Quasi-experimental Research Articles

The effectiveness of mindfulness-based therapy on enhancing adjustment and reducing impulsivity among Iranian couples

The aim of this study was to assess the effectiveness of a mindfulness-based training program in improving marital adjustment and reducing impulsivity among Iranian couples. The study used a quasi-experimental design with two groups: experimental and control. The sample of the current study consisted of 16 married couples from the city of Tehran, totaling 32 participants. The participants were randomly assigned to two groups, experimental and control, with each group consisting of 8 couples. The results indicated the effectiveness of the mindfulness program in enhancing marital adjustment, with the posttest mean rising to (2.86), and the average impulsivity score decreased to 2.59, indicating a significant reduction in impulsivity among Iranian couples. Mindfulness-based therapy directly affects participants’ ability to regulate immediate emotions. This increased awareness significantly helps in managing harmful mental behaviors such as impulsivity, substance abuse, and poor adaptability. Future research should investigate the broader effects of mindfulness on mental and behavioral outcomes, with a focus on addressing impulsivity in young couples. Additionally, incorporating mindfulness-based therapy for couples both before and during marriage could enhance interpersonal relationships and overall quality of life.

An Innovative STEAM-Based Method for Teaching Cycloidal Curves in Engineering Higher Education

Robotics offers innovative possibilities at all levels of education, which should be considered when planning the teaching process for certain engineering mathematics topics in higher education. This paper introduces a new teaching–learning technique that utilizes STEAM-based methods to explore cycloidal curves for Computer Science Engineering BSc students. Traditional frontal teaching has been enhanced with methods addressing the generational needs of students, including problem-based learning, STEAM integration, and project-based learning. We developed a methodological model that merges traditional teaching advantages with practical modern approaches suitable for Generation Z. The four-stage model for learning cycloidal curves employs various didactical approaches, utilizing different learning techniques at each stage to create an engaging and effective learning experience. A vital component of this model is the use of Desmos dynamic geometry software to create animations alongside educational robotics to aid visualization. We conducted quantitative studies with 98 first-year Computer Science Engineering students using a quasi-experimental research design to evaluate the new teaching technique’s effectiveness. Results from the Mann–Whitney U test indicated that the experimental group significantly outperformed the control group. Additionally, the Kruskal–Wallis test confirmed that the four-stage model for learning cycloidal curves enhances learning achievement for all students, regardless of their prior knowledge.

The Effectiveness of Word Wall Media on Students' Vocabulary Mastery

The purpose of this study was to investigate the effects of word wall media on students' vocabulary mastery in the seventh grade of SMPN 8 Rupat. The research applied a quasi-experimental design, with two classes as the experimental and control groups. This study used a one-equivalent control group design (pre-test and post-test). The samples for this research were 36 students in VII-1 and VII-2 classes. According to the result, the average for the pre-test was 33.42, while the average for the post-test was 76.15. For more details, a paired T-test was conducted on the students' pre-test and post-test scores. The results revealed that students taught with Word Wall media showed improved vocabulary mastery compared to their counterparts because the sig. (2-tailed) value following the paired sample T-test is 0.000, which is smaller than 0.05.

Improving Mental Health Outcome in Hypertensive Patients: The Role of Relaxation Techniques

Background: Relaxation techniques (progressive muscle relaxation and deep breathing) have an impact on the patients with hypertension as they produce a relaxation response within the body and thus, are efficient in lowering the stress and blood pressure in the patients. Objective: This study aims to determine the role of relaxation techniques (progressive muscle relaxation and deep breathing) on improving mental health outcome in hypertensive patients (depression, anxiety and stress). Methodology: A Quasi-experimental design used to guide this study, it was conducted by use of a pre-posttest approach during the period 26th of November, 2023 to 7th of April, 2024. A non-probability (purposive) sampling has been performed during a selection of (100) patients who attending Outpatient Clinic in Al-Diwaniyah Teaching Hospital, (50) patients as control group and (50) patients as study group. The researcher used a socio-demographic and psychological parameter scale (DASS-21). Results: The findings of the current study show highly statistically significant differences in post-test between study and control group (at P ≤ 0.001). On other hand, there is no statistically significant difference in the pre-test between the two group of all psychological parameter (at P ≤ 0.05). Conclusion: Based on the study's findings, progressive muscle relaxation and deep breathing exercises can both proved to be significantly effective in improve mental health in hypertensive patients (depression, anxiety and stress). Recommendations: In order to reduce hypertension and other psychological parameters in patients with essential hypertension, the researcher suggested combining pharmacological therapies with non-drug therapy (relaxation techniques intervention) in the management of hypertension.

