Objective: We conducted a prospective cohort study to examine the effects of a leadership development program on psychological grit and job readiness among college students, primarily as a means to strengthen the public health workforce. Methods: College students opted in to a two-year leadership development program (LDP; N = 31), and college major-matched controls were recruited to complete similarly administered measures (N = 93). Directed by the Social Interdependence Model, LDP participants engaged in group physical activity sessions, university student leadership opportunities, mentoring, and team-ship training. Job readiness scores and Grit-S questionnaire scores were collected at follow-up. Adjusted regression models were estimated to compare outcomes by group. Results: Grit-S scores were 12% higher among LDP participants, and job readiness scores were 19% higher. Additionally, regression results showed that participation in the LDP was associated with higher scores on the Grit-S scale (b = 1.39, p = .004) and job readiness scale (b = .81, p = .03). Conclusions: Our findings show that graduating from a Social Interdependence-based LDP was associated with significantly higher job-readiness and grit scores compared with matched peers.
Objective:Our community-based participatory research partnership sought to explore the impacts of Hurricane Helene on Appalachian queer communities. Methods:In December 2024, our partnership conducted interviews with community-based peer navigators (N = 9) who were part of the trial of the Appalachian Access Project intervention designed to support use of prevention and care services among queer persons in Appalachia. Interviews examined effects of Helene on peer navigators and their communities and were analyzed by partnership members using constant comparison, an approach to developing grounded theory. Results:Four meta-themes and ten subthemes emerged: 1) queer community resilience (mutual aid and grassroots organizing, unity across identities, and renewed commitments to community support and advocacy); 2) increased challenges accessing resources for queer communities (infrastructure damage, communication barriers and misinformation, and disruption of essential and affirming health services); 3) mental health impacts for queer communities (trauma, anxiety, and uncertainty and the role of social networks); and 4) vulnerabilities for queer communities in hurricane recovery (economic hardship and systemic inequities in recovery resource access). Conclusions:Findings can inform policy and practice to address the effects of Helene and future disasters on marginalized communities. Integrating Appalachian queer community needs and assets into emergency preparedness and response is critical.
Objectives:Tobacco use is the leading cause of preventable disease and death, disproportionately affecting marginalized groups. Addressing these disparities requires a workforce skilled in tobacco addiction research and intervention. The STRONGER Scholar Program trains medical students in tobacco dependence research and treatment and its intersection with health equity to meet workforce needs. Methods:Medical students (n = 7; national catchment) participated in the 10-week program. Scholars developed tobacco-related research projects with a faculty mentor and participated in interdisciplinary programming, including tobacco treatment specialist training, sessions on linking research knowledge to clinical practice, and a health promotion campaign masterclass. Mixed methods were used for program evaluation of this first scholar cohort. Results:Scholars showed gains in all targeted constructs and reported high satisfaction with programming, strongly agreeing that it advanced understanding of how their research connected with clinical practice. The health promotion campaign masterclass was lauded, among other innovative program components. Qualitative findings supported quantitative results. Conclusions:This pilot study of the STRONGER Scholar Program showed promise in preparing the future physician-scientist workforce to address patients' tobacco use through research-informed practice and yielded information for future improvement. Results and lessons learned can inform the design of other research education programs.
Objective: This study examined the relationship between family, social, and healthcare provider support and the caregiving ability of parents of children with cancer in Indonesia. Methods: A quantitative cross-sectional study was conducted among 126 parents of pediatric cancer patients at the Islamic Hospital of Surabaya. Data were collected using validated Likert-scale instruments: the Family Support Scale, Peer Support Questionnaire, and Nursing Support Scale. Parental caregiving ability was assessed across three domains: emotional regulation, provision of nutrition and medication, and cooperation with medical procedures. Multiple linear regression analysis was applied. Results: Family, social, and healthcare provider support were all statistically significant predictors of caregiving ability (Adjusted R2 = 0.43; p < .001). Family support showed the strongest influence ((3 = 0.39), followed by healthcare provider support ((3 = 0.28) and social support ((3 = 0.19). Conclusions: Family cohesion, healthcare partnership, and social connectedness are critical to strengthening parental caregiving. Integrating psychosocial and family-centered care into Indonesia's National Cancer Control Program and National Action Plan for Childhood Cancer may enhance holistic pediatric oncology services nationwide.
