Search Results (193)

This study analyses the effectiveness of a contextualized teaching and learning sequence (TLS) based on forensic entomology (FE) to disprove the idea of spontaneous generation (SG) among students enrolled in the Higher Vocational Education and Training (VET) Cycle in Pathological Anatomy and Cytodiagnosis. Through an inquiry- and project-based learning approach, students replicate a version of Francesco Redi’s historical experiments, enabling them to engage with core scientific concepts such as the metamorphic cycle of insects and the role of entomology in forensic science. The research adopts a semiquantitative and exploratory design. It investigates: (1) whether students’ prior knowledge about FE and related biological processes is sufficient to refute SG; (2) to what extent this knowledge is influenced by their previous academic background and gender; and (3) whether a contextualized TLS can significantly enhance their conceptual understanding. The results reveal that most students begin with limited initial knowledge of FE and multiple misconceptions related to SG, irrespective of their previous study. Gender differences were observed at baseline, with women showing lower prior knowledge, but these differences disappeared after the intervention. The post-intervention data demonstrate a significant improvement in student’s ability to reject SG and explain biological processes coherently. The study highlights the importance of integrating entomology into health-related VET programs, both as a means to promote scientific literacy and correct misconceptions and as a pedagogical tool to foster critical thinking. It also highlights the potential and historically grounded methodologies to equalize learning outcomes and strengthen the scientific preparation of future healthcare professionals. Full article

African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care. Full article

Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and sustainable healthy lifestyle behaviors within the context of physical literacy is notably scarce. In this context, the aim of this study is to examine the effect of e-health literacy on a sustainable healthy lifestyle and to evaluate the mediating role of physical literacy in this relationship. Methods: A total of 835 adolescents from high schools across Türkiye voluntarily participated in this study. During the data collection process, the e-Health Literacy Scale, the Perceived Physical Literacy Scale, and the Healthy and Sustainable Lifestyle Scale were utilized. Data were analyzed using the JASP (version 0.18.3.0) software. Correlation analysis and structural equation modeling were conducted, and the bootstrap method (n = 5000) was employed for mediation analysis. Results: The effect of e-health literacy on a sustainable healthy lifestyle was found to be positive and statistically significant (β = 0.452, p < 0.001). Similarly, e-health literacy significantly predicted physical literacy (β = 0.755, p < 0.001), and physical literacy significantly predicted a sustainable healthy lifestyle (β = 0.310, p < 0.001). The mediating effect was also statistically significant (β = 0.234, p < 0.001). The model explained 32% of the variance in healthy lifestyle behaviors. Conclusions: The findings indicate that evaluating e-health literacy and physical literacy together provides a holistic approach to fostering sustainable healthy lifestyle habits among adolescents. It is recommended that intervention programs be structured to encompass both areas of competence. Full article

Background/Objectives: Health literacy plays a fundamental role in adolescents’ health-related decisions and behaviors. The aim of our study was to assess the level of health literacy among 16–17-year-old students in Southern Hungary and to examine the associations between sociodemographic characteristics and health behaviors. Methods: This cross-sectional quantitative study was conducted in the autumn of 2024 in Baranya and Somogy counties. A total of 133 students completed a self-administered questionnaire including sociodemographic variables and health behaviors. Health literacy was measured using the validated HELMA-H instrument. Statistical analysis included chi-square tests, t-tests, and ANOVA (p < 0.05). Results: Overall, 62.7% of the students demonstrated adequate, while 37.3% demonstrated inadequate levels of health literacy. No significant association was found between overall health literacy and sociodemographic variables; however, partial associations were observed on specific subscales. Boys reported better access to health information (p = 0.037), while children of mothers with higher educational attainment scored better in comprehension (p = 0.042) and appraisal (p = 0.036). In the case of the numeracy subscale, children of mothers with the lowest educational level showed significantly better results (p = 0.006). Students with higher health literacy levels were less likely to smoke or consume caffeine; however, a reverse trend was observed regarding alcohol consumption. Physical activity showed a positive association with healthier behaviors (p < 0.05). Discussion: The use of digital technologies, interactive learning strategies, and the involvement of family members—especially mothers—may support the development of health-conscious decision-making in adolescents. Consequently, health education programs should focus not only on knowledge transfer but also on fostering critical thinking and decision-making skills. Full article

