Standard Health Education Research Articles

Effects of Visualized Health Education Based on Health Belief Model on Self-Management of Patients Undergoing Maintenance Hemodialysis.

Patients with end-stage renal disease often require maintenance hemodialysis (MHD). Effective self-management is crucial for the prognosis of patients undergoing MHD; however, their self-management practices remain suboptimal. This study aimed to explore the effects of visualized health education based on health belief model on self-management, self-efficacy, quality of life, and quality of dialysis in patients undergoing MHD. A total of 93 patients undergoing MHD from a tertiary hospital in Guangzhou were recruited between December 2021 and June 2022 and divided into control (n = 44) and intervention (n = 49) groups according to their dialysis time. The control group received standard health education, while the intervention group received visualized health education based on the Health Belief Model (3 months, 3 times a week, about 1 hour each time). The Hemodialysis Self-Management Instrument, Self-Efficacy Scale, Hemodialysis Knowledge Questionnaire, and 12-Item Short-Form Health Survey were used before and after intervention. Physiological indices related to hemodialysis (serum potassium, phosphorus, intact parathyroid hormone, albumin, and hemoglobin) were collected. After intervention, the intervention group showed significantly higher scores in self-management ability (63.0 [57.0, 68.5]), self-management efficacy (29.0 [26.0, 31.0]), hemodialysis knowledge (21.0 [20.0, 22.0]), and quality of life (68.8 [56.3, 79.2]) than the control group (P < .05). More individuals in the intervention group achieved normal ranges for hemoglobin, albumin, serum potassium, and serum phosphorus. The visualized health education intervention significantly enhanced self-management level, self-efficacy, and quality of life in patients undergoing maintenance hemodialysis. This approach is recommended for broader application.

Rapid, Tailored Dietary and Health Education Through A Social Media Chatbot Microintervention: Development and Usability Study With Practical Recommendations.

There is an urgent need to innovate methods of health education, which can often be resource- and time-intensive. Microinterventions have shown promise as a platform for rapid, tailored resource dissemination yet have been underexplored as a method of standardized health or dietary education; social media chatbots display unique potential as a modality for accessible, efficient, and affordable educational microinterventions. This study aims to provide public health professionals with practical recommendations on the use of social media chatbots for health education by (1) documenting the development of a novel social media chatbot intervention aimed at improving dietary attitudes and self-efficacy among South Asian American young adults and (2) describing the applied experiences of implementing the chatbot, along with user experience and engagement data. In 2023, the "Roti" chatbot was developed on Facebook and Instagram to administer a 4-lesson tailored dietary health curriculum, informed by formative research and the Theory of Planned Behavior, to 18- to 29-year-old South Asian American participants (recruited through social media from across the United States). Each lesson (10-15 minutes) consisted of 40-50 prescripted interactive texts with the chatbot (including multiple-choice and open-response questions). A preintervention survey determined which lesson(s) were suggested to participants based on their unique needs, followed by a postintervention survey informed by the Theory of Planned Behavior to assess changes in attitudes, self-efficacy, and user experiences (User Experience Questionnaire). This study uses a cross-sectional design to examine postintervention user experiences, engagement, challenges encountered, and solutions developed during the chatbot implementation. Data from 168 participants of the intervention (n=92, 54.8% Facebook; n=76, 45.2% Instagram) were analyzed (mean age 24.5, SD 3.1 years; n=129, 76.8% female). Participants completed an average of 2.6 lessons (13.9 minutes per lesson) and answered an average of 75% of questions asked by the chatbot. Most reported a positive chatbot experience (User Experience Questionnaire: 1.34; 81/116, 69.8% positive), with pragmatic quality (ease of use) being higher than hedonic quality (how interesting it felt; 88/116, 75.9% vs 64/116, 55.2% positive evaluation); younger participants reported greater hedonic quality (P=.04). On a scale out of 10 (highest agreement), participants reported that the chatbot was relevant (8.53), that they learned something new (8.24), and that the chatbot was helpful (8.28). Qualitative data revealed an appreciation for the cheerful, interactive messaging of the chatbot and outlined areas of improvement for the length, timing, and scope of text content. Quick replies, checkpoints, online forums, and self-administered troubleshooting were some solutions developed to meet the challenges experienced. The implementation of a standardized, tailored health education curriculum through an interactive social media chatbot displayed strong feasibility. Lessons learned from challenges encountered and user input provide a tangible roadmap for future exploration of such chatbots for accessible, engaging health interventions.