Socio-Formative Didactic Strategies to Strengthen Social Skills in Medical Technology University Students, 2021

The results of the investigation were aligned with the objective of determining the influence of the program in the strengthening of social skills in university students of Medical Technology of the National University of Jaén. It is an applied, explanatory, longitudinal research, with a quantitative approach and quasi-experimental design, with pre-test and post-test in experimental and control groups. The hypothetical-deductive method was used, with a population of 289 students and 80 for the sample. The Observation Form and the Social Skills Evaluation Scale were used. The results showed a good to excellent level of social skills in all the participants of the experimental group of the II and VI cycle. The means per academic cycle increased by 32 and 35.75 respectively. By dimensions according to academic cycle, the first social skills increased by 6.2 and 5.4, advanced social skills by 5.05 and 4.85, skills related to feelings by 5.45 and 5.1, alternative social skills to aggression by 3.95 and 6.7, social skills to cope with stress by 7.4 and 8.45, and finally social planning skills by 3.95 and 5.25 respectively. In conclusion, the program has a significant influence on strengthening social skills in university students, with a greater influence in the experimental group of the VI cycle (35.75 percentage points).

Effectiveness of a health literacy intervention targeting both chronic kidney disease patients and health care professionals in primary and secondary care: a quasi-experimental study.

Chronic kidney disease (CKD) patients with limited health literacy are at risk for faster disease progression. To counteractthis problem, we developed 'Grip on your Kidneys' (GoYK), an intervention targeting patients and health care professionals. We assessed the effect on self-management, patient activation, clinical parameters, consultation quality, and the professionals' use of health literacy strategies. We further evaluated the process. A quasi-experimental study included 147 patients with CKD and 48 professionals from Dutch general practices and nephrology clinics. Patients and professionals in the intervention group (IG) received GoYK. Control patients received care-as-usual from the participating professionals. Data were collected with questionnaires and from patient records at baseline (T0), 4months (T1) and 9months (T2). No effects on self-management and patient activation were found. Conversely, at T2, the proportion of patients with hypertension decreased in the intervention group (odds ratio = 0.45, 95% confidence interval (95%CI) [0.20, 0.99]). In the intervention group, more lifestyle topics were discussed, at T1 (difference = 0.80, 95%CI [0.28, 1.31]) and T2 (difference = 0.69, 95%CI [0.14, 1.25]). Furthermore, several outcomes related to consultation quality improved. Professionals in the intervention group improved the use of health literacy strategies more, at T1 (difference = 0.64, 95%CI [0.33, 0.95]) and T2 (difference = 0.56, 95%CI [0.19, 0.93]). In general, patients and professionals considered GoYK to be useful. GoYK is promising, and offers a blueprint to optimize care for patients with limited health literacy. Researchers should develop and test interventions like GoYK, focusing on patients at risk for CKD, and with very low health literacy.

Effect of Custom-Made Foot Orthotics on Multi-Segment Foot Kinematics and Kinetics in Individuals with Structural Hallux Limitus.

The first metatarsophalangeal joint (MTPJ) and the first ray are crucial in walking, particularly during propulsion. Limitation in this joint's sagittal plane motion, known as hallux limitus, can cause compensatory movements in other joints. Some studies assessed the impact of various foot orthoses designs on the foot biomechanics; however, a comprehensive understanding is lacking. This study compared the effects of two custom-made foot orthoses (CFOs) on the foot joint kinematics and kinetics in patients with structural hallux limitus (SHL). In this quasi-experimental study, 24 patients with hallux limitus were assessed in three conditions: (i) barefoot, (ii) shod with a cut-out custom foot orthosis (cut-out CFO), and (iii) shod with an anterior forefoot-stabilized element custom foot orthosis (AFSE CFO), fitted into a minimalist neoprene shoe. Multi-segment foot kinematics and kinetics were assessed during the stance phase of the gait. A decrease in ankle and midfoot inversion, as well as in ankle plantarflexion, was found in both orthotic conditions. Regarding the first MTPJ, a greater dorsiflexion was observed with the patient being barefoot compared to both of the conditions under study. From the current finding, it should be concluded that neither of the custom foot orthoses produced the predefined functional effects.

