Search Results (88)

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. 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

The rapid spread of artificial intelligence (AI) in education means that students need to master both AI literacy and personal agency. This study situates a sample of 425 Slovenian secondary technical students within a three-tier framework that maps psychological empowerment onto AI literacy outcomes within a cultural–historical activity system. The agency competence assessments yielded four profiles of student agency, ranging from fully empowered to largely disempowered. The cluster membership explained significant additional variance in AI literacy scores, supporting the additive empowerment model in an AI-rich vocational education and training context. The predictive modeling revealed that while self-efficacy, mastery-oriented motivations, and metacognitive self-regulation contributed uniquely—though small—to improving AI literacy, an unexpectedly negative relationship was identified for internal locus of control and for behavioral self-regulation focused narrowly on routines, with no significant impact observed for grit-like perseverance. These findings underscore the importance of fostering reflective, mastery-based, and self-evaluative learning dispositions over inflexible or solely routine-driven strategies in the development of AI literacy. Addressing these nuanced determinants may also be vital in narrowing AI literacy gaps observed between diverse disciplinary cohorts, as supported by recent multi-dimensional literacy frameworks and disciplinary pathway analyses. Embedding autonomy-supportive, mastery-oriented, student-centered projects and explicit metacognitive training into AI curricula could shift control inward and benefit students with low skills, helping to forge an agency-driven pathway to higher levels of AI literacy among high school students. The most striking and unexpected finding of this study is that students with a strong sense of competence—manifested as high self-efficacy—can achieve foundational AI literacy levels equivalent to those possessing broader, more holistic agentic profiles, suggesting that competence alone may be sufficient for acquiring essential AI knowledge. This challenges prevailing models that emphasize a multidimensional approach to agency and has significant implications for designing targeted interventions and curricula to rapidly build AI literacy in diverse learner populations. Full article

Background/Objectives: The under-five mortality rate (U5MR) remains a serious health challenge in Indonesia, with low birth weight (LBW) being a key risk factor. This study aimed to identify predictors of survival among under-five children with LBW using data from the 2017 Indonesia Demographic and Health Survey (IDHS). Methods: This cross-sectional study included 625 children under five with LBW. The dependent variable was under-five mortality (children aged 0–59 months), while the independent variables include child (gender), maternal (age at delivery, education, empowerment, delivery complications, and breastfeeding history), health service (antenatal care-ANC and place of delivery), and household (wealth quintile and residence) factors. Data were obtained from the 2017 IDHS using household and women’s questionnaires and analyzed using univariate analysis, Kaplan–Meier estimation, and Cox regression. Results: 41 of 625 children born with LBW died before the age of five. The Kaplan–Meier estimation found that maternal (delivery complications and breastfeeding history), health service (ANC history and place of delivery), and household factors (residence) significantly influenced the survival of LBW children. The Cox regression results showed that LBW children who were breastfeed and whose mother had adequate antenatal care visits had a lower risk of under-five mortality. Surprisingly, children born in health facilities had a significantly higher risk of death compared to those born elsewhere. Conclusions: Exclusive breastfeeding, adequate antenatal care, and place of delivery are important determinants of survival among children born with LBW. This support targeted interventions to improve the survival chances of children born with LBW, particularly in their early years of life. Full article

This study investigates the economic welfare of refugees and host communities in Kenya, utilizing bi-monthly panel data collected from May 2020 to May 2022. The analysis employs a fixed effect model, which effectively captures the nuances of welfare differences between urban and camp refugees. The key findings reveal that income and economic participation are critical determinants of welfare, with urban refugees exhibiting greater sensitivity to income fluctuations compared to their camp counterparts. Larger household sizes negatively impact welfare, while education levels and gender dynamics play pivotal roles. This study emphasizes the need for tailored interventions for economic empowerment, particularly for women-headed households, and highlights the importance of partnerships between NGOs and local governments. Overall, this research enhances the understanding of refugee welfare in Kenya and provides actionable policy suggestions aimed at promoting equity and integration. Full article