Objective: As a major hot topic of current research, living alone is highly exploratory and strongly influences older adults. Therefore, we aimed to conduct a bibliometric analysis to obtain structural and significant insights into the characteristics of living alone for older adults and to identify the latest research frontiers and hot topics. Methods: We identified articles published between 2003 and 2022 from the Web of Science Core Collection database. We used VOSviewer software to map and visualize the publications. Results: We included a total of 1880 publications in our analysis. The US and China had the most output (418 and 226 papers, respectively) to this field. "Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review" by Holt-Lunstad J et al, published in Perspectives on Psychological Science in 2015, is the most cited paper with 2867 and has played an important role in guiding the development of this field. Conclusions: Research papers were published mainly in the geriatrics-gerontology category. Loneliness and social isolation were recognized as the focus of research on living alone for older adults.
Objective: Classroom activity breaks (ABs) have physical and cognitive benefits, although effectiveness of Web-based ABs remains unexplored. The purpose of this study was to assess impacts of three-minute Web-based AB on physical activity (PA) and time off-task in second graders (N = 38). Methods:This quasi-experimental design was implemented in a primary school setting. The SenseWear Armband assessed PA and a modified Behavioral Observation System in Schools assessed time off-task. Children participated twice in four conditions: control (CON), non-active breaks (NAB), one active break (1AB), and two active breaks (2ABs). Breaks entailed physically active or meditation GoNoodle videos. Results: Number of breaks was a significant predictor of PA (F(2, 68.47) = 25.85, p <.001), eliciting significantly higher PA intensity with each additional AB. We found a significant interaction between break type (CON, NAB, 1AB) and lesson (middle, post) (F(2, 163.95) = 4.73, p=.01), with a significant main effect for break type (F(2, 166.67) = 10.52, p<.001). Break type affected time off-task during post-lesson (F(2, 167.26) = 13.67, p<.001), with the AB condition demonstrating significantly lower time off-task than CON or NAB. Conclusion: Web-based ABs are an effective way to increase PA intensity and decrease time off-task in second graders.
Objective: We examined differences in salient beliefs about physical activity (PA) and their influence on PA intention and behavior among South Korean university students before and during the COVID-19 pandemic. Methods: We used the Theory of Planned Behavior as a basis for the study. We used a repeated cross-sectional design. We conducted elicitation studies, and main and followup surveys with South Korean university students at two time points during September-October 2018 (n = 234) and September-December 2021 (n = 199). We used content analysis to identify salient beliefs about PA; we used structural equation modeling to analyze relationships among salient beliefs, PA intention, and behavior. Results: Prior to the pandemic, salient beliefs such as 'builds social relationships,' 'takes too much time,' and 'friends' significantly predicted PA intention and behavior. During the pandemic, 'improves health status,' 'family members,' and 'laziness' were significant predictors of PA intention and behavior although students' average weekly PA time was decreased by half during the pandemic. Conclusions: The findings highlight how salient beliefs can shift substantially across contexts. Identifying such changes may improve predictions of PA engagement among university students, not only in the post-pandemic era but also in preparation for potential future public health crises.
Objective: The food taboo phenomenon remains prevalent in villages around Nusantara Capital City and is linked to stunting. A qualitative study exploring food taboos, stunting incidence, and related challenges is essential. Methods: Using a phenomenological approach with in-depth interviews, we involved informants from the Regional Health Office, Food Security Office, and parents of children suspected of stunting, from Penajam Paser Utara and Kutai Kartanegara regencies. Results: Food taboo traditions in East Kalimantan, such as avoiding gabus fish and Pundur fruit for pregnant and lactating women, hinder nutritional fulfillment, worsening stunting. These issues are compounded by unsanitary environments and limited clean water access. Whereas posyandu education (integrated health service post) has been implemented, geographical, economic, and various education challenges persist. Conclusions: Dietary restrictions rooted in tradition aggravate stunting in East Kalimantan. The government must enhance culturally sensitive education, improve health services and clean water access, and involve community leaders to address nutrition-related taboos.
