Search Results (422)

Cancer remains a growing public health concern in South Africa, particularly in underserved communities where disparities in awareness and access to care contribute to delayed diagnosis. This study evaluated the impact of a culturally tailored educational intervention based on an adapted Cancer-Community Awareness Access Research and Education (c-CARE) module in Johannesburg and iLembe districts. A pilot study using a quasi-experimental pre–post design was conducted to assess changes in knowledge and attitudes among 210 traditional health practitioners, community health workers, and faith-based leaders. Structured surveys measured awareness of multiple myeloma, prostate, lung, breast, and cervical cancers. Data were captured in REDCap and analyzed using SPSS version 30. Significant improvements in knowledge were observed across all cancers. Awareness of lung cancer increased from 74.3% to 96.7%, multiple myeloma from 26.7% to 96.7%, prostate cancer from 52.5% to 98.3%, breast cancer from 93.4% to 98.7%, and cervical cancer from 84.8% to 96.0%. Participants demonstrated improved understanding of screening modalities and risk factors, including tobacco-related harms. Despite these gains, screening-related fears remained evident. These findings demonstrate that contextually adapted, community-based training can strengthen cancer literacy and support early detection strategies in underserved settings. Full article

Background/Objectives: Pain behaviors observed during movement may complement self-reported and performance-based assessment in chronic nonspecific low back pain (NSLBP). The Pain Behaviour Scale (PaBS) quantifies clinician-observed pain behavior severity during functional tasks, but no Turkish version has been evaluated. This study translated and culturally adapted the PaBS into Turkish and examined its reliability, agreement, measurement error, and construct validity. Methods: This cross-cultural adaptation and psychometric validation study included 102 adults with chronic NSLBP. The PaBS was translated, back-translated, reviewed by an expert panel, and pilot tested. Participants completed clinical questionnaires and standardized physical performance tests. Two independent raters scored the PaBS at baseline; one rater repeated scoring after one week. Reliability was analyzed using ICCs. Measurement error, agreement, and construct validity were assessed using SEM, MDC95, percentage agreement, Cohen’s kappa, Bland–Altman analysis, and predefined correlation hypotheses. Results: Total-score interrater reliability was excellent (ICC = 0.95), and intrarater reliability was high (ICC = 0.96), although the latter should be interpreted cautiously because participant status changed between sessions. MDC95 values were 2.05 and 1.85. Individual behavior agreement ranged from 81.4% to 100.0%, but item-level findings should be supplementary. All construct-validity correlations were in the expected direction; however, most were stronger than predefined expectations, and only 1 of 13 hypotheses met both direction and magnitude. Conclusions: The Turkish PaBS appears reliable for assessing observed pain behavior severity during functional movement in adults with chronic NSLBP. Construct-validity findings should be considered preliminary because stronger-than-expected correlations may reflect construct overlap with disability, fear-avoidance, and physical performance. Full article

(1) Background: Medication administration errors (MAEs) are potentially harmful incidents that may be avoidable. This study aimed to assess the proportion of self-reported MAE reporting among nurses in Saudi Arabia and to identify the associated factors. (2) Methods: A descriptive cross-sectional study was conducted among 259 nurses at a teaching hospital from January to March 2023. Data were collected via an electronic questionnaire and analyzed using descriptive statistics. (3) Results: The results of this study revealed that medication administration errors were reported at a higher level. The study demonstrated that nurses notify their department when a medication administration error occurs. The primary contributing factors identified for not reporting MAEs were high workload (84.1%) and fear of legal action (42.5%). Double-checking medications was the most recommended preventive measure (99.7%). (4) Conclusions: Recommendations to increase MAE reporting include workload management and fostering a non-punitive reporting culture to enhance patient safety. Full article

Patient embarrassment represents a significant yet often underrecognized barrier to effective gynecological care. This review integrates multidisciplinary evidence from Embase, PubMed, PsycINFO, and the Cochrane Library (2000–2025) to examine the relationship between embarrassment, shame, and modesty and their impact on care-seeking behaviors, clinical outcomes, and healthcare utilization. Available data indicate that embarrassment is consistently associated with reduced participation in preventive screening, with up to one-third of non-attenders citing modesty-related concerns. In symptomatic patients, these emotional barriers contribute to clinically meaningful diagnostic delays, particularly in conditions such as cervical cancer, vulvar cancer, and endometriosis. Embarrassment also affects in-consultation behavior, with a substantial proportion of patients reporting withheld concerns or incomplete disclosure of medically relevant information. The consequences extend beyond delayed diagnosis to include reduced treatment adherence, increased disease severity at presentation, and higher healthcare costs due to more complex and resource-intensive interventions. Contributing factors include cultural stigma, prior negative clinical experiences, fear of judgment, and aspects of the clinical environment that may heighten patient vulnerability. Full article

