Search Results (507)

Organized youth sport has considerable potential to promote young people’s physical health, well-being, and personal and social development. However, these positive outcomes are not guaranteed. When sport environments are poorly structured, excessively performance-oriented, or inadequately supervised, participation may also lead to exclusion, excessive pressure, and other harmful experiences. Creating genuinely youth-centered sport environments is therefore essential, both to foster positive developmental outcomes and to prevent transgressive behavior. Despite growing attention to these issues, the field of youth sport lacks an overarching framework for the development of pedagogically sound, development-oriented, and socially safe sport environments. This study aimed to develop an overarching framework that integrates the developmental, motivational, and safeguarding dimensions of youth sport into one coherent model for creating optimal learning environments. Through an iterative process, a practice-based framework was developed, theoretically grounded, and initially operationalized. Early versions of the framework were subsequently examined for conceptual alignment through expert opinions, focus groups, and group discussions with existing European youth sport initiatives. This process resulted in the development of the Youth Sport Compass (YSC), a coherent conceptual and practical framework designed to support youth-centered and socially safe sport environments. Experts from different countries and disciplines considered the framework highly relevant, conceptually robust, and broadly applicable in practice. The YSC provides a strong conceptual and practical foundation for coaches, sport organizations, and policymakers seeking to create pedagogically sound, youth-centered, and socially safe sport environments. Although the YSC is firmly grounded in theory and practice, it has yet to be empirically validated. Further research is needed to assess its validity and practical effectiveness. Full article

This study aims to determine the effect of an education intervention on female athletes’ menstrual health knowledge, communication, and perceived importance of menstrual cycle tracking, and whether factors such as age, education level, or hormonal contraceptive use influence these outcomes. Three athlete cohorts engaged in two workshops and received targeted handouts. Participants (n = 51) completed surveys before, after, and 3 months following the intervention, which included a menstrual health knowledge assessment and a series of ratings to ascertain perceived knowledge; likelihood that they would discuss menstrual health with teammates, coaches, medical staff, and performance staff; and perceived importance of menstrual cycle tracking. Bayesian generalised linear mixed models and Bayesian linear mixed models were used to understand the effect of time and interactions between time and age, educational level, or hormonal contraceptive use. Actual and perceived knowledge and likelihood to communicate with teammates and performance staff appeared to be higher post-intervention and were retained for at least three months. The importance of menstrual cycle tracking increased from post-intervention to follow-up, while no change in communication with coaches or medical staff was observed. There appeared to be some effect of age, education level, and hormonal contraceptive use on knowledge and communication with medical staff. A menstrual health education intervention could be a practical and effective strategy to promote menstrual health literacy and communication in sport settings. Full article

Background/Objectives: Wheelchair users with multiple sclerosis (MS) often face barriers that restrict participation in physical activity and exercise training. This manuscript reports on participant feedback to guide evaluating and refining a novel exercise training program, Seated Physical activity INtervention (SPIN). SPIN was adapted from the Guidelines for Exercise in MS (GEMS) approach using a three-step community-engaged research framework based on meeting the needs of wheelchair users with MS. Methods: Semi-structured interviews were conducted with 9 participants who completed the 16-week SPIN intervention. The key SPIN intervention components were the exercise prescription, exercise equipment, and behavioral coaching grounded in Social Cognitive Theory. Formative interview domains included overall experience, enjoyable and missing components, delivery modifications, barriers, lessons learned, and additional research topics of interest. Data were analyzed and reported using a rapid qualitative analysis approach. Results: Interviews averaged 16 ± 10 min. Participants reported enjoying SPIN, noting program strengths as being flexible and appropriate for individuals with MS, receiving coaching calls by knowledgeable staff that offered support and accountability, and receiving exercise equipment and video demonstrations. Participants also identified strategies for enhancing the program such as including peer support, offering real-time feedback during exercise, and adding other wellness behavior topics (e.g., diet). Conclusions: The results offer helpful ideas to consider when developing exercise training programs for wheelchair users with MS and other disabilities that may improve health and well-being. Full article

