Search Results (157)

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa. Methods: The study was carried out via a two-armed randomized controlled trial including 40 patients with PCa at a medical center in Philadelphia. During the 3-month period, the intervention group (PNF+) received health coaching utilizing an interactive text message system, and the control group received healthy eating text messages for the same duration. The outcome variables were feasibility and acceptability. Results: The PNF+ group (n = 27) had high adherence to health coaching (82%), picture response (85%) and moderate adherence to the PNF window (69%). The intervention was rated highly acceptable with no reported A/E associated with the intervention, and most participants planning to continue in some capacity. At 3 months, the PNF+ group had numerically lower BMI (29.1) and body weight (195.2 lbs) compared to the control group (n = 13; BMI 31.6, weight 223.3 lbs). Improvements in patient-reported outcomes were observed in both groups. FACIT-F scores (higher scores indicate less fatigue) increased in the PNF+ group (43.6 to 45.2) and in the control group (42.5 to 45.5). FACT-P scores (higher scores indicate better quality of life) increased in the PNF+ group (121.3 to 125.5) but decreased slightly in the control group (121.1 to 119.8). Between-group comparisons of change from baseline showed no statistically significant differences across outcomes (all p > 0.05). Conclusions: The intervention demonstrated partial feasibility and high acceptability. It was associated with numerically lower BMI and body weight and favorable changes in patient-reported outcomes, particularly quality of life; however, no statistically significant differences were observed between groups. These findings should be interpreted cautiously given the small sample size and require confirmation in larger, adequately powered trials. Full article

Background/Objectives: Prediabetes (PD) does not always progress to type 2 diabetes; however, lifestyle modification and weight loss are recommended to prevent disease progression. This study aimed to determine whether a text message-based intervention for older adults with PD in South Korea could reduce glycated hemoglobin (HbA1c) levels and promote healthy habits. Methods: A randomized controlled trial with two parallel groups was conducted and approved by the Institutional Review Board of Wonju Severance Christian Hospital (IRB No: CR321379). A text message intervention was provided only to the intervention group for six months, while the control group was advised to maintain their usual daily routines. The text messages covered the following categories: nutrition, exercise, medical knowledge, lifestyle, and self-reflective thoughts. Results: A total of 96 participants aged 50 years and older underwent clinical measurements, completed the Korean Health Habits Questionnaire, and were assessed for quality of life at baseline and after the intervention. HbA1c, waist circumference, and fasting blood glucose decreased significantly in both groups (p < 0.05). The intervention group demonstrated significant improvements in body mass index, low-density lipoprotein cholesterol, total cholesterol, and milk consumption. In contrast, instant food consumption increased significantly in the control group, resulting in significant between-group differences (p < 0.05). In addition, the frequency of late-night eating increased significantly within the control group (p < 0.05). Conclusions: Text message-based interventions may serve as an effective adjunctive self-management strategy to improve HbA1c levels and promote healthy habits in older adults with prediabetes. Full article

Background: Motivational text messages can encourage increased physical activity. This study aimed to validate motivational text messages among older adults and care partners and to assess differences in perceived motivational value between the two groups. Methods: We designed nine motivational text messages to capture nine distinct physical activity scenarios. For this cross-sectional observational study, we enrolled 14 content experts, 310 older adults, and 305 care partners. Content experts assessed the relevance, while the older adults and care partners assessed the perceived motivational value of each text message on a 5-point Likert scale. We computed the item content validity index and assessed differences in perceived motivational value among older adults and care partners using quantile regression while adjusting for sociodemographic and health characteristics. Results: The item content validity index ranged from 0.86 to 1.00. The median (interquartile range) perceived motivational value for each text message was 4.0 (3.0–5.0), and there were no statistically significant differences in reported motivational values between older adults and care partners. Conclusion: We present nine content-validated text messages with high motivational value for older adults and care partners that can be integrated into technology-based intervention studies and may improve physical activity behavior in both groups. Full article

