Reduce Risk Behaviors Research Articles (Page 1)

Purpose It has been well-documented in the consumer behavior literature that risk relievers play an important role in reducing perceived risk. However, the research on the efficacy of risk relievers in segmenting online customers is scant. Thus, this study aims to investigate the usefulness of risk relievers in online shopping by presenting a cluster analysis of consumer risk reduction behavior based on risk-reliever utility scores and to understand whether these risk-reliever segments differ on the basis of perceived risk dimensions and purchase intention. Design/methodology/approach The data were collected from a survey of 677 customers using a nonprobability sampling technique. A two-step cluster analysis, using hierarchical and nonhierarchical clustering, was conducted on risk-reliever utility scores to segment the customers based on their risk reduction behavior. Furthermore, multivariate discriminant analysis was used to validate the results of cluster analysis. The segments were profiled based on their sociodemographic and behavioral characteristics. Later, one-way analysis of variance was applied to identify differences in the dimensions of perceived risk and purchase intention across clusters. Findings The cluster analysis on the risk-reliever utility scores yielded a classification of customers into four groups − maximum security seekers, minimum security seekers, information seekers and guarantee seekers. Discriminant analysis confirmed the validity of the four-cluster solution. Research limitations/implications This study contributes to the existing literature on risk relievers by augmenting a new perspective of customer segmentation based on their risk reduction behavior. The findings are limited to the cultural context of the study. The researchers are, therefore, encouraged to extend the clustering approach to other developing countries to enhance the generalizability of the results. Practical implications The classification of customers provides better knowledge to the service providers about the preferences of risk relievers by different user segments. It offers valuable insights into the understanding of customers’ risk reduction behavior that will influence marketers to adopt different strategies for each segment to the alleviation of risk perception. Originality/value The originality of the research is its novelty in examining risk reduction as a segmentation variable to guide marketers toward adopting effective risk reduction strategies based on the personality and behavioral characteristics of each user segment.

The AEMA, within the Government of Alberta, Canada, is the coordinating agency for emergency management across the province. The Be Prepared programme, within the AEMA, aims to educate individuals, households and communities on how to recognise risks, improve risk literacy and make preparedness a part of daily life. The rising frequency and severity of disasters, which can put lives at risk and disrupt day-to-day life, necessitates increased risk literacy, hazard understanding and disaster risk reduction actions among all sectors of society. Disaster research and post-incident assessments reflect the reality that while many people may recognise the need for disaster preparedness, some may fall short in practice, whether due to lack of resources, knowledge, or a failure to recognise the urgency of risks. The lack of preparedness among the public remains a consistent finding in disaster studies, highlighting the need for improved education and resources to address these gaps. Creating disaster-ready and resilient communities requires a cultural shift towards preparedness. This can be achieved by applying lessons from public relations strategies to influence behaviour change, emphasising frequent and targeted communications using an intersectional lens and equipping local champions with the tools to bring communities together and motivate preparedness action. This paper explores the development and implementation of the Government of Alberta's Be Prepared programme, a cost-effective, non-structural mitigation initiative aimed at enhancing local emergency preparedness through public education. The programme seeks to foster a culture of preparedness by promoting the Be Prepared initiative as a trusted resource for communities to champion. It examines how public relations strategies, such as year-round engagement, communication, partnership building and research-driven evaluation, can support the emergency management sector in encouraging disaster risk reduction behaviours. These strategies collectively form an evidence-based approach to strengthening community resilience and preparedness. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/.