Objectives: To examine disordered eating behaviors, orthorexic tendencies, binge-eating episodes, attitudes toward exercise, perceived hormone-related symptoms and body image perception among competitive bodybuilders across different levels of competitive experience. Methods: In this cross-sectional study, 60 competitive bodybuilders (29 men, 31 women) completed an anonymous online questionnaire. The survey evaluated demographic characteristics, coaching and training management, phase-specific symptoms (such as libido, sleep, eating behaviors, and menstrual alterations), orthorexic tendencies, exercise addiction, and body-image perception. Results: Both sexes reported reduced libido, increased hunger, and sleep disturbances, along with frequent weight monitoring and common binge-eating episodes. Moreover, females frequently reported menstrual irregularities. ORTO-15 scores indicated a potential risk of orthorexia nervosa, while EAI-3 scores suggested a risk of exercise addiction in novice females and advanced males, with differences in mood regulation and guilt across sex and experience. Males showed higher perceived and ideal muscle mass, whereas females reported higher perceived body fat and a preference for leaner physiques. Conclusions: Competitive bodybuilders of both sexes exhibit post-competition binge eating, mood- and appearance-driven exercise behaviors, and pronounced body-image concerns. Screening, education on energy availability, structured post-competition support, and health-focused coaching are recommended to prevent the progression from sport-specific practices to clinical pathology. Full article

Background: Modifiable lifestyle factors may contribute additively to colorectal cancer (CRC) risk in individuals who already have non-modifiable risk factors, such as prior colorectal neoplasia or significant family history of CRC. However, the impact of multicomponent lifestyle interventions (such as dietary modification, physical activity, and counselling) on behavioural modification, risk of colorectal neoplasia, and quality of life (QoL) in this population has not yet been systematically reviewed. Aims: The primary aim was behavioural change (change in body weight, diet, physical activity, sedentary lifestyle, smoking, and alcohol consumption). The secondary aim was colorectal neoplasia outcomes, including the incidence of precancerous lesions and/or cancer and CRC mortality/survival, and QoL, including specific domains. Methods: This review was conducted following the Cochrane guidelines for Systematic Reviews of Interventions. Both randomised and non-randomised studies assessing the effect of multicomponent lifestyle interventions on behavioural modification, risk of colorectal neoplasia, mortality, and quality of life in people at above-average risk of CRC were included. Medline/Ovid, Cochrane Library, Web of Science, and Scopus were searched. Screening, data extraction, and risk of bias assessment were independently performed by two reviewers using the revised Cochrane Risk of Bias (RoB) tools. Results: Of the 4174 studies screened, 10 interventional studies were eligible for inclusion, which had outcomes for behavioural change or quality of life. No interventions assessed neoplasia risk or mortality outcomes. Multicomponent lifestyle interventions mainly targeting diet and physical activity, delivered via a telephone-based or health coaching approach, showed positive effects on healthy behaviours and quality of life compared with usual care, although some studies reported inconsistent results. Conclusions: There is emerging evidence that multicomponent lifestyle interventions may offer beneficial effects on practicing healthy behaviours and improving QoL for individuals at above-average risk for CRC and undergoing colonoscopy surveillance. Full article

Previous research demonstrates that housing security and quality influence physical and mental health. Despite a rich literature on housing and health, less is known about the processes through which housing mobility programs directly affect family health. We use a single-case design to examine how the health of families with children is impacted by Families Flourish, a mobility program that combines three years of rental assistance with life coaching and placement in safe, well-resourced neighborhoods. Drawing on developmental and formative evaluation data, including longitudinally collected surveys, interviews, and administrative records, we trace families’ experiences over time. Our analysis identifies distinct pathways through which mobility improves mental and physical health—via improved indoor air quality, reduced environmental and parental stress, and enhanced access to resources. Initial health gains are subsequently leveraged to improve educational and economic outcomes. We observe a temporal sequence in outcomes, with early physical health gains and later mental health improvements as stability and safety increase. We conclude by situating these identified pathways within existing scholarship and discussing implications for planning and fair housing practice. Full article