Firefighters face elevated risks of alcohol misuse due to occupational stress, trauma exposure, and cultural norms within the fire service. This beta test study evaluated the feasibility, acceptability, and preliminary outcomes of From Bottle to Nozzle, a digitally delivered alcohol awareness and prevention intervention tailored for firefighters. Fifty fire service personnel were invited to participate; 46 consented and completed baseline questionnaires, and 22 completed the full program. The intervention consisted of five self-paced online modules incorporating multimedia content, quizzes, and self-assessments that addressed alcohol history, fire service culture, risk-reduction strategies, communication, and health effects. Pre- and post-intervention assessments measured changes in alcohol-related knowledge, alcohol use, motivation to reduce drinking, and usability. Reinforcement messages were delivered via text and email. Alcohol-related knowledge improved significantly post-intervention, particularly in the general and total knowledge domains. Moderate drinkers showed reductions in drinking days and AUDIT scores. Among heavy drinkers, overall consumption declined slightly, though binge-drinking episodes increased. Changes in motivation to reduce drinking were mixed. Usability ratings were high, with an 80% module completion rate and favorable feedback on program brevity and format, though navigation and video length were noted as challenges. From Bottle to Nozzle demonstrated strong feasibility and acceptability. While knowledge gains were robust, behavioral outcomes were mixed, highlighting the need for larger controlled studies with extended follow-up. Full article

Respiratory infections cause substantial morbidity and mortality in older adults and other at-risk adult populations. Despite the availability of effective vaccines, adult vaccination coverage remains suboptimal. This narrative review examines strategies designed to improve vaccine uptake among non-pregnant adults aged ≥18 years and inform future adult vaccination strategies. We conducted a targeted literature search using keywords for vaccination, respiratory diseases, strategy/program/implementation, and adults in PubMed database and CDC, WHO, and ECDC websites, between 2014 and 2024. A snowball search of literature reviews and key references was also performed to identify additional relevant studies. Eligible publications focused on vaccination strategies against influenza, COVID-19, and pneumococcal disease targeting non-pregnant adults (≥18 years). We categorized the strategies by intervention type to describe their influence on vaccination campaigns and vaccine uptake/coverage. We included 45 publications, encompassing strategies focused on individual decision-making, healthcare system functions, and national policy. Educational and awareness interventions (such as healthcare worker/provider recommendations during consultation, phone calls, letters, text messages, and social media outreach) reportedly raised vaccination rates. Access-related factors, including convenient vaccination sites and free or subsidized vaccines, were reported to be important factors in improving coverage in underserved communities. Within healthcare settings, strategies such as continuous vaccine provider training and workflow/process optimization were shown to enhance vaccination delivery. At the local or national policy levels, legislation governing program targets shaped immunization efforts and facilitated collaborations and partnerships to expand campaign reach. The findings may inform policymakers and public health/immunization practitioners in designing context-specific immunization initiatives that effectively reach adult populations. Full article

Background: Chronic pain, which affects over 50 million adults in the United States, has stimulated growing interest in natural and nutrition-based remedies as adjuncts to pharmacologic therapies. Evidence suggests that turmeric and related extracts (i.e., curcuminoids) may provide pain relief, albeit often at levels above dietary ranges, while piperine from black pepper exhibits bioenhancer characteristics of relevance with dietary exposures. Objective: To test the effectiveness of dietarily relevant amounts of turmeric with and without black pepper on self-reported pain ratings among adults with chronic pain. Methods: A randomized, crossover clinical trial tested the effectiveness of turmeric only (one of three amounts within culinary ranges) or turmeric with black pepper to influence pain in adults ≥ 40 years of age. Participants (n = 30, with moderate pain: 4–7 on 0–10-point scale) were enrolled in a 21-day trial, and an experience sampling methodology approach was used. Participants were prompted to report current pain using the numeric pain rating scale (NPRS; 0–10) via text message three times per day for the full study period. Data were averaged and analyzed via linear mixed effects models for repeated measurements. Results: Pain ratings from baseline to week 3 were reduced and statistically significant (p < 0.001) but not statistically different between groups. The provided turmeric, both with and without black pepper, and varying amounts of turmeric (300 mg, 1 g, and 3 g, n = 10 participants/amount) did not show statistically significant differences in pain ratings (p = 0.157 and p = 0.338, respectively). Conclusions: Consuming dietarily relevant amounts of turmeric, either alone or with black pepper, appears to improve average pain ratings. This result suggests a feasible dietary option for further study of nutritional interventions for chronic pain management. Full article