BackgroundDigital health interventions (DHIs) can broaden the reach of HIV prevention interventions and overcome barriers for young cisgender men who have sex with men (YMSM). Community-based organizations (CBOs) have delivered HIV prevention interventions for decades, but few studies have examined how CBOs implement DHIs, including recruitment and retention. Keep It Up! (KIU!) is a Centers for Disease Control and Prevention–designated best-evidence DHI that can promote risk reduction behaviors and reduce sexually transmitted infection incidence.ObjectiveWe sought to descriptively assess CBOs’ approaches to recruitment and retention, elucidate lessons learned, and provide examples of recruitment and retention for future implementers.MethodsTwenty-two CBOs in counties with high HIV rates and large proportions of YMSM were selected through a request for proposal process to implement KIU!. Data were extracted from request for proposal applications and notes from monthly calls with CBO staff. Twenty-five staff members across CBOs were interviewed in the middle of implementation. A descriptive thematic analysis of the lessons learned in recruiting and retaining participants was performed. The research team developed an application dashboard for CBO staff to register participants, track participant progress through the intervention, record and track participant contact, and export usage data. CBO logins to the KIU! dashboard were tracked across the implementation. To descriptively compare approaches to recruitment and retention, the study team divided CBOs according to annual HIV testing volume in the 3 years prior to implementation and years of HIV service provision to YMSM.ResultsThe most frequent modes of recruitment were outreach and community partnerships (21/22, 95%), and the least frequent modes were via hook-up apps (6/22, 27%) and participant referrals (5/22, 23%). CBOs with a low HIV testing volume used online recruitment slightly more frequently, while medium-volume CBOs most frequently used hook-up apps for recruitment. Low-volume CBOs more frequently used phone calls and emails to remind participants to complete intervention modules, while high- and medium-volume CBOs more frequently used text messages. CBOs with more years of HIV service provision to YMSM more frequently had a set reminder schedule for contact with participants. CBO staff identified a need to change how KIU! is pitched to clients by using personalized, recipient-centered language rather than technical jargon. CBOs changed intake forms to ensure that staff remembered to offer KIU! to participants. CBOs had a difficult time retaining participants despite holding in-person events for enrolled participants (eg, raffles and trivia nights) and altering the frequency with which they reminded participants to complete modules.ConclusionsAlthough CBOs had experience in implementing other evidence-based interventions with YMSM, there was no consensus on successful recruitment and retention strategies for this population. We have presented approaches that future CBOs may use in their own implementation of KIU!.

To identify latent profiles of ego depletion among older adults with type 2 diabetes mellitus (T2DM), and analyze how these profiles relate to health promotion behaviors. A cross-sectional study surveyed 220 older adults with T2DM on ego depletion and health promotion behaviors. Latent profile analysis identified distinct profiles of ego depletion, and multinomial logistic regression explored their links to health promotion behaviors. Latent profile analysis revealed three distinct profiles: high cognitive depletion, high behavioral depletion, and high emotional depletion. The high behavioral depletion profile was associated with fewer complications, more hypoglycemia, better stress management, greater enjoyment of life, and increased health responsibility. The high emotional depletion profile had lower levels of physical activity, reduced risk reduction behaviors, poorer stress management, and less adherence to a healthy diet. Tailored interventions addressing ego depletion are crucial for improving health promotion behaviors in this population.

While the value of prevention and health promotion is widely acknowledged in public health, quantifying their full impact remains a persistent challenge. Health Impact Assessment (HIA) is a promising tool to evaluate the broader effects of policies, programmes, and interventions on population health. However, its application to prevention-especially in areas like behavioural risk reduction, upstream determinants, and community-level interventions-faces several methodological and practical constraints. Quantifying the effects of preventive actions often requires long time horizons, indirect causal pathways, and measuring intangible outcomes such as improved quality of life or reduced health inequalities. Moreover, estimating the return on investment (ROI) or cost-effectiveness of prevention is complicated by fragmented data, the influence of social and environmental contexts, and challenges in translating evidence into actionable policy. As a result, prevention remains underfunded and undervalued compared to treatment-focused interventions. Today, the question of how to effectively measure and justify investments in prevention is an active area of research and policy debate. The urgency of this issue is underscored by the pressing need to prevent a “healthcare infarction”-a situation where health systems become overwhelmed due to insufficient preventive measures. This concern is being addressed at both international and national levels. Internationally, organizations like the OECD and the European Observatory on Health Systems and Policies are actively engaging in efforts to strengthen health system resilience, with a particular focus on preventive care. At the national level, the Netherlands has set a leading example via its ‘Investment Model for Prevention’, which aims to quantify and guide investments in preventive health measures. These efforts highlight the critical importance of integrating prevention into health policy and the need for robust frameworks to evaluate its impact. As health systems worldwide face increasing pressures, emphasizing prevention is not merely a theoretical ideal, but an urgent and practical necessity for ensuring sustainable and effective healthcare delivery. In this roundtable, we will bring together the latest insights and developments in the research and policy discussions surrounding the value of prevention and health promotion. Building on international and national frameworks, we will engage in a focused policy debate on how to better integrate prevention into health systems. Participants will have the opportunity to discuss the challenges of measuring and demonstrating the impact of preventive measures. We will also examine the pros and cons of current approaches, addressing the practical and methodological obstacles that hinder their widespread adoption. Together, we will identify concrete actions to ensure that prevention takes a more prominent role in shaping the future of health policy.Key messages• Integrating prevention into health systems is crucial for long-term sustainability, but challenges in measuring impact and return on investment remain a barrier to broader adoption.• Active research and policy discussions are exploring how to overcome methodological obstacles and ensure prevention plays a central role in future health systems.

