Positive Health Behaviors Research Articles

Needs and Preferences for Remote-Delivered Mindfulness-Based Cognitive Therapy in Patients After Acute Coronary Syndrome: A Qualitative Study.

Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms. To guide MBCT adaptation for ACS patients for a future clinical trial, this qualitative study aimed to explore ACS patients' (1) symptoms after ACS, (2) needs for behavioral health treatment, (3) perspectives on mindfulness intervention and group videoconference delivery, and (4) willingness to self-collect dried blood spots in a research study. We compared ACS patients with and without depressive symptoms to highlight particularly relevant treatment topics for patients developing depression following ACS experience. From 2/2019-11/2019, we conducted semi-structured individual telephone interviews with N = 23 patients after ACS (N = 13 with and N = 10 without elevated depressive symptoms; 63.4 (SD = 8.5) years, 87% male, 96% non-Hispanic white, 7.1 (SD = 7.5) years since ACS). In qualitative content analyses, four independent coders coded each interview. Participants with depressive symptoms experienced emotional, physical, social, and health behavior problems, while those without depressive symptoms made positive health behavior changes and struggled with anxiety symptoms. Both groups were interested in a behavioral health treatment for emotional and social support. Most were willing to participate in a mindfulness group via videoconferencing; some preferred in-person, but accessibility and convenience outweighed these cons. Almost all were willing to self-collect dried blood spots and some were already familiar with this technique. ACS patients, especially those with depressive symptoms, need help managing a multitude of quality of life concerns that can be targeted with an adapted MBCT approach. A videoconference-delivered MBCT approach is of interest. Suggestions for adapting MBCT to target the needs of ACS patients are discussed.

Development, acceptability and usability of culturally appropriate survivor narrative videos for breast cancer treatment in Botswana: a pilot study

ObjectivesNarrative communication has demonstrated effectiveness in promoting positive health behaviours, delivering support and coping with complex decision-making. Formal research evaluating this intervention for cancer treatment in Africa is lacking. We...

Using FLO text-messages to enhance health behaviours and self-management of long-term conditions in South-Asian patients.

Cultural and communication differences faced by South-Asian (SA) ethnic minority groups have led to challenges in the delivery of health care and complex management of long-term conditions (LTCs). We aim to explore the use of text-messaging in SA communities, through the Florence (FLO) health messaging system utilised within U.K. health sectors, to enhance positive health behaviours and self-management. A mixed-methods approach was used for this study involving two phases. Phase 1 includes the administration of the patient activation measure to assess SA patient level of skills, knowledge, and confidence to self-manage their LTC; whilst in Phase 2 semi-structured interviews were conducted, exploring the experiences of users and non-users of FLO text messaging to promote self-management behaviours. Forty participants (Florence users (n = 20) and non-users (n = 20)) completed the patient activation survey once after using FLO, and took part in interviews. Differences were noted to exist between the two groups (p < .01). Users appeared to have higher activation levels and better self-management behaviours (p < .01 (p = .00). Interviews elicit participants' perceptions of the text messaging system, along with key themes relative to behavioural constructs: socio-demographical factors; influencing behaviour changes, self-management, and uptake of text messages amongst SA ethnic minorities. Text messaging and mHealth are being extensively used amongst general populations to monitor and enhance health. The study of SA patient experiences and their use of text messages within the United Kingdom (UK) remains scarce. Therefore, results from the study identify health beliefs that influence patient engagement with digital health interventions and their self-management. Developing policies and culturally appropriate education guidelines for healthcare practitioners can allow for the provision of culturally sensitive interventions tailored in terms of normative, cultural, and religious beliefs; which in turn will address crucial aspects including SA patient information and educational needs supporting their self-management journey.