Adolescent behavioural intentions: Secondary outcomes from a cluster randomized controlled trial of the Health4Life school-based lifestyle modification intervention.

Health4Life: a school-based eHealth intervention targeting multiple health behaviour change (MHBC). Does Health4Life impact secondary outcomes of self-reported intentions regarding six lifestyle behaviours in adolescents (alcohol use, tobacco smoking, screentime, physical activity, discretionary beverage consumption, and sleep)? We implemented a cluster randomized controlled trial within secondary schools across three Australian states. Schools were randomly assigned (1:1) to receive either the Health4Life intervention, which consisted of a six-module, web-based program and accompanying smartphone app, or an active control (standard health education). Randomization was stratified by site and school gender composition (using Blockrand in R). All students aged 11-13years who attended the participating schools and were fluent in English were eligible. Students completed self-report questionnaires at baseline, post-intervention, 12months, and 24months. Outcomes were intentions to try alcohol, try tobacco, reduce screentime, engage in physical activity on most or all days, swap discretionary beverages for water, and meet sleep guidelines. Mixed effects models estimated between-group differences in the outcomes over 24months. Immediately post-intervention, Health4Life significantly reduced intentions to try alcohol and tobacco and increased intentions for longer sleep and reduced screentime compared to control. Intervention effects on screentime intentions persisted at 12months but not at 24months. No lasting effects were observed on intentions for physical activity or discretionary beverage consumption. Health4Life shows promise in influencing adolescent intentions across various MHBC areas, especially immediately after intervention. However, further investigation is needed to sustain these intention changes beyond short term to facilitate behaviour change.

Health changes from trans-theoretical model-based education in older adults with mild cognitive impairment: A randomized controlled trial

BackgroundLow awareness and misconceptions surrounding mild cognitive impairment highlight the urgent need for effective health education. Reluctance to seek intervention and poor adherence to management strategies make behavior-oriented health education essential. ObjectiveTo assess the effectiveness and clinical significance of a trans-theoretical model-based health education program on cognitive-behavioral outcomes in older adults with mild cognitive impairment. DesignA two-arm and assessor-blinded randomized controlled trial. Settings and participants100 community-dwelling older adults with mild cognitive impairment in Huzhou, China. MethodsParticipants were randomly assigned to a trans-theoretical model-based health education program (weekly 45–60 min sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or a wait-list control group receiving standard health education. Disease knowledge, behavioral stage, and adherence to health management behaviors were assessed at baseline, 8-week, and 20-week. Effects were evaluated at the group level via generalized estimating equation and at the individual level using reliable and clinically significant change. ResultsThe trans-theoretical model-based health education program demonstrated significant effects over the wait-listed control. Generalized estimating equation analyses showed statistically significant effects on behavioral stage (β8-week = 1.04, 95%CI = 0.34–1.75; β20-week = 1.72, 95%CI = 0.95–2.49), disease knowledge (β8-week = 1.14, 95%CI = 0.26–2.02; β20-week = 1.78, 95%CI = 0.87–2.69), and adherence to health management behaviors (β8-week = 6.20, 95%CI = 2.03–10.37; β20-week = 10.74, 95%CI = 6.47–15.01) at both measured intervals. Additionally, global cognitive function (β8-week = 0.60, 95%CI = -0.18–1.38; β20-week = 2.42, 95%CI = 1.64–3.20), Purdue Pegboard Test Assembly and Bimanual Tasks (β8-week = 0.16/0.38, 95%CI = -0.21–0.53/−0.18–0.94; β20-week = 0.96/1.80, 95%CI = 0.57–1.35/1.17–2.43) improved significantly over time. Reliable and clinically significant change analyses at 8 weeks indicated significant improvements in the intervention group: 57 % of participants improved in disease knowledge (22 % clinically significant), 90 % in adherence to health management behaviors (17 % clinically significant), and 61 % in global cognitive function (10 % clinically significant). By 20 weeks, these rates increased to 63 % (29 %), 100 % (25 %), and 78 % (27 %). However, non-significant improvements in depression symptoms and sleep quality were found at individual-level assessment. ConclusionsThis study shows that the trans-theoretical model-based health education program effectively enhances cognitive-behavioral health outcomes in older adults with mild cognitive impairment, with benefits persisting for 12 weeks. Future research should further explore the potential mechanisms underlying the cognition and behavior-enhancing effects of this program. Registration numberChiCTR1900028351.

