Search Results (610)

Grounded in health behavior theory, this study examined patterns of preventive health behavior in a culturally diverse, multilingual region of northern Italy using data from a representative population survey (n = 2090). Preventive behaviors were assessed using the 16-item Good Health Practices (GHP-16) scale. Latent profile analysis (LPA) identified five behavioral profiles, ranging from ‘Globally Low Engagers’ to ‘Comprehensive High Engagers’. Binary logistic regression compared ‘Globally Low Engagers’ to ‘Broadly Moderate Preventers’, examining predictors including gender, age, education, language, chronic disease status, health literacy (HLS-EU-Q16), patient activation (PAM-10), mistrust of health information, living situation, and healthcare employment. The results showed that men, younger adults, individuals with low patient activation, those living alone, and respondents with high mistrust of health information had higher odds of belonging to the low engagement group. Health literacy and language group membership were not significantly associated with the profile membership. Item-level comparisons revealed gender differences in information-seeking, oral hygiene, and dietary behaviors, with men reporting lower engagement. These findings support a segmentation-based understanding of preventive health behavior and highlight the need to address personal capacities and contextual barriers in interventions while challenging assumptions of uniformly higher female health vigilance. Full article

Background: Despite their high prevalence and potential for significant morbidity, hemorrhoidal symptoms remain underreported and undertreated. Misconceptions and stigma may delay care-seeking behaviors and negatively influence patient outcomes. Methods: We conducted a cross-sectional, questionnaire-based study in Romania to assess public awareness, attitudes, and barriers related to hemorrhoidal disease. The survey included 185 participants and evaluated variables such as symptom severity, understanding of the condition, perceived stigma, and willingness to consult a physician. Results: Only 30.8% of participants had sought medical advice for hemorrhoidal symptoms. Younger age (p < 0.001), male sex (p = 0.013), and lower levels of perceived severity were significantly associated with reluctance to seek medical care. The most frequently reported barriers were embarrassment and fear of invasive diagnostic procedures. Colonoscopy and digital rectal examination were identified as major deterrents by 39.5% and 38.9% of respondents, respectively. Educational level influenced both the perceived understanding of the disease (p = 0.001) and comfort in discussing anal symptoms (p = 0.002). Gender preference for physicians was significantly associated with respondent sex (p = 0.007) but not with education or age. Conclusions: Hemorrhoidal disease remains a stigmatized and underestimated condition. Public health efforts should prioritize educational interventions, destigmatization campaigns, and improved physician–patient communication to facilitate earlier diagnosis and better disease management. Full article

Background: Telehealth is an essential component of modern healthcare, and it was especially relevant during the COVID-19 pandemic, but disparities in digital and technological literacy among health professionals may limit its equitable adoption and impact. Objective: This study seeks to validate an eight-item telehealth literacy survey among health professionals in Central–South Chile and to examine demographic and behavioral determinants of literacy levels, developing predictive models to identify key factors. Methods: In this cross-sectional study, 2182 health professionals from urban and rural centers in Central–South Chile completed the adapted survey along with questions on age, gender, nationality, and frequency of telehealth use. We assessed internal consistency (Cronbach’s α), explored factor structure via exploratory factor analysis (EFA), and tested associations using Pearson correlations, t-tests, one-way ANOVA, and both linear and multinomial logistic regressions. Results: The instrument demonstrated high reliability (Cronbach’s α = 0.92) and a two-factor structure explaining 65% of variance. Age negatively correlated with literacy (r = −0.26; p < 0.001), while the frequency of telehealth use showed a positive correlation (r = 0.26; p < 0.001). Female professionals and those in urban settings scored significantly higher on telehealth literacy (p = 0.005 and p < 0.001, respectively). The reduced multinomial model achieved moderate classification accuracy (51.65%) in distinguishing low, medium, and high literacy groups. Conclusions: The validated survey is a reliable tool for assessing telehealth literacy among health professionals in Chile. The findings highlight age, gender, and geographic disparities, and support targeted digital literacy interventions to promote equitable telehealth practice. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