Black Female Adolescents and Sexual Violence: A Quantitative Investigation

Abstract: According to the Centers for Disease Control and Prevention, Black teenagers are disproportionately impacted by sexual violence. It is estimated that millions of Black teens experience intimate interpersonal violence each year. Black girls are more likely than any other marginalized group to experience sexual violence. According to the National Center on Violence Against Black Women, it is estimated that one in four Black girls will be sexually assaulted before the age of 18. The more information one has concerning how social determinants serve as conduits and barriers to the prevalence of sexual violence, the more beneficial to all communities, and especially Black girls and women. To help fill this gap in knowledge, this paper utilizes critical race theory and intersectionality as theoretical frameworks; employs secondxary analysis of the Black adolescent girls sample within the Adolescent Behaviors and Experiences Survey from the Centers for Disease Control and Prevention, as well as hierarchical logistical regression modeling to examine the relative impact of positive health behaviors, sexual behavior, and key demographics on whether a respondent had ever experienced sexual violence. Further, to examine gender differences across these relationships for Black adolescents, analyses are performed first for both genders and then separately for male and female respondents. The findings suggest that Black adolescent females who do not engage in risky health behaviors are less likely to experience sexual violence. This study demonstrates that the experience of sexual violence is not directly correlated with risky health behaviors, but the results do suggest that overindulgence in any of the identified risky behavior could create a climate conducive for the experience of sexual violence.

Dietary practices for older adults in institutional and non-institutional gerontological care

The aging process dictates the daily energy needs of the elderly (aged 65 years and older) and their food intake, which depends on basic physiological needs, physical activity, individual needs of the elderly and many other factors, where monitoring of gerontological public health indicators is extremely important for health protection. This is precisely why this work is focused on reviewing the role and compliance of positive health behavior related to healthy diet of the elderly, geronto-tropometric characteristics of nutritional assessment, assessment of nutritional status via the NRS 2002 web service, assessment of energy needs of the elderly in relation to age, physical activity, morbidity, ratio of intake of macronutrients and micronutrients and the importance of the eight dietary rules for the elderly population. The main causes of mortality in the population aged 65 and over were singled out, and the main dietary norms from the manual “Nutritional-gerontological norms/menus in homes for the elderly and gerontological centers of institutional and non-institutional gerontological care” were singled out. The results state the adequacy of the quality of the menus (according the health status), as well as the importance of compliance with the energy and nutritional needs of the elderly, which will result in a healthy body mass (normal body mass index). Such achievements require an interdisciplinary approach that mainly contributes to the preservation of functional ability, disease prevention and improvement of health and quality of life in old age.

Kontrola zdrowia u dzieci w wieku szkolnym

The contemporary young generation is struggling with an increasing tendency to engage in anti-health behaviors. The process of health locus of control is influenced by many determinantsof health, both in physical and mental terms. The influence of all determinants, family and peer environment, or socio-economic status can contribute to positive or negative health behaviors, and thus shape internal or external health locus of control among children.

Impact of Digital Learning Platforms on Behaviour Change Communication in Public Health Education

This conceptual research explores the transformative potential of digital learning platforms in the realm of behaviour change communication within the context of public health education. With the rapid advancement of digital technology, the traditional methods of health communication are being reimagined, offering new opportunities and challenges for promoting healthier behaviours and lifestyles. The research seeks to understand the evolving landscape of digital learning platforms and their integration into public health education programs. It investigates how these platforms can be leveraged to design and disseminate behaviour change communication interventions effectively. The study examines the theoretical foundations that underpin behaviour change communication and the ways in which digital learning platforms can enhance these foundations. Furthermore, the research addresses the critical issue of accessibility and inclusivity, as digital platforms have the potential to bridge the gap between diverse populations in terms of health literacy, socio-economic status, and geographical location. By employing a conceptual framework that combines elements of health communication theory, pedagogy, and technology adoption models, this study aims to provide insights into the effective utilization of digital learning platforms for behaviour change communication. Findings indicate that the use of digital learning platforms has led to increase engagement in public health education. This exploration is expected to shed light on the potential of these platforms to drive positive health behaviour change among diverse populations and pave the way for more informed strategies in the field of public health education. Ultimately, this research aims to encourage further exploration and development of digital learning tools for behaviour change communication in public health, with the potential to make a significant impact on global health outcomes.

