Search Results (2,219)

Background/Objectives: Adolescent sexuality is multidimensional, yet brief instruments