Health Education Journal
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Background: Educational video is a productive means to advocate lifestyle modifications such as changes in the dietary routine. This study assesses the understandability, actionability and suitability of newly developed educational videos aimed at encouraging dietary adjustments among hypertension patients. Method: In all, 183 participants were recruited via convenience sampling and rated the understandability, actionability and suitability of the videos using the Patient Education Materials Assessment Tool for Audio-Visual material (PEMAT-A/V) and the Suitability Assessment of Materials (SAM) scale. Results: Eleven videos were developed from five main topics related to the dietary management of hypertension. Participants agreed that all videos were highly understandable, actionable and suitable for use as educational tools, with scores of more than 85%, 89% and 80%, respectively. Conclusion/Implications: Overall, the newly developed videos gained high scores for understandability, actionability and suitability. This finding reflects positive acceptance of the videos among various healthcare professionals and patients with hypertension.

Objectives: Healthy and sustainable eating should be encouraged in children. This study aimed to create, apply and evaluate the effectiveness of a specially designed, school-based educational programme to promote healthy and sustainable eating in children. Design: Pilot, school-based educational intervention, aimed at promoting health and sustainable eating patterns in children. Setting: Four schools (two primary schools and two kindergartens) in Attica, Greece. Method: The 3-month, pilot intervention consisted of a teacher training session, an educational package (11 teaching sessions, 1 session/per week), 3 separate parents and teachers’ educational sessions, and 2 teacher feedback meetings. In total, 290 children (intervention group n = 230, control group n = 60) aged 5–11 years old from four schools in Attica, Greece, participated in the study. Parents completed a specially designed questionnaire before and after the intervention, assessing children’s anthropometric characteristics, children’s adherence to a Mediterranean Diet (MD) and physical activity levels, together with usual eating and food waste behaviours in the household. Results: Children’s adherence to a MD was not significantly affected by the educational intervention. However, there was a significant increase in children’s fruit consumption, with 48% of the children eating at least two portions of fruit per day after the intervention. With respect to the food sustainability behaviours of the household, the intervention group threw away less food and, in particular, fewer fresh fruit and less bread, following the intervention. Conclusion: There is evidence that the educational programme can positively affect certain healthy eating behaviours in participating children.

Objective: Teachers face high levels of occupational stress, which can influence their mental well-being and contribute to teacher burnout. Healthy levels of exercise, a good diet and adequate sleep can reduce stress and improve mental well-being outcomes. This study explores the characteristics and effectiveness of lifestyle interventions on teachers’ mental well-being, including burnout; discusses directions for future programmes; and aims to identify the nature of evidence and gaps in the research field. Methods: A scoping review was conducted in May 2020 via ERIC, Medline, Embase, PsycINFO, Education Source, CINAHL, SPORTDiscus and Scopus databases. The search included relevant peer-reviewed articles on physical activity, nutrition and sleep interventions reporting teachers’ mental well-being outcomes. A quality assessment tool was used to appraise the quality and risk of bias of the included studies. Results: Sixteen intervention studies met the inclusion criteria. All studies incorporated physical activity into the intervention; however, only four included aspects of nutrition or sleep. No studies reported only nutrition or sleep interventions alone. The heterogeneity of interventions and their reported outcomes makes comparisons difficult. In general, the quality of the included studies was low due to small sample sizes, poor study design and incomplete reporting of information. Conclusion: Preliminary evidence suggests lifestyle interventions can improve mental well-being outcomes for teachers; however good-quality research is needed to improve the evidence base. Future interventions should have stronger research designs and larger sample sizes and use established measurements for assessing outcomes.

Objectives: The aim of this study was to describe the needs of adolescents with type 1 diabetes mellitus for acquiring self-care and psychosocial skills for the progressive self-management of the disease, as a prelude to the development of an educational programme. The parents and health care professionals who supported young people were also asked to provide their insight into adolescents’ needs. Methods, design and setting: Qualitative focus group design with a thematic analysis informed by social-cognitive theory. Results: Findings highlight gaps and divergence in the perceived needs of adolescents engaged with in existing structured educational programmes. Suggestions for change to future programmes were identified, including the implementation of educational follow-ups outside of hospital settings and an educational programme open to family and friends to foster support from the adolescents’ social circle. The use of digital media is proposed as an on-demand (rather than planned) educational method. Conclusion: This study provides information relevant to the development of new educational programmes for adolescents with type 1 diabetes in the south of France. Future programmes should be structured so as to promote active participation by adolescents from the start of the programme through to its evaluation.

