Introduction:The FDA has the authority to regulate tobacco products, including the implementation of graphic health warnings on cigarette packaging. This study examines the short-term effects of these front-of-package health warnings on smokers' attention, package preferences, and intentions to quit. Methods:A total of 951 smokers were recruited via Amazon Mechanical Turk. Participants completed an online survey that included demographic questions, measures of attention to warnings, package choice, and quit intention. Participants were randomly assigned to view cigarette packs with or without warnings. Results:First, exposure to warnings increased attention to the warning area (OR = 1.747, p = 0.0109), and increased the likelihood of choosing packages without warnings as prices increased (OR = 18.244, p<0.001). Additionally, focusing on the warning content also made smokers more likely to choose packages without warnings as price increased (OR = 5.025, p<0.001). However, warnings had no significant effect on quit intentions. Conclusions:Warnings effectively capture attention and influence cigarette package preferences, but their impact on quit intentions was not detectable after single exposure. These findings suggest that while warnings may affect short-term purchasing behavior, they are insufficient for driving cessation. Future research should investigate the long-term impact of warnings and consider other factors influencing quitting behavior.
Objectives: This study was an exploration of the long-term relationship between changes in workforce participation and psychological well-being among Korean older adults. Methods: Using nationally representative data from 2006 to 2022, an estimate fixed-effects models was made to predict depression scores based on labor status transitions, analyzing 23,516 person-years of observations. Subsequent models were developed to examine multivariate interaction terms with retrospective properties of career history after controlling for potential confounding bias arising from time-invariant variables. Results: There were significant links between employment status changes and depression. Individuals who transitioned to full retirement or post-retirement work were at a higher risk of experiencing depression compared to those who continued working. Furthermore, findings revealed that the psychological benefits of delayed retirement were not found among agricultural and unskilled manual workers as well as workers in precarious jobs. Conclusions: The disparities in health outcomes associated with labor force transitions highlight the complexity of productive engagement among older adults, particularly in the context of limited public support for aging populations.
Objectives: In this study, we examined the main and interactive effects of severe obesity and self-rated health on handwashing, which is the most effective way to prevent COVID-19. We report factors that contribute to good self-rated health among adolescents with severe obesity. Methods: We surveyed a stratified cluster sample of 54,848 adolescents concerning their weight and height, self-rated health, and handwashing behaviors. Results: The main effects of severe obesity and self-rated health on handwashing behavior were statistically significant; handwashing scores of those without severe obesity and those with good selfrated health were higher than those with severe obesity and those with poor self-rated health. Although the interaction effect between severe obesity and self-rated health was non-significant, the handwashing score of the group with both severe obesity and poor self-rated health was the lowest among all groups. Additionally, among adolescents with severe obesity, 81.8% had good self-rated health. Our analysis showed that contributing factors were economic status, academic achievement, and mother’s education level. Conclusions: This study highlights the urgent need for tailored health education programs to address health perception inaccuracies and promote effective handwashing practices among adolescents with severe obesity.
Objective: To provide insight into how the availability of a new heated tobacco product (glo HTP) may influence combustible cigarette and other tobacco and nicotine‐containing products (TNP) use behavior among current regular cigarette smokers in the United States in their natural environment. Methods: 1180 participants between the ages of 21 and 60 were enrolled in a prospective observational study across ten study sites in the South, Midwest, and Mid-Atlantic United States. A smartphone-based electronic diary (eDiary) was used to record self-reported daily ad libitum use of combustible cigarettes (CC), the glo HTP (comprising a glo heating device and four HTP consumables termed “neo sticks”), and other TNP. Participants recorded all TNP use, including CC, during a one-week baseline period with no glo HTP availability and subsequently during a 6-week actual use period (AUP) with glo HTP available ad libitum. In addition to eDiary consumption data, subjective experiences and product use behaviors were queried at regular site visits and at the study end. Results: There was an overall reduction in combustible cigarette use during the six-week AUP. A considerable proportion (60.8%) of study participants who used glo HTP became “established users,” defined as using at least 100 neo sticks over the AUP. A 30.0% decrease in median number of cigarettes smoked per day (CPD) (from 11.0 to 7.7 CPD) was observed for those who remained in the study through Week 6 and completed the final survey, with approximately 4% recording no cigarette use at Week 6. Over the course of 6 weeks, a sizable proportion (26.0%) reduced their CPD consumption by 50% or more compared to baseline. At the same time, there were no increases in the means of combined total tobacco product uses per day for all subgroups observed. Conclusions: The results suggest that participants substituted some or all of their cigarette use with glo HTP. Availability and use of glo HTP may help some smokers migrate away from the use of combustible cigarettes, suggesting that this product could play a key role in tobacco harm reduction and positively impact public health.
