Significant Increase In Knowledge Research Articles

PEMBERIAN EDUKASI TENTANG PENTINGNYA IMUNISASI LENGKAP DAN VAKSINASI POLIO

Immunization is a public health intervention that is very effective in preventing serious infectious diseases. In this context, polio vaccination plays an important role because polio can cause permanent paralysis and even death. The aim of this activity is to increase knowledge, awareness and community participation about the importance of immunization, especially polio vaccination, through providing accurate information and eliminating misinformation, as well as facilitating access to health services. Method: This service begins with preparation and includes monitoring and evaluation. Where the interventions carried out are counseling, distribution of educational materials, door-to-door visits, and mobile posyandu to the community. Results: there has been a significant increase in knowledge, awareness and positive attitudes of the community towards immunization and polio vaccination. The evaluation showed a 45% increase in knowledge and a supportive change in attitudes. Conclusion: Service activities in Bandar Kidul Village succeeded in increasing the community's knowledge and positive attitudes towards polio immunization. This activity could be a model for other regions and is recommended to be held regularly with structured material and developed for maternal and child health (KIA).

Brief transition-focused education for families of autistic youth: preliminary mixed-methods investigation

Purpose The transition to adulthood is one of the most challenging and complex processes for autistic youth and their families. Few evidence-based transition support programs exist, and those that have garnered support require long-term commitments and resources that may prohibit participation by families with financial and time limitations. The current study investigated the feasibility and initial promise of a brief, caregiver-focused educational transition program for families of autistic youth delivered in the community over a single day. Methods Quantitative informant-report and qualitative interview data were collected from 12 caregivers of autistic youth before and after program participation. Using a partially mixed sequential equal status design, quantitative and qualitative data were integrated to evaluate change in caregiver transition knowledge and empowerment, as well as caregivers’ perceptions of program feasibility, acceptability, and usefulness. Results Caregivers reported significant increases in knowledge of transition-related topics and sense of empowerment regarding their family life. Caregiver perceptions of the intervention suggest they found it feasible, acceptable, and useful. Conclusions Short-term transition programming may be a helpful option for caregivers who seek transition supports for autistic youth.

Evaluation of Two Online Learning Courses for Evidence-Based Trauma Treatments: TFCBTWeb2.0 and CPTWeb2.0

Web courses for evidence-based treatments (EBTs) are an important component of training models and broader treatment dissemination and implementation. However, there exists limited research on the efficacy of large-scale online training, as most studies exploring these trainings focus on web courses designed for a specific research project. This project explored participation and knowledge acquisition in two large-scale web courses for trauma-focused EBTs: TFCBTWeb2.0 and CPTWeb2.0. Data were extracted for 174,193 TFCBTWeb2.0 learners and 12,024 CPTWeb2.0 learners, including learner characteristics (e.g., degree, years of experience) and knowledge acquisition from course module pre- and posttest scores. Learners demonstrated significant increases in knowledge for all TFCBTWeb2.0 and CPTWeb2.0 modules. Examination of completion status (i.e., started vs. completed the course) indicated that learners who identified as trainees or early career professionals were more likely to complete a web course, compared to those with terminal degrees and 5+ years of experience. Learners who registered for TFCBTWeb2.0 prior to the COVID-19 pandemic also had slightly higher completion rates compared to peri-COVID-19 learners. Taken together, these findings suggest that web courses can be an effective tool for increasing EBT knowledge. Further, completion rates for both web courses suggest the potential importance of system-level factors (e.g., agency/supervisor support) to increase the likelihood of completing these types of trainings.