THE ROLE OF SENSE OF PURPOSE IN HEALTH NAVIGATION AMONG MARGINALIZED OLDER ADULTS

Abstract A sense of purpose is a central, self-organizing life aim that guides choices and behaviors . In older adulthood, having a sense of purpose is linked with positive health. Understanding how older adults who identify as socially marginalized (e.g., racially/ ethnically diverse, LGBTQ+) leverage purpose to navigate their health, for example, when setting health values, making health decision, or adapting to health challenges may support development of tailored resources to combat social disparities embedded in healthcare systems.. This study used qualitative thematic analysis (Braun &amp; Clarke, 2012). to explore the role of purpose in marginalized older adults’ current health navigation and including how purpose and health navigation change across adulthood. Nineteen older men and women who identified as socially marginalized (Mage = 66.5) participated in semi-structured interviews Analyses revealed that older adults draw on purpose to guide health by maintaining personally meaningful, health-related (e.g., health education, caregiving) vocations into late life and by modeling positive health behaviors for others . Further, the role of purpose in health navigation changed across their adulthoods: participants described shifts from adversity-driven purpose to wellness-focused purpose, translating early adversity into current health motivation, and finding space for their authentic purpose when health was considered to stabilize. Findings demonstrate that, for marginalize older adults, their relationship with their own health may improve across the lifespan as they overcome adversity and health becomes enmeshed in purpose. Findings support refining health interventions to account for the role of purpose for older adults who have faced undue social hardship.

Oral Health Knowledge, Attitudes, and Clinical Practices of Pediatricians and Pediatric Residents: A Cross-Sectional Study.

Background Pediatricians are the first line in the provision of healthcare for children. They can make an important contribution to the oral health of their patients because they usually see children and parents early and frequently in life. This study aims to assess the pediatricians' and pediatric residents' oral health knowledge, attitudes, and practices with patients. Methods A structured English survey was developed based on previous surveys in the literature. It collected data on oral health knowledge, attitudes, and practices. Pediatricians were visited and invited to take the survey. A link to the survey was sent via email to all pediatric residents. An oral health practice score was created based on participants' responses to the practice questions, and a linear regression assessed its predictors.Frequencies of oral health knowledge, attitudes, and practiceswere presented and compared between both groups by the chi-square test. Results A total of 218 pediatricians and residents were surveyed. The oral health knowledge was low overall, but it was higher among pediatricians, 10.0±1.9, compared to the residents, 8.2±2.5 (P<0.001). The attitude ranged from 66.3% agreeing with the statement "Limited time with patients makes it difficult to integrate oral health into primary care practice" to 87.4% agreeing with the statement "Primary healthcare physicians should know their local dentists to facilitate dental referral and treatment." Overall, pediatricians practice positive oral health behaviors more than pediatric residents, and higher knowledge levels predicted more positive oral health practices. Conclusion Despite acknowledging their important role in promoting oral health, pediatricians' and future pediatricians' knowledge is poor, and their participation in oral health continues to be limited. The potential for the non-dental workforce to greatly improve children's oral health is underexploited. The healthcare system should seek to integrate medical and dental practices better. Incorporating oral health into residency programs and providing continuous education courses are strongly encouraged.

Health status of childcare center providers in a COVID-19 hotspot.

Childcare center providers in Miami-Dade County, Florida a COVID-19 hotspot, are made up almost entirely of ethnic minority women. This is a critical frontline staff that is now encountering the triple threat of respiratory illnesses from respiratory syncytial virus (RSV), influenza viruses (or the seasonal flu), and COVID-19. To examine sociodemographic characteristics, anthropometrics, and health behaviors that were collected from a sample of CCC teachers in Miami Dade County, a COVID-19 hotspot. Cross-sectional data were used from Healthy Caregivers, Healthy Children (HC2), a randomized controlled intervention trial (#NCT02697565) for healthy weight maintenance among children 2-to-5 years old, conducted in 24 subsidized childcare centers in MDC in 2015-2018. Prevalence was determined by frequency or mean/standard deviation of each variable. Chi-squared analyses were performed to test for differences in BMI categories. In this sample of childcare center providers (n = 255), the majority (61%) had an elevated body mass index. Positive health behaviors such as regular exercise and eating fruits and vegetables were only reported in about a third of the sample. It is vital that we encourage the uptake of regular vaccination schedules as a means to protect our community, especially the critical frontline workers that have been caring for our young children.

Healthy Behaviors Among Non-Hispanic Black and Hispanic People Affected by Cancer During the Posttreatment Survivorship

Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors’ experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people. Objective This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis. Methods The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used. Results The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system–related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma). Conclusion Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living. Implications for Practice Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.