Objectives: This study seeks to provide a complete communication model that integrates the SMCR communication theory with the Health Communication Model, utilising the Interactionism Model as the foundational framework. It investigates causal correlations among factors and corroborates findings through a subsequent qualitative phase to improve communication techniques that promote healthy behaviours and well-being. Methods: A mixed methods approach employing an explanatory sequential design was utilised. Phase 1 was a quantitative investigation with 800 elderly volunteers (mean age = 68 years and 9 months) selected by stratified quota sampling. Data were gathered utilising 13 validated questionnaires (6‐point rating scale; overall reliability = 0.755). Phase 2 employed a phenomenological methodology involving 18 people, aged 60 to 80, selected by purposive and snowball sampling techniques. Data were collected via focus groups and comprehensive interviews to investigate communication obstacles and guide strategic development. Results: Quantitative results corroborated all five theories. The model fit indices were acceptable: X2 = 98.623, df = 49, p = 0.013, RMSEA = 0.037, CFI = 0.986, TLI = 0.985, SRMR = 0.052. Principal factors encompassed communication for health literacy (β = 0.804), quality of life (β = 0.843), psychological resilience (β = 0.709), information exposure (β = 0.743), and health literacy (β = 0.832). 2) Qualitative findings indicated: (a) urban elderly individuals possessed superior access to health information owing to familial support, educational background, and media exposure; (b) intricate content and digital access impediments obstructed engagement; (c) peer communication was regarded as reliable; (d) simplicity and usability were favoured in technological applications; and (e) communication tools that enhance familial interaction were greatly esteemed. Conclusions: The study advocates for the improvement of health-oriented media literacy and the implementation of routine mental health evaluations every three months. Government assistance is crucial for the expansion of healthcare networks for the elderly. Eight strategic directions are recommended: 1) Age-appropriate language; 2) Diverse and accessible media; 3) Participatory communication; 4) Family and social involvement; 5) Behavior-driven activities; 6) Gradual technology integration; 7) Consistent follow-up; 8) Culturally sensitive messaging.
Background: The increasing digitization of healthcare services has prompted hospitals to integrate web-based applications aimed at enhancing service delivery and patient satisfaction. However, empirical evaluations of such systems that incorporate both medical and non-medical service dimensions remain limited in emerging healthcare settings. Objective: This study aims to assess the impact of the SIKAP web application on patient satisfaction by examining its mediating role between the quality of healthcare services—both clinical and administrative—and patient outcomes. Methods: A cross-sectional analytic observational design was employed involving 500 patients at Dr. Sumantri Hospital, Parepare, Indonesia, from July to December 2024. Data were collected through a validated structured web-based questionnaire and analyzed using Structural Equation Modeling (SEM) via AMOS 24.00. Results: The findings reveal that both medical (β = 0.169, p = 0.037) and non-medical (β = 1.336, p = 0.002) service quality significantly influence the utilization of the SIKAP application, with non-medical services exerting a stronger effect. Furthermore, SIKAP use positively impacts patient satisfaction (β = 0.349, p < 0.001) by improving communication, transparency, and access to information. Model fit indices (CFI = 0.938, RMSEA = 0.045, SRMR = 0.039) support the robustness of the proposed framework. Conclusions: This study substantiates the role of web-based applications as mediators in the relationship between service quality and patient satisfaction. It contributes to the theoretical development of TAM and ECM-IT by integrating organizational and patient-centric dimensions. Future research should explore longitudinal effects and the role of digital literacy in technology acceptance within hospital ecosystems.
Objectives: To examine farmer suggestions for improving healthy food access in rural areas, and to evaluate the feasibility of using a mobile application to improve efficiency of a produce prescription program in rural eastern North Carolina. Methods: Qualitative interviews with farmers (N=5) were conducted via Zoom in Spring-Summer 2023. In July 2023, University students (N=10) beta-tested a mobile application by completing pre-determined tasks and were queried about potential improvements. Two independent coders developed consensus codebooks from verbatim transcripts, and independently coded each transcript. Results: Farmers suggestions included reaching out to community groups serving youth, re-branding farming as a more modern career, and donation stations for produce. Farmers viewed the mobile application as having promise to improve the reimbursement process yet were uncertain about the application’s potential to improve healthy food access among their customers. Among University students, the most popular features of the mobile application included the social networking and maps showing the nearest produce outlets. Conclusions: Research on increasing rural healthy food access is needed, with a focus on promoting local produce farming and creating non-conventional methods of increased access to healthy foods among rural residents.