The effect of structured psychoeducation for caregivers of ALS patients on perceived stress, psychological resilience and self-compassion.

Patients diagnosed with amyotrophic lateral sclerosis (ALS) become dependent on caregivers to meet their daily needs and perform personal care activities. For this reason, ALS is a disease that can challenge both the patient and the caregiver physically, mentally and socially. Supporting the caregiver indirectly affects the patient's quality of care and mental well-being. Therefore, this study aimed to determine the effect of a structured psychoeducation program on coping with stress, psychological resilience and self-compassion in caregivers of ALS patients. This quasi-experimental study with a pre-test-post-test control group was conducted with caregivers of 62 ALS patients in Türkiye. The study was conducted between July 2023 and February 2024. A psychoeducation program was applied to five different groups via zoom application for 6 weeks each. The survey form, Perceived Stress Scale, Brief Resilience Scale and Short Form of Self-Compassion Questionnaire were used as measurement tools. The chi-squared test and paired samples t-test were used to analyze the data. While there was no significant difference between the intervention group and the control group in the pre-test in terms of their mean scores on the coping with stress inventory, short psychological resilience scale and self-compassion scale, at the post-test, psychological resilience and self-compassion scores were significantly higher in the intervention group. This study revealed that psychoeducational programs that support caregivers are effective in increasing psychological resilience and self-compassion.

Does green transportation affect carbon emission efficiency? Evidence from a quasi-experimental study in China

The establishment of a low-carbon transportation system (LCTS) holds prominent importance in advancing modern transportation development and achieving green growth. Employing the LCTS pilot policy as a shock to green transportation construction in China, we investigate its influence on carbon emission efficiency (CEE) using urban panel data from 2006 to 2021. Results based on difference-in-differences (DID) show that LCTS contributes to increasing CEE following such a pilot policy. This finding still holds after we perform a propensity score matching DID method, double machine learning, instrumental variable method, heterogeneous treatment effect, and other robustness checks. Meanwhile, the mediation analysis shows that the increased CEE can be accounted for by spurring green innovation activities. Moreover, the moderation outcomes reveal that FinTech exerts a positive moderating influence on the increased impacts of LCTS on CEE. Heterogeneity analysis shows that LCTS's impact on CEE varies by region and development level. Overall, our research stresses the importance of green transportation construction in shaping CEE, which has significant practical and theoretical implications for scholars and policymakers.

The effect of guided group reflection on the ability and convenience of breaking bad news in pre-hospital emergency staff

BackgroundBad news refers to any information that create negative changes in a person’s understanding or expectations of in present and future. Breaking Bad News (BBN) is a stressful task that may have disturbing effects on the professional performance and general health of the medical staff. Pre-hospital emergency staff often needs to deliver bad news to the patient or his family. This study was conducted to determine the effect of guided group reflection training on the ability and comfort of BBN in pre-hospital emergency staff.MethodsThis quasi-experimental study was conducted on 95 staff of the pre-hospital emergency, in the test and the control groups. For the test group, a 4-hour training workshop on BBN was held, and then a group was formed in virtual space to discuss and exchange opinions about the scenarios of BBN and reflecting on it. Data collection tools were SPIKES Questionnaire and the Visual Analogue Mood Scale. The data were analyzed with SPSS V.18.ResultsThe mean score of the ability to BBN after the intervention was 44.01 ± 6.21 in the test group and 31.40 ± 4.51 in the control group, and a significant difference was found using the independent t-test (P = 0.0001). Besides, the mean scores of the convenience of BBN in post-test was 5.52 ± 1.64 in the test group and 3.50 ± 1.28 in the control group using the independent t-test with a significant difference (P = 0.0001).ConclusionAccording to the findings, training in guided group reflection improved the ability to BBN and its convenience in pre-hospital emergency staff. Therefore, it is suggested the use of this method in training for health care providers. Relating to BBN.