Background: Artificial Intelligence (AI) and Machine Learning (ML) technologies, such as conversational agents, are becoming increasingly essential tools across multiple industries, particularly in healthcare. This paper presents a scoping review (PRISMA-ScR) of conversational agents (CAs) in mobile health coaching systems (MHCS). It examines existing applications of MHCS, focusing on development strategies, usage contexts, impacts on users, benefits, and research gaps, emphasizing the ability of explainable artificial intelligence (XAI) in making health guidance and decision-support recommendations transparent, trustworthy, and interpretable, if properly integrated. This scoping review identifies opportunities to maximize the use of conversational agents, explainable AI, and mobile technologies to make mobile health coaching systems more accessible and trustworthy, as well as further research gaps worth exploring. Objective: This scoping review maps the evidence on CAs and XAI-enabled technologies in MHCS, identifies trust-related design criteria, categorizes reported outcomes, and highlights opportunities for explainable conversational agents (XCA) in a mobile health context, especially in tackling general medical conditions pertinent in underserved settings. Eligibility criteria: Reported eligible resources evaluated, designed, or conceptually analyzed existing CAs, XAI techniques, and MHCS, AI-supported medical dialogue systems, e-coaching systems, and mobile health applications. We considered sources only relevant to healthcare, health coaching, trust, explainability, or patient engagement that were published between 2006 and 2025. Sources of Evidence: Searches were conducted in IEEE Xplore, Google Scholar, Springer, ScienceDirect/Elsevier, ProQuest, and ACM Digital Library, supplemented by targeted web searches and backward citation checks. Charting methods: Data were charted by system type, communication mode, health context, operational mode, technology used, XAI/trust features, degree of automation, study designs and outcome classification. We applied a revised outcome classification: generated desired outcome (GDO) and partially generated desired outcome (P-GDO), and did not generate desired outcome (DN-GDO). Results: A total of 201 resources were collected. Charted studies clustered around CAs in health, MHCS for chronic diseases and stress management, XAI methods such as LIME, SHAP, Prospector, and counterfactual explanations, and trust-related elements such as voice quality, communication style, appearance, social intelligence, privacy, and performance quality. Most health CAs and MHCS addressed chronic diseases, mental health, or behavior change; fewer addressed general medical diagnosis or autonomous mobile-based primary care support. Conclusions: Existing evidence suggests that CAs and MHCSs can support engagement, coaching, education, and selected decision-support tasks, but evidence for safe, autonomous, explainable general practice functionality remains limited. Future work should prioritize clinically supervised XCA designs, core safety assessment, interfaces with transparent explanation, data protection, culturally and linguistically responsive implementation, and future-oriented review in underserved mobile health settings. Full article

Background: The National Research Mentoring Network (NRMN) aims to enhance capacity in the biomedical research workforce through mentorship, professional development, and networking. This study focuses on the Strategic Empowerment Tailored for Health Equity Investigators (NRMN-SETH) program, which supports early-stage investigators (ESIs), including those from underrepresented groups, in developing grant-writing skills. Using a realist evaluation framework, this study explores the contexts, mechanisms, and outcomes contributing to the program’s effectiveness. Methods: A directed content analysis approach was employed, guided by the realist evaluation framework. Data sources included speaker slides, moderator notes, and participant observations from the 2024 RCMI NRMN-SETH session. Context-mechanism-outcome configurations were analyzed to identify key stakeholders, enabling factors, and barriers to success. Results: Five key mechanisms emerged: social support, peer accountability, knowledge of grant-writing strategies, technical grant-writing knowledge, and access to mentoring. Critical contexts included protected time for grant writing, access to subject-matter experts, and participant readiness. Institutional leadership support and cross-institutional collaborations were identified as essential for sustainability. Conclusions: The NRMN-SETH program effectively supports ESIs through mentorship and technical guidance, fostering equitable participation in biomedical research. Future efforts should focus on institutional investment in mentorship, grant readiness, and expanded access to subject-matter experts to enhance the program’s scalability and long-term impact. Full article

Background: Chronic pain remains a primary driver of global disability and impaired quality of life. While digital conversational agents (CAs) have emerged as scalable tools for symptom monitoring and self-management via patient-reported outcome measures, their clinical efficacy remains poorly synthesized. This systematic review and meta-analysis aimed to evaluate the impact of CA-based interventions on PROMs in adults with chronic pain. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched from inception to 22 October 2025. Eligible studies were RCTs including adults with chronic pain and evaluating fully automated CA interventions, such as digital coaching or messaging programs. PROMs related to pain, well-being, disability, and work-related outcomes were extracted. Continuous outcomes were synthesized using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Five RCTs involving 572 participants were included. Interventions were self-guided, digitally delivered, and lasted 4 to 12 weeks. The overall pooled analysis suggested a potential benefit of CA-based interventions on PROMs (SMD = −0.43; 95% CI −0.55 to −0.31; p < 0.00001), although heterogeneity and risk of bias across studies warrant cautious interpretation. Improvements were observed particularly in pain intensity, although evidence for other outcomes was less consistent, with some studies reporting benefits in quality of life, fear of movement, and well-being. Conclusions: CA-based interventions may have potential as adjuncts in chronic pain management; however, the current evidence is limited and should be interpreted with caution due to heterogeneity and risk of bias across studies. These tools may represent a scalable solution for supporting remote symptom monitoring and self-management within digital health frameworks, although further high-quality evidence is required. Full article