Objective: This study addresses a crucial gap in understanding multiple health risk behaviors (MHRBs) among adolescents and young adults by presenting a conceptual model of interconnectedness of health risk behaviors. Our model emphasizes that combined MHRBs amplify potential harms and complicate health outcomes. Methods: We conducted a rapid review focused on two key areas: (1) the impact of multiple risky behaviors on mental health and (2) potential intervention strategies to mitigate adverse MHRB outcomes. Following a quality assessment, we categorized 30 studies into three themes to inform our conceptualization of MHRBs. Results: The review revealed a high prevalence of studies on adolescents and collegeaged individuals engaging in MHRBs. Mental health studies indicated negative outcomes, and intervention-focused studies suggested that behavior change techniques could effectively mitigate these risks. Analyzing themes facilitated the development of a theoretical model called IMHRBDynamic that integrates MHRBs, offering a comprehensive understanding of how these behaviors interact and influence overall health outcomes. Conclusion: Our conceptualization of MHRBs promotes early interventions addressing individual and socio-environmental factors to strengthen youth health outcomes systemically.
Objective: In this study, we assessed the impact of the GERMAS mobile app on knowledge, attitudes, and practices (KAPs) for non-communicable disease (NCD) prevention among Indonesian university students. Methods: We used a quasi-experimental pretest-posttest control group design with 40 students. We used validated KAP questionnaires and clinical measures (BMI, blood pressure, uric acid). We analyzed data using paired t-tests and Wilcoxon signed-rank tests. Results: The intervention group showed statistically significant improvements. "Good" knowledge increased from 0% to 27.5% (p < .001), attitudes improved to the "enough" category (p < .001), and healthy practices rose from 50% to 100% (p < .001). Systolic (p = .014) and diastolic blood pressure (p = .029) and gout levels significantly decreased (p < .001). Changes in BMI, glucose, and cholesterol were not statistically significant. Conclusions: The GERMAS app enhanced health literacy and behaviors while reducing certain clinical risk factors, highlighting its potential as a mobile-based strategy for NCD prevention.
Objective: In this review, we explore the prevalence, patterns, and contributing factors of selfmedication among Indian youth, encompassing both healthcare and non-healthcare students, to support targeted interventions. Methods: The review was conducted following Joanna Briggs Institute (JBI) guidelines, employing the Arksey and O’Malley framework for methodological rigor and the PAGER framework for synthesis. Systematic searches were performed across PubMed, Scopus, and Indian repositories for studies published in English between January 2010 and December 2024. Inclusion was based on PICO criteria, and a quality appraisal checklist for observational studies was used. Results: We included 76 studies involving 23,497 students (14,639 females and 8858 males). The prevalence of self-medication was 69% among healthcare students and 70% among non-healthcare students. Analgesics (70%-91%) and antibiotics (20%-90.7%) were most commonly used. We identified major knowledge gaps in dosage, side effects, and safety, with pharmacies and previous prescriptions serving as the primary sources. Adverse drug reactions were reported by 19.9% of participants. Conclusion: High rates of self-medication among Indian youth underscore the urgent need for educational strategies and regulatory actions to promote safe, informed medication practices.
Objective: Tobacco use remains a leading preventable cause of severe health conditions, notably chronic obstructive pulmonary disease (COPD) and severe COVID-19 complications. Tobacco prevalence is particularly high among Louisiana Medicaid enrollees compared to privately insured individuals; yet, its full long-term impact remains unclear. We aimed to examine how tobacco use, alongside demographic and clinical factors, influences COPD and COVID-19 incidence among Medicaid participants over time. Methods: Using Louisiana Department of Health data (January 2020-February 2023), we performed chi-square tests and multivariate logistic regression models across three study waves, assessing associations between risk factors and new disease cases. We calculated adjusted odds ratios (AORs) after controlling for demographics, comorbidities, and healthcare utilization. Results: Tobacco use significantly predicted new COPD (AOR = 1.12, 95% CI = 1.05-1.18) and COVID-19 cases (AOR = 1.66, 95% CI = 1.15-2.38). Other key predictors included older age, sex, region, and existing comorbidities, each of which was all significantly associated with increased disease incidence. Conclusions: By clearly linking tobacco use, demographic disparities, and clinical conditions to heightened COPD and COVID-19 risks, we highlight an urgent need for tailored tobacco cessation and prevention initiatives in Louisiana's underserved Medicaid population.