Objective: In low tuberculosis (TB) incidence countries, linguistic and cultural dissonance between families experiencing infectious TB and TB health care providers is a barrier to effective communication and successful treatment. The purpose of this research was to explore infectious TB education and counselling from the perspective of patients and family members who are foreign-born. Design/Setting: One component of a multiphase, qualitative case study conducted in Calgary, a large city in western Canada. Method: Data were collected through semi-structured interviews, chart review and field notes and analysed thematically. Eight families were represented in the 6 patient and 13 family member participants who had recently experienced infectious TB. Results: Three themes were generated from the data: ‘learning about TB from many sources’, ‘reassurance and connection’ and ‘missing information’. Participants described learning about TB in different ways, feeling reassured once they knew more and sharing information with others. Overall, participants expressed satisfaction with education and counselling received. However, there were indications that communication problems had occurred. Participants asked questions during the interview, described areas of lingering confusion and shared TB-related behaviours incongruent with medical understanding. Knowledge gaps often increased isolation. Conclusion: Gaps in infectious TB education and counselling have negative impacts on patient and family member well-being. Education and counselling can be improved using multiple modes of communication, proactively addressing common misperceptions and reducing barriers to patient participation. Improvements could empower families to better manage their own experience and share accurate TB information with their communities.

Background: Nearly 60% of teenagers in the USA have experienced abusive online behaviour. Identifying effective programmes to address these behaviours and promote digital citizenship is a research priority to reduce the rate of occurrence and consequential harmful effects of abusive online behaviour. Purpose: To evaluate the effectiveness of a Digital Citizenship Curriculum in increasing knowledge of digital citizenship and reducing cyberbullying and online aggression among middle-schoolers in an underserved community using a free curriculum. Method: Middle-schoolers participated in pilot implementation of a Digital Citizenship Curriculum (DCC) to evaluate its effectiveness in increasing knowledge of digital citizenship and reducing cyberbullying and online aggression. Follow up interviews were conducted to explore participants’ perceptions of the curriculum. Results: Participants demonstrated a statistically significant increase in their knowledge of digital citizenship with an increase of 2.96 in the mean score ( p < .001). Paired t-tests by gender demonstrated a significant difference in pre-post assessment mean scores for girls ( p < .001). Post-intervention perceptions indicate the curriculum was positively received and informative. Conclusion: Identifying cost-effective and resource-friendly programmes that support social-emotional learning and promote digital citizenship is crucial for underserved populations. Regions such as Appalachian Ohio often lack the resources to fund costly curriculum aimed at online aggression prevention. This study supports the implementation of the DCC and indicates the need for future research on the long-term effects of the curriculum on middle school participants.

Background and purpose: In 2020, the New Zealand Ministry of Education updated the national curriculum policy for sexuality education, broadening the focus to ‘relationships and sexuality education’ and strengthening guidance for both primary (Years 1–8) and secondary (Years 9–13) schools. The resulting guides detail how schools might take a ‘whole school approach’ to this area, including dedicated curriculum time at all levels of compulsory schooling. Methods and conclusions: This article summarises the key thinking and research that informs the latest curriculum policy update and provides justification for the content in the policy. Significant aspects include a framework based on Te Tiriti o Waitangi (The Treaty of Waitangi), Indigenous knowledges and human rights; attention to issues of bullying and inclusion; and the responsibility of schools to address gender and sexual diversity in programmes and the whole school. This background paper discusses the evidence that informs the curriculum policy update, as well as aspects of the policy context in New Zealand that precede these changes.