Human behavioural and occupational factors play a critical role in sustaining malaria transmission. This study aimed to identify factors associated with poor levels of knowledge, attitudes, and practices (KAP) and factors influencing risk behaviours among at-risk populations. A survey of 402 at-risk individuals was conducted in Sisaket Province in late 2022, where substantial progress in malaria elimination has been achieved. Data was collected using a structured questionnaire. Descriptive statistics and logistic regression models were used to identify factors associated with KAP and malaria risk behaviours. Over half of the participants demonstrated good knowledge (51.5%), attitudes (64.7%), and practices (58.2%) regarding malaria transmission, treatment, and prevention. Poor attitudes were significantly more likely among individuals with lower education levels [primary or below: aOR = 2.2, 95% CI 1.2-4.0); senior primary: aOR = 2.5, 95% CI 1.4-4.8] and low socioeconomic status (aOR = 1.8, 95% CI 1.1-3.0). Poor practices were less common among individuals working in agriculture (aOR = 0.2, 95% CI 0.1-0.5). Risk behaviours were significantly more frequent among males (aOR: 2.8, 95% CI 1.2-6.8) and individuals with poor practices (aOR: 3.5, 95% CI 1.6-8.1). Despite overall moderate KAP levels, gaps in attitudes and risk behaviours persist. Targeted strategies, such as social and behaviour change communication, should focus on improving attitudes among individuals with low education levels and reducing risk behaviours among males and those with poor practices by promoting adherence to effective preventive measures.

Cancer survivors face an increased risk of cardiovascular disease (CVD) due to treatment-related toxicity, lifestyle factors, and comorbidities. Addressing CV health is crucial for improving quality of life and long-term outcomes. The American Heart Association’s Life’s Essential 8 framework highlights modifiable determinants of CV health, emphasizing early detection and monitoring. Mobile health (mHealth) technologies, such as wearables and smartphone apps, offer continuous tracking, yet their applications in cancer survivorship remain unclear. This review systematically characterizes the types of mHealth technologies used to monitor CV health in cancer survivors, focusing on the specific data collected (major adverse CV events, CV risk factors, and surrogate endpoints) and the use of active versus passive collection methods. A systematic search of PubMed, Scopus, Embase, and Web of Science identified studies published between January 1, 2016, and June 13, 2024. Eligible studies included observational and interventional designs assessing at least one CV outcome using mHealth. Data were extracted on design, technology type, and outcomes. Risk of bias was evaluated using the Cochrane RoB-2 and ROBINS-I tools. Fourteen studies (13 interventional, one observational) met criteria. Physical activity was the most monitored risk factor, followed by HR. The most common technologies were mobile apps and commercial wearables. Passive methods typically captured PA and HR, while active methods captured PA, symptom tracking, and diet. A key finding was the lack of integration with electronic medical records, highlighting a gap in clinical implementation. mHealth provides scalable tools to track CV health indicators in cancer survivors. Findings highlight the potential to support practice by enabling remote oversight of risk-reducing behaviors and guiding lifestyle interventions. However, we also identified gaps, including the underutilization of biomarkers (e.g., HRV) and the lack of integration with electronic records. Future research must address these gaps to translate real-time data into clinical insights and optimize survivorship care.