Osteoporosis Knowledge and Its Risk Factors in Older Adults With Upper Extremity Fragility Fractures: A National Cross-Sectional Study.

It is crucial to recognize upper extremity fragility fractures as sentinel events that allow healthcare professionals the opportunity to identify and address underlying factors contributing to poor bone health, thereby reducing the risk of future fragility fractures. This study seeks to evaluate the extent of understanding and factors influencing osteoporosis in older adults with upper extremity fragility fractures, aiming to establish a foundation for enhancing their comprehension. A total of 1443 participants in 31 provinces were included in this study as survey subjects from September to November 2023. A general information questionnaire and an osteoporosis knowledge assessment tool were used for a cross-sectional survey. The univariate analysis and logistic regression were used to analyze the risk factors. The score of osteoporosis knowledge assessment tool of participants was 10.00 (7.00, 12.00), with only 24.95% scoring above 12 points. Being in an eastern hospital, suffering from chronic obstructive pulmonary disease, being diagnosed as severe osteoporosis, having bone mineral density testing, receiving osteoporosis health education, and receiving health education by phone were associated with higher knowledge of osteoporosis. The osteoporosis knowledge of older adults with upper extremity fragility fractures needs to be improved. To help the secondary prevention of osteoporosis, the standardized osteoporosis health education should be strengthened, and attention should be paid to key groups.

Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi

BackgroundInadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes. ObjectivesTo improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi. MethodsWe performed a 2-armed (1:1) cluster-randomized controlled trial in Southern Malawi, enrolling pregnant women at gestational age 12–18 wk. Twenty villages (clusters) were randomly assigned to an intervention or a control group. A nutrition education and counseling (NEC) intervention consisted of education sessions followed by cooking demonstrations and counseling sessions. The women were encouraged to use locally available nutrient-dense foods to enhance dietary adequacy and -diversity. We applied linear programming to identify food combinations that could increase micronutrient intakes. The control group received standard antenatal health education. ResultsAmong the 311 women recruited, 187 (60%) completed the trial. We found no significant difference in mean birth weights recorded within 1 or 24 h of birth between the intervention and control groups. Intervention infants had greater birth length (P = 0.043) and abdominal circumference (P = 0.007) compared to controls, whereas other birth outcomes did not differ significantly. Notably, a quantile analysis revealed that the NEC intervention favored birth weight among mothers with a height below the mean height of the participant sample (156 cm) (P-interaction = 0.043). ConclusionsTailoring NEC in food-insecure communities did not result in a significant difference in birth weight among infants of the participating mothers, but mean birth length and abdominal circumference were greater in the intervention group compared to controls. We noted that the NEC intervention favored birth weight among mothers with a lower height than the mean sample height. Our results warrant further investigation into offering tailored NEC early in pregnancy and on a larger scale.This trial was registered at clinicaltrials.gov as NCT03136393.

Effectiveness of the Individualized Self-Care Program Based on Orem's Self-Care Theory: Impact on Learning Needs and Self-Care Behaviors Following Coronary Artery Bypass Surgery – A Randomized Controlled Trial