Effect of modified constraint-induced movement therapy along with bimanual massed practice on upper extremity functions in tetraplegics: a pilot study

Background and objectiveConstraint-induced movement therapy is a widely used rehabilitation program in the stroke population, but its application in spinal cord injury is limited. The objective of the study is to determine the feasibility of modified constraint-induced movement therapy (mCIMT) in incomplete tetraplegia exhibiting upper limb weakness and activities of daily living (ADLs) difficulty.MethodThis is a quasi-experimental one-group pilot study, consisting of 12 subjects diagnosed with incomplete tetraplegia. They received 2-h sessions of modified constraint-induced movement therapy of the weaker hand along with a 1-h session of bimanual massed practice, 5 days a week for 3 weeks. Apart from this, they were asked to do 3 h of constrained-induced movement therapy daily 5 days a week for 3 weeks at their home as a part of a home exercise program. Box and block test (BBT) and Spinal Cord Independence Measure version III (SCIM-III) were taken as the primary measure, and manual function test (MFT) and capabilities for upper extremity (CUE) were used as secondary measures to access hand functions and ADLs. Subjects were examined during pre-intervention and post-intervention.ResultsAfter 3 weeks of intervention, the mean change of the score for the trained hand showed significant changes in the scores of the box and block test (p = 0.03), manual function test (p = 0.02), SCIM-III (p = 0.03), and CUE (p = 0.02).ConclusionThis preliminary study revealed that modified CIMT may be a feasible and effective alternative for hand rehabilitation in incomplete tetraplegia.

Choking under pressure in online and live esports competitions

This paper explores the phenomenon of choking under pressure within the context of esports, particularly focusing on the difference between online and live competitive settings and on high-pressure situations during overtime rounds. Employing a quasi-experimental design, the research leverages an extensive dataset covering professional CS:GO matches from 2012 to 2022 (match-level) and from 2015 to 2023 (round-level), including performance metrics such as players' ratings, headshot percentages, and teammate damage. The findings indicate a substantial decrease in the performance of esports players during overtime. This effect, however, is significantly mitigated in online competitions compared to live events. The study also reveals that while individual performance suffers under pressure, the impact on team coordination is less pronounced in online settings, suggesting that the virtual environment might offer a buffer against the negative effects of stress on team dynamics. This study enriches our understanding of performance psychology in digital settings but also opens up new avenues for research on stress, teamwork, and performance in professional and virtual environments.

Interventions to mitigate EHR and documentation burden in health professions trainees: A scoping review.

Health professions trainees (trainees) are unique as they learn a chosen field while working within electronic health records (EHR). Efforts to mitigate EHR burden have been described for the experienced health professional (HP), but less is understood for trainees. EHR or documentation burden (EHR burden) affects trainees, although not all trainees use EHRs, and use may differ for experienced HPs. To develop a model of how interventions to mitigate EHR burden fit within the trainee EHR workflow: the Trainee EHR Burden Model. 1) Examine trainee experiences of interventions aimed at mitigating EHR burden(scoping review). 2) Adapt an existing workflow model by mapping included studies(concept clarification). We conducted a 4-database scoping review applying PRISMA-ScR guidance, examining scholarly, peer-reviewed studies that measured trainee experience of interventions to mitigate EHR burden. We conducted a concept clarification categorizing, then mapping studies to workflow model elements. We adapted the model to intervenable points for trainee EHR burden. We identified 11 studies examining interventions to mitigate EHR burden that measured trainee experience. Interventions included: curriculum, training, coaching on the existing EHR for both simulated or live tasks; evaluating scribes' impact; adding devices or technology tailored to rounds; team communication or data presentation at end-of shift handoffs. Interventions had varying effects on EHR burden, most commonly measured through surveys, and less commonly, direct observation. Most studies had limited sample sizes, focused on inpatient settings, and physician trainees. Few studies measured trainee perspectives of interventions aiming to mitigate EHR burden. Many studies applied quasi-experimental designs and focused on inpatient settings. The Trainee EHR Burden Model, adapted from an existing workflow model, offers a starting place to situate points of intervention in trainee workflow. Further research is needed to design new interventions targeting stages of HP trainee workflow, in a range of clinical settings.