Hispanics are over-represented in outdoor occupations; therefore they face an elevated risk of skin cancer. However, there is limited research examining these workers' self-risk perceptions and sun-protective behaviors. This study explores Hispanic outdoor workers' knowledge, attitudes, barriers, and facilitators for engaging in sun-protective behaviors to inform a culturally-tailored intervention. We conducted a mixed methods study with Hispanic outdoor workers (n = 25) over 18years old. Three focus groups were held in-person or virtually. Participants were recruited through community partners, flyers, and referrals. Focus groups were conducted in Spanish, recorded, transcribed, and analyzed using Rapid Qualitative Analysis. We used descriptive statistics to analyze quantitative data. Most participants were male (88%), 40% completed up to 8th grade education, and 60% were uninsured. Results revealed four key themes: skin cancer awareness, risk perception, risk-reduction strategies, and barriers/facilitators for risk-reduction behaviors. Participants reported daily sun exposure ranging from 3 to 10h, often with limited access to shade. Sunglasses (57.1%) and long sleeves (52.4%) were commonly used, while sunscreen use remained low (19.0%) due to discomfort, stigma, and limited knowledge. Many participants (20%) never took protective measures and expressed uncertainty about their skin cancer risk (40%). Despite these challenges, participants showed significant interest in learning more about sun protection. Our findings suggest that Hispanic outdoor workers have limited knowledge and low perceived skin cancer risk. This study highlights the need for tailored educational initiatives to address skin cancer prevention for Hispanic outdoor workers.

Association of fentanyl test strip results and change in drug use behaviors: A multi-state, community-based observational study.

Abstract To increase the understanding of shellfish toxin risks and support safe harvesting practices, the Sitka Tribe of Alaska develops and organizes environmental education programs. This study (ClinicalTrials.gov ID: NCT05247229) evaluates the Tribe's new middle school program, drawing on the theory of planned behavior to investigate pre‐post‐program shifts in beliefs and behavioral intentions related to shellfish harvesting and mitigating exposure risks by checking a tribally run website with near real‐time toxin level data. Participants included 50 middle school students across three Southeast Alaska communities—Sitka, Hoonah, and Juneau. Research activities included pre‐ and post‐program surveys and interviews. We used generalized estimating equation linear regression of survey data to investigate pre‐post‐program changes in beliefs and behavioral intentions related to shellfish harvesting and risk reduction and how changes in beliefs relate to changes in behavioral intentions. Interviews contextualized beliefs and behavioral intentions measured in surveys. Following the program, participants reported more positive perceptions and increased behavioral intentions related to shellfish harvesting and checking toxin levels, although differences emerged across sites and Alaska Native identity. Participants' understanding of the risk reduction strategy and confidence in abilities to check toxin levels also increased, suggesting that integrating risk perception in the theory of planned behavior and practical risk reduction strategies in environmental education tailored to local ecological and cultural contexts can be effective in promoting safe behaviors. Additionally, participants emphasized the influence of their family's harvesting practices on their beliefs and behaviors, suggesting the importance of family engagement in environmental education.