PurposeThis study aimed to investigate the specific learning needs of patients within the experimental group after receiving the Individualized Self-Care Program (ISCP) at two key time points: Time 2 (Day 2, Week 1) and Time 3 (Day 15, Week 3). Furthermore, it aimed to compare the effectiveness of the ISCP in improving self-care behavior between the experimental group and the control group, which received standard health education. MethodsThe study utilized a Randomized Controlled Trial (RCT) design and included a consecutive sample of 128 patients who had undergone their first CABG procedure. These patients were randomly divided into two groups: the experimental group (n = 64) and the control group (n = 64). The experimental group received an ISCP at Time 2 and Time 3 after being discharged, whereas the control group received standard health education. Statistical analyses included paired t-tests to assess differences in learning needs over time and Repeated Measures Analysis of Variance (ANOVA) to evaluate the effectiveness of the ISCP on self-care behavior. ResultsA paired t-test indicated a statistically significant difference in the total number of learning needs identified within the experimental group between Time 2 and Time 3 assessments. Patients in the experimental group initially identified more learning needs at Time 2 (4.3±1.5), but their knowledge significantly improved at Time 3, leading to fewer learning needs (2.6±1.1). Furthermore, an ANOVA comparing the experimental and control groups showed that the ISCP effectively improved self-care behavior in the experimental group, with significantly greater improvements compared to the control group, which received standard health education. ConclusionISCP delivered in early recovery enhances self-care behaviors and addresses postdischarge gaps. The study also revealed that patients' learning needs change over time during home recovery, emphasizing the importance of tailored self-care programs for CABG patients after discharge.

The Effect of a Health Literacy Program on Alcohol Use among Medical Students in Hubei Province, China: A Randomized Controlled Trial

Introduction: Health literacy (HL) plays an important role in alcohol consumption. Improving alcohol-related HL offers an integrated approach to prevent and reduce high-risk alcohol use. This study aimed to determine the effects of a HL program (HLP) on medical students’ drinking behaviors. Methods: A randomized controlled trial was conducted from June 2023 to January 2024 among medical students. One hundred and four students were randomly allocated to the intervention (n = 52) and control (n = 52) groups. The intervention group received the HLP over six sessions, while the control group received standard health education. Data were collected through interviews using a structured interview questionnaire. Independent t-tests, paired sample t-tests, Chi-squared tests, and Chi-square for trend were applied for statistical analysis. Results: Following the HLP, the intervention group exhibited a significant increase in the mean total HL score, cognitive skills, access skills, communication skills, self-management skills, media skills, and decision skills compared to the control group (P &lt; 0.05). Moreover, the intervention group showed a significant decrease in the number of harmful drinkers compared to the control group (P &lt; 0.05). Conclusion: HLPs are effective in improving HL and reducing alcohol consumption among medical students. Our findings suggest incorporating HLPs into adolescents’ health education activities.

Improving physical and mental health in women with breast cancer undergoing anthracycline-based chemotherapy through wearable device-based aerobic exercise: a randomized controlled trial.

Aimed to assess the impact of wearable device-based aerobic exercise on the physical and mental well-being of women with breast cancer (BC) undergoing chemotherapy. Forty adult women with BC who underwent anthracycline-based chemotherapy were randomly allocated to the exercise group (n = 21) or the control group (n = 19). Both groups received standard health education and oncology care. In addition, the exercise group wore wearable devices to engage in moderate to high-intensity (50-90% HRmax) aerobic exercise during chemotherapy, while the control group did not carry out exercise intervention. Health-related physical fitness level, physical activity energy expenditure (PAEE), anxiety and depression scores, sleep quality, cancer-related fatigue, and overall quality of life (QoL), were assessed both before (prior to the first chemotherapy session) and after (prior to the fifth chemotherapy session) the exercise intervention. Exercise-related adverse events, exercise compliance, number and severity of gastrointestinal reactions and myelosuppression occurred were recorded during the exercise intervention. After the intervention, compared to the control group, the exercise group (1) had significantly higher relative VO2peak (p = 0.003) and handgrip strength (p < 0.001); (2) had significantly higher PAEE (p < 0.001); (3) had a significantly lower scores in anxiety (p = 0.007), depression (p = 0.028), sleep quality in domains of subjective sleep quality (p = 0.010), sleep disturbances (p = 0.004), daytime dysfunction (p = 0.007), cancer-related fatigue in domains of physical (p < 0.001) and affective (p < 0.001); and (4) had a significantly lower scores in QoL in domains of physical well-being (p < 0.001) and emotional well-being (p = 0.019), while a significantly higher scores in functional well-being (p < 0.001). Patients in the exercise group experienced less severe gastrointestinal reactions (p = 0.028) and myelosuppressive symptoms (p < 0.001) than that in the control group. Patients in the exercise group had no serious exercise-related adverse events, with a mean exercise adherence of 81.8%. Wearable device-based aerobic exercise during chemotherapy can be an effective adjunctive therapy to improve physical and mental health in BC patients. https://www.chictr.org.cn/showproj.html?proj=200247, Identifier: ChiCTR2300073667.