Indoor radon constitutes a public health issue in various regions across the United States as the second leading cause of lung cancer following tobacco smoke. The U.S. Environmental Protection Agency advises radon mitigation interventions for residential buildings with indoor radon concentrations exceeding the threshold level of 4 pCi/L. Despite considerable research assessing the technical effectiveness of radon mitigation systems, there remains a gap in understanding their broader influence on occupant behavior and preferences in residential design. This study aims to investigate the impact of residing in radon-mitigated homes within the Commonwealth of Kentucky—an area known for elevated radon concentrations—on occupants’ preferences regarding healthy home design attributes. The objectives of this research are twofold: firstly to determine if living in radon-mitigated homes enhances occupant awareness and consequently influences their preferences toward health-related home attributes and secondly to quantitatively evaluate and compare the relative significance homeowners assign to health-related attributes such as indoor air quality, thermal comfort, and water quality relative to conventional attributes including home size, architectural style, and neighborhood quality. The overarching purpose is to explore the potential role radon mitigation initiatives may play in motivating occupants towards healthier home construction and renovation practices. Using choice-based conjoint (CBC) analysis, this paper compares preferences reported by homeowners from radon-mitigated homes against those from non-mitigated homes. While the findings suggest a relationship between radon mitigation and increased preference for indoor air quality, the cross-sectional design limits causal interpretation, and the possibility of reverse causation—where health-conscious individuals are more likely to seek mitigation—must be considered. The results provide novel insights into how radon mitigation efforts might effectively influence occupant priorities towards integrating healthier design elements in residential environments. 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

The study examines how individual skills influence adolescents’ and young adults’ commitment to climate protection and global health. Based on 21st-century skills and transformative education, it focuses on competences in science, geography, mathematics, religion, ethics, and media. A representative online survey of 783 participants in Germany assessed topic relevance, information-seeking behavior, and active engagement. The results show that subject-specific skills significantly affect engagement, especially when closely related to the topics. Scientific, mathematical, and geographical competences enhance all three engagement dimensions. Media competence primarily increases perceived importance, while religious and ethical competences positively influence all areas. Structural equation modeling reveals a process: perceived relevance leads to information search, which then drives engagement. Thus, competences have both direct and indirect effects on active involvement. The findings highlight that long-term engagement is not only driven by campaigns but also by education that equips young people with the skills to recognize important issues, seek information, and take action independently. Full article

As health and well-being become central concerns in the post-pandemic tourism landscape, health tourism is evolving to prioritize not only physical recovery but also psychological engagement and emotional value. This study explores how gamified design can enhance tourist participation and experience quality within health-related tourism contexts. By integrating theories from tourism psychology and game-based experience design, a structural equation model is proposed to examine the relationships among memorable tourism experiences, tourist motivation, game design elements, flow experience, and perceived value, and their joint influence on behavioral intention. Data collected from tourists who engaged in gamified experiences were analyzed using structural equation modeling (SEM) techniques. The results identify a dynamic “participation–immersion–value” mechanism, in which gameful design fosters flow and perceived value, thereby mediating gamification’s impact on behavioral intention. These findings offer valuable insights for health tourism developers and experience designers seeking to create emotionally engaging, motivating, and sustainable visitor experiences in the context of health and well-being. Full article