Effect of educational intervention based on the theory of planned behavior (TPB) on amount of salt intake in pregnant women with PreHypertension

BackgroundPrehypertension is one of the common disorders during pregnancy. Reducing salt intake is among the best cost-effective interventions to reduce the risk of hypertension. The present study aimed to explore the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on amount of salt consumed by prehypertensive pregnant women.MethodsThe present quasi-experimental study was conducted in 2022 on 61 prehypertensive pregnant women visiting the Comprehensive Health Services Centers in Birjand, Iran. Pregnant women were selected through a convenience sampling method and randomly assigned to intervention and control groups. A blood pressure test and a 24-hour urine test were taken in 3 stages (before, immediately after, and one month after the intervention). A reliable and valid questionnaire based on the TPB was used to measure the cognitive variables. The intervention program included three training sessions based on the TPB held on an online platform (WhatsApp social network). Data were analyzed using repeated measures ANOVA and longitudinal marginal model with the GEE approach in SPSS19. The significance level for all statistical tests was set at p < 0 0.05.ResultsAfter intervention, the mean score of perceived behavioral control (p = 0.02), intention (p = 0.004), and salt consumption behavior (p = 0.03) increased significantly in the intervention group, and the mean score of systolic blood pressure (p < 0.001) and diastolic blood pressure (P < 0.01) decreased significantly in this group. In the control group, a statistically significant difference was observed in the systolic and diastolic blood pressure of the subjects (p < 0.01). However, the score of attitude, subjective norms, perceived behavioral control, intention, salt consumption behavior and the daily salt intake did not show a statistically significant difference over time (P < 0.05).ConclusionThe present findings showed that the perceived behavioral control, intention, behavior, systolic and diastolic blood pressure can be modifiable variables to improve the amount of salt consumed by pre-hypertensive pregnant women. Therefore, we recommend that the present model be used to develop interventions to improve health indicators in pregnant women as a highly susceptible group in society.

The Effect of Implementation of Skin Care Guidelines on Nurses’ Knowledge Regarding Skin Care and Incidence of Skin Injuries Among Neonates at a Private Tertiary Care Hospital

Background: Skin care of sick newborns is important because skin acts as a barrier to prevent neonates from infections which may lead to neonatal morbidity and mortality. The highly technological environment of the neonatal intensive care unit (NICU) makes them vulnerable to loss of skin integrity. In acute care setting maintenance of skin integrity is considered as an established quality indicator representing nursing care. Aim of Study: The study aimed to determine the effect of skin care guidelines on nurses’ knowledge related to skincare and the incidence of skin injuries among neonates. Methodology: Pre-post quasi-experimental study was conducted in the NICU of a private tertiary care hospital. A consecutive sampling technique was used. The intervention comprised educational sessions and demonstrations of skin care practices from AWHONN skin care guidelines. The data on the nurses’ knowledge were collected through self-developed and self-administered questionnaires. Skin injuries were recorded on a checklist through observation for 1 month before and after the intervention. A paired sample t-test was used for comparing knowledge and continuous demographical variables. While the incidence density ratio was calculated for skin injuries. Results: There was a statistically significant improvement in the nurses’ knowledge of skin care from pre (mean 15.06 ± 5.16) to post (mean19.40 ± 5.17) measurement P-value .001. Incidence density rate of skin injuries reduced from 19% to 3% after the implementation of skin care guidelines. Conclusion: Through the implementation guidelines nurses’ knowledge and practices regarding skin care improved while skin injuries among neonates were reduced.

A Quasi-Experimental Study on Code-Switching in Enhancing The Reading Comprehension Skills of ABEL Students

This quasi-experimental study investigated the effectiveness of code-switching in enhancing the reading comprehension skills of ABEL (Alternative Basic Education for Literacy) students at Agusan del Sur State College of Agriculture and Technology. A two-group design was implemented, with one group receiving instruction incorporating code-switching and the other using traditional English-only methods. Standardized tests assessed reading comprehension, and data analysis included frequency, percentage, mean scores, t-tests, and ANCOVA. Results showed that students in the code-switching group achieved a significantly higher average score (7.48, "Very Satisfactory") compared to the control group (6.22, "Satisfactory"). This significant difference (p-value = .002) demonstrates that code-switching led to markedly improved reading comprehension skills. The study concludes that code-switching is a highly effective strategy for enhancing reading comprehension in ABEL students, offering a more impactful approach than traditional English-only instruction. The research recommends integrating code-switching into teaching practices to facilitate understanding of complex topics and language structures, ultimately contributing to a more accessible and effective learning experience for students. Future research is encouraged to explore the broader applicability of code-switching across diverse educational contexts to further inform pedagogical best practices.

