare promotion schemes for improving MS awareness in the community. Design: The study adopted a cross-sectional design and a convenience sampling method. Method: Chinese adults aged 18–65 years and living in the community completed a self-administered questionnaire, providing socio-demographic information and indicating their knowledge of MS using a validated knowledge of MS (K-MS) scale comprising 10 multiple-choice questions. The scores of K-MS can range from 0 to 100. Results: A total of 297 participants were recruited (mean age = 51.3 ± 8.9 years), 66.7% of whom were women. More than half of all participants ( n = 154) were identified as having MS and numerous participants were obese ( n = 158). The mean K-MS score was 44.9 out of 100; most participants (61%) scored below 50, indicating a poor level of MS knowledge. Participants who were older, had a lower level of education or were unemployed scored the lowest. Conclusion: Acquiring knowledge of MS is crucial for preventing the development of type 2 diabetes and cardiovascular diseases. However, Chinese adults in a community setting exhibited poor understanding of MS. Public health efforts regarding primary prevention of cardiovascular diseases should be targeted at improving MS knowledge. Additional measures are needed to assist people in the low socioeconomic classes.

The Sexual Possible Selves and Strategies of First-Semester College Students: What Do They Hope for and Fear and How Do They Plan to Get There?

The purpose of this study was to expand research on emerging adult sexuality by examining first-semester college students’ (N = 282) possible selves and strategies related to sex, and by considering whether these varied by demographic characteristics. Students were first asked to describe what they expected and feared regarding sex and sexuality in the coming year and were then asked to articulate strategies for achieving goals and avoiding fears. Content analysis of participants’ responses to open-ended questions revealed that expected possible selves commonly discussed included abstinence, interpersonal relationships, physical/sexual health, and exploration. Fears commonly discussed included reputation, risk-taking behaviors, and rape/assault. Categorical comparisons indicated abstinence and interpersonal relationships were the most prominent foci of expected sexual possible selves (SPS) and strategies, and physical/sexual health was the most prominent focus of feared SPS and strategies. Chi-square analyses indicated significant variations in SPS, feared selves, and strategies based on sex, intercourse experience, and relationship type. Binomial logistic regression analyses indicated religiosity differences in the SPS and strategies of abstinence, explore/experiment, physical/sexual health, interpersonal relationship, and risk-taking behaviors. Implications for research and sexual health education for college-based populations are discussed.

The Double Standard at Sexual Debut: Gender, Sexual Behavior and Adolescent Peer Acceptance.

A sexual double standard in adolescence has important implications for sexual development and gender inequality. The present study uses longitudinal social network data (N = 914; 11-16 years of age) to test if gender moderates associations between adolescents' sexual behaviors and peer acceptance. Consistent with a traditional sexual double standard, female adolescents who reported having sex had significant decreases in peer acceptance over time, whereas male adolescents reporting the same behavior had significant increases in peer acceptance. This pattern was observed net of respondents' own perceived friendships, further suggesting that the social responses to sex vary by gender of the sexual actor. However, findings for "making out" showed a reverse double standard, such that female adolescents reporting this behavior had increases in peer acceptance and male adolescents reporting the same behavior had decreases in peer acceptance over time. Results thus suggest that peers enforce traditional sexual scripts for both "heavy" and "light" sexual behaviors during adolescence. These findings have important implications for sexual health education, encouraging educators to develop curricula that emphasize the gendered social construction of sexuality and to combat inequitable and stigmatizing peer responses to real or perceived deviations from traditional sexual scripts.

Women and Health: Women's Dual Roles as Both Recipients and Providers of Healthcare.

With the many economic, demographic, social and epidemiological global transitions, a Harvard-Penn-Lancet commission reviewed the current health status of women and its relationship to sustainability, and redefined the field as women and health. Four major recommendations were offered, insuring mechanisms to count women properly as providers and recipients of care, to value them by insuring protective policies, to treat and compensate them fairly and equitably, and to develop strategies to be accountable for sustaining and implementing the recommendations. However, without a life span approach to women, and their health, and without universal access to comprehensive health care, women's wellbeing and abilities to function up to their full capacities will be compromised. These recommendations have many implications for health care, education and practice.