Global refugee flows’ increasing scale and complexity pose significant challenges to national education systems. Turkey, hosting one of the largest populations of refugees and individuals under temporary protection, faces unique pressures in ensuring equitable educational access for refugee students. Addressing these challenges requires a shift from linear, fragmented interventions toward holistic, systemic approaches. This study applies a Community-Based System Dynamics (CBSD) methodology to explore the systemic barriers affecting refugee students’ participation in education. Through structured Group Model Building workshops involving teachers, administrators, and Non-Governmental Organization (NGO) representatives, a causal loop diagram (CLD) was collaboratively developed to capture the feedback mechanisms and interdependencies sustaining educational inequalities. Five thematic subsystems emerged: language and academic integration, economic and family dynamics, psychosocial health and trauma, institutional access and legal barriers, and social cohesion and discrimination. The analysis reveals how structural constraints, social dynamics, and individual behaviors interact to perpetuate exclusion or facilitate integration. This study identifies critical feedback loops and leverage points and provides actionable insights for policymakers and practitioners seeking to design sustainable, systems-informed interventions. Our findings emphasize the importance of participatory modeling in addressing complex societal challenges and contribute to advancing systems thinking in refugee education. Full article

As mental health has gained prominence in recent years, elite ice hockey players have shared their experience of psychological problems, including adverse alcohol use, anxiety, depression, distress, eating disorders, and sleep disturbances. Mental health remains a sensitive issue for ice hockey players, as stigma, a strong hockey culture, lack of mental health literacy, and negative past experiences with seeking help constitute barriers to seeking support. This scoping review aims to identify the psychological factors contributing to elite ice hockey players’ well-being. After screening the titles and abstracts of three databases within a 2002–2025 timeframe, a total of 517 articles were retrieved. Seventeen articles targeting ice hockey athletes over 14 years of age competing at an elite level were selected. Three main categories emerged from the included studies: anxiety and depressive symptoms, motivational variables, and coping strategies at different career stages. Factors such as retirement, concussions, social support, parenting style, task-approach goals, and task-oriented behavior were influential components to the well-being and mental health of elite ice hockey players. Using the Lazarus and Folkman model, the identified psychological factors may help athletes and various actors surrounding them to better understand athletes’ well-being. Full article

This entry explores the psychological, developmental, and organizational dynamics of people-pleasing behavior, analyzing its roots in childhood conditioning, cultural reinforcement, and evolutionary mechanisms. It highlights how chronic approval-seeking compromises authenticity, mental health, and workplace productivity, while proposing interventions for individuals and organizations to cultivate assertiveness and healthier relational patterns. Full article

Background and Objectives: Urinary incontinence (UI) is a prevalent condition that significantly affects quality of life but remains underreported. Understanding the factors that influence patients’ decisions to seek medical consultation is essential for improving care-seeking behavior and ensuring timely intervention. This study aimed to identify the facilitators of seeking medical consultation among individuals with UI in a Saudi secondary care setting. Materials and Methods: A cross-sectional study was conducted from December 2024 to April 2025 among adult patients with UI attending urology and urogynecology outpatient clinics at a single tertiary center. Participants completed a structured, self-administered questionnaire that comprised sociodemographic data, the ICIQ-UI SF, and 33 potential motivators for seeking care, categorized into six domains. Results: A total of 241 participants were included in the study. The 33-item scale demonstrated excellent internal consistency (Cronbach’s α = 0.945). The most influential domains were daily and physical impact, followed by emotional and psychological factors. Top facilitators included interference with prayers (66.8%), use of pads (62.2%), social limitations (63.9%), frequent clothing changes (64.7%), and fear of worsening symptoms (63.5%). Cultural factors, such as access to same-sex specialists (52.2%), were also prominent. Logistic regression identified age, marital status, and motivators from several domains as significant predictors. Key independent predictors included prayer interference, leakage frequency, and gender-concordant care. Conclusions: Help-seeking for UI is influenced by physical, emotional, social, and cultural factors. Enhancing patient education, addressing sociocultural sensitivities, and promoting physician-led discussions foster earlier care-seeking and improve health outcomes in populations with traditionally low treatment uptake. Full article