Background: Circadian rhythm disruption caused by shift work alters metabolic and hormonal pathways, which accelerates chronic disease onset, leading to decreased quality and quantity of life. This study aimed to determine whether a practical lifestyle intervention emphasizing nutrition timing and recovery habits could mitigate the metabolic and psychological effects of night-shift work. We conducted a randomized, open-label, crossover trial with two 8-week periods. Methods: Female healthcare workers (n = 13) aged 18–50 years with a body mass index (BMI) between 27 and 40 kg/m² and working predominantly night shifts (≥30 h/week for ≥6 months) were randomized. During the 8-week intervention phase, participants received daily text messages with guidance on food, sleep/rest, and physical activity and were provided with whey protein isolate powder and grain-based snack bars to consume during work shifts. The program targeted improved nutrient timing, adequate protein intake, and structured rest without formal exercise training, allowing evaluation of dietary and behavioral effects feasible for this population. Total caloric (~30 kcal/kg lean mass) and protein (2 g/kg lean mass) needs were measured, along with sleep/rest goals of 6–8 h/24 h. Primary outcome measures were change in visceral fat percentage (VF%) by DXA and mental/physical quality of life (RAND SF-12). Secondary outcomes included fasting triglycerides, ALT, blood glucose, LDL, actigraphy, and fecal microbiome. Mixed-design two-way ANOVA was conducted to assess the effects of group (immediate [IG] and delayed [DG]), time (baseline, 8-week crossover, and week 16), and Group $\times$ Time (GxT) interactions, and Bonferroni correction was applied to post hoc t-tests. Results: Eleven participants completed the study. Both groups increased dietary protein intake (p < 0.001), and a GxT interaction for VF% (p = 0.039) indicated DG reduced VF% to a greater extent (−0.335 ± 0.114% (p = 0.003) vs. 0.279 ± 0.543% (p = 0.158)). Mental and physical QOL, objectively measured physical activity and sleep, serum lipids and inflammatory markers, and fecal microbiota remained unchanged (p > 0.05 for all GxT). Conclusions: The findings suggest that targeted nutrition and recovery strategies can modestly improve dietary intake and visceral fat; however, consistent with prior work, interventions without structured exercise may be insufficient to reverse broader metabolic effects of circadian disruption. This trial was registered at ClinicalTrials.gov, identifier: NCT06158204, first registered: 28 November 2023. Full article

This study evaluated emergency preparedness, covering knowledge, challenges, and culturally and linguistically appropriate resources among five resettled refugee communities in Central Ohio: Afghan, Bhutanese, Congolese, Ethiopian/Eritrean, and Somali. It also explored youth perceptions of community engagement and the effectiveness of current crisis support initiatives. A mixed-methods approach was used, consisting of a cross-sectional quantitative survey of 266 adults and a qualitative 60-min focus group discussion with 10 youth from the resettled communities. Quantitative data was analyzed with descriptive statistics and Chi-square tests assessing differences in preparedness across communities. Quantitative findings showed that the Bhutanese group reported the highest familiarity with preparedness concepts (33.3%), while Afghan and Congolese communities showed significant gaps. Of the 266 overall respondents, only 39.5% had an emergency plan, and 15.8% felt extremely confident in handling emergencies. Language barriers were major challenges, along with those related to race and ethnic identity, religious practices, and cultural norms. Effective platforms for engagement included community meetings, religious sites, and social media, with text messages and phone calls preferred for emergency communication. Youth discussion highlighted key public health concerns, particularly gun violence, substance abuse, and mental health crises, with stigma and limited resources further hindering preparedness efforts. Participants emphasized the need for culturally relevant interventions and stronger community engagement. Full article