Objective: In this study, our objective was to develop and validate a Transtheoretical Model (TTM)-based questionnaire to assess dietary iron intake in adolescent girls of ages 13-18 years. Methods: A 38-item pool developed based on TTM constructs underwent psychometric analysis. We assessed face and content validity by participants and experts. We measured internal consistency and stability using Cronbach's alpha and an intraclass correlation coefficient (ICC). We assessed construct validity through confirmatory factor analysis (CFA). Results: The items contributed to a satisfactory content validity index (CVI >= .8). CFA showed good model fit with comparative factor index (CFI = .991-1.00), goodness of fit index (GFI = .954-.983), and root mean square error of approximation (RMSEA = .059-.079). The questionnaire demonstrated satisfactory reliability, with internal consistency (Cronbach's alpha = .734-.919) and stability (ICC = .775-.879). Conclusion: This validated questionnaire enables assessment of behavioral changes related to dietary iron intake in adolescent girls and can guide interventions to improve iron consumption.
Objective: Older adults are at risk for loneliness and social isolation. The COVID-19 pandemic exacerbated this vulnerability. The objective of this work was to describe and generalize older adults' experiences using communications technology to stay connected throughout the COVID-19 pandemic. Methods: We conducted semi-structured interviews with 20 older adults We used purposive sampling. We used NVIVO to conduct a thematic analysis of the qualitative transcript data. Results: Whereas many older adults reported profound changes in their social patterns during the COVID-19 pandemic, a large portion of respondents reported minimal change. Some of our respondents employed longstanding forms of technology to maintain social connections, whereas others leveraged newer forms to help them navigate the altered social landscape. We found differences in the degree of willingness to embrace technology during the COVID-19 pandemic. These differences appear to be influenced by variations in perceived opportunities, perceived difficulties, and concerns about privacy. Conclusions: Our results highlight opportunities to leverage communications technology to mitigate social isolation and loneliness among older adults during a public health emergency. They also illuminate opportunities to address the general and longstanding problems of social isolation and loneliness among older adults.
Objective: Many countries integrate school health programs for early detection and intervention for certain health risks. In this study, we assessed school policies and practices regarding the health of the students in public schools, and determined the possibility of establishing an integrated school health program. Methods: We studied personnel at 67 schools, and conducted a detailed evaluation of children in two public schools in Islamabad, including a survey of school health policies, teachers' training, and a NEEDS (Nutrition, Eye, Ear, Dental & Skin) screening by trained teachers and healthcare professionals. Results: Among 67 schools, none provided on-site health services, with no designated school health coordinator, and most lacked a school health policy. All expressed willingness to implement a school health program. Screening revealed 33% of students with nutrition problems, 8.5% vision problems, 5% hearing difficulties, 45% dental issues, and 39% skin and hygiene concerns. Teacher training was effective, and most of agreed to take the responsibility of health screening children. Conclusions: Implementing an integrated school health program can be a challenge because of resource constraints; yet, it can enhance student health and learning outcomes through teachers' training and systematic screenings. Such a model can yield positive outcomes and improved students' well-being.
Objective: The purpose of this study was to evaluate the effects of a responsible fatherhood program, with a focus on employment. Methods: Fathers (n = 195) participated in a 40-hour program, designed to help them improve relationships, parenting skills, and economic stability, including employment. Fathers were randomly assigned to an intervention group or a control group. Intervention fathers received the program and case management. Fathers in the control group received case management. All fathers completed a pretest questionnaire. Then intervention fathers participated in the intervention program. After the intervention, all fathers completed the posttest questionnaire and participated in workforce training. Six months post-program, all fathers completed a follow-up questionnaire. Results: There was a statistically significant (p < .01) reduction in unemployment and increase in full-time employment from pretest to posttest and from pretest to follow-up, among participants in both the intervention and control groups. The difference between groups was not statistically significant, but the gains within both groups at posttest were even greater at follow-up (eg, 294% increase in full-time employment from pretest to follow-up among intervention participants). Conclusion: Employment status improved for both intervention and control groups. For practitioners seeking to help fathers improve economic stability, these employment results are encouraging.