Background: Despite the significant global disease burden associated with HPV infection, the vaccination coverage among female college students in China remains suboptimal. This study aimed to examine HPV vaccination coverage, knowledge levels, and determinants influencing vaccination behavior among female college students in northern China, utilizing the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional online survey was conducted from December 2024 to January 2025, involving 4076 female students from six universities in Jinan, China. The participants were categorized into three groups: vaccinated (VG), willing-to-vaccinate (WTG), and unwilling-to-vaccinate (UTG). Data on sociodemographic characteristics, HPV knowledge, health beliefs, and vaccination behavior were analyzed using ANOVA, chi-square tests, correlation analysis, and multivariate logistic regression. Results: The vaccination rate was 18.11%, with 40.19% expressing willingness to vaccinate and 41.71% expressing unwillingness. Vaccinated students demonstrated higher levels of HPV knowledge (6.66 ± 2.67 compared to 4.76 ± 3.10 in the UTG, p < 0.001) and were predominantly from urban areas (OR = 0.64, p < 0.001). The key determinants of vaccination uptake included perceived benefits (OR = 1.54, p < 0.001), perceived barriers (OR = 3.34, p < 0.001), self-decision-making ability (OR = 1.80, p < 0.001), and social motivation (OR = 0.21, p < 0.001). Notably, increased knowledge was associated with vaccine hesitancy in the WTG group (OR = 0.45, p < 0.001), indicating that information overload may adversely affect decision-making processes. Structural barriers, such as cost (42.63%), safety concerns (46.59%), and misconceptions (e.g., 57.76% cited “no sexual activity” as a reason for refusal), significantly impeded vaccine uptake. Conclusions: The low coverage of HPV vaccination is indicative of deficiencies in knowledge, socioeconomic disparities, and cultural perceptions. Tailored interventions should focus on educational efforts to correct misconceptions, provide subsidized access to vaccines, and implement empowerment strategies that enhance self-efficacy and informed decision-making. Policymakers should incorporate these findings into national cervical cancer prevention programs to address the gap between vaccination intention and behavior among young women in China. Full article

Background/Objectives: Youth mental health significantly impacts future well-being, with nearly half of mental health disorders emerging during adolescence. Civic engagement is defined as active participation in the community to improve conditions for others or to help shape the community’s future. It offers a unique opportunity to enhance youth mental well-being, acting as a protective factor against mental health struggles. In this line, Relational Developmental Systems Theory posits that positive youth development is positively linked to civic engagement. The main objective of this literature-based paper is to identify, select, assess, and synthesize the existing literature on interventions promoting mental health in the youth through civic engagement, resulting in an up-to-date review. Methods: Following PRISMA guidelines, a search was conducted using PsycInfo, Scopus, and Web of Science to gather studies published between 2018 and 2023, based on the combination of key terms: (“civic engagement” OR “social participation”) AND (“mental health” OR “psychological adjustment” OR “well-being”) AND (adolescen* OR teen* OR youth OR “young people”) AND (program* OR intervention OR training OR education). Data extraction and risk-of-bias assessments were performed. Results: Ten studies were included in this review which suggest that civic engagement programs improve youth mental health outcomes, including reduced anxiety, reduced sadness, and increased resilience. These programs foster empowerment, sense of belonging, and social connections, while also enhancing interpersonal skills and career aspirations. Youth also gain valuable skills such as leadership, communication, and problem-solving, contributing to educational and vocational growth. However, challenges such as socio-economic barriers and attendance issues can impact some outcomes, with variations in effectiveness across programs. Conclusions: Youth civic engagement programs should integrate mental health support to mitigate the emotional costs of activism, ensuring greater participation and well-being. It is important to adapt these programs to local contexts and provide flexibility to strengthen participation and community impact. Future research should explore the role of cultural, gender, and socio-economic factors in shaping program outcomes and utilize randomized controlled trials to improve the validity and generalizability of findings. Full article

Background: Traditionally, community-based education (CBE) programmes have been utilised for teaching medical students clinical and interpersonal skills through placement in underserved environments. This pilot cohort study tested an extended model of CBE by infusing patient education into student-conducted consultations with the dual objectives of stimulating improved learning for the students and improved health literacy for the patients. Methods: The intervention involved 38 final-year medical students and 85 adult patients and from underprivileged communities in North West London. The students first undertook online preparatory workshops on health literacy, communication skills, and cultural competence. Subsequently, they imparted 20–30 min educational sessions on chronic disease management and preventive care to the patients on their clinical placements. The quantitative measurement used pre- and post-intervention questionnaires, and the qualitative measurement was based on reflective diaries and patient feedback. Paired t-tests were used for statistical comparisons, while a thematic analysis was used for textual answers. Results: Student confidence in breaking down medical jargon improved from 2.8 ± 0.7 to 4.4 ± 0.5 (p < 0.01), and confidence in making use of visual aids improved from 2.5 ± 0.8 to 4.2 ± 0.6 (p < 0.01). Understanding among the patients of their health conditions improved from 27% to 74% (p < 0.001), and self-confidence in their ability to manage their health improved from 31% to 79% (p < 0.001). The qualitative feedback noted improved empathy, cultural sensitivity, and a positive effect on patient empowerment through tailored education. Conclusions: This CBE intervention had two benefits: improving teaching and communication skills in students and greatly enhancing health literacy in underserved patients. The integration of structured education into usual care encounters holds the promise of a scalable, sustainable method for addressing health disparities. Longer longitudinal studies are necessary to assess its long-term success and incorporation into medical education. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a growing global health threat, requiring an approach that integrates human, animal, and environmental health. Public awareness and responsible antibiotic use are key to combating AMR. This study examines the knowledge, attitudes, and practices related to antibiotic use among the general population in Serbia, exploring their impact on antimicrobial stewardship efforts. Methods: A cross-sectional study was conducted in December 2022 using a three-stage stratified random sample of the Serbian population. The Eurobarometer questionnaire was utilized with permission from the European Commission. Statistical analyses included multivariate ordinal logistic regression to identify predictors of desirable attitudes and behaviors related to antibiotic use. Results: Almost two-thirds of respondents (61.6%) reported not receiving any advice on rational antibiotic use, underscoring the need for education of the general population and raising awareness. A Higher Antibiotic Knowledge Score was associated with a 60% greater likelihood of favorable attitudes and a 21% greater likelihood of rational antibiotic use. Pharmacists were identified as the primary source of antibiotic-related information for the general population in Serbia, but there is limited public interest and awareness of antibiotic use in animals, as well as of the bans on using antibiotics to stimulate growth in farm animals within the EU. Conclusions: Through targeted educational interventions, strengthening interdisciplinary collaboration and AMR control measures is necessary for human and veterinary medicine. Although pharmacists are the primary source of information about antibiotics for the population in Serbia, collaboration with physicians and their empowerment should be introduced to strengthen antimicrobial stewardship further. Full article

