Search Results (455)

According to the literature, the advancement of information and communication technology (ICT) has increased individual exposure to scams, turning fraud victimization into a significant concern. While prior research has primarily focused on socio-demographic predictors of fraud victimization, this study adopts a behavioral perspective that is grounded in the Signal Detection Theory (SDT) to investigate the likelihood determinants of individuals becoming fraud victims. Using survey data of 671 Indonesian respondents analyzed with the Partial Least Squares Structural Equation Modeling (PLS-SEM), we explored the roles of vigilance and financial literacy in moderating the relationship between fraud exposure and victimization. Our findings substantiate the notion that higher exposure to fraudulent activity significantly increases the likelihood of victimization. The results also show that vigilance negatively moderates the relationship between fraud exposure and fraud victimization, suggesting that individuals with higher vigilance are better at identifying scams, thereby decreasing their likelihood of becoming fraud victims. Furthermore, financial literacy is positively related to vigilance, indicating that financially literate individuals are more aware of potential scams. However, the predictive power of financial literacy on vigilance is relatively low. Hence, while literacy helps a person sharpen their indicators for detecting fraud, psychological, behavioral, and contextual factors may also affect their vigilance and decision-making. Full article

Enhancing farmers’ digital literacy is both an inevitable requirement for adapting to the digital age and an important measure for promoting the sustainable development of livestock and poultry manure resource utilization. This study surveyed and obtained data from 1047 farm households in Ningxia and Gansu, two provinces in China that have long implemented livestock manure resource utilization policies, from December 2023 to January 2024, and employed the binary probit model to analyze how digital literacy influences farmers’ willingness to adopt two livestock manure resource utilization modes, as well as to analyze the moderating role of three policy regulations. This paper also explores the heterogeneous results in different village forms and income groups. The results are as follows: (1) Digital literacy significantly and positively impacts farmers’ willingness to adopt both the “household collection” mode and the “livestock community” mode. For every one-unit increase in a farmer’s digital literacy, the probability of farmers’ willingness to adopt the “household collection” mode rises by 22 percentage points, and the probability of farmers’ willingness to adopt the “livestock community” mode rises by 19.8 percentage points. After endogeneity tests and robustness checks, the conclusion still holds. (2) Mechanism analysis results indicate that guiding policy and incentive policy have a positive moderation effect on the link between digital literacy and the willingness to adopt the “household collection” mode. Meanwhile, incentive policy also positively moderates the relationship between digital literacy and the willingness to adopt the “livestock community” mode. (3) Heterogeneity analysis results show that the positive effect of digital literacy on farmers’ willingness to adopt two livestock manure resource utilization modes is stronger in “tight-knit society” rural areas and in low-income households. (4) In further discussion, we find that digital literacy removes the information barriers for farmers, facilitating the conversion of willingness into behavior. The value of this study is as follows: this paper provides new insights for the promotion of livestock and poultry manure resource utilization policies in countries and regions similar to the development process of northwest China. Therefore, enhancing farmers’ digital literacy in a targeted way, strengthening the promotion of grassroots policies on livestock manure resource utilization, formulating diversified ecological compensation schemes, and establishing limited supervision and penalty rules can boost farmers’ willingness to adopt manure resource utilization models. Full article

Health literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention. Full article

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

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

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

Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient perspectives are lacking. This is the first nationwide study from Turkey, a setting of increasing HIV incidence, assessing PLWH perspectives on switching to LA-CAB/RPV and the influence of motivational factors on treatment preferences. Materials and Methods: A prospective, multicenter, cross-sectional study was conducted across 11 HIV treatment centers representing all regions of Turkey. Virologically suppressed PLWH meeting current eligibility criteria for LA-CAB/RPV were included. Treatment preferences (switch to LA-CAB/RPV or remain on oral ART) and five anticipated motivational domains, namely perceived efficacy, safety, convenience, privacy, and cost, were systematically assessed through structured, face-to-face interviews. Results: Among 200 eligible participants, 86% (n = 172) preferred switching to LA-CAB/RPV. In all subgroups, LA-CAB/RPV was preferred over oral ART, except for those with no formal literacy. Prior awareness of LA-CAB/RPV was significantly associated with the switching preference (p < 0.001), with healthcare providers being the most common source of information, at 45.5% (n = 172) (p < 0.001). Residential proximity to the healthcare center (p = 0.018) and all motivational factors significantly influenced the preference (p < 0.05). Notably, when participants who initially chose to remain on oral ART were asked whether they would reconsider switching if injections were administered every six months, overall preference for long-acting therapy increased from 86% to 98%. Conclusions: High clinical eligibility and strong acceptability for LA-CAB/RPV were observed among Turkish PLWH. Our findings demonstrate that structured motivational factors significantly influence the treatment preference. Addressing these patient-centered factors and logistical barriers may support the successful integration of long-acting therapies into routine HIV care. Future longer-interval agents may improve patient-centered acceptability. Full article