5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024.

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Acceptability and barriers of a GP-physiotherapist partnership in the diagnosis and management of COPD in primary care: A qualitative study.

Chronic obstructive pulmonary disease (COPD) is commonly diagnosed and managed in primary care but there is evidence that this has been suboptimal, with low confidence expressed in providing interventions requiring behaviour change. The aim of this study was to determine the acceptability of a general practitioner (GP)-physiotherapist partnership in the diagnosis and management of COPD in primary care and to explore the experiences of participants during the implementation of the model. Semi-structured interviews were conducted with physiotherapists (n = 3), GPs (n = 2), practice nurses (PNs) (n = 2) and patients (n = 12) who had participated in the InNovaTivE Gp-physiotheRapist pArTnErship for copD (INTEGRATED) trial. We sought to explore participants' views about their experiences and perceived benefits, barriers and facilitators to the implementation of this model of care. Interviews were transcribed, coded and thematically analysed. Synthesis of the data was guided by the Theoretical Domains Framework for clinician interviews and the health belief model for patient interviews. All clinicians felt that this integrated model helped to optimise care for patients with COPD by facilitating evidence-based practice. GPs and PNs valued the physiotherapist's knowledge and skills relating to diagnosis and management, which was reported to complement their own management and improve patient outcomes. Patients reported a sense of empowerment following their appointments and acknowledged improved self-management skills. However, physiotherapists reported many patients were already engaging in positive health behaviours. Responses were mixed on the effectiveness of the model in facilitating teamwork between clinicians with different perspectives concerning management, communication pathways and logistical issues, such as time and room availability, being cited as barriers. An experienced cardiorespiratory physiotherapist embedded into a small number of primary care practices to work in partnership with GPs for COPD diagnosis and management was acceptable and viewed as beneficial for patients. Barriers relating to logistics and resources remain, which must be addressed to optimise implementation. Patient input was obtained from qualitative feedback from a prior study conducted by two authors and was used to refine the model of care to determine the added value of a physiotherapist integrated into the primary care team. This feedback was also used to refine the interview guides utilised in this study determine the acceptability of this model of care. We had health service involvement from the rehabilitation service of the local health district who were directly involved in determining study aims and establishing the project around the priorities for their chronic disease integration service. For example, this project aimed to engage with a less severe patient population in primary care who would benefit from pulmonary rehabilitation. The findings from this study will be used to further tailor the model of care to the needs of the public and patients. ACTRN12619001127190.

Abstract A105: Healthy behaviors among non-Hispanic Black and Hispanic people affected by cancer during the post-treatment survivorship

Abstract Background: Racial and ethnic minoritized people, historically experience inequities, are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in Non-Hispanic Black (NHB) and Hispanic people. Objective. This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis. Methods. The data was collected in a mixed-method study through semi-structured interviews with 29 NHB and Hispanic cancer survivors between June- October 2022. Conventional content analysis was used. Results. The lived experiences of cancer survivors were narrated in three themes; 1- Impact of a cancer diagnosis on oneself, 2- Facilitators and Barriers to health and health behaviors, and 3- Utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (e.g., symptoms, comorbidities), behavioral (e.g., help-seeking behavior, sleep pattern), physical/built environment (e.g., available sources, neighborhood), and sociocultural environment (e.g., income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (e.g., insurance coverage, personal preferences, perceived discrimination, and stigma). Conclusion. NHB and Hispanic people affected by cancer, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, appeared to have challenges prioritizing health behaviors and maintaining healthy living. Implications for Practice. Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners. Keywords. Cancer survivorship, health behaviors, racial disparities, non-Hispanic Black and Hispanic people Citation Format: Memnun Seven, Ann Marie Moraitis, Marilyn J. Hammer, Jessica Pearlman, Allecia Reid, Susan Sturgeon, Jennifer Wenzel. Healthy behaviors among non-Hispanic Black and Hispanic people affected by cancer during the post-treatment survivorship [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A105.