Background: The World Health Organization defined specific recommendations about digital tobacco cessation modalities as a self-management tool or as an adjunct to other support for adults. Objectives: The present umbrella review primarily aimed to assess the long-term (≥6 months) effectiveness and adherence of the different standalone digital tobacco cessation modalities (mobile text messaging, smartphone apps, Internet-based websites and programs, AI-based), administered individually or in combination; secondarily, the study aimed to assess the effect on smokers’ health. Methods: The present study (PROSPERO number: CRD42024601824) followed the PRISMA guidelines. The included studies were qualitatively synthesized and evaluated through the AMSTAR-2 tool. Results: Forty-five systematic reviews were included, encompassing 164,010 adult daily smokers of combustible tobacco. At 6 months, highly interactive or human-centered digital tools showed higher effectiveness (biochemically verified continuous abstinence rates (CARs) were 11.48% for smartphone apps and 11.76% for video/telephone counseling). In contrast, at 12 months, simpler, less interactive tools demonstrated higher effectiveness (self-reported CARs was 24.38% for mobile text messaging and 18.98% for Internet-based). Adherence rates were generally high, particularly with human-centered digital tools, amounting to 94.12% at 6 months and 64.08% at 12 months. Compared with individually administered digital tobacco cessation modalities, at 12 months, combined ones registered slightly higher effectiveness (self-reported CARs were 13.12% vs. 13.94%) and adherence (62.36% vs. 63.70%), potentially attributed to the multi-component nature and longer durations. Conclusions: Clinicians should prioritize combined digital tobacco cessation interventions that incorporate human-centered engagement initially, alongside simpler, sustained digital support to enhance long-term effectiveness and adherence. Future research should explore long-term medical and oral health benefits to assess the impact on overall health and well-being. Full article

Using individualized approaches leads to longer-term pro-health behavior change. Both technological delivery methods and values-centered Acceptance and Commitment Therapy (ACT) are useful frameworks for personalized interventions. This investigation sought to explore the effects that valuing had on health using an internet-delivered audio and writing group-level intervention. Specifically, we replicated the use of domain-specific outcomes and idiographic motivational statements sent via text message while additionally employing individualized intervention delivery components, objectives, and statistical methods. While this intervention did not generate significant improvement in health behaviors relative to a control in a sample of 107 college student participants, it has implications for future digital health intervention design and implementation as well as the further development of theoretically consistent valuing research methods. Full article

Background/Objectives: Vaccine hesitancy is one of the top ten threats to global health. It is necessary to develop appropriate strategies to address vaccine hesitancy. This systematic review aimed to analyze strategies used to improve the acceptance of vaccines, address doubts, and/or increase confidence and motivation in routine vaccination across all age groups. Methods: A systematic review was conducted of the MEDLINE, Dialnet, Scielo, CINAHL, and CENTRAL databases between 2018 and 2023. The inclusion criterion was full-text studies in English or Spanish that improve the degree of acceptance of vaccines and were evaluated by vaccination rate or pre- or postintervention tests. For data extraction, each study was categorized as community education, tailored messages, media, and new technologies. Results: A total of 1938 studies were identified, 38 of which were selected. New technology-based interventions used in the adult population for several vaccines offer broad reach, user interaction, and data accessibility. Tailored message strategies were used mainly among parents to foster strong relationships through respectful and empathetic dialog. Community education programs were targeted mainly at adolescents, emphasizing the use of structured, appropriate and interactive materials. Media campaigns were used as a support strategy for community education and new technology strategies due to their simplicity, wide coverage, and reach. Conclusions: The best strategies for reducing hesitancy are multicomponent interventions with structured and organized educational content based on the reasons for hesitancy and tailored to the target population. Therefore, caution must be taken when applying interventions, given that no single strategy can address this issue. Full article

Background/Objectives: The majority of Canadian children bring a home-packed lunch to school, and previous research suggests lunches are of poor nutritional quality. This pilot study aimed to test the feasibility, acceptability, and preliminary impact of an eHealth family-based intervention designed to improve the nutritional quality of home-packed lunches. Methods: In this 12-week intervention, families (n = 20 parents with children aged 4–8 years) received a toolkit which included a cookbook on tips for preparing healthy lunches and 15 tested lunch box-friendly recipes, a lunch box, text messages, and an online cooking class. Feasibility was assessed via documentation of intervention delivery and participant retention rates. Acceptability was assessed via post-intervention surveys and semi-structured interviews in a sub-sample of parents (n = 9). Preliminary impact was assessed using 3-day lunch food records. Descriptive statistics were used to assess feasibility and acceptability, and Wilcoxon signed-rank tests were used to evaluate changes in the nutritional content of packed lunches. Results: Findings indicated a high retention rate (85%), and the majority (94%) of participants reported that the intervention was helpful and that they would recommend it to another parent. Qualitative interviews suggest parents found the recipes practical and diverse, the lunch box and the cooking class helpful, and some reported increased confidence and greater awareness of the foods being packed. No changes in the nutritional content of packed lunches were observed (n = 10 children). Conclusions: In summary, a home-packed lunchbox intervention is feasible and well accepted by families, but further refinements are needed to optimize its impact before a full-scale trial. Full article