Abstract Background. Religion has long served as a salient identity marker and a basis for social conflict, often making visibly religious individuals vulnerable to targeted violence. Despite growing scholarly attention to hate crime, few studies have examined how religiously motivated victimization and behavioral adaptation unfold across national contexts, particularly among young people. This study applies Routine Activity Theory to explore both risk exposure and post-victimization adaptation. Aims. This paper investigates religious hate crime victimization and subsequent adaptive behavior in four countries using a routine activity approach. We examine how various aspects of religious life and routine activities, such as identity visibility, public practice, and social networks, are associated with variation in the risk of experiencing religiously motivated threats or violence. Second, we assess the strategies reported by victims that may reflect efforts to manage perceived risk. Methods. Based on survey data from 4122 young adults, we compare risk and adaptation patterns across multiple national and religious contexts. Results. More visible religious expressions and public engagement are associated with a higher likelihood of victimization, while networks of co-religionists are linked to lower risk. Victimization is also associated with greater likelihood of risk reduction behaviors such as avoiding risky situations, carrying weapons, or relying on co-religionists for safety. Conclusion. The analysis contributes to Routine Activity Theory by highlighting associations between religious routines, identity markers, and perceived target visibility, as well as potential behavioral responses following victimization. Findings are consistent across countries, suggesting robust patterns of risk and adaptation with implications for theory, policy, and victim support.

Mobile health (mHealth) applications are positioned to provide information and support anywhere and anytime, though few focus on overdose-related harm reduction. We aimed to describe the use of an e-harm reduction smartphone application theoretically based on self-determination theory among people who inject drugs. We enrolled 60 clients from 3 syringe services programs in Wisconsin in a single-arm, pre-post pilot study between December 2022 and June 2023. Eligible participants used opioids and injected drugs within the past week. Participants received a smartphone, unlimited data plan, and e-harm reduction focused mHealth application based on the self-determination theory principles of autonomy, competence, and relatedness. The app was used to deliver a 12-week overdose risk reduction intervention. Every week, participants self-selected 1 of 11 available overdose-focused harm reduction goals and received tailored education, resources, and support from study staff through the smartphone application. We evaluated the use of app features, intervention adherence, and described the most commonly selected overdose risk reduction goals. Of available app features, participants most often used private messaging (median, interquartile range [IQR] days used: 28 [18-53]), viewed a motivational "thought of the day" (median [IQR] days used: 24 [15-47]), and interacted with discussion boards (median [IQR] days used: 12 [5-24]). Of 12 available weekly goal-setting intervention activities, participants completed a median of 9 (IQR: 4-11). Of 448 completed goal-setting activities, reducing drug injection and reducing drug use were the most commonly selected goals (chosen N = 86 [19.2%] and N = 81 [18.1%] times, respectively) followed by quitting use (N = 69 times, 15.4%), and reducing solitary drug use (N = 54 times, 12.1%). An e-harm reduction mHealth application was used by participants for overdose risk reduction goal setting, messaging, and viewing motivational content. Future studies will evaluate benefits of engaging with e-harm reduction mHealth applications for overdose prevention intervention relative to a control group.

Xylazine test strips (XTS) allow for rapid identification of xylazine in drugs, yet little is known about those using XTS. Therefore, this study explores the characteristics of people who use drugs (PWUDs) who use XTS and examines risk reduction behaviors associated with XTS use. This observational cohort study was conducted in New York between September and December 2023 as part of a larger study. Questions about XTS use were added to the parent study's baseline survey of PWUDs and were completed by 254 PWUDs. Sociodemographic characteristics compared XTS users to nonusers. Propensity score weighting using inverse probability of treatment weights was used to examine the association of ever-using XTS with risk reduction behaviors and the drug type used. Sixty-six participants (26%) had used XTS; 80% trusted the results, and 79% were confident in their ability to use XTS to detect xylazine. Those who had used XTS were more likely to have naloxone nearby (aOR=7.51, 95% CI: 2.26-24.95, P=0.001), use a test shot (aOR=2.43, 95% CI: 1.18-5.01, P=0.016), have someone check on them while using (aOR=2.52, 95% CI: 1.23-5.19, P=0.012), and watch someone use the same drugs (aOR=2.35, 95% CI: 1.19-4.65, P=0.014). XTS use was associated with using opioids (aOR=3.68, 95% CI: 1.38-9.81, P=0.009) and injecting drugs (aOR=4.32, 95% CI: 1.91-9.77, P<0.001). Our study demonstrates that XTS use appears to be associated with engaging in risk reduction behaviors, suggesting XTS can be a useful harm reduction tool. More research is needed to assess whether PWUDs change their drug consumption behaviors based on XTS results.