Background/Objectives: Obesity is a chronic, relapsing disease with a widening gap between clinical need and the availability of specialist care. Artificial intelligence (AI) may enable earlier risk detection, more precise phenotyping, and scalable behavioural support across obesity treatment pathways. This narrative review synthesises contemporary AI applications across the obesity care continuum and evaluates their translational readiness. Methods: A targeted search of PubMed/MEDLINE and Google Scholar (January 2024–January 2026) was conducted, complemented by citation chaining. Evidence was synthesised across four domains: (1) risk prediction and screening, (2) environmental and behavioural determinants, (3) multimodal phenotyping and precision stratification, and (4) AI-enabled lifestyle interventions and behavioural coaching (AIBC). Results: Electronic health record (EHR)-based models demonstrate clinically useful discrimination for early risk identification. Multimodal approaches refine stratification beyond body mass index (BMI)-centric classification. AI-enabled behavioural coaching (AIBC) platforms show emerging evidence of clinically meaningful weight loss, including non-inferiority to human coaching; however, long-term effectiveness, generalisability, and equity remain insufficiently established. Conclusions: AI is positioned to become a core enabler of personalised obesity pathways. Safe translation requires external validation, bias auditing, transparent reporting, human oversight, and post-deployment surveillance aligned with clinical guidelines and regulatory expectations. Full article

Background/Objectives: Digital systems are being increasingly used to mediate pediatric care, yet many competency models remain predominantly technical and may unintentionally dilute patient- and family-centered care. This study aimed to identify empirically grounded digital competencies that enable pediatric nurse leaders to sustain patient- and family-centered care and to propose a practice-ready competency map. Methods: An interpretative phenomenological study was conducted across three hospitals in Saudi Arabia, purposively selected for varying levels of digital maturity. Ten pediatric nurse leaders completed two in-depth, semi-structured interviews (60–90 min) and a four-week reflective journal. Data were analyzed ideographically and then across cases using interpretative phenomenological analysis. Interviews were conducted in Arabic or English; translation included professional translation, partial back-translation (30%), and bilingual review. Results: Four interlinked competency domains emerged: (1) Relational digital presence, co-viewing the electronic health record, narrating documentation, and coordinating gaze and screen use to preserve relational connection; (2) Vulnerable expertise, micro-coaching at the point of care and transparent discussion of near-misses to build psychological safety; (3) Culturally legible communication, multimodal, language-congruent communication and explicit boundaries for sensitive information; and (4) Judgment-with-data, documenting override rationales and balancing algorithmic indicators with contextual family need. Together, these domains formed a screen-side competency map translating lived experience into trainable micro-practices. Conclusions: Digital competence in pediatric nursing leadership is relational, culturally situated, and clinically interpretive rather than a linear technical checklist. Embedding these competencies into leadership development and digital workflow design may help protect and strengthen patient- and family-centered care in technology-mediated pediatric care. Full article

Background: Infants discharged home from a neonatal intensive care unit (NICU) often have multiple ongoing medical needs. The Coached, Coordinated, Enhanced Neonatal Transition (CCENT) program provides nurse navigator-led support for caregivers of high-risk infants through their first year after transitioning from the NICU to home. The objective was to compare health care resource use and costs between CCENT and standard care control groups post-discharge. Methods: Resource use and costs were collected at 4 months and 12 months post-discharge from families enrolled in the CCENT randomized controlled trial across Canada. Infant healthcare utilization and parent mental health service use and costs were analyzed from public health care system and family payer perspectives and were compared statistically between groups and within groups over time. Results: A total of 97 and 105 infants were randomized to the intervention and control groups, respectively. Significant reductions in use of medications and equipment were observed over time in both groups while use of allied health professionals decreased and emergency department (ED) visits increased for CCENT. Annual total healthcare costs per child to the public payer were $4135 (95% CI $2825, $5709) for the CCENT group and $4578 (95% CI $2246, $8356) for controls. The cost of delivering CCENT was $669 per family (SD $362). The average annual out-of-pocket cost per family was $724 (95% CI $467, $1024) for CCENT and $728 (95% CI $479, $1007) for controls. Conclusions: This study indicates the importance of considering patterns of healthcare utilization, program costs and costs to families when implementing NICU to home care interventions. Excluding the cost of a nurse navigator, costs to the healthcare system were not increased in the intervention group. Such a program may help families access appropriate care. Full article