Objective: There has been a dramatic increase in firearm purchases contributing to demographic shifts in firearm ownership and the need for safe firearm storage in American households. Safely securing firearms is essential for preventing firearm injuries, but more research is needed to understand and identify potential motivators and barriers that can be addressed with public health interventions. The purpose of this study was to elicit salient beliefs (behavioral, normative, and control) pertaining to safely storing handguns among gun owners. Methods: We used the theoretical underpinnings of the Theory of Planned Behavior in this study. We recruited handgun owners (n = 31) between the ages of 24 and 74 via Forthright Access, a third-party paneling service. Participants completed a survey of open-ended questions about safely storing their handgun. Results: Key motivating beliefs for safe handgun storage included the desire to have home defense and to protect children in the home. Participants also expressed that they were more likely to store their handgun safely when encouraged by law enforcement and family members. Conclusions: Findings from this study can be used to inform subsequent studies that recruit larger, representative samples to test which theoretical factors most strongly predict safe storage behaviors.
Objective: Evaluations of the OTC Medicine Safety program confirm that safety knowledge gaps significantly improve after one exposure. We evaluated students' knowledge throughout the school year. Methods: Twenty participating schools administered quizzes to measure students' safety knowledge. Ten test schools implemented the program and measured baseline knowledge, and at 1 week, 10 weeks, and 8 months. Ten control schools administered quizzes using a similar timeline. Following quiz completion, control schools implemented the program. Results: At baseline, students had 43.5% correct answers. One week later, test students increased 27.1 points (p < .001), statistically higher than control students (-2.2 points, p < .001). Ten weeks after participation, test students' remained improved (+23.6 points, p < .001), significantly higher than control students (-0.3 point, p < .001). At 8 months, test students' remained higher than baseline (+25.5 points, p < .001), and significantly higher than control students (+1.06 points, p < .001). We found statistically significant improvement over time in urban schools, low socioeconomic (SES) schools, grades 5 and 6, and between boys and girls. Conclusion: OTC Medicine Safety improved students' short-and long-term knowledge of safe practices with similar results across school type, SES setting, minority enrollment, grade, and sex.
Objective: Complications during pregnancy, childbirth, and postpartum can have long-term effects, contributing to maternal and infant mortality. In this study, we examined the impact of the Information-Motivation-Behavior (IMB) Skills Model on preventive behavior among postpartum mothers at risk of complications and depression. Methods: Using a cross-sectional design, we sampled 300 pregnant women selected using a cluster random sampling technique in Ponorogo Regency, Indonesia. The dependent variable was preventive behavior. The independent variables were information, motivation, and behavioral skills. We analyzed data using path analysis. Results: Preventive behavior in addressing pregnancy complications and postpartum depression is directly influenced by the behavioral skills (b = 0.15; 95% CI = 0.12, 0.27; p = .025), knowledge about pregnancy complications and postpartum depression (b = 0.22; 95% CI = 0.10, 0.34; p < .001), and motivation to engage in preventive behavior (b = 0.19; 95% CI = 0.08, 0.30; p = .001). Educational level positively affects pregnant women's knowledge (b = 0.16; 95% CI = 0.05, 0.27; p = .003); women with an education level of senior high school or beyond have a better understanding of preventive behavior (b = 0.16; 95% CI = 0.05, 0.27; p = .003). Motivation is negatively influenced by parity (b =-0.14; 95% CI =-0.25,-0.03; p = .011). Conclusion: The IMB Skills Model is effective for predicting preventive behavior toward pregnancy complications and postpartum depression.
Objective: In this paper, we examine substance use disparities among heterosexual and sexual and gender minority adolescent e-cigarette and combustible cigarette users, dual users, and non-users in West Virginia (WV). Methods: With the 2021 WV Youth Risk Behavior Survey (N = 483) as our data set, we used chi-square tests to examine the hypothesis of equal proportions across sexual and gender minority (SGM) groups for selected tobacco product and substance use variables. Logistic regression models for each tobacco product then determined whether the SGM groups were at greater risk for engagement in other substance use. Results: SGM females reported higher lifetime use of e-cigarettes and combustible cigarettes, and a greater proportion were dual users (p < .05). Regression models revealed greater likelihood of electronic cigarette use (OR = 5.65, p < .0001), combustible cigarette use (OR = 3.53, p < .0001), and dual users (OR = 3.66, p < .0001) among those who also reported the use of more substances compared to nonusers; however, non-significant interaction tests suggest the response to the use of more substances is similar for heterosexual and SGM groups. Conclusions: Tobacco product use remains elevated in this sample, especially among SGM females. However, all groups were at greater risk for the engagement in other substance use if they engaged in any form of tobacco product use regardless of sexual orientation.