Abstract A139: Examining the association of cardiovascular health attainment with cancer screening adherence in community-dwelling Black women

Abstract Purpose of the study Cancer and cardiovascular disease are leading causes of death in the United States and share modifiable risk factors. Increasing ideal cardiovascular health indicated by the American Heart Association’s Life’s Simple 7 metrics (LS7: blood pressure, glucose, cholesterol, body mass index, physical activity, and smoking) and cancer screening adherence are both associated with reducing cancer-related mortality. However, there have been no studies to identify associations between LS7 and cancer screening adherence. It is well documented that people adopting positive health behaviors like physical activity and healthy eating have higher cancer screening adherence. Unfortunately, disparities by race exist in both engagement in health behaviors (key metrics of LS7) and cancer screening. Cancer screening disparities between Black and White women have narrowed over time; however, there are disparities in LS7 attainment by race. Here, we examined the association of LS7 attainment with screen detectable cancer (breast, cervical, and colorectal) adherence in Black women. Methods The Partnering in Negating Statistics (P.I.N.S.) for Black Women Initiative promotes health and wellness among Black women. Its community wellness events provide health education, screenings (e.g., breast, cervical, and cardiovascular health), and research participation opportunities. At P.I.N.S. events, LS7 metrics (score range 0-14) and self-reported cancer screening history were collected. The associations of LS7 with cancer screening adherence were examined using multinomial logistic regression adjusting for age, income, and education. Results In 2021 and 2022, 296 Black women participated in cardiovascular health screenings. They had a mean age of 50.1 years (SD 14.1); 66% employed; 88% insured; 69% with educational attainment ≥ college. The 166 participants with complete LS7 data had intermediate cardiovascular health with a median score of 8 [7-10]. In age adjusted models, a 1-unit increase in LS7 attainment was associated with a 45% higher odds of breast cancer screening adherence (OR 1.45, 95%CI: 1.03, 2.05; n=93), which was similar with full adjustment (OR 1.50, 95% CI: 0.95, 2.39; n=91). There was no association of LS7 attainment with cervical (OR 1.09, p=0.40; n=124) or colorectal cancer (OR 1.05, p=0.70; n=84) screening adherence. Conclusions In community-dwelling Black women, increasing LS7 attainment may increase odds of breast cancer screening adherence. Research with a larger sample is needed. Citation Format: Timiya S. Nolan, Songzhu Zhao, Amaris Williams, Guy Brock, Stephanie S. Ogonuwe, Faith Metlock, Alicia McKoy, Loletia Davis, Aldenise P. Ewing, Karen Patricia Williams, Electra D. Paskett, Joshua J. Joseph. Examining the association of cardiovascular health attainment with cancer screening adherence in community-dwelling Black women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A139.

Dental public health education in Egypt: a cross-sectional survey

Background and aimDental Public Health (DPH) education prepares future workforce to promote positive oral health behaviors, prevent oral diseases, and monitor disease distribution and trends taking into considerations best practices, needs and available resources. Scarce information is available about dental education in African countries and Egypt has the greatest number of dental schools in Africa. This study assessed the undergraduate DPH education in Egyptian universities including topics taught, methods of teaching, assessment, and the academics’ specialties.MethodsA survey targeted 43 Egyptian universities with Bachelor of Dentistry (BDS) programs identified on the website of the Supreme Council of Egyptian Universities in 2022. Thirty-six deans could be reached by post and/ or email. The survey appraised the school profile and capacity, and methods of teaching and assessment in DPH courses in undergraduate dental programs. The survey also inquired who taught DPH courses and what was covered in the courses. Descriptive statistics were displayed.ResultsWe received 21 (58.3%) responses from 36 deans/ senior officials. Of the universities, 52.4% were private and 47.6% were public. Most participants reported that DPH courses in BDS programs were taught by Pediatric Dentistry academics (71.4%) and DPH academics (57.1%) in 3rd, 4th and 5th years of the 5-year BDS programs. Teaching DPH consisted of face-to-face lectures (100%) and seminars (95.2%) and assessment included written exams with close ended questions (95.2%) and open-ended questions (71.4%). Twenty schools reported teaching the definition of DPH, definition of oral health, and determinants of oral diseases. Nine schools addressed the planning of oral health services and five schools taught about remuneration and payment systems.ConclusionTeaching and assessment of DPH in Egyptian dental schools use traditional methods with limited active engagement of the students. Variations among the schools exist in the DPH topics covered and most instructors were not primarily specialized in DPH. Development of dental/ oral health services calls for more emphasis on DPH education in the curriculum in Egypt.