Background: Panvascular disease (PVD) is a systemic atherosclerotic condition that poses a substantial threat to global health. Despite the recognized importance of early proactive screening, proactive screening beliefs among high-risk populations are poorly understood. Objective: To explore the proactive screening beliefs among Chinese high-risk patients for PVD based on the Health Belief Model (HBM), so as to provide evidence for developing targeted nursing intervention strategies and health policies. Methods: A descriptive qualitative study was conducted. Employing a purposive sampling strategy with maximum variation, participants at elevated risk for PVD were recruited from a tertiary hospital in Shanghai between October and December 2025 to conduct semi-structured interviews. Data saturation guided sample size (n = 22; 14 male, 8 female; mean age 62.68 years). Data were analyzed using qualitative content analysis. Results: Five main themes were extracted: multifaceted perceptions of susceptibility, multidimensional fear of severity, positive attitudes toward the benefits of proactive screening, multiple perceived barriers to proactive screening, and significant differences in self-efficacy for proactive screening. Conclusions: The proactive screening beliefs in Chinese high-risk patients of PVD were deeply embedded in local cultural values and healthcare realities. Tailored health education, age-friendly service optimization, and stratified intervention strategies are urgently needed to reduce screening barriers and improve population-wide proactive screening beliefs. Full article

Using theories of Afrocentricity (African Indigenous Knowledge) and of positioning, we investigated how Sub-Saharan African immigrant parents (SSAIP) support their Grade 6–9 children’s mathematics learning in Canada. Individual interviews were collected from twelve immigrant parents living in an urban community in Alberta and new to Canada (within five years). We ask: what are the mathematics experiences and perspectives of Sub-Saharan African immigrant families? We analyzed interview data from 12 SSAIPs from Greater Edmonton, Canada to identify the storylines they shared regarding their experiences and perspectives of mathematics learning. The prevailing storylines were interpreted through an African Indigenous Knowledge lens. We found that parents adjust their mathematics learning support for their children by negotiating their experiences from two cultural worlds of education: pre-colonial (African Indigenous Knowledge) and colonized worldviews, their home and host cultures, generally. We identified these storylines, some of which sit in tension with each other: “mathematics learning is a communal responsibility”, “mathematics teachers share responsibility for the moral upbringing of the child”, “mathematics as memory work is feared and stressful”, “adults tell children what to do”, “adults negotiate with children about what to do”, and “success in mathematics is a gift from God”. We interpreted the storylines through the Akan Adinkra epistemologies which manifest in the Adinkra symbols and sayings, and through our experiences living and working in Sub-Saharan Africa, to determine the way each storyline aligned with old African or new African ways. This study will be beneficial for educators wishing to adopt culturally responsive ways of engaging immigrant families in their children’s mathematics learning. Full article

Artificial intelligence (AI) is increasingly embedded in marketing work, yet employees who use AI tools may not always disclose AI’s role in producing their outputs. This study examines AI disclosure silence, defined as employees’ intentional withholding of information about the use, role, or contribution of AI tools in work-related outputs after AI has already been used. Unlike AI avoidance or resistance, this construct concerns post-adoption concealment; unlike general employee silence, it focuses on the hidden technological contribution behind visible work. Drawing on Conservation of Resources Theory and Psychological Safety Theory, the study investigates how threat-based conditions, safety and governance conditions, and AI-related capability are associated with AI disclosure silence. Data were collected through a two-wave survey of 635 marketing employees who actively used AI tools at work. The analysis combined measurement validation, Necessary Condition Analysis (NCA), fuzzy-set Qualitative Comparative Analysis (fsQCA), and explainable machine learning. The findings show that no single condition operated as a strong necessary bottleneck. Instead, AI disclosure silence appeared through multiple pathways involving AI anxiety, fear of negative evaluation, perceived creativity threat, perceived job insecurity, low trust in management, weak psychological safety, and unclear AI policy. SHapley Additive exPlanations (SHAP)-based interpretation further indicated that fear of negative evaluation, AI anxiety, perceived creativity threat, and trust in management had the strongest model-based predictive relevance. The study contributes to workplace AI and employee silence research by positioning AI disclosure silence as an emerging post-adoption disclosure construct. It also highlights the need for clear AI disclosure norms, non-punitive managerial responses, AI-assisted authorship guidelines, and psychologically safe AI-governance practices. The findings should be interpreted as configurational and predictive evidence rather than causal effects, and further scale validation across sectors and cultures is encouraged. Full article