A Novel Approach to Safe Patient Handling and Mobility Training in Physical Therapist Education

Background: Safe patient handling and mobility (SPHM) training is prevalent in health care education and practice. However, there is limited evidence of this training in physical therapist education programs. Purpose: To determine if a single training session with a mobile laboratory equipped with SPHM equipment increases the knowledge of SPHM principles and techniques and is valuable to students prior to their first clinical experience. Methods: Training included a 1-hour lecture on SPHM principles, research, and techniques, followed by two 50-minute SPHM practice stations. One session was conducted using a mobile laboratory. Students completed a pretest/posttest measuring knowledge of SPHM principles. Students completed a survey regarding the perception and placement of SPHM training within the curriculum. Results: A total of 129 students in a physical therapist education program were invited to participate; 59 from first-year cohorts and 70 from second- and third-year cohorts. Eighty-seven students volunteered to participate, including all 59 students from the first-year cohorts receiving training as the experimental group, and 28 from the other cohorts receiving no training as the control group. Seventy students met the criteria for survey data analysis; 42 experimental and 28 control. Of those who received training, 90.5% reported that SPHM training improved their confidence prior to their inpatient clinical experience; 85.5% in the control group would have felt more confident being placed in an inpatient facility if they received SPHM training, and 85.7% of the experimental group and 89.3% of controls agreed that SPHM training should be performed prior to the first clinical experience. A paired t test showed that first-year students reported a statistically significant increase in knowledge of SPHM principles (P < .001). Conclusions: Physical therapist education programs should consider SPHM training prior to students’ first clinical experience to increase student confidence in inpatient settings.

Enhancing participant understanding and ethical considerations in clinical trial biospecimen research: Insights from an oncology setting in India

This study explores the KAP of clinical trial participants on the use of surplus biospecimens for future research in Indian oncology trials. A hospital-based prospective study was conducted among 112 oncology clinical trial participants. Non-probability purposive sampling technique was used to recruit the participants. This study captured their socio-demographic information and pre and post-KAP assessment by using self-administered questionnaires and its highlights ethical concerns and the lack of global guidelines. The main goal is to understand participants’ understanding and opinions on sample collection, utilization, and storage, as well as the ethical implications. SPSS software used for statistical analysis to evaluate pre and post-intervention KAP scores using frequency, percentage, mean difference, standard deviation, and applied paired t-test and Wilcoxon signed ranks test to assess Different KAP Levels. The study analyzed knowledge, attitude, and practice levels among oncology clinical trial participants using statistical tests. Pre-test to post-test comparisons showed significant increases in knowledge (p < 0.001, Wilcoxon Signed Ranks Test), attitude (p < 0.001, paired-samples t-test), and practice (p < 0.001), highlighting the intervention’s effectiveness. This study highlights the effectiveness of interventions in improving the knowledge, attitude, and practice (KAP) of oncology clinical trial participants in India regarding the use of surplus biospecimens, emphasizing the importance of standardized guidelines in global oncology trials.

Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital.

Dialectical behavior therapy (DBT) has strong evidence in support of its effectiveness in reducing suicide attempts, anger, impulsivity, and substance abuse. It has been implemented in a variety of forensic settings to help with these challenges, despite limited research on the efficacy of DBT within this population. The current study presents treatment outcomes from an established DBT program in a maximum-security forensic facility. Outcomes included self-reported functioning, behavioral outcomes, and assessment of DBT skills knowledge among inpatients who participated in either comprehensive DBT or DBT skills training. Behaviorally, the study found a significant decrease in rates of patient assaults and reduced use of "Pro re nata" (PRN) medication for anxiety or agitation over the course of DBT treatment. During the first six months of treatment, self-reported symptoms of depression, emotional and behavioral dysregulation, and psychological inflexibility significantly decreased. Within this time frame, patients also displayed a significant decrease in the use of dysfunctional coping skills and a significant increase in knowledge pertaining to emotion regulation and interpersonal effectiveness. The results of this study largely support the use of DBT in forensic settings.

Piloting “From the Inside Out” — a toolkit addressing tuberculosis-related self-stigma