The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation

IntroductionNon-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies...

Fidaxomicin versus oral vancomycin for Clostridioides difficile infection among patients at high risk for recurrence based on real-world experience.

Clostridioides difficile infection (CDI) is a common nosocomial infection and is associated with a high healthcare burden due to high rates of recurrence. In 2021 the IDSA/SHEA guideline update recommended fidaxomicin (FDX) as first-line therapy. Our medical center updated our institutional guidelines to follow these recommendations, prioritizing FDX use among patients at high risk for recurrent CDI (rCDI). This pre- post- quasi-experimental study included patients with a presumptive diagnosis of CDI at risk for recurrence (age >/= 65 years, immunocompromised, severe CDI) that received vancomycin (VAN) or FDX between October 2019 to October 2022. Patients who received bezlotoxumab, had fulminant CDI, or received <10 days of the same antibiotic for their full treatment course were excluded. Patients were evaluated for rCDI within 8 weeks of completion of therapy, subsequent episodes of CDI within 12 months, and CDI-related admissions within 30 days. Of 397 CDI regimens evaluated, 196 received VAN and 201 received FDX. Rates of rCDI (9.2% vs 10%, P = 0.86), subsequent CDI within 12 months of therapy completion of therapy (19.4% vs 26%, P = 0.12) and 30-day CDI-related readmissions (3% vs 4.5%, P = 0.6) were similar between patients who received VAN versus FDX. Outcomes were similar between patients treated with FDX and VAN for the treatment of CDI among those at high risk for rCDI, using our outlined criteria. Although we observed a trend toward lower rates of rCDI among immunocompromised patients, this finding was not significant. Further investigation is needed to determine which patients with CDI may benefit from FDX.

Impact of Video-Based Error Correction Learning for Cardiopulmonary Resuscitation Training: Quasi-Experimental Study.

Video-based error correction (VBEC) in medical education could offer immediate feedback, promote enhanced learning retention, and foster reflective practice. However, its application in cardiopulmonary resuscitation (CPR) training has not been investigated. The objective of this study is to assess whether the VBEC procedure could improve the training performance of CPR among anesthesiology residents. A quasi-experimental study was conducted among anesthesiology residents between December 2022 and April 2023. Primary outcomes included a posttraining knowledge test and practical assessment scores. Secondary outcomes included the number of residents who correctly conducted CPR at each step, the rate of common mistakes during the CPR process, and the self-assessment results. A total of 80 anesthesiology residents were divided into a VBEC group (n=40) and a control group (n=40). The VBEC group underwent a 15-minute VBEC CPR training, whereas the control group underwent a 15-minute video-prompting CPR training. The posttraining knowledge test score of the VBEC group was significantly higher than that of the control group (73, SD 10.5 vs 65.1, SD 11.4; P=.002). The residents in the VBEC group had lower error rates in "failure to anticipate the next move" (n=3, 7.5% vs n=13, 32.5%; P=.01) and "failure to debrief or problem solve after the code" (n=2, 5% vs n=11, 27.5%; P=.01), as well as better performance in the "secure own safety" step (n=34, 85% vs n=18, 45%; P<.001) than those in the control group. The VBEC group showed significantly higher confidence in CPR than the control group (n=?, 62.5% vs n=?, 35%; P=.03). VBEC may be a promising strategy compared to video prompting for CPR training among anesthesiology residents.

The Role of Gamification in Teacher Training for Educational Inclusion

This research sought to evaluate the impact of a gamified resource program on inclusive education learning and the strengthening of inclusive skills in university students in the city of Machala, Ecuador; focusing on knowledge and understanding. The research has a quantitative approach, with a quasi-experimental design, used an Educational Inclusion questionnaire with multiple options which was based on a Likert scale, was used as a data collection instrument, with a representative sample of 60 students of the seventh semester of the Pedagogy of Experimental Sciences career. After the implementation of the learning sessions, a significant improvement was observed in the experimental group, evidenced by an increase in the "Achieved" category and a significant reduction in the "Start" category. Inferential analysis showed that the program had a significant impact compared to the control group, with a significance level of 0.001. In conclusion, the program proved to be an effective tool to strengthen the dimension of knowledge and understanding in university students, thus contributing to Sustainable Development Goal number 4 on quality education.