Health literacy is a critical determinant of health outcomes, yet it is often overlooked, particularly among marginalized groups. This paper explores the significance of health literacy, with a particular focus on low-income African American and Black (AA/B) men, a population that faces unique challenges due to intersecting factors such as race, gender, socioeconomic status, and educational disparities. We examine how these factors contribute to health literacy gaps, highlighting adverse effects on health outcomes for AA/B men compared to the general population. Additionally, we stress the growing importance of digital literacy in an increasingly technology-driven world. Not actively addressing digital health literacy, especially within chronic disease self-management programs (CDSMPs), further exacerbates health disparities within this group. Recommendations are provided for improving health literacy, with specific strategies to also enhance general literacy and digital literacy, among low-income AA/B men. The paper also advocates for a systematic review of the existing literature on health literacy among this group, emphasizing the need for tailored interventions that account for the unique challenges faced by low-income AA/B men. In conclusion, the paper underscores the critical need for targeted research and practical approaches to improve health literacy and ultimately health outcomes for AA/B men in the digital age, particularly through CDSMPs. Full article

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

Background: Internationally, digital health interventions have increasingly been adopted within hospital settings. Optimising their clinical implementation requires user involvement, but there is a lack of evidence regarding how this should be done. Objectives: This study was carried out to understand the acceptability and usability of a prototype Digital Antibiotic Review Tracking Toolkit and identify modifications required to optimise it ahead of a trial. Methods: The optimisation process involved online semi-structured interviews with a purposive sample of fifteen healthcare professionals recruited from Scotland and England, along with three service users, to gather feedback on the prototype’s design, content and delivery. Participants’ negative views were specifically sought to identify adaptations needed to ensure that the intervention’s components aligned optimally with end-user needs. Data were analysed using Framework Analysis guided by the RE-AIM implementation science framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to identify key themes. Results: Participants mostly voiced positive views regarding the prototype, finding it acceptable, feasible and engaging. They also identified concerns relating to its adoption, system functionality, accessibility and maintenance that needed to be addressed. Anticipated low adoption rates were linked to issues surrounding computer literacy. This detailed user feedback informed rapid adjustments to the intervention to enhance its acceptability, perceived future credibility and usability in hospitals. Conclusions: This novel study illustrates how to identify, modify and adapt a digital intervention quickly and efficiently using qualitative iterative methods. Findings highlight the critical importance of contextualising end-user experience with health interventions to facilitate future engagement, uptake, and long-term use. This study also demonstrates how core elements of the MRC framework can be operationalised to help refine prototype digital interventions pre-trial. Full article

In regions with sustained air pollution, the adoption of protective health behaviors is critical, particularly among pregnant women—a population marked by physiological vulnerability and heightened receptivity to preventive guidance. Understanding and supporting patient-driven behavioral change requires attention to individual perception and awareness, which are shaped by socio-economic and spatial factors, as well as access to credible information. Objectives: This study investigates how pregnant women in Serbia perceive air quality, identifies determinants that influence these perceptions, and evaluates the extent and nature of behavioral adaptations undertaken to mitigate exposure-related risks. Methods: A cross-sectional survey was conducted among 279 pregnant women using a structured, researcher-administered questionnaire. Collected data included demographic and psychosocial variables, air quality perceptions, self-reported health effects, and behavioral responses. Residential proximity to land-use attributes was assessed using GIS-based spatial analysis. Results: Most participants perceived air quality as poor (68.8%), primarily informed by unofficial sources such as mobile applications and social media. Living close to continuous urban fabric (OR = 0.180, 95% CI: 0.059–0.558, p = 0.003) and water (OR = 0.306, 95% CI: 0.127–0.738, p = 0.008) was associated with poorer perceptions, while proximity to forests (OR = 2.938, 95% CI: 1.323–6.525, p = 0.008) correlated with more favorable assessments. Despite prevalent concern, around half of respondents (50.2%) reported no behavioral modifications. Importantly, none had received guidance from healthcare professionals on the topic. Conclusions: These findings highlight critical gaps in environmental health literacy and provider engagement. Integrating tailored communication and behavioral support in existing prenatal counseling could advance health-related quality of life in this vulnerable population. Full article

Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development (ECD) centres in Makhanda, South Africa, through a community-based participatory research approach. Using a mixed-methods approach combining questionnaire interviews, focus group discussions, direct observations, and community asset mapping across eight ECD centres enrolling 307 children aged 0–5 years, the study engaged ECD facilitators and analysed dietary practices across these centres. Results indicated that financial constraints severely affect the quality and diversity of food provided at the centres, thus undermining the ability to provide nutritionally adequate meals. The average amount spent on food per child per month at the centres was R90 ± R25 (South African Rand). Although three meals were generally offered daily, cost-driven dietary substitutions with cheaper, less diverse alternatives, often at the expense of nutritional value, were common. Despite guidance from Department of Health dieticians, financial limitations contributed to suboptimal feeding practices, with diets dominated by grains and starchy foods, with limited access to and rare consumption of protein-rich foods, dairy, and vitamin A-rich fruits and vegetables. ECD facilitators noted insufficient parental contributions and low engagement in supporting centre operations and child nutrition provision, indicating a gap in awareness and limited nutrition knowledge regarding optimal infant and young child feeding (IYCF) practices. The findings emphasise the need for sustainable, multi-level and community-led interventions, including food gardening, creating ECD centre food banks, parental nutrition education programmes, and enhanced financial literacy among ECD facilitators. Strengthening local food systems and establishing collaborative partnerships with communities and policymakers are essential to improve the nutritional environment in ECD settings. Similarly, enhanced government support mechanisms and policy-level reforms are critical to ensure that children in resource-poor areas receive adequate nutrition. Future research should focus on scalable, locally anchored models for sustainable child nutrition interventions that are contextually grounded, community-driven, and should strengthen the resilience of ECD centres in South Africa. Full article

Background: The increasing prevalence of dementia and mild cognitive impairment (MCI) among the elderly population is a global health issue. Information and Communication Technology (ICT)-based interventions hold promises for maintaining cognition, but their viability is affected by several challenges. Objectives: This study aimed to significantly assess the effectiveness of ICT-based cognitive and memory aid technology for individuals with MCI or dementia, identify adoption drivers, and develop an implementation model to inform practice. Methods: A PRISMA-based systematic literature review, with the protocol registered in PROSPERO (CRD420251051515), was conducted using seven electronic databases published between January 2015 and January 2025 following the PECOS framework. Random effects models were used for meta-analysis, and risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Results: A total of ten forms of ICT interventions that had proved effective to support older adults with MCI and dementia. Barriers to adoption included digital literacy differences, usability issues, privacy concerns, and the lack of caregiver support. Facilitators were individualized design, caregiver involvement, and culturally appropriate implementation. ICT-based interventions showed moderate improvements in cognitive outcomes (pooled Cohen’s d = 0.49, 95% CI: 0.14–1.03). A sensitivity analysis excluding high-risk studies yielded a comparable effect size (Cohen’s d = 0.50), indicating robust findings. However, trim-and-fill analysis suggested a slightly reduced corrected effect (Cohen’s d = 0.39, 95% CI: 0.28–0.49), reflecting potential small-study bias. Heterogeneity was moderate (I² = 46%) and increased to 55% after excluding high-risk studies. Subgroup analysis showed that tablet-based interventions tended to produce higher effect sizes. Conclusions: ICT-based interventions considerably enhance cognition status, autonomy, and social interaction in older adults with MCI and dementia. To ensure long-term scalability, future initiatives must prioritize user-centered design, caregiver education, equitable access to technology, accessible infrastructure and supportive policy frameworks. Full article

Chronic disease self-management (CDSM) is critical for improving health outcomes, particularly for individuals with low health literacy who face barriers in accessing and understanding medical information. This study examined the role of tailored digital health interventions in reducing stress and improving quality of life among individuals with chronic conditions. A multisite randomized controlled trial including 309 participants at baseline aged 40 to 90 years was conducted using a mobile app that provided self-management information at different literacy levels. Latent growth curve modeling (LGM) computed in Mplus was used to assess changes in stress over time and its impact on quality of life. The results indicated that successful tailoring of health information was significantly associated with reductions in perceived stress, which, in turn, predicted improvements in quality of life. These findings suggest that personalized digital interventions may enhance engagement with self-management strategies, alleviate psychological distress, and contribute to better overall well-being. This study highlights the importance of tailoring health content to users’ literacy levels and informational needs, underscoring the potential of mobile health solutions for improving CDSM. Future research should explore additional mechanisms underlying these effects and assess the long-term sustainability of digital interventions in diverse populations. These results provide valuable insights into optimizing mobile health applications to support individuals with chronic conditions. Full article