Background: The rapid advancement of generative artificial intelligence is transforming music composition from an exclusively human-centric activity into a hybrid human–algorithmic domain. Despite technological progress and growing commercial integration, consumer acceptance of AI-generated music remains empirically underexplored. Methods: This study formulates and empirically evaluates a multidimensional theoretical model integrating nine frameworks—including UTAUT2, parasocial interaction theory, anthropomorphism theory, authenticity theory, and innovation resistance theory—through a quantitative cross-sectional survey of 466 young adults aged 17–28. Confirmatory factor analysis and multiple regression analysis (with robust standard errors) were employed. Results: The model explained 63.6% of the variance in behavioral intention (R² = 0.636). Five constructs emerged as significant predictors: hedonic motivation (β = 0.136, p = 0.017), parasocial relationships (β = 0.121, p = 0.002), social influence (β = 0.126, p = 0.002), performance expectancy (β = 0.102, p = 0.019), and innovation resistance (β = −0.089, p = 0.029). Authenticity concerns, ethical AI concerns, anthropomorphic perceptions, and technological substitution fears were non-significant in the multivariate model. Conclusions: Young consumers’ acceptance of AI-generated music is primarily driven by experiential, social, and relational factors rather than ethico-cultural concerns. These findings have substantive implications for creative industries navigating algorithmic cultural production. Full article

Western theories and empirical comparative research on attitudes toward immigrants and their rights have largely overlooked Latin America. To address this gap, we conducted multilevel ordered logistic regression analyses on Latinobarómetro surveys from 17 countries (N = 19,004). The findings show that support for immigrants’ social rights is more contingent on immigration-related benefits—especially cultural enrichment—than on perceived threats. When threats do mobilize opposition, the perceived fiscal burden emerges as the sole significant driver, overriding both concerns about labor market competition and fears of rising crime. Furthermore, right-wing individuals were no less supportive of immigrants’ social rights than left-wing individuals. Instead, the most welfare-chauvinist attitudes were found among the politically disengaged. At the macrosocial level, the results provide evidence that contextual factors not only exert a direct statistical effect on public support for immigrants’ social rights but also moderate the influence of perceived micro-level threats. In particular, the national unemployment rate and the immigrant stock exacerbate the exclusionary effect of the perceived fiscal burden on levels of support among citizens. Ultimately, these findings challenge some theoretical assumptions derived from intergroup threat theory, provide novel evidence for the Threat-Benefit Model, and further suggest a distinct political dynamic in the region. Full article