The iCARE Nigeria study is evaluating a daily text message medication reminder intervention (TXTXT) to improve viral suppression and medication adherence among youth living with HIV (YLH), aged 15–24 years. In this sub-study, we evaluated text message responsiveness (text-back) at 24 weeks of the intervention as an indicator of engagement, as well as barriers and facilitators at one of six clinical study sites. Differences in responses by age group, birth sex, schooling status, education, mode of infection, and weekend/weekday and holiday/non-holiday periods were analyzed using t-test and multiple linear regression. Focus group discussions were conducted among three groups (low, average, and high text message responsiveness) and analyzed using a rapid content analysis approach. Overall, TXTXT responsiveness was 26.5% (4606/17,367); older age (18–24 years) and weekdays (versus weekends) were significantly associated with higher responsiveness. Facilitators included being comfortable receiving personalized text messages. Barriers included a lack of airtime and messages received late. Overall, text-back responsiveness to daily medication adherence messages among YLH was low, better among older participants, and higher on weekdays. Addressing barriers and promoting facilitators may improve responsiveness. Full article

Background/Objectives: Colorectal (CRC), breast (BC), and cervical cancer (CC) pose a significant health burden, yet screening programs have been proven to reduce cancer-specific mortality and other non-lethal endpoints. Mobile health (mHealth) technologies can enhance adherence, but effectiveness varies. This scoping review aims to explore mHealth apps for cancer screening developed with community engagement, identifying research approaches and gaps. Methods: A scoping review following PRISMA-ScR guidelines analyzed studies on mHealth apps for cancer screening developed through community engagement. Community engagement was classified per WHO’s definition. Databases were searched using a PCC-based strategy; eligible studies involved app development, excluding hypothetical apps or text messaging-/social media-only interventions. Screening and data extraction were conducted independently. Results: Thirteen articles were included. Findings indicate a growing but limited body of evidence, with most studies focusing on CRC and BC and involving minority populations through mHealth apps. Key engagement phases included research design, CAB establishment, and recruitment, while priority setting was never community-led. The wMammogram, Meet ALEX, and mMammogram apps improved screening knowledge, intention, and participation, while ColorApp enhanced knowledge but not attitudes. Only CBPR-based studies included dissemination, and one involved the CAB in data analysis. Some studies acknowledged community contributions, though details on ColorApp’s engagement were limited. Conclusions: Standardized engagement frameworks combined with mHealth were associated with greater community involvement and may improve equity. No community-designed mHealth app was found for CC screening, despite its relevance. Future research should address gaps in CC programs, prioritize early community involvement, and assess the long-term impact of mHealth interventions. Full article

Introduction: The feasibility of enrolling and retaining diverse kidney transplant (KT) seekers in remote studies is sparsely reported. Aims: This study examined the use of a mobile communication strategy to enroll and retain participants within a clinical trial of an automated digital intervention to promote self-learning for kidney transplant access. Materials and Methods: Adult KT-seekers were identified from an administrative database at a transplant center and recruited by email or text supplemented by verbal prompts. Multivariable logistic regression was used to explore participant- and study-level characteristics associated with enrollment and response rates. Results: Between April 2022 and June 2023, 743 patients were invited to participate, and 422 were enrolled. Enrollers were more likely to be younger (aOR 1.02; p < 0.001). Early enrollment was associated with text message invitation (OR 2.69, p ≤ 0.014). Survey completion at 1 month was similar across patient sociodemographic, clinical, and study characteristics; however, participants self-reporting Black race were underrepresented at month 6 (OR 0.55, p = 0.015) and month 12 (aOR 0.37, p = 0008), and males were underrepresented at month 12 (aOR 0.45, p = 0.028). Conclusion: Mobile communication methods are viable for enrolling diverse KT-seeking patients and collecting survey data remotely. More work is needed to learn how to best recruit older people and retain diverse groups long-term. Full article