BackgroundSelf-stigma among people who have tuberculosis (TB) can contribute to non-adherence to medication and disengagement from care. It can manifest in feelings of worthlessness, shame, and guilt, leading to social withdrawal and disengagement from life opportunities. Self-stigma may also affect families of those who have TB, or healthcare workers who treat them. However, few interventions addressing TB self-stigma exist to date.MethodsWe piloted the delivery of a toolkit of psychosocial interventions using a “training-of-trainers” approach with six staff members of a TB-focused NGO (Non-Governmental Organisation) and partner organisations in Jakarta, Indonesia. These trainers could then disseminate the toolkit among community partner organisations. Local staff involvement throughout the study supported translation and adaptation to enhance cultural and language appropriateness. Over a 2-day training-of-trainers workshop, the NGO staff were familiarised with the mode of delivery of the toolkit, which they then delivered via a four-day participatory workshop with 22 people who have TB/TB survivors, who were representatives of partner organisations working among communities affected by TB.ResultsThe newly-trained local facilitators delivered the toolkit to the participants, who self-reported significant increases in knowledge and efficacy around TB self-stigma post-intervention compared to baseline (Z = 1.991, p = 0.047, Wilcoxon signed-rank test). The participants’ levels of self-compassion were also significantly higher post-workshop (Z = 2.096, p = 0.036, Wilcoxon signed-rank test); however, these effects were not maintained at 3-month timepoint. There was also a significant increase post-workshop in one of the participants’ Ryff dimensions of psychological wellbeing, that of positive relationships with others (Z = 2.509, p = 0.012, Wilcoxon signed-rank test) but this was also not maintained at the 3-month timepoint.ConclusionsThe observed changes in recipients’ self-reported levels of knowledge and efficacy, self-compassion, and psychological wellbeing may warrant further investigation into the best modalities for toolkit delivery (frequency, dose, duration) and support for individuals as they progress through the TB treatment journey.

Effect of an educational intervention package on knowledge, perception and behavioral intention for breast cancer screening among adolescent students of Kathmandu Metropolitan City

Background: Breast cancer is the most common cancer among women worldwide and is the second most common in Nepal. This study assessed the effect of an educational intervention package on knowledge, perception, and behavioral intention for breast cancer screening among adolescent students of Kathmandu Metropolitan City.Methods: A pretest -posttest control group study design was used. Each intervention and control groups included 159 participants, selected from two randomly chosen public secondary schools. Both groups completed self-administered pretest-posttest questionnaires. Educational intervention was given to the intervention group. Data was entered in EpiData 3.1 and analysed by using IBM SPSS 16 version. Wilcoxon Signed Rank test compared the difference in pretest-posttest scores within groups, and the Mann-Whitney U tested the difference between the control and the intervention groups. Results: In pretest-posttest comparisons, the intervention group showed an increase in the percentage of participants scoring at least the median value across knowledge (change: 18.0%, p<0.001), overall perception (change: 20.8%, p <0.001), and behavioral intention (change: 56.6%, p<0.001). There was significant increase in knowledge, perception, and behavioral intention among the intervention group compared to the control group (p<0.05). Conclusion: The educational intervention package showed a notable effect in increasing adolescent students’ intention to get screened for breast cancer. This study emphasizes the need to incorporate breast cancer screening programs into school-level curricula. In addition, this encourages adolescents to take a proactive stance when it comes to health consciousness.

A community based intervention to modify preventive behaviors of cutaneous leishmaniasis in children: a randomized controlled trial based on PRECEDE PROCEED model

ObjectivesIran ranks among the top six countries globally with a significant incidence of Cutaneous Leishmaniasis (CL). Using planning models is one community-based intervention to promote preventive behaviors. The purpose of our study was to evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in modifying preventive behaviors related to CL in children through mother training in a community intervention.MethodsA randomized controlled trial based on the PPM model was conducted on 168 mothers (intervention (n = 84) and control group (n = 84) with 10 years old children in the rural areas of Iran. Mothers from 7 village areas were randomly allocated to the intervention (2 village) and control groups (5 village). The intervention group received a program comprising eight 90-minute training sessions and environmental interventions. In this study, we utilized the PPM as a framework to design the questionnaires on Leishmaniosis prevention behavior. Participants in both groups completed the questionnaires at baseline (before the intervention), immediately after the intervention, and at the 2-month follow-up. Analysis of the data was conducted utilizing SPSS20, with statistical significance set at p < 0.05.ResultsCompared to the control group, the intervention group showed significant increases in knowledge, enabling factors, reinforcing factors, attitude, and preventive behaviors related to Cutaneous Leishmaniasis over time from baseline to follow-up (P < 0.001). No significant differences (P > 0.05) were observed in the alterations of the PPM construct, knowledge, and preventive behaviors within the control group from pre-intervention to follow-up.ConclusionsCommunity (education and environmental) intervention based on PPM is feasible and acceptable to modify preventive behaviors of Cutaneous Leishmaniasis in children by increasing a mother’s knowledge and attitude as well as changing enabling and reinforcing factors.Trial registrationIRCT20160619028529N8.