Background: Cervical cancer is among the most common cancers affecting women worldwide, with high morbidity and mortality in low- and middle-income countries. In Saudi Arabia, most cases are diagnosed at a late stage despite the availability of free HPV vaccination and screening. Objectives: To identify Saudi women’s perceptions of the HPV vaccine using the Health Belief Model, estimate willingness to receive the HPV vaccine and the factors influencing it, assess uptake of Pap smear and HPV vaccine, and define barriers to both practices. Methodology: A cross-sectional study of a convenience sample of 1334 Saudi women aged 16 to 65 years, from all regions of Saudi Arabia, was conducted. Data were collected via an online questionnaire that included sociodemographic characteristics, beliefs about the HPV vaccine based on the Health Belief Model, vaccine hesitancy, and HPV vaccine and Pap smear uptake. Data were analyzed using SPSS version 29. Results: Only 6% completed their vaccination series or received at least one dose; 37.3% planned to get vaccinated; and 56.7% stated they do not intend to get vaccinated. The main reasons for vaccine refusal were lack of trust (41.8%) and fear of side effects (32.3%). Only 21% had undergone Pap smear testing, with barriers including embarrassment and fear. Among the HBM constructs, perceived susceptibility, benefits, and barriers remained statistically significant predictors of HPV vaccination. Increased perceived susceptibility and benefits raise the likelihood of accepting the HPV vaccine, while higher perceived barriers lessen it. Vaccine hesitancy had a significant negative effect on willingness to receive the HPV vaccine (OR = 0.78, 95% CI 0.69–0.90, p < 0.01). Additionally, Pap smear uptake was an independent predictor of the intent to get the HPV vaccine (OR = 1.78, 95% CI 1.25–2.54, p < 0.01). The independent factors influencing HPV vaccine uptake were largely similar to those affecting the willingness to receive the vaccine, except for age, perceived benefits, and Pap smear uptake. Conclusions: There is a gap between Saudi women’s intention to get HPV vaccinated and actual vaccination. Women who saw a high risk of HPV-related cancer, believed in vaccine efficacy, had a Pap smear, and were open to vaccination were more likely to vaccinate. Hesitant women and those perceiving barriers were less likely to vaccinate or consider it. The main gaps for future campaigns are perceptions of HPV severity and cultural factors influencing decision-making. Emphasizing HPV as a cancer-related virus rather than a sexually transmitted infection can reduce barriers and highlight its severity. Full article

Falls among older adults are a major public health concern. Older adults living in low-income housing (LIH) are at higher risk of falls due to disadvantages linked to social determinants of health, yet remain underrepresented in research. This study aimed to assess the feasibility of a program addressing fear of falling and its consequences on activity levels among older adults living in LIH in Côte-des-Neiges (Montreal, QC, Canada). A mixed-methods pilot feasibility study was conducted using Bowen et al.’s framework, drawing on data collected through questionnaires, observation grids, attendance records, and semi-structured interviews. The program consisted of six 90 min sessions designed to enhance participants’ confidence in preventing falls while promoting engagement in activities. Fourteen older adults (mean age = 75.5 years) were recruited. Outcome data on fall-related psychological factors, activity engagement, and knowledge about falls were collected before and after the program. Moreover, older participants’ perceived benefits were assessed following program completion. Post-program interviews with older adults, facilitators, and a community field worker were conducted to further explore program feasibility, including its acceptability, implementation, and integration. The program showed strong acceptability and a high attendance rate (95%). Although no statistically significant pre-post changes were observed in the outcome variables, older participants reported several benefits at post-test, including improved knowledge about fall prevention (100%) and greater confidence in their ability to avoid falls (85%). These findings support the feasibility of implementing this culturally adapted fall prevention program in similar LIH settings and provide valuable insights for its refinement and future research. Further investigation is warranted to examine the program’s feasibility across other LIH settings and linguistic groups, as well as to assess its effectiveness. Full article

Background: Cultural, religious, and spiritual (CRS) needs are central to holistic palliative and end-of-life care (PEoLC), yet the confidence and perceived preparedness of community and voluntary sector staff in addressing them remain underexplored. As PEoLC increasingly occurs in community settings, understanding staff preparedness for culturally and spiritually sensitive care is vital. Objective: This service evaluation examined CRS perceived preparedness and confidence among staff across Leicester, Leicestershire, and Rutland (LLR), exploring perceived challenges and available resources. Methods: A modified Confidence and Perceived preparedness in the CRS Care Survey was distributed to healthcare, hospice, charity, and community staff (May–August 2025). Likert scale data (n = 39) were analysed descriptively; qualitative responses underwent thematic analysis using Braun and Clarke’s framework, which was co-produced with stakeholders. Results: Staff placed high importance on CRS needs (cultural M = 4.48, SD = 0.61; religious/spiritual M = 4.66, SD = 0.53) but reported lower confidence in the organisational capacity to meet them (M = 3.15 and M = 3.05). Qualitative survey findings showed that staff recognised CRS needs as central to holistic, individualised care, emphasising proactive assessment and avoiding assumptions. Barriers included fear of causing offence, organisational constraints, and challenges in supporting families, alongside concerns about unmet needs. Participants highlighted reliance on informal resources and a clear need for accessible, lived-experience-based training and practical guidance. A prototype CRS resource toolkit, including lived-experience videos and guidance for supporting Muslim patients, was co-developed and reviewed by healthcare, community, and public contributors. Conclusions: Staff commitment to CRS-sensitive PEoLC is strong, but practical tools and training are lacking. A virtual CRS toolkit could enhance confidence, communication, and culturally responsive care across multidisciplinary settings. Full article