Background/Objectives: Preventive health behaviors are key to disease prevention and health system sustainability; however, population-level factors remain understudied in multilingual regions. South Tyrol, an autonomous multilingual province in Northern Italy, provides a unique setting to examine how sociodemographic and linguistic factors shape preventive behaviors. Methods: A stratified, population-representative survey of 2090 adults (aged ≥18 years) was conducted in South Tyrol in 2024. Preventive behavior was assessed using the validated 16-item Good Health Practices Scale (GHP-16). Key predictors included age, sex, education, living situation, language group, employment in the health/social sector, health literacy (HLS-EU-Q16), patient activation (PAM-10), and the mistrust of professional health information. Weighted statistics and multivariable linear regression were used to identify associations. Results: The GHP-16 scores varied significantly across sociodemographic and psychosocial strata. Female sex, older age, higher education, higher patient activation, and sufficient health literacy were independently associated with greater engagement in preventive behaviors. Patient activation showed the strongest graded effect (β = 1.739). The mistrust of health professionals was inversely associated with behavior (β = –0.050, 95% CI: –0.090 to –0.009). Italian speakers reported higher GHP-16 scores than German speakers (β = 0.377), even after adjusting for covariates. Item-level analysis revealed small but consistent differences, particularly in information-seeking and vaccination behavior. Conclusions: Preventive behaviors in South Tyrol are shaped by demographic, psychosocial, and linguistic factors. Patient activation and health literacy are key modifiable predictors, whereas language group differences suggest structural and trust-related disparities that require tailored public health strategies in multilingual settings. Full article

Background/Objectives: Visual impairment (VI) represents a significant health challenge among older adults, particularly due to their limited understanding of health information. This study aimed to investigate and compare the health information-seeking behavior (HISB) of older adults with VI across different stages of eye care. Methods: A cross-sectional comparative study was conducted in 248 older adults with VI in various stages of eye care, including the pre-visit stage (n = 84), treatment stage (n = 83), and follow-up stage (n = 81) at the Shenzhen Eye Hospital from July to October 2024. Participants completed an HISB questionnaire encompassing four dimensions: attitude, needs, sources, and barriers. Results: The overall mean score of HISB varied significantly among the different eye care stages. The treatment stage had the highest scores (3.70 ± 0.32), particularly in attitudes toward health information and information needs. Poor self-reported overall health facilitated HISB in each stage. In the pre-visit stage, higher income was associated with increased HISB, while a lack of internet access reduced it. In the treatment stage, higher education was associated with higher HISB, whereas moderate-to-severe VI and certain income levels were associated with negative effects. In the follow-up stage, rural residence and spousal or child caregiving emerged as key facilitators of HISB. Conclusions: The treatment stage is a critical period for HISB engagement in older adults with VI. Healthcare providers should consider stage-specific factors of HISB to optimize health information delivery. Full article

Objective: Utilizing the Health Care Access Barriers (HCAB) Theoretical Framework, this study examined latent profiles of barriers to prenatal care among pregnant women in Alabama and whether these profiles mediate or moderate the relationship between pregnancy intentionality and early prenatal care initiation. Methods: An explanatory mixed-method design was employed, integrating quantitative analysis of Alabama Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 data (2016–2021) with qualitative insights from expert interviews. Latent class analysis (LCA) identified subgroups based on reported barriers. Multivariable logistic regression assessed the association between pregnancy intentionality and early prenatal care initiation, controlling for covariates. A Firth-penalized multivariable logistic regression model tested interaction effects. Results: Planned pregnancy was associated with higher odds of early prenatal care initiation (OR = 0.78, 95% CI [0.49, 1.23], p = 0.286), though this association was not statistically significant. Barrier profiles did not significantly moderate or mediate the relationship. The interaction term was nonsignificant (OR = 5.19, 95% CI [0.22, 828.94], p = 0.309), and the mediation pathway was also not supported (indirect effect = 0.012, p = 0.518). Expert interviews emphasized ongoing systemic and cognitive barriers that hinder timely access. Conclusions: Although pregnancy intentionality was not a statistically significant predictor of early prenatal care initiation, qualitative findings highlighted persistent barriers that continue to constrain access. These results underscore the need for multilevel strategies to address informational and logistical challenges. Future research should evaluate additional pathways that influence care-seeking behaviors. Full article