Objectives: The aim of this study was to examine how patients can act as the core channel of health communication for medical institutions, and discuss strategies that can enable medical institutions to enhance their capabilities in health communication. Methods: Through a qualitative research design and a thematic evaluation approach, the study utilized both primary and secondary data to analyze health information dissemination channels between hospitals. The sample comprised doctors and patients in the tertiary hospitals in Hainan Province, who participated in discussions and interviews, in addition to data enhancement through observation. Result: Medical institutions across China attach great importance to health communication and health education through medical prescriptions. In the Hainan Province particularly, patients were trained as health messengers, actively participating in health communication activities. Based on such measures and to meet people’s health communication needs, a star chain health communication model was built to cover the whole Hainan province. Conclusions: Reasonable use of health education prescriptions can help enhance the role of patients as the core channel for health communication in medical institutions. Implications include strengthening the characteristics and patterns of patients disseminating health education prescription information and offer practical and scalable solution for enhancing dissemination of health education prescription information through patient channel.
Objectives: Theoretical frameworks such as the theory of planned behavior (TPB) may provide a basis to study psychological factors associated with inhalation adherence among individuals with chronic obstructive pulmonary disease (COPD). The present study was designed to assess the predictability of TPB constructs for adequate adherence to inhalation therapy among this population. Methods: Using convenience sampling, 374 Taiwanese males with COPD (mean age: 72.69 years [SD??9.53] completed the Intention of Inhaled Medication Adherence Scale (which is based on TPB constructs), and the Test of Adherence to Inhalers Questionnaire. Structural equation modeling (SEM) was used to assess direct/indirect associations and likely mediating mechanisms. Results: The SEM model indicated a good fit and demonstrated the direct effects of subjective norms (β=0.254, p=0.003) and attitude (β=0.186, p=0.018) on adherence intention. There was also an indirect association between subjective norms and adherence through behavioral intention (β=0.039; p=0.046). Conclusions: The TPB appears to be a suitable theoretical framework to assess inhalation adherence among individuals with COPD. Further research is warranted using the theory among individuals with different sociodemographic variables affected by COPD as well as those with other respiratory conditions.
Objectives: Panic attacks have been found to be one of the most debilitating and costly mental disturbances in the United States (e.g., Wulsin et al.1); however, little research investigates its relationships with health behaviors. Thus, this study examines relationships between the health behaviors of eating, sleeping, and vitamin D and Omega 3 intake and the severity of panic attacks. Methods: Using snowball sampling online and posting physical flyers, 160 adults who has experienced panic attacks completed anonymous online surveys. Results: More frequent changes in amount of food consumption and less frequent vitamin D intake were determined to link to significantly higher panic severity in Pearson and Spearman’s rank order correlation tests. More recent changes in eating time were found to be associated with higher numbers of panic symptoms. Conclusions: The findings shed light on the connections between panic severity and associated health behaviors, such as maintaining consistent food consumption and more frequent (daily) vitamin D intake. Generalizability is limited by the lack of racial and different developmental stage diversity in participants. Future randomized control studies can focus on investigating the causal relationships between consistent food intake and higher frequency in taking Vitamin D and decreased panic severity.
Objectives: Consistent physical activity is important for reducing poor physical and mental health outcomes. Despite being aware of the benefits of physical activity, many people struggle to engage regularly. Various strategies have been suggested to improve an individual’s adherence to physical activity, including, time-of-day preference (i.e., morningness/eveningness). The current study aims to apply constructs from the theory of planned behaviour and temporal self-regulation theory to predict physical activity engagement, with additional predictors of enjoyment and morningness/eveningness. Methods: A prospective design was used to collect data from 228 participants, at two time points, seven days apart. Two hierarchical multiple regressions were used to examine the relationship between the predictor variables and physical activity engagement. Results: Individuals with greater perceived behavioural control had stronger intentions to be physically active, while past engagement, environmental cues, and habit (automaticity) directly predicted physical activity engagement. However, morningness/eveningness and enjoyment were not significant predictors. Conclusion: This study combined theories to predict physical activity engagement, while morningness/eveningness did not predict physical activity engagement, the study underscores the importance of perceived control, habit, and cues. These insights can help tailor interventions, emphasizing factors like automaticity and past behaviour to promote sustained physical activity.