Objective: Familial hypercholesterolaemia (FH), an autosomal dominant disorder causing elevated low-density lipoprotein (LDL) cholesterol from birth resulting in premature cardiovascular disease, is only diagnosed in 10% of affected patients. This study involved partnering with patients with FH and with primary care providers (PCPs) to understand health priorities and translate them into hypotheses for future research and enhancement of health practices via electronic health records (EHRs). The goal was to strengthen genetic health education for clinicians and for patients and their families, including improved diagnosis, knowledge and treatment. Perceptions regarding genetic health education and healthcare related to FH facilitated by the use of an EHR for diagnosis and treatment have not been studied. Design: Mixed-methods exploratory qualitative research and surveys. Setting: Qualitative research included five focus groups, 34 semi-structured key informant interviews and open-ended survey items with patients and PCPs at a large medical centre in Western New York. Method: Data were thematically coded to identify themes as formative work for the improvement of relevant EHR features, diagnosis, treatment and genetic health education via information sharing between clinicians and patients. Results: Themes included genetic health knowledge; the importance of being diagnosed; communication between patients, family members and medical professionals; outreach via patients’ own advocacy; and treatment, technology, motivation, trust, outside resources (for further genetic health education and support) and awareness of effective treatments. Conclusion: Patients and clinicians can contribute to the development of EHR support for the genetic health education of patients and their families, and for improved diagnosis and treatment of FH. Using their ideas in the development of effective strategies could improve the currently low rate of FH diagnosis and cascade screening (for family members), as well as enhance physician and patient genetic health knowledge and self-empowerment.

Objective: Evidence suggests the increased prevalence of diabetes among South Asian (SA) adolescents is due to their genetic risk profile. The South Asian Adolescent Diabetes Awareness Program (SAADAP) is a pilot intervention for SA youth in Canada with a family history of type 2 diabetes mellitus (T2DM). We sought to investigate changes in (1) diabetes knowledge and associated risk factors, (2) risk perception and (3) health behaviours among adolescents participating in SAADAP. Design: One-group pre-test, post-test design informed by a commitment to community-based participatory research (CBPR). Setting: Sixty-eight adolescents aged 13–17 years with a family history of T2DM participated in SAADAP in a clinical-community setting in Canada. Method: Pre–post questionnaires were administered to evaluate diabetes knowledge and associated risk factors, risk perceptions and health behaviours. Analyses were restricted to 49 participants who attended at least four diabetes education sessions. Results: The mean age of adolescents was 14.5 years, and 57.1% self-identified as girls. The difference in knowledge about the definition, symptoms and complications of T2DM from baseline to post-intervention was 3.32 out of 21 ( p < .001) among SA youth. There was significant increase in learning about diabetes risk factors ( p < .001) from baseline to post-intervention. Almost 60% of participants exhibited no change in their risk perception after intervention. Approximately two-thirds of the participants self-reported positive changes in health behaviours after completing the programme. Conclusion: SAADAP showed promising outcomes in raising knowledge and improving health behaviours in SA adolescents with a family history of diabetes. Larger controlled trials with longer follow-up are recommended to support and expand on the current findings.

Objective: Health apps for smartphones have largely overlooked one means of expanding effectiveness: namely, inviting access by secondary app users who can contribute positively to primary users’ lives. We report on outcomes from field testing a cooking app where dissemination included both mothers who were household cooks (primary users) and their children (secondary users). Setting and Method: The app, VeggieBook, aimed to increase the use of vegetables in meals and snacks by household cooks. Clients at 15 community pantries were randomly assigned to receive or not receive the app. The same vegetables were supplied to all participants. In each family in the experimental group, the mothers and a 9- to 14-year-old child were each given their own portal into the app. Interviews before, during and after the project and electronic capture of app use measured key variables. The app’s impact on children was gauged by whether or not they became involved in helping prepare family dinners. Results: Availability of VeggieBook increased children’s collaboration with their mothers, even though the app contained scant content urging this. Collaboration occurred most often in families where electronic media (television, phones, earbud devices) did not intrude on socialising during meals, and there were opportunities to acknowledge children’s kitchen contributions. Conclusion: Implications are identified for the creation of other health apps intended for disease prevention and management. Secondary users (spouses, home caregivers, children and friends) could also be targeted to use apps meant for primary users (people at-risk for illness or patients), thereby building collective action towards improving health.