Risk Assessment Tool of Breast Cancer and Barriers against Breast Self-Examination among Nurses: An Educational Program

Purpose. Breast cancer is considered a huge health problem among women all over the world due to its increased mortality rate. Breast cancer deaths are decreased by 28–34% due to improvement in treatment and early detection. In order to detect breast cancer early and provide the best possible therapy, knowledge and awareness are essential. So, this study aimed to assess risk of breast cancer among nurses, the knowledge and practices of breast self-examination (BSE) and determine its barriers, and implement an educational program for them. Design. A quasiexperimental research design was used. Methods. This study was conducted at two university hospitals (main university hospital and woman’s health hospital). A purposive sample of 280 nurses with age more than thirty-five years were included in the study using three tools, namely, structure interview questionnaire, breast cancer risk assessment tool, and a structured breast cancer knowledge and practice questionnaire. Nurses’ knowledge and practices regarding breast cancer and BSE were first assessed and then they were provided with two educational courses covering theoretical and practical information. One month after the program ended, the nurses’ knowledge and practices were assessed again. Results. About 3.2% of the participants have five years high risk of developing breast cancer according the risk assessment tool, the main barriers of do not do BSE did not find any symptoms and scared from finding any abnormality. There was a significant increase in knowledge and practice of breast self-examination posteducation compared to pre-education (73.2 and 98.2%, respectively). Also, there was a statistically significant difference between pre- and postprogram with a p value of 0.0001. Conclusion. This study concluded that 3.2% of the nurses with high risk of developing breast cancer needed a follow-up; more than half of them do not perform breast self-examination because they think that do not have any symptoms in the breast and the educational program with a significant effect on knowledge and practices of nurses. So, the researchers recommend the nurses need for an empowerment program and support by providing assistance in places of work as done free clinical examination and mammography by female specialist for privacy.

Increased knowledge about clean and healthy living behavior in an effort to prevent diarrhea

Diarrhea is one of the common public health issues, especially in areas with poor sanitation and unhealthy lifestyles. Preventive efforts against diarrhea involve not only medical interventions but also the importance of education on PHBS (Clean and Healthy Living Behavior). This study aims to evaluate the effectiveness of increasing knowledge about PHBS in preventing diarrhea. The research method used is experimental with a pre-test and post-test control group design. The subjects consist of two groups: the intervention group receiving PHBS education and the control group without education. Data collection was done through knowledge questionnaires before and after the intervention. The results showed a significant increase in knowledge about PHBS in the intervention group after receiving education, compared to the control group. This indicates that PHBS education is effective in improving the knowledge and understanding of the community in preventing diarrhea. The conclusion of this research emphasizes the importance of PHBS education in preventing diarrhea in the community. Structured and comprehensive education programs can be an effective strategy to reduce the incidence of diarrhea and improve public health overall.

L’électroconvulsivothérapie, toute une (psycho)éducation !

BackgroundElectroconvulsive therapy (ECT) remains an essential, yet often stigmatized, treatment in psychiatry. Addressing this issue, our study introduces and evaluates a psychoeducational intervention aimed at demystifying ECT for patients and their caregivers, using the QuAKE (Questionnaire on Attitudes and Knowledge of ECT). MethodsThis psychoeducational approach was designed for individuals indicated for ECT and their caregivers. The session's effectiveness was gauged by comparing pre- and post-intervention QuAKE scores. Statistical significance was determined using paired Student t-test. ResultsThe study included 20 participants, with caregivers constituting 90% of the sample. The intervention led to a statistically significant increase in knowledge (mean increase of 7.55 points, p<0.001) and a notable decrease in stigmatizing attitudes (mean decrease of 9 points, p<0.001) towards ECT, as measured by the QuAKE scales. DiscussionThe significant improvements in both knowledge and attitudes underline the potential benefits of incorporating psychoeducational interventions into ECT treatment protocols. Future research should further explore the role of such interventions in the broader treatment pathway, enhancing patient and caregiver understanding and acceptance of ECT.