Objectives: The Human papillomavirus (HPV) vaccine is a cornerstone of cancer prevention, yet uptake remains suboptimal in many countries. This study analyzed the factors influencing HPV vaccine acceptance among adults, including a focused analysis of parental behaviors. Methods: Data were collected through a web-based survey using a questionnaire. We performed univariable analysis and three logistic regression analyses to investigate the determinants in the overall sample and among parents. Results: A total of 1821 participants were surveyed. HPV vaccination uptake was low, with only 6.9% of the total sample and 7.6% of young adults (18–35 yo) vaccinated. Among parents, 47.9% had vaccinated children aged 12–17, and 21.1% those aged 18 and over. Higher health literacy was associated with positive attitudes (OR 2.03, 95% CI 1.48–2.79), while receiving information from pediatricians or gynecologists was linked to children’s vaccination status (OR 7.30, 95% CI 2.29–23.31) and parents’ intentions for future HPV vaccination (OR 5.86, 95% CI 1.85–18.50). Adequate knowledge emerged as a strong predictor of positive attitudes (OR 6.50, 95% CI 4.91–8.61) and parents’ intentions (OR 4.89, 95% CI 2.21–10.84). Vaccination status was a key factor influencing parental decisions and overall vaccine acceptance. Conclusions: These findings highlight the critical role of health professionals and the need for targeted communication to address persistent knowledge gaps and promote HPV vaccine confidence within general population. Full article

Citizen science (CS) is increasingly recognized as a complementary approach for addressing soil health challenges—including erosion, pollution, nutrient imbalances, and biodiversity loss—by harnessing public participation to broaden spatial and temporal data collection. This review synthesizes findings from the following: (i) a systematic analysis of peer-reviewed literature and grey sources, (ii) a database of 96 CS initiatives compiled by the European PREPSOIL project, and (iii) questionnaire surveys and workshops conducted in five Living Labs across Europe. Our analysis indicates that volunteer-driven monitoring can enhance the volume and granularity of soil data, providing critical insights into parameters such as organic carbon content, nutrient levels, and pollutant concentrations. However, persistent challenges remain, including inconsistencies in data validation, volunteer attrition, and concerns regarding digital literacy and data privacy. Despite these challenges, ongoing efforts to standardize protocols, integrate remote sensing and sensor-based validation methods, and employ feedback mechanisms improve data reliability and participant engagement. We conclude that sustained capacity-building, transparent data governance, and stakeholder collaboration, from local communities to governmental bodies, are essential for fully realizing the potential of citizen science in soil conservation. This work is framed within the context of the European Soil Mission, and CS is demonstrated to meaningfully support sustainable land management and evidence-based policymaking by aligning public-generated observations with established scientific frameworks. Full article

As populations age globally, governments face mounting challenges in reconfiguring healthcare and housing systems to support aging-in-place. This study offers a comparative analysis of South Korea and the United Kingdom, examining how each country integrates digital technologies, such as Artificial Intelligence (AI), telecare, and smart housing systems, into their aging strategies. South Korea employs a centralized, technology-driven approach that prioritizes the national rollout of AI-enabled smart homes and digital health infrastructure. In contrast, the UK advances a decentralized, community-based model emphasizing social housing, localized care delivery, and telecare integration. Despite these differing trajectories, both nations face shared limitations, including high implementation costs, digital literacy barriers, and concerns about data privacy. Critically, the study finds that the success of aging-in-place efforts is shaped not only by technological capacity but also by governance dynamics, political continuity, and institutional coordination. In response, the paper proposes policy recommendations alongside an ethical framework grounded in transparency, autonomy, informed consent, and equity. Sustainable aging-in-place strategies require not only innovative technologies, but also inclusive governance and ethically robust design to ensure accessibility, trust, and long-term impact. Full article

Background/Objectives: Dementia is a growing public health issue, especially in rapidly aging societies like Taiwan, where nearly 10% of adults over 65 show signs of cognitive decline. Given that mild cognitive impairment (MCI) serves as a critical stage for early intervention, this study examined the feasibility and preliminary effectiveness of a virtual reality (VR)-based dementia prevention program, specifically designed based on self-regulated learning (SRL) principles to enhance dementia knowledge, health literacy, and self-efficacy among older adults with MCI. Methods: A pilot randomized controlled trial (RCT) was conducted with 60 older adults aged 65 and above with MCI. Participants were randomly assigned to either an experimental group, which received a VR-based dementia prevention program, or a comparison group, which received routine paper-based educational materials. Results: The experimental group demonstrated significant improvements in overall dementia knowledge and all subdomains. Significant gains were also observed in critical health literacy and self-efficacy, though no significant changes were found in overall health literacy. Conclusions: The preliminary findings suggest that the SRL-informed VR program showed initial effectiveness in enhancing dementia knowledge, critical health literacy, and self-efficacy among older adults with MCI, highlighting its potential as an innovative approach to dementia prevention education. Full article