Background/Objectives: Lower-limb amputation profoundly affects individuals and their family caregivers, particularly during home transition after hospital discharge. Understanding the needs, challenges, and emotions during this period is essential for designing effective family centered empowerment interventions. This study aimed to explore the lived experiences of amputees and their caregivers, identify their needs and challenges, and identify strategies to foster empowerment, resilience, and adaptation after amputation. Methods: This qualitative, descriptive-exploratory study involved semi-structured interviews with 37 dyads, each comprising an amputee who has undergone major dysvascular lower-limb amputation and their primary caregiver, who provided home care. The participants attended follow-up consultations post-amputation. Data were collected over a 13-month period and analyzed using qualitative content analysis based on Bardin’s methodology, with support from ATLAS.ti 23.3.4 software for coding and data organization. Results: Four categories emerged: (i) difficulties faced, including loss of autonomy, mobility challenges, architectural barriers, and emotional strain; (ii) home discharge, emphasizing functional training for amputees and caregivers and the need for community support; (iii) impact of amputation, highlighting acceptance difficulties, psychological distress, social isolation, and lifestyle changes; and (iv) empowerment strategies, focusing on psychological support, skills training, assistive devices, and coordinated care. Tailored interventions such as peer support, home adaptations, and multidisciplinary care are essential for resilience, independence, and improved quality of life. Conclusions: Family centered empowerment strategies are vital for improving the outcomes of amputees and caregivers. Interventions that prioritize caregiver education, psychological support, and enhanced accessibility promote resilience, autonomy, and quality of life. These findings highlight the need for integrated hospital-to-community programs. Full article

Against the backdrop of global climate change, extreme weather events, such as heavy rainfall, typhoons, tsunamis, and rising sea levels, have become frequent, posing unprecedented challenges to human society. As an important strategy for coastal cities to respond to climate change, climate-induced evacuation is influenced by complex and diverse factors. This study delves into the driving mechanisms of population migration willingness, revealing the dynamic balance of push, pull, and resistance factors and their interaction with individual value orientations affecting migration decisions. By constructing a Logistic Regression Model, this research quantitatively analyzes the significant impacts of personal circumstances, family characteristics, living conditions, risk perception, compensation relocation, and supportive policies on climate-induced migration willingness, using Shanghai as a case study. The findings indicate that age, education level, household size, housing type, risk perception, and compensation policies are key factors. Building upon the multidimensional capital interaction mechanisms and dynamic threshold response patterns identified in the research, this study proposes a three-phase progressive policy framework: initially, establishing an integrated human–material–social capital framework to implement tiered relocation incentive programs, which address decision window constraints through cognitive empowerment and asset replacement strategies; subsequently, creating a dynamic compensation adjustment mechanism by developing policy toolkits aligned with inverted U-shaped utility curves while enhancing synergistic effects between cultural cognition transformation and vocational training; and ultimately, innovating an institutional–cultural co-governance paradigm that rebalances public service dependency and place attachment through spatial equity redistribution. Specific recommendations encompass designing modular risk education curricula, establishing social network transplantation mechanisms, piloting climate citizenship regimes, and constructing cross-border governance knowledge platforms. These multidimensional interventions encompassing capital restructuring, threshold responsiveness, and cultural adaptation offer valuable policy insights for resolving the “development resilience–migration inertia” paradox in coastal cities. Full article