Exploration of decision aids to support advance care planning: A scoping review.

Advance care planning is a process through which people communicate their goals and preferences for future medical care. Due to the complexity of the decision-making process, decision aids can assist individuals in balancing potential benefits and risks of treatment options. While decision aids have the potential to better promote advance care planning, their characteristics, content and application effectiveness are unclear and lack systematic review. Therefore, we aimed to explore these three aspects and establish a foundation for future research. Scoping review. This scoping review adheres to the framework proposed by Arksey and O'Malley and the PRISMA-ScR list. Six English-language databases were systematically searched from the time of construction until 1 December 2023. Two researchers conducted the article screening and data extraction, and the extracted data was presented in written tables and narrative summaries. Of the 1479 titles and abstracts, 20 studies fulfilled the inclusion criteria. Types of decision aids were employed, mainly websites and videos. Decision aid's primary components center around 11 areas, such as furnishing information, exploring treatment and care preferences. The main manifestations were a significant increase in knowledge and improved recognition of patients' target value preferences. Among the aids, websites and videos for advance care planning have relatively high content acceptability and decision-making process satisfaction, but their feasibility has yet to be tested. Decision aids were varied, with content focused on describing key information and exploring treatment and care preferences. Regarding application effects, the aids successfully facilitated the advance care planning process and improved the quality of participants' decisions. Overall, decision aids are efficient in improving the decision-making process for implementing advance care planning in cancer and geriatric populations. In the future, personalised decision aids should be developed based on continuous optimization of tools' quality and promoted for clinical application. The paper has adhered to the EQUATOR guidelines and referenced the PRISMAg-ScR checklist. This is a review without patient and public contribution. https://doi.org/10.17605/OSF.IO/YPHKF, Open Science DOI: 10.17605/OSF.IO/YPHKF.

Carbon Monoxide Poisoning: From Occupational Health to Emergency Medicine.

Carbon monoxide poisoning remains a leading cause of accidental poisoning worldwide (both at home and at work), and it is also a cause of suicidal poisoning. Such poisoning can arise following prolonged exposure to low levels of CO or following brief exposure to high concentrations of the gas. In fact, despite exposure limits, high safety standards, and the availability of CO alarms, nearly 50,000 people in the United States visit the emergency department each year due to poisoning. Additionally, CO poisoning in the United States causes up to 500 deaths each year. Despite the widespread nature of this form of poisoning, known about for centuries and whose damage mechanisms have been recognized (or rather hypothesized about) since the 1800s, early recognition, especially of late complications, and treatment remain a medical challenge. A well-designed therapeutic diagnostic process is necessary so that indication for hyperbaric or normobaric therapy is correctly made and so that patients are followed up even after acute exposure to diagnose late complications early. Furthermore, it is necessary to consider that in the setting of emergency medicine, CO poisoning can be part of a differential diagnosis along with other more frequent conditions, making its recognition difficult. The last thirty years have been marked by a significant increase in knowledge regarding the toxicity of CO, as well as its functioning and its importance at physiological concentrations in mammalian systems. This review, taking into account the significant progress made in recent years, aims to reconsider the pathogenicity of CO, which is not trivially just poisonous to tissues. A revision of the paradigm, especially as regards treatment and sequelae, appears necessary, and new studies should focus on this new point of view.

Pneumococcal Perplexity: Improving Awareness of Updated Pneumococcal Vaccination Recommendations in Two Large Military Treatment Facilities.