Effectiveness of a Community-Based First Aid Education Program on Choking for Laypersons in Surabaya, Indonesia: A Quasi-Experimental Study

Choking is a leading cause of accidental death, particularly among children and the elderly. Prompt first aid, especially the Heimlich maneuver, is crucial in preventing fatalities. This study aimed to evaluate the effectiveness of a community-based first aid education program on choking in Surabaya, Indonesia. A quasi-experimental, pre-post design was implemented in Surabaya. Participants were recruited from various community settings (workplaces and community centers). The intervention group received a comprehensive first aid education program on choking, while the control group received standard health education. Knowledge and skills related to choking first aid were assessed before and after the intervention. A total of 350 participants completed the study (175 per group). The intervention group demonstrated a significant improvement in knowledge (p &lt; 0.001) and skills (p &lt; 0.001) related to choking first aid compared to the control group. Additionally, the intervention group reported increased confidence in their ability to respond to choking emergencies. The community-based first aid education program significantly enhanced knowledge, skills, and confidence in choking first aid among laypersons in Surabaya. Such programs should be considered as a public health strategy to reduce choking-related morbidity and mortality.

Multilevel Interventions and Dental Attendance in Pediatric Primary Care

Untreated tooth decay is disproportionately present among low-income young children. While American Academy of Pediatrics (AAP) guidelines require pediatric clinicians to implement oral health care, the effectiveness of these oral health interventions has been inconclusive. To test the effectiveness of multilevel interventions in increasing dental attendance and reducing untreated decay among young children attending well-child visits (WCVs). The Pediatric Providers Against Cavities in Children's Teeth study is a cluster randomized clinical trial that was conducted at 18 pediatric primary care practices in northeast Ohio. The trial data were collected between November 2017 and July 2022, with data analyses conducted from August 2022 to March 2023. Eligible participants included Medicaid-enrolled preschoolers aged 3 to 6 years attending WCVs at participating practices who were enrolled at baseline (WCV 1) and followed-up for 2 consecutive examinations (WCV 2 and WCV 3). Clinicians in the intervention group received both the practice-level (electronic medical record changes to document oral health) and clinician-level (common-sense model of self-regulation theory-based oral health education and skills training) interventions. Control group clinicians received AAP-based standard oral health education alone. Dental attendance was determined through clinical dental examinations conducted by hygienists utilizing International Caries Detection and Assessment System criteria and also from Medicaid claims data. Untreated decay was determined through clinical examinations. A generalized estimating equations (GEE) approach was used for both clinical examinations and Medicaid claims data. Eighteen practices were randomized to either intervention or control. Participants included 63 clinicians (mean [SD] age, 47.0 [11.3] years; 48 female [76.2%] and 15 male [23.8%]; 28 in the intervention group [44.4%]; 35 in the control group [55.6%]) and 1023 parent-child dyads (mean [SD] child age, 56.1 [14.0] months; 555 male children [54.4%] and 466 female children [45.6%]; 517 in the intervention group [50.5%]; 506 in the control group [49.5%]). Dental attendance from clinical examinations was significantly higher in the intervention group (170 children [52.0%]) vs control group (150 children [43.1%]) with a difference of 8.9% (95% CI, 1.4% to 16.4%; P = .02). The GEE model using clinical examinations showed a significant increase in dental attendance in the intervention group vs control group (adjusted odds ratio, 1.34; 95% CI, 1.07 to 1.69). From Medicaid claims, the control group had significantly higher dental attendance than the intervention group at 2 years (332 children [79.6%] vs 330 children [73.7%]; P = .04) but not at 3 years. A clinically but not statistically significant reduction in mean number of untreated decay was found in the intervention group compared with controls (B = -0.27; 95% CI, -0.56 to 0.02). In this cluster randomized clinical trial, children in the intervention group had better dental outcomes as was evidenced by increased dental attendance and lower untreated decay. These findings suggest that intervention group clinicians comprehensively integrated oral health services into WCVs. ClinicalTrials.gov Identifier: NCT03385629.

Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study

BackgroundThe global aging population presents challenges that are particularly acute in China. Older Chinese adults’ attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs.MethodsThis mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group.ResultsForty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one’s acceptance and others’ avoidance, and evaluation of the life education program.ConclusionsThe KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort.Trial registrationThis study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176.

Influence of health education based on the transtheoretical model on kinesiophobia levels and rehabilitation outcomes in elderly patients undergoing total knee arthroplasty

ObjectiveIn this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. MethodsElderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. ResultsBetween January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. ConclusionHealth education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Efficacy and safety of traditional Chinese manual therapy (Tuina) in patients with non-specific chronic low back pain: a study protocol for a randomised controlled trial

IntroductionNon-pharmacological interventions play a crucial role in the management of non-specific chronic low back pain (NSCLBP). One prime example is Tuina, a traditional Chinese manual therapy that incorporates pressing, kneading...

Enhancing Nutritional Status and Quality of Life in Hemodialysis Patients: The Impact of Internet-Based Cognitive Behavioral Therapy

This study examined the effects of internet-based cognitive behavioral therapy on the nutritional status and scores from the Knowledge, Attitude, and Practice questionnaire in maintenance hemodialysis patients. Patients in the traditional therapy group received standard health education, whereas those in the experimental group participated in three months of this therapy. Clinical and nutritional indicators, including blood biomarkers and Knowledge, Attitude, and Practice questionnaire scores, were recorded for both groups before and after the treatment. Post-treatment, the group receiving internet-based cognitive behavioral therapy exhibited higher blood calcium levels, increased upper arm circumference, and reduced levels of potassium and phosphorus. They also showed comparatively lower scores in Nutritional Risk Screening 2000 and Malnutrition Inflammation, along with higher Visual Analog Scale scores (P &lt; 0.05). The internet-based cognitive behavioral therapy group exhibited higher albumin and prealbumin levels, reduced transferrin, total cholesterol, creatinine, and urea levels, and modified quantitative subjective global assessment scores than the traditional therapy group (P &lt; 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P &lt; 0.05). These results indicate that internetbased cognitive behavioral therapy can improve the nutritional status, Knowledge, Attitude, and Practice questionnaire scores, and overall quality of life in maintenance hemodialysis patients, highlighting its potential benefit in patient outcomes.

Smart Technology for Aging and Reducing Disability (STAReD): Study protocol for a randomized pragmatic clinical trial

BackgroundThere is a critical need to improve quality of life for community-dwelling older adults with disabilities. Prior research has demonstrated that a smart, in-home sensor system can facilitate aging in place for older adults living in independent living apartments with care coordination support by identifying early illness and injury detection. Self-management approaches have shown positive outcomes for many client populations. Pairing the smart, in-home sensor system with a self-management intervention for community-dwelling older adults with disabilities may lead to positive outcomes. MethodsThis study is a prospective, two-arm, randomized, pragmatic clinical trial to compare the effect of a technology-supported self-management intervention on disability and health-related quality of life to that of a health education control, for rural, community-dwelling older adults. Individuals randomized to the self-management study arm will receive a multidisciplinary (nursing, occupational therapist, and social work) self-management approach coupled with the smart-home sensor system. Individuals randomized to the health education study arm will receive standard health education coupled with the smart-home sensor system. The primary outcomes of disability and health-related quality of life will be assessed at baseline and post-intervention. Generalizable guidance to scale the technology-supported self-management intervention will be developed from qualitatively developed exemplar cases. ConclusionThis study has the potential to impact the health and well-being of rural, community-dwelling older adults with disabilities. We have overcome barriers including recruitment in a rural population and supply chain issues for the sensor system. Our team remains on track to meet our study aims.