Sexual minority men (SMM) have elevated rates of methamphetamine use, which is deeply integrated into their sexual identities, sexual behaviors, and cultural spaces. Smartphone applications (apps) are often used to procure drugs and sexual partners. This study was a randomized clinical trial that evaluated the efficacy of the adaptation of an evidence-based intervention (Getting Off) into a mobile app format. From May 2021 to May 2023, 226 SMM who self-reported methamphetamine use in the past year were randomized to immediate delivery (ID) of the Getting Off app (n = 113) or a 30-day delayed delivery (DD) of the Getting Off app (n = 113). The average DSM-5 score for MUD was in the severe range (8.9 out of a possible 11). Mixed-effects models showed that at 1-month assessment, participants in the ID condition had significantly fewer days of injection methamphetamine use (estimate = -0.57; SE = 0.15; p < 0.001), lower likelihood to have condomless anal intercourse (CAI; estimate = -1.14; SE = 0.47; p = 0.017), and CAI while high on methamphetamine (estimate = -1.15; SE = 0.49; p = 0.021) in the past 30days, compared to the DD condition. When comparing pre- to post-app delivery, the combined ID and DD sample showed significant reductions in all methamphetamine use and sexual risk outcomes, including days using and injecting methamphetamine, CAI, and CAI while high on methamphetamine (p < 0.05 for all post-app assessments, with some fluctuations at certain time points). Overall, the reductions in methamphetamine use and sexual risk behaviors demonstrated the efficacy of the Getting Off app, which is extremely promising for the future of app-based treatment options.

Introduction and Objective: Acute emotional stress with big football matches is recognized to precipitate cardiovascular events in some individuals. The purpose of this narrative review is to address the existing scientific evidence regarding the association of viewing football matches with the risk of cardiovascular events like myocardial infarction, arrhythmias, and sudden cardiac death. Methods: The review was based on an extensive PubMed database search conducted in April 2025. Articles were graded on methodology, sample description, scope of study, and results reported. There were no restrictions on publication dates. English-language studies and applicable book chapters only were considered. Conclusions: The studies indicate that emotionally charged matches - especially if spectators are strongly bonded or identify intensely with their team - can raise the risk of cardiovascular incidents, especially in men who have a background of cardiovascular illness. Population data are contentious, nevertheless, and additional confounding variables like alcohol consumption, smoking, and unhealthy diet might be involved. Healthy emotional reactions (e.g., victories) can be protective. The public health interventions should aim at reducing behaviour and offer emergency readiness in risk high-risk environments like stadiums or fan zones. The measures of public health should emphasize reducing risk behaviour and offer emergency preparedness in high-risk environments like stadiums.

Despite adolescents making up a significant part of the global population, they have high rates of substance use, linked to various health problems and risky behaviours and increased risk of negative social, cognitive, and physical consequences. Studies on substance use and related risk behaviours among adolescents in Tanzania are crucial for informing targeted interventions and policies to safeguard the health and development of this vulnerable population. We aimed to assess the prevalence and determinants of substance use among adolescents in the Tanga region, eastern in Tanzania. We conducted a secondary analysis of cross-sectional survey data among 1,262 in-school (n = 1,031) and out-of-school (n = 231) adolescents conducted in Tanga, Tanzania in 2021. Data was collected using the Global School Health Survey (GSHS) questionnaire that included questions on substance use, specifically alcohol, smoking marijuana and tobacco, and recreational drugs like cocaine and heroin. Modified Poisson regression models estimated the factors influencing lifetime and current (within the past 30 days preceding the survey) substance use using Stata software version 17. Among 1,262 adolescents, the lifetime and current prevalence of substance use were 8.6% and 3.2%, respectively (4.1% and 0.8% among in-school vs. 29% and 13.9% among out-of-school adolescents). The most reported substance used over a lifetime among both in-school and out-of-school adolescents was smoking (2.3% and 27.7%), followed by alcohol drinking (2% and 10.4%). A higher likelihood of lifetime and current substance use was found among older adolescents (15-19 years), males, and who owned a mobile phone, with a social media account, with history of sexual activity, and out-of-school adolescents. Substance use is common among the adolescent population in eastern Tanzania. Policies to keep adolescents in school are instrumental in reducing risk behaviours during adolescence. Targeted behaviour change interventions should be considered for older adolescents (15-19 years), out-of-school, males, and those exposed to sexual activities.