Vaccinations are an essential aspect of preventive medicine. In October 2021, the pneumococcal conjugate vaccine-20 (PCV-20) and PCV-15 were authorized for use in adults by the U.S. FDA. In 2022, the Advisory Committee on Immunization Practices (ACIP) subsequently published updated pneumococcal vaccination recommendations that incorporate both PCV-20 and PCV-15. Pneumococcal vaccination is effective in reducing pneumococcal disease, particularly in high-risk patient groups such as those with chronic lung disease; however, the updated dosing schedule for pneumococcal vaccinations can be quite confusing, especially if patients have previously received "older" vaccinations, such as pneumococcal polysaccharide vaccine-23 or PCV-13. The purpose of this quality improvement project was to increase providers' knowledge of current ACIP pneumococcal vaccination recommendations, including indications and dosing schedule, and to improve pneumococcal vaccination rates among eligible adults and children. Focused education sessions were presented to primary care and subspecialty residents, fellows, and staff at Brooke Army Medical Center and Wilford Hall Ambulatory Surgical Center regarding current ACIP pneumococcal vaccination recommendations. Sessions included information about PCV-15 and PCV-20 vaccines, indications for vaccination, and dosing schedules. Subjective knowledge of updated ACIP pneumococcal vaccination recommendations was assessed among primary care and subspecialty residents, fellows, and staff via an anonymous survey both pre- and post-intervention. Number of PCV-20 vaccinations given and estimated vaccination rates of patients aged 19 to 64 years with asthma were assessed pre- and post-intervention over a 6 month time span. Of surveyed providers, only 9% discussed vaccinations at every visit and 11% did not discuss vaccinations at all. There was a statistically significant increase in providers' knowledge of pneumococcal vaccination guidelines for children post-intervention (P = .01) but no statistically significant increase in knowledge for guidelines for adults, for patients that have received prior pneumococcal vaccines, or in overall confidence in recommending pneumococcal vaccines. There was a 17% increase in the number of PCV-20 vaccinations given post-intervention (198 pre-intervention, 232 post-intervention). The estimated PCV-20 vaccination rate for adults aged 19 to 64 years with asthma increased from 14.9% pre-intervention to 19.5% post-intervention (P = .33). There is a significant knowledge gap regarding ACIP pneumococcal vaccination recommendations among military providers and a low pneumococcal vaccination rate for adults aged 19 to 64 years with asthma at Joint Base-San Antonio MTFs. Focused education sessions were effective in increasing providers' knowledge of updated pneumococcal vaccination recommendations, confidence in recommending vaccines, total number of pneumococcal vaccinations given, and estimated pneumococcal vaccination rate for adults with asthma. The validity of conclusions drawn from our data were limited because of discordant numbers of survey respondents as well as potentially inaccurate estimates of pneumococcal vaccination rates pre- and post-intervention. Despite this, the results warrant continued education of pneumococcal vaccines, indications, and dosing schedules.

Extending Knowledge on Biosecurity in Small-scale and Backyard Systems in the United States

The number of small-scale and backyard operations has increased in the United States during the past decade, but there is currently a lack of outreach efforts and readily-available educational materials targeting these farming systems. We developed a webinar series on biosecurity to provide training for small-scale and backyard producers, and training tools that can be used by local veterinarians and extension educators to disseminate knowledge and consistent recommendations more effectively. Fewer people attended the webinars than registered, suggesting a gap between interest in biosecurity and commitment to the topic. Participants in the webinar series reported a high level of satisfaction and a significant increase in knowledge.

Empirical analysis of lead neurotoxicity mode of action and its application in health risk assessment

The mode of action (MOA) framework is proposed to inform a biological link between chemical exposures and adverse health effects. Despite a significant increase in knowledge and awareness, the application of MOA in human health risk assessment (RA) remains limited. This study aims to discuss the adoption of MOA for health RA within a regulatory context, taking our previously proposed but not yet validated MOA for lead neurotoxicity as an example. We first conducted a quantitative weight of evidence (qWOE) assessment, which revealed that the MOA has a moderate confidence. Then, targeted bioassays were performed within an in vitro blood-brain barrier (BBB) model to quantitatively validate the scientific validity of key events (KEs) in terms of essentiality and concordance of empirical support (dose/temporal concordance), which increases confidence in utilizing the MOA for RA. Building upon the quantitative validation data, we further conducted benchmark dose (BMD) analysis to map dose-response relationships for the critical toxicity pathways, and the lower limit of BMD at a 5% response (BMDL5) was identified as the point of departure (POD) value for adverse health effects. Notably, perturbation of the Aryl Hydrocarbon Receptor (AHR) signaling pathway exhibited the lowest POD value, measured at 0.0062 μM. Considering bioavailability, we further calculated a provisional health-based guidance value (HBGV) for children's lead intake, determining it to be 2.56 μg/day. Finally, the health risk associated with the HBGV was assessed using the hazard quotient (HQ) approach, which indicated that the HBGV established in this study is a relative safe reference value for lead intake. In summary, our study described the procedure for utilizing MOA in health RA and set an example for MOA-based human health risk regulation.