Fear of Missing Out (FoMO) has become a salient emotion in consumer markets shaped by social media, scarcity appeals, and social display. Yet limited research has examined FoMO as a consumption-specific emotion associated with consumer dispositions, situational cues, and post-purchase intentions. Drawing on Social Comparison Theory, Self-Determination Theory, and the Stimulus–Organism–Response (S-O-R) framework, this study examines the relationships among Materialism, Envy, Scarcity, FoMO, Impulsive Buying (IB), and Repurchase Intention (RI). Survey data from 518 Chinese consumers with prior Pop Mart purchasing experience were analyzed using PLS-SEM. The results show that Materialism, Envy, and Scarcity were positively associated with FoMO, with Scarcity showing the strongest relationship. FoMO was positively associated with IB, and IB was positively associated with RI. The results also supported three serial mediation paths, indicating that FoMO and IB served as sequential mediators between Materialism, Envy, Scarcity, and RI. This study extends FoMO research to cultural and creative product consumption and provides insight into how consumption-related emotions are associated with sustained purchase tendencies. Full article

Access to primary care services is essential for promoting mental health, yet immigrants experiencing homelessness face significant barriers to care. This study explores factors that influence access to primary care services in the UK. A qualitative design was employed, involving in-depth semi-structured interviews with 30 immigrants experiencing homelessness and 30 stakeholders across healthcare, voluntary, and local authority sectors. Data were analysed using thematic analysis, guided by the Levesque framework of healthcare access and an intersectionality lens. Findings reveal that access is influenced by intersecting structural barriers, including fear of detention and deportation, cultural stigma surrounding mental health, digital exclusion, and financial hardship. These barriers delay help-seeking and shift care-seeking toward emergency services. Increasing reliance on digital systems in primary care further excludes individuals with limited access to devices, connectivity, or digital skills. These findings indicate that barriers to accessing primary care services may hinder the early identification and preventive management of mental health needs among homeless immigrants. Improving access requires structural reforms that address legal, financial, and digital barriers, alongside more culturally responsive and trust-based care. Without such changes, digital health innovations risk reinforcing existing inequalities and limiting the role of primary care in early mental health intervention and prevention. Full article

Background: Mental health concerns are notably common among students attending universities in Saudi Arabia, and low engagement with psychological services has been widely documented in this population group. Telemental health has emerged as a promising alternative under Vision 2030’s digital transformation agenda, although the determinants of university students’ intentions to use these services have received limited empirical attention in Saudi Arabia. Objective: This study examined attitudes toward telemental health services, perceived barriers to seeking psychological help, and predictors of behavioral intentions to use telemental health services among university students in Saudi Arabia, based on the Technology Acceptance Model and Theory of Planned Behavior. Methods: A cross-sectional design was employed using an online, self-administered questionnaire. A total of 236 undergraduate students from three large universities in Riyadh were recruited using convenience sampling methods. We examined demographic variables, telemental health attitude variables (ease of use, usefulness, subjective norms, trust in telemental health, relative advantage, intentions, and attitudes), and barrier subscales (fear of stigma, trust in mental health professionals, difficulties in self-disclosure, perceived devaluation, and lack of knowledge) among university students. Descriptive statistics, Welch’s t-tests, and multiple linear regression analyses were conducted using SPSS (version 29). Results: Participants demonstrated moderately positive attitudes toward telemental health (M = 74.15, SD = 16.11) and reported moderate overall barriers (M = 50.76, SD = 14.44), with trust in mental health professionals being the most prominent barrier. The regression model explained 58.0% of the variance in behavioral intentions (F(19, 211) = 15.35, p < 0.001). Attitude was the strongest predictor (β = 0.534, p < 0.001), followed by trust in telemental health, sex, and difficulty in self-disclosure. Conclusions: Culturally tailored awareness campaigns, trust-building communication, and gender-sensitive service design are recommended to promote the adoption of telemental health by Saudi university students. These efforts align with Vision 2030’s digital health priorities and may support the equitable expansion of mental healthcare access in this population. Full article