Background: Children and adults with disabilities are widely acknowledged to have poorer health and emotional wellbeing than their non-disabled peers, which is further compounded by less access to health services and health-promoting activities. A relatively untried solution is to mobilize community initiatives such as sports to promote better health. Method: Special Olympics (SO) is an international sports organization present in over 200 countries and jurisdictions, engaging with just under four million athletes with intellectual disabilities annually. Research on the perceptions of sports coaches around incorporating health promotion within their sports training has been scarce. Likewise, little attention has been paid to identifying athletes’ understanding of what health means to them and actions that would make them healthier. A qualitative, descriptive study was conducted with eight national SO programs involving 62 coaches and 47 athletes. Group interviews were conducted via Zoom and a thematic content analysis was made of their responses. Results: In all countries, coaches and athletes agreed that the most common needs were healthy eating, healthy weight and exercise. Good mental wellbeing and sleeping well were also named. Ideas were sought from both sets of participants regarding how coaches could assist their athletes to attain better health and the barriers they might face in doing so. Conclusions: Three main conclusions emerged. Athletes and coaches were aware of health deficits and knew of ways to reduce them. Both appreciated the contribution that coaches could make through motivating athletes and providing training activities but were dependent on suitable resources being available to them. Engagement with families and available health and social care services was essential. Health-oriented, sporting activities offer promise in improving the health and wellbeing of persons with developmental disabilities, particularly in less affluent countries with fewer health professionals and poorly developed primary care services. Full article

Remote exercise supervision and functional movement assessment require sensing pipelines that can capture body motion, interpret protocol progression, and provide meaningful feedback within the same runtime environment. This paper presents ORAMA, an integrated computer vision platform for the execution and remote monitoring of digital exercises and clinically oriented assessment protocols related to physical fitness, mobility, balance, and health. The system combines ZED 2i stereo capture and depth-aware body tracking with a protocol-driven software architecture that includes a computer-vision pipeline, an exercise and assessment engine, a real-time feedback layer, persistent session handling, structured output generation, and a chatbot-assisted interaction path. Unlike solutions that focus only on movement recognition, ORAMA organizes each task as an explicit executable protocol with calibration stages, state transitions, task-specific metrics, and live visual guidance. The paper analyzes the system architecture, reviews the surrounding literature on virtual coaching and rehabilitation-oriented computer vision, and demonstrates representative user-interface and runtime views for both assessment and exercise scenarios. The present work reports a prototype architecture and representative operational demonstrations, rather than a completed clinical validation or participant-based efficacy study. The resulting platform shows how markerless 3D body tracking can be embedded within a unified and interpretable environment for guided exercise, functional testing, and remote follow-up without requiring wearable sensors. Full article

Doping remains a major threat to athlete health and sport integrity. Although anti-doping efforts have traditionally focused on athletes, increasing attention has turned to Athlete Support Personnel (ASP) due to their influence on athletes’ decisions, behaviors and involvement in anti-doping rule violations. This narrative review aimed to synthesize the existing literature on the role of ASP (including coaches, physicians, pharmacists, sport psychologists, nutritionists, physiotherapists, parents and other family members) in anti-doping, with particular attention to their influence on athletes’ knowledge, attitudes, behaviors, education and decision-making related to doping. Coaches, physicians, and pharmacists are among the ASP groups most frequently examined in the literature, although substantial knowledge gaps remain across all groups. Coaches shape motivational climates and ethical norms but often lack adequate understanding of anti-doping regulations and supplement risks. Physicians and pharmacists play key roles in medication management and Therapeutic Use Exemptions procedures, though incomplete regulatory knowledge may contribute to inadvertent violations. Nutritionists are central in preventing supplement-related doping, while research on sport psychologists and physiotherapists remains limited despite their preventive potential. Parents significantly shape athletes’ moral development and susceptibility to doping, acting as protective or risk factors depending on family dynamics. Overall, anti-doping education for ASP remains inconsistent. In conclusion, ASP plays an essential yet heterogeneous role in influencing doping-related behaviors. Strengthening role-specific and interdisciplinary anti-doping education, particularly within university programs and professional development, appears critical for enhancing ASP competence and promoting a sustainable culture of clean sport. Full article