Promoting Inclusivity in Physical Education and Health With the Theory of Multiple Intelligences

By integrating Howard Gardner’s theory of multiple intelligences (MI theory) into health and wellness education, we can honor student uniqueness, promote inclusivity in the learning space, and increase the adoption of positive health behaviors. The MI theory proposes that every individual possesses unique strengths and weaknesses for learning that are characterized within eight intelligences: linguistic, logical-mathematical, spatial, musical, bodily-kinesthetic, interpersonal, intrapersonal and naturalistic. Wellness educators can center these intelligences and structure materials in a way that offers opportunities to engage more of the intelligences through student-centered practices. Doing so employs individual student strengths and fosters development in areas of weaknesses. Utilizing this theory in the planning of health and physical education content has an opportunity to increase understanding and enjoyment of lessons by establishing inclusive spaces for all students to engage in learning.

Enhancing Perceived Health Competence: The Impact of Persuasive Social Support Features in Health and Fitness Apps

This study investigates how users’ perception of persuasive social support features influences perceptions of their health competence in health and fitness apps. Within the support of existing theories/frameworks on social support, the study develops a research model and hypotheses. Quantitative data was collected from 469 health and fitness app users and analyzed using partial least squares structural equation modelling. The results demonstrates that providing users with a means to share their experiences out of the desire to boost their ego and gain social recognition as well as a means to learn new behaviors by observing and imitating other’s behaviors within the app increases their confidence in their capabilities to perform and maintain positive health and fitness behaviors and outcomes using the app. The findings suggest that users’ perception of their health competence can be significantly improved when social support features are incorporated into health and fitness apps.

Dental professionals’ views on motivational interviewing for the prevention of dental caries with adolescents in central Norway

BackgroundEstablishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients.MethodsAs part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level.ResultsA total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists.ConclusionsA high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.

Guideline evaluation and implementation mechanisms in school health services (GuideMe): protocol for a hybrid randomized factorial trial

BackgroundNorwegian school health services received a national best-practice guideline in 2017. To promote healthy life skills and identify adolescents needing support, the guideline includes strong recommendations for individual consultations with all 8th graders and increased collaboration with schools. To help implement the recommendations, a blended implementation strategy (SchoolHealth) was co-created with school nurses, students, and stakeholders. SchoolHealth consists of three implementation elements: Digital dialog and administration tool (audit and feedback +), Dialog support (external consultation), and Collaboration materials (targeted dissemination). This hybrid study will test the main and combined effects of the elements on guideline fidelity and effectiveness.MethodsThe GuideMe study is a factorial cluster randomized controlled trial examining SchoolHealth's effectiveness on guideline fidelity and guideline effectiveness goals. Forty Norwegian secondary schools will be randomized to eight different combinations of the elements in SchoolHealth. Participants will include school nurses and school personnel from these schools, and 8th grade students (n = 1200). Primary outcomes are school nurses' fidelity to the guidelines and student's ability to cope with their life (i.e., health literacy, positive health behaviors and self-efficacy). Quantitative methods will be used to test effects and mechanisms, while mixed- and qualitative methods will be used to explore mechanisms, experiences, and other phenomena in depth. Participants will complete digital questionnaires at the start and end of the schoolyear, and after the consultation during the schoolyear. The study will run in two waves, each lasting for one school year. The multifactorial design allows testing of interactions and main effects due to equal distribution of all factors within each main effect. Sustainment and scale-up of optimized SchoolHealth elements using national infrastructure are simultaneously prepared.DiscussionThe study will investigate possible effects of the implementation elements in isolation and in combination, and hypothesized implementation mechanisms. In-depth study of user experiences will inform improvements to elements in SchoolHealth. The results will yield causal knowledge about implementation strategies and the mechanisms through which they assert effects. Mixed-methods will provide insights into how and when the elements work. Optimizing guideline implementation elements can support adolescents in a crucial life phase.Trail registrationISRCTN24173836. Registration date 8 August 2022.