Child protection requires qualified professionals. E-Learning has become increasingly important in professional continuing education, particularly during the COVID-19 pandemic. This study explored expectancies for, experiences with, and attitudes toward e-learning among a selectively recruited sample of professionals working with children and compared these findings with those from a population-based sample of non-retired persons in Germany. Data from 660 professionals working with children and having prior experience with child-protection-related e-learning (“selective sample”) were compared with 1794 non-retired persons over 16 years of age from a population-based German sample. Questionnaires assessed, at one measuring point, prior participation in e-learning, experiences with or expectancies for e-learning, attitudes toward e-learning, and perceived impact of the COVID-19 pandemic on e-learning. Regression analyses and analysis of variance were conducted. Within the population-based sample of non-retired persons, social professions showed among the highest participation rates in e-learning and comparatively positive attitudes toward e-learning. Participants with prior e-learning experience reported more positive attitudes than participants without prior experience. The selective sample reported more positive experiences with and attitudes toward e-learning and perceived a stronger impact of the COVID-19 pandemic on e-learning than participants from the social professions subgroup of the population-based sample. Prior participation in e-learning was associated with more positive attitudes toward e-learning. E-learning appears to be a promising continuing education format for professionals engaged in child protection. However, findings should be interpreted cautiously because the selective sample was not representative of child protection professionals and was likely affected by self-selection bias.
In JB Priestley's play set in 1912, a police inspector interrupts a wealthy industrialist family's dinner party to investigate the apparent suicide of a young pregnant woman. Through the inspector's questioning, the play explores the individual and collective role that each family member has played in the woman's death. Through a public health lens, the play offers penetrating insights into social determinants of health such as the role of power and wealth, workers' rights, welfare and charitable assistance, and gender. In this article, we critically reflect upon the continuing parallels we see in 21st century public health. If inspector Goole called again today, what would he find?
Health-related behaviors such as tobacco use, alcohol consumption, sexual practices, poor diet, and physical inactivity are major contributors to morbidity and mortality in low- and middle-income countries (LMICs). Although behavioral interventions can promote healthier behaviors, their effects are often modest. Applying behavior change theory is important for designing effective interventions; however, there is limited evidence on whether educational interventions in LMICs are grounded in such theories. Therefore, this scoping review maps the existing literature on educational interventions that apply behavior change theories to improve health-related behaviors in LMICs. This scoping review was performed following the Joanna Briggs Institute methodology and reported utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for studies published between August 2000 and August 2025 in PubMed, Web of Science, the Cochrane Library, and Google Scholar. Two separate reviewers looked at the titles, abstracts, and full texts using set criteria for inclusion. Data were extracted using a standardized form and synthesized narratively. Fifteen studies met the inclusion criteria. The most frequently reported theories were the health belief model, theory of planned behavior, social cognitive theory, and the Capability, Opportunity, Motivation—Behavior model. These theories were applied across interventions targeting condom use, physical activity, cervical cancer screening, HIV testing, and lifestyle modification. However, the extent of theoretical application varied considerably. In several studies, theories were mentioned without clear description of how constructs were translated into intervention components. Studies with more explicit linkage between theory and intervention design tended to report more consistent behavioral outcomes, although findings across studies were heterogeneous. Behavior change theories are commonly referenced in educational interventions in LMICs, but their application is often inconsistent and insufficiently operationalized. The heterogeneity of study designs and reporting limits the ability to draw conclusions about their effectiveness. Future research should improve the clarity of theoretical operationalization, strengthen reporting of intervention components, and enhance contextual adaptation to better understand how theory informs behavior change interventions.
Abstract Background Literacy is the ability to read, understand, and utilize information and to communicate through verbal and written communication. Health literacy applies these skills in a healthcare context. Healthcare professionals’ (HCP) perceptions of patients’ health literacy levels are crucial to allow delivery of information in a clear and accessible manner. Methods This was a cross-sectional study in secondary care with opportunistic recruitment of HCPs and patients. Patients completed a demographic questionnaire and the Medical Term Recognition Test (METER), a validated measure of functional health literacy. HCPs provided an estimation of the patient’s health literacy after their care interaction. Comparisons between METER results and HCP estimations were made to assess HCPs’ estimations accuracy. Results Health literacy was assessed for 142 patients. Of the 220 estimations by HCPs, 55.5% were correct. Consultants had the highest accuracy (70%). Other HCP groups’ accuracy ranged between 44.7% and 55.8%. The intraclass correlation coefficient (ICC) assessed the agreement between HCPs’ estimations and patient’s health literacy, revealing poor agreement (ICC = 0.2; CI = 0.074, 0.327; P = .00117). Conclusions This reveals disparities between HCPs’ estimation and METER-assessed functional health literacy. Addressing this gap is crucial in allowing HCPs to provide more tailored communication to empower patients in decision-making.
Given the adverse health outcomes and barriers to healthcare associated with homelessness, this study aimed to explore its impact on health, identify barriers to healthcare access, and examine perceived needs and effective interventions from the perspectives of people experiencing homelessness, individuals with lived experience of homelessness, and professionals working in health and social services. A qualitative study was conducted in Zaragoza, Spain, using semi-structured interviews with 27 participants, including people experiencing homelessness (n = 11), individuals with lived experience of homelessness (n = 7), and professionals (n = 9). Participants were recruited through purposive sampling. Data were analysed using thematic analysis. Participants described homelessness as having a substantial impact on physical, mental, and social well-being. Mental health emerged as a major concern, with depression, anxiety, emotional distress, suicidal ideation, and loneliness frequently reported. Physical health problems included chronic diseases, respiratory conditions, pain, injuries, poor nutrition, sleep deprivation, and substance use disorders. Barriers to healthcare access included administrative requirements, lack of documentation, digital exclusion, long waiting times, stigma, discrimination, and limited availability of specialized mental health services. Participants identified multidisciplinary care, continuous psychological support, community-based interventions, and stable housing combined with personalized psychosocial support as key components of effective care. Homelessness requires integrated, trauma-informed, and person-centred public health responses. Reducing barriers to healthcare, strengthening mental health services, and expanding multidisciplinary interventions may reduce health inequalities and improve health outcomes and social inclusion among people experiencing homelessness.