This study explores digital inequality as a socio-spatial phenomenon within the context of smart inclusion, focusing on the Regional Unit of Xanthi, Greece—a region marked by ethno-cultural diversity and pronounced urban–rural contrasts. Using a mixed-methods design, this research integrates secondary quantitative data with qualitative insights from semi-structured interviews, aiming to uncover how spatial, demographic, and cultural variables shape digital engagement. Geographic Information System (GIS) tools are employed to map disparities in internet access and ICT infrastructure, revealing significant gaps linked to geography, education, and economic status. The findings demonstrate that digital inequality is particularly acute in rural, minority, and economically marginalized communities, where limited infrastructure intersects with low digital literacy and socio-economic disadvantage. Interview data further illuminate how residents navigate exclusion, emphasizing generational divides, perceptions of technology, and place-based constraints. By bridging spatial analysis with lived experience, this study advances the conceptualization of digitally inclusive smart regions. It offers policy-relevant insights into how territorial inequality undermines the goals of smart development and proposes context-sensitive interventions to promote equitable digital participation. The case of Xanthi underscores the importance of integrating spatial justice into smart city and regional planning agendas. Full article

In modern medical education, a robust understanding of statistics is essential for fostering critical thinking, informed clinical decision-making, and effective communication. This paper explores the synergistic value of early and continued statistical education for medical students and residents, particularly in relation to the expanding field of sports supplementation and its impact on athletic performance. Early exposure to statistical principles enhances students’ ability to interpret clinical research, avoid cognitive biases, and engage in evidence-based practice. Continued statistical learning throughout residency further refines these competencies, enabling more sophisticated analysis and application of emerging data. The paper also addresses key challenges in integrating statistics into medical curricula—such as limited curricular space, student disengagement, and resource constraints—and proposes solutions including interactive learning, case-based teaching, and the use of public datasets. A unique emphasis is placed on connecting statistical literacy to the interpretation of research in sports science, particularly regarding the efficacy, safety, and ethical considerations of sports supplements. By linking statistical education to a dynamic and relatable domain like sports performance, educators can not only enrich learning outcomes but also foster lasting interest and competence in quantitative reasoning. This integrated approach holds promise for producing more analytically proficient and clinically capable physicians. Full article

Urban wetlands are increasingly recognized for their ecological and cultural benefits, yet remain underutilized due to limited public awareness and environmental literacy. This study investigates how visitors’ perceptions of wetland ecosystem services influence their motivations to engage with a constructed wetland in Putrajaya, Malaysia. By integrating the ecosystem services framework with push-pull motivation theory, the research aims to bridge knowledge gaps and inform sustainable wetland tourism planning. A structured questionnaire was administered to 420 visitors, with 385 valid responses (response rate: 91.7%). Data were analyzed using non-parametric tests (Kruskal–Wallis, Spearman correlation) and multiple regression analysis. Results show that cultural and regulating services are perceived most positively, while emotional restoration and aesthetic appreciation emerged as key motivational drivers. Regression findings reveal that push factors are stronger predictors of ecosystem service engagement than pull factors. These insights highlight the importance of emotional and psychological connections to nature, offering practical implications for urban wetland management, visitor education and environmental communication strategies. 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 future of marine sustainability depends on public understanding and trust in the policy recommendations that emerge from scientific research. For common pool marine resource decisions made by the people who depend on these resources for their food, employment, and economic future, understanding the current status of these marine systems and change is essential to ensure these resources will persist into the future. As such, the informal learning infrastructure is essential to increasing marine science literacy in a changing world. This mixed-methods research study analyzed the distribution and accessibility of marine science education and research across Alaska’s five geographic regions. Using the PRISMA framework, we synthesized data from 198 institutions and analyzed peer-reviewed literature on marine ecosystems to identify geographic and thematic gaps in access to informal science learning and research focus. In parallel, we undertook geospatial analysis and resource availability to describe the distribution of resources, types of informal learning infrastructure present across the state, regional presence, and resources to support informal marine science learning opportunities. Findings from this multifactor research revealed a concentration of resources in urban hubs and a lack of consistent access to learning resources for rural and Indigenous communities. The configurative literature review of 9549 publications identified topical underrepresentation of the Bering Sea and Aleutian Islands, as well as a lack of research on seabirds across all regions. Considered together, these results recommend targeted investments in rural engagement with marine science programming, culturally grounded partnerships, and research diversification. This review concludes that disparities in learning resource support and government-funded priorities in marine wildlife research have created conditions that undermine the local people’s participation in the sustainability of sensitive resources and are likely exacerbating declines driven by rapid change in Arctic and sub-Arctic waters. Full article