With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing effective policy strategies for dementia risk reduction. This study explores the moderating role of dementia-related fear on the relationship between perceived cognitive decline and engagement in dementia risk reduction behaviors. A cross-sectional study was conducted among 200 Chinese community-dwelling middle-aged and older adults. Hierarchical regression and simple slope analysis were used to assess the moderating effect of dementia-related fear on the relationship between perceived cognitive decline and motivation to engage in dementia risk reduction behaviors. A significant correlation was found between perceived cognitive decline and increased motivation to engage in dementia risk reduction behaviors (r=0.44). Dementia-related fear acted as a significant moderator; motivation was positively associated with low to moderate levels of fear, whereas this association diminished and became non-significant at higher levels of fear. The findings suggest that while lower levels of dementia-related fear may be linked to increased motivation for engaging in risk reduction behaviors, elevated levels of fear do not appear to support such engagement. Rather than emphasizing the negative impacts of dementia, public health strategies should empower individuals with actionable messages to engage in dementia risk reduction behaviors.

Background: Refractive errors are a leading cause of vision impairment, affecting over a billion people worldwide. Medical students are at high risk due to prolonged screen exposure and academic demands. Objectives: The objective of this study was to estimate the proportion of refractive errors among undergraduate students of a medical college in South Kerala and determine the factors associated with refractive errors. Materials and Methods: An Institutional-based cross-sectional study was conducted among 375 medical students over 3 months (July to September 2024) using a semi-structured, expert-validated questionnaire. Data were collected via Google Forms, cleaned, and analyzed using SPSS Trial Version 28. Results were expressed as frequencies and percentages, with significance tests applied. Results: Refractive errors were found in 50.7% of participants, with myopia (90%) being the most common, followed by astigmatism (7.9%) and hypermetropia (0.5%). Among those affected, 94.7% were diagnosed before joining medical college, and spectacles were the primary corrective measure (92.6%). A significant association was found between refractive errors and female gender (P = 0.006), urban residence (P = 0.016), higher maternal education (P = 0.001), family history of refractive errors (P = 0.001), eye rubbing (P = 0.001), and daily computer use (P = 0.001). Other sociodemographic and behavioral factors showed no significant association. Conclusion: The high proportion of refractive errors among medical students necessitates targeted interventions. Awareness campaigns, regular eye check-ups, and reducing risk behaviors such as excessive eye rubbing and prolonged screen time are crucial for improving visual health.

Because a cure and a vaccine for the human immunodeficiency virus (HIV) are not expected for at least several years, prevention of AIDS is the only means of reducing the spread of the disease. While education, information, and persuasion may be changing the HIV-related attitudes and even behaviors of some individuals, without a theoretical framework, the reasons why some individuals have changed and why other individuals have not changed are elusive. Three social-psycho logical models that have been applied to health-related behavior-the Health Belief Model (HBM), the Ajzen-Fishbein attitude-behavior model (AFM), and Leventhal et al.'s Self-Regulatory Model (SRM)-are tested in this study. The extent to which each model's variables are related to self-reported behavior change related to HIV and current HIV-related behavior are compared. Results indicate that the SRM and AFM contributed significantly to predicting risk behavior change, and that the HBM and AFM contributed significantly to predicting current risk behavior, after controlling for risk behavior change. Significant predictors of risk behavior change included timeline, identity, and self-efficacy from the SRM; sexual impulse (a barrier) from the HBM; and attitudes about the behaviors from the AFM. Significant predictors of current risk behavior included several barriers from the HBM and negative attitude about risk-reducing behaviors from the AFM.

Cost-effectiveness of vaccination strategies to control future mpox outbreaks in England: a modelling study