Gaps in sexual health content of healthcare professional curriculum: a systematic review of educational interventions

BackgroundSexual health care, including assessment and patient teaching, is part of comprehensive patient care. Health professional (medical and nursing) students’ education in sexual health lacks uniformity in content and assessment skills.ObjectivesThe current systematic review aimed to assess sexual health educational curriculum for health professional students regarding the educational content, duration, and evaluation of these educational interventions.MethodsThis systematic review followed the preferred reporting guidelines for systematic reviews. A comprehensive search was conducted between May–August, 2023 across four databases (PubMed, Scopus, CINAHL, EMBASE), outlining 614 sources. Following the screening process, 36 educational intervention studies were deemed eligible for inclusion. The quality assessment of these studies was conducted using The Effective Public Health Project tool, which was found appropriate for evaluating this type of research.ResultsThe studies had a global representation, with most studies conducted in the US. Limited nursing educational interventions were found. Three main categories emerged from the analysis of the educational interventions: one-time interventions, workshops, and semester courses. These categories differed in terms of their duration. Upon evaluating the educational intervention programs, it was found that the majority relied on participant self-reporting, while only a few included objective evaluations.ConclusionsThis review revealed inconsistencies in educational content for healthcare professional students and may impact their clinical skills, particularly in sexual health. The variation in content, duration, and evaluation methods created challenges in assessing the interventions. The lack of standardized sexual health education highlighted a significant gap, raising concerns about students’ ultimate proficiency in this area. Bridging this divide is essential by integrating comprehensive sexual health content and assessment skills into the health professional curriculum.

Abstract C019: Comparing the effectiveness of different community education approaches on colorectal cancer knowledge

Abstract Introduction: Colorectal cancer (CRC) incidence and mortality varies greatly among racial/ethnic groups nationally. Community outreach and education are effective strategies to enhance knowledge of CRC and have been shown to increase screening for CRC. The University of New Mexico Comprehensive Cancer Center implements Screen to Save, a community-based CRC screening initiative through the National Outreach Network Program. During the COVID-19 pandemic, restrictions on in-person engagement led to the development and implementation of alternative delivery strategies. Our site continued in-person education as possible, and added Zoom and fully self-paced via QR code options for community member participation. Very little is known regarding the effectiveness of different delivery modes. The purpose of this research is to examine the relationship between method of education session delivery and participant CRC knowledge. Methods: Participants were recruited via community organizations, Facebook advertising, and referrals from local stakeholders. Both before and after a standardized health education session, participants completed a survey assessing their knowledge of CRC risk and screening recommendations. Participant demographics were descriptively summarized. Estimates of mean changes, and 95% confidence intervals (CI), were obtained for each content delivery type. Differences in these changes were compared using ANCOVA approaches. Results: There were 239 participants who completed the educational sessions in-person (n=81), via Zoom (n=66), or using the self-paced module (n=92), Groups did not differ significantly in composition for age (p=0.72) or gender (p=0.33), but did differ in race, ethnicity, and education level (p&amp;lt;0. 001). Those who participated in any delivery method improved their knowledge scores by 11.6 (95% CI: 9.9-13.3) percentage points. For in-person, Zoom, and self-paced groups, the improvements were 14.1 (95% CI: 10.6-17.6, p&amp;lt;0.001), 11.5 (95% CI: 9.1-13.8, p&amp;lt;0.001), and 9.4 (95% CI: 6.7-12.1, p&amp;lt;0.001) percentage points, respectively. When comparing pre vs post score differences among session types while adjusting for pre scores, and for baseline differences in race, ethnicity, and education, the differences in improvement for the three different session types were not significantly different (p=0.68). For in-person, Zoom, and self-paced groups adjusted improvements were 9.2 (95% CI: 0.5-17.5), 11.1 (95% CI: 1.9-19.8), and 10.1 (95% CI: 1.5-18.3) percentage points, respectively. Conclusion: Health education sessions delivered in person, via Zoom, and by self-paced online modules are associated with increases in participant knowledge of CRC. As Cancer Centers expand community outreach and engagement to address cancer health disparities in their catchment areas, a better understanding of the relative effectiveness of different delivery strategies is needed. Further research will help to discern population characteristics predictive of different strategies and link these approaches to screening uptake. Citation Format: Lila A. Baca, Yadira Aguero, Angelica Solares, Vernon Shane Pankratz, Shiraz I. Mishra, Miria Kano, Andrew L. Sussman. Comparing the effectiveness of different community education approaches on colorectal cancer knowledge [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C019.