High blood pressure in older adults poses significant risks, including cardiovascular disease, stroke, and renal failure; yet, its management is often overlooked. Nurse-led personalised interventions provide essential guidance, helping patients adhere to treatment plans and adopt lifestyle changes, improving outcomes and quality of life. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Six electronic databases were searched systematically (CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Scopus). Five research studies were included in this review, from five countries (India, Korea, China, Turkey and Thailand). Primary data were synthesised using descriptive and thematic analysis methodology. The five main themes from this review relate to nurse-led empowerment strategies for hypertension management, variability in blood pressure outcomes, the importance of tailored education and counselling, the role of regular follow-ups and support, and environmental support. Overall, nurse-led personalised interventions improve blood pressure management and patient engagement in older adults, highlighting the need for research into their long-term effectiveness and broader applicability. Full article

Disparities in financial literacy between males and females pose significant challenges in the developing world, particularly in terms of banking sector participation and economic engagement. Women, in particular, face greater difficulties in managing personal and household income due to lower financial literacy levels compared to men. This research aims to analyze the causes, effects, and potential measures to address these disparities, situating the discussion within socio-cultural, educational, and economic contexts. A systematic review and bibliometric analysis were conducted to examine relevant studies, with Open Alex serving as the primary database. The search was conducted from 2010 to 2024. Initially, 1620 papers were identified and through stringent inclusion criteria following PRISMA guidelines, 193 studies were selected for the final review. The study employed bibliometric techniques such as co-authorship, keywords analysis, and citation analysis to identify key topics, contributors, and research gaps in the literature. The findings reveal that socio-cultural practices, a lack of resources, and low income levels significantly contribute to women’s financial illiteracy. Furthermore, the research underscores the increasing recognition of the importance of adopting a gender-sensitive approach to financial literacy. These disparities limit women’s decision-making power and exacerbate socio-economic imbalances in developing countries. This study offers valuable implications for policy and practice, advocating for targeted interventions to enhance women’s financial literacy and economic participation. The results emphasize the need for differentiated strategies and provide a foundation for future research focused on closing the gender gap in financial competence and economic empowerment. Full article

Chronic kidney disease (CKD) is a growing public health challenge in Spain, driven by population ageing and increasing risk factors. In this context, the CARABELA-CKD initiative brought together over 100 representatives from the CKD healthcare ecosystem in Spain to address this critical issue by identifying needs and improvement areas in the current management of CKD patients and proposing a comprehensive optimization of the Spanish CKD care process. This collaborative initiative involves leading scientific societies including the S.E.N. (Spanish Society of Nephrology), the SEEN (Spanish Society of Endocrinology and Nutrition), and the SECA (Spanish Society of Quality of Care), in partnership with AstraZeneca. CARABELA-CKD emphasizes data-driven decision-making and continuous quality improvement to identify and deliver innovative solutions that enhance patient care. Building on existing CKD care models, we performed an in-depth analysis of the current barriers in enhanced care and determined a series of healthcare quality indicators and areas for improvement. These areas encompass standardized protocols for care delivery, patient empowerment through education, and fostering collaboration among healthcare professionals and authorities. The CARABELA-CKD framework promotes a holistic, multidisciplinary approach, treating CKD management as a cross-functional process. As a result of this collaborative effort, a series of interventions are proposed, oriented to empower healthcare professionals to deliver personalized, high-quality care with the ultimate aim of improving patient outcomes and quality of life. Full article

Background: Hypertension remains a significant public health challenge in Ghana. Understanding the experiences of hypertensive patients can inform strategies to improve their management. This study explored the perceived enablers and barriers to hypertension management among patients in the Ashanti region, Ghana, using the Chronic Care Model as a framework. Methods: In-depth interviews were conducted with 20 hypertensive patients receiving care at Komfo Anokye Teaching Hospital. Inductive thematic analysis was employed to identify key themes and subthemes. Results: Several barriers to hypertension management emerged, including economic constraints, environmental and lifestyle factors, knowledge and awareness deficits, medication-related issues, and policy and provider-level barriers. Conversely, enablers such as patient empowerment, education, healthcare access, and policy and provider support and relationships were identified. Conclusions: Effective hypertension management requires addressing a complex interplay of barriers and enablers. Interventions targeting economic factors, lifestyle modifications, knowledge dissemination, medication adherence, and systemic improvements are crucial. Additionally, empowering patients, enhancing education, improving healthcare access, and fostering strong provider–patient relationships can significantly contribute to better outcomes. Future research should investigate the impact of a multi-level intervention on hypertension management in Ghana. Full article