Background/Objectives: Weight gain is frequently observed during and following breast cancer therapy. Women with overweight/obesity have poorer breast cancer prognoses and are more likely to develop comorbidities. The present study describes the development and qualitative assessment of the acceptability of the NutriLife study, a lifestyle weight management intervention with dietetic counseling and digital tools for breast cancer survivors (BCSs). Methods: The intervention was developed using the Medical Research Council (MRC) framework, informed by a systematic literature review and stakeholder input. Acceptability was assessed using the Theoretical Framework of Acceptability (TFA). A total of 22 BCSs with overweight/obesity participated in focus groups, and 5 dietitians/nutritionists specializing in breast cancer in Greece participated in semi-structured interviews. The data were further analyzed using thematic analysis. Results: Stakeholders assessed the intervention as acceptable across all TFA constructs. The intervention was characterized as supportive, easily adaptable, time-efficient, well-organized, beneficial, and professionally driven, with potential barriers including limited personal time, inadequate digital literacy, insufficient self-care, and lack of commitment. Gradually increasing goals may be helpful and less stressful, while educational resources enhance focus on these objectives, thus encouraging intervention participation. Ensuring confidentiality was perceived as central to promoting health. Conclusions: The evidence-based, co-participatory design of the NutriLife intervention was perceived as acceptable by the participating stakeholders and will be pilot-tested in a randomized controlled trial. Full article

A partially ordered set (or a poset, for short) is a set endowed with a partial order relation, i.e., with a reflexive, anti-symmetric, and transitive binary relation. As mathematical objects, posets have been intensively studied in the last century, coming to play essential roles in pure mathematics, logic, and theoretical computer science. More recently, they have been increasingly employed in data analysis, multi-criteria decision-making, and social sciences, particularly for building synthetic indicators and extracting rankings from multidimensional systems of ordinal data. Posets naturally represent systems and phenomena where some elements can be compared and ordered, while others cannot be and are then incomparable. This makes them a powerful data structure to describe collections of units assessed against multidimensional variable systems, preserving the nuanced and multi-faceted nature of the underlying domains. Moreover, poset theory collects the proper mathematical tools to treat ordinal data, fully respecting their non-numerical nature, and to extract information out of order relations, providing the proper setting for the statistical analysis of multidimensional ordinal data. Currently, their use is expanding both to solve open methodological issues in ordinal data analysis and to address evaluation problems in socio-economic sciences, from multidimensional poverty, well-being, or quality-of-life assessment to the measurement of financial literacy, from the construction of knowledge spaces in mathematical psychology and education theory to the measurement of multidimensional ordinal inequality/polarization. Full article

Information asymmetry leads to farmers’ opportunistic behavior of disobeying pest control regulations in certified vegetable areas, but the improvement of farmers’ digital literacy has become an important means to break through the constrained dilemma of pest control information and change farmers’ pest control behaviors. Based on survey data from certified vegetable areas of Shaanxi, Gansu, and Ningxia provinces in China, this study used Heckman two-stage model to analyze the impact of the improvement of farmers’ digital literacy on opportunistic behavior in pest control. The results are as follows. Firstly, the improvement of farmers’ digital literacy can restrain their opportunistic behavior in pest control. Secondly, the improvement of farmers’ digital literacy restrain their opportunistic behavior through three paths, namely, enhancing the awareness of obeying pest control regulations for certified vegetables, reducing the cost and risk of pest control in obeying the certification standards. Thirdly, the traceable certification label plays a positive moderating role in the process of improving digital literacy to restrain farmers’ opportunistic behavior. Accordingly, this study suggests strengthening the training of farmers’ digital literacy, promoting the digitalized traceability system for certified vegetables, establishing examination mechanisms for online pesticide purchases and logistics distribution, and imposing severe penalties for opportunistic behaviors. Full article