A Randomized Standard-of-Care Controlled Trial of Xenogeneic Platelet-Rich Plasma Lotion to Reduce Acute Radiation Dermatitis in Breast Cancer Patients

Breast cancer patients experience acute radiation dermatitis (ARD) during radiation therapy (RT). The Multinational Association for Supportive Cancer Care published clinical practice guidelines for the prevention and treatment of ARD in 2013, and mild bathing at the irradiated site is the standard health education. This study examined the prophylactic effect of the newly developed xenogeneic platelet-rich plasma (PRP) lotion on acute radiation dermatitis (ARD) for breast cancer patients. Ductal carcinoma in situ and early-stage breast cancers were enrolled after breast conserving surgery. Hypo-fractionated whole breast irradiation (42.5 Gy in 16 fractions) followed by tumor bed boost (10 Gy in 5 fractions) was used. Patients were randomly assigned to the Standard of Care (SOC) group (n = 48) or the PRP lotion group (n = 52). In both groups, patients were educated with standard health education on topical skin care. In the PRP lotion group, patients were instructed to apply the provided lotion twice a day, starting from the first day of RT: the first application within 1 hour after the daily RT session, the second at bedtime, and continue during the weekends. Patients were instructed not to apply the lotion within 6 hours before daily RT. We recorded the following skin reaction every week during RT and two weeks after RT: ARD was graded following the RTOG definition by two radiation oncologists; Dermatology Life Quality Index (DLQI) and Visual Analogue Scale for Pain (VAS Pain) were subjectively scored by patients to present patient-reported outcomes. The statistical software was used for all statistical analyses. The patient characteristics in both groups were balanced except for a higher body mass index in the PRP lotion group. One patient did not complete RT in the SOC group due to pain intolerance. The severity of ARD grading in both groups is shown in Table. In comparison to the SOC group, the PRP lotion group demonstrated significantly reduced and delayed progression of ARD (p<0.01) and VAS Pain (p<0.01) during the whole RT course and two weeks after RT. The DLQI significantly improved at the 2nd week (p = 0.003), 3rd week (p = 0.01), 4th week (p<0.001), and the two weeks post-RT (p<0.001) period; however, this was not observed during the 1st week (p = 0.68). Similarly, the DLQI value progressively worsened two weeks after RT in the SOC group but not in the PRP lotion group. This is the first study to use xenogeneic PRP lotion to prevent ARD clinically. The outcome of this study validated the prophylactic effects of xenogeneic PRP lotion on ARD, subsequently leading to an improved quality of life across the RT course.

Innovative Integrated Motivational Interviewing for Dual Management in Tuberculosis Patients with Diabetes (MID-DOT) in Malaysia

(1) Background: Achieving successful tuberculosis (TB) treatment outcomes among diabetic patients is a real challenge as TB complicates control of diabetes. This study aimed to evaluate the effectiveness of an integrated dual management educational module, MID-DOTS, which uses the mmotivational interviewing (MI) technique implemented within directly observed treatment as part of a short course (DOTS) program in TB patients with diabetes (TB/DM). A randomized controlled trial was conducted in the northeastern state of Malaysia. (2) Methods: One hundred and twenty-four TB patients with diabetes received educational intervention using a MID-DOT module that used the MI technique, which was repetitively applied by TB nurses throughout a 6-month DOTS program while another 122 patients were given standard health education. Study outcomes include the proportion of patients with successful TB treatment, and changes in HbA1c and diabetic self-care scores at 6 months. (3) Results: The successful TB treatment outcome was 88% in the intervention group versus 72% in the control group (RR = 1.24; 95%CI 1.16, 1.58). A significant reduction of HbA1c (mean difference 0.82%; 95%CI 0.66, 0.98) and significantly higher diabetes self-care score (mean difference 8.49; 95%CI 7.38, 9.59) were also shown in the intervention group. (4) Conclusions: A dual TB/DM educational strategy which integrates the MI technique applied repetitively within the DOTS program is effective in increasing successful TB treatment as well as improving diabetic outcomes.