Do Not Freak Me Out! The Impact of Lip Movement and Appearance on Knowledge Gain and Confidence

Virtual agents (VAs) have been used effectively for psychoeducation. However, getting the VA’s design right is critical to ensure the user experience does not become a barrier to receiving and responding to the intended message. The study reported in this paper seeks to help first-year psychology students to develop knowledge and confidence to recommend emotion regulation strategies. In previous work, we received negative feedback concerning the VA’s lip-syncing, including creepiness and visual overload, in the case of stroke patients. We seek to test the impact of the removal of lip-syncing on the perception of the VA and its ability to achieve its intended outcomes, also considering the influence of the visual features of the avatar. We conducted a 2 (lip-sync/no lip-sync) × 2 (human-like/cartoon-like) experimental design and measured participants’ perception of the VA in terms of eeriness, user experience, knowledge gain and participants’ confidence to practice their knowledge. While participants showed a tendency to prefer the cartoon look over the human look and the absence of lip-syncing over its presence, all groups reported no significant increase in knowledge but significant increases in confidence in their knowledge and ability to recommend the learnt strategies to others, concluding that realism and lip-syncing did not influence the intended outcomes. Thus, in future designs, we will allow the user to switch off the lip-sync function if they prefer. Further, our findings suggest that lip-syncing should not be a standard animation included with VAs, as is currently the case.

Empowerment Posyandu cadres in the transfer of spinach-based technology for early stunting prevention

The issue of nutritional health among toddlers has become a concern for the Indonesian government. The aim of this initiative is twofold: firstly, to prevent and early detect stunting in toddlers by leveraging local food resources through spinach-based technology, and secondly, to enhance the skills of Posyandu health cadres in spinach-based technology and improve their knowledge on stunting prevention. The service team will provide health education on stunting prevention using lecture and discussion methods and conduct anthropometric measurements. Practical or demonstration methods will be used to make cakes and jelly candies. The next stage is evaluation. Findings from the community empowerment evaluation show that health cadres are able to make jelly candy and spinach biscuits. The level of knowledge and skills of cadres on early stunting prevention and anthropometric measurements increased compared to before community empowerment. The evaluation results for knowledge and skill levels after training were 79.4 versus 66.5 before training. Paired t-test analysis found that the p-value was 0.002, so it was concluded that there was a significant increase in knowledge and skills scores in transferring spinach technology before and after training.

The Importance of Eating Healthy and Nutritionally Balanced Food for Elementary School Children

&#x0D; Health and well-being are important aspects of human life. One of the key factors that affect health is diet. The food we consume directly affects our physical and mental state. This activity aims to increase elementary school children's knowledge of the importance of eating healthy and nutritionally balanced foods. Method As an alternative solution to the problems that have been identified, counselling activities are carried out on the importance of eating healthy and nutritionally balanced foods in elementary school children. The method to increase this knowledge is counselling on the importance of eating healthy and nutritionally balanced foods. The techniques used in this activity include advising on the importance of eating healthy, nutritionally balanced foods and distributing leaflets. Based on the evaluation results, there has been a significant increase in knowledge about eating healthy and nutritionally balanced foods. Education and awareness about a healthy and nutritionally balanced diet are very important. The public needs to be adequately informed about the nutritional value of food and ways to adopt a healthy diet. Thus, it is expected to improve the quality of life, reduce disease risk, and create a healthier and more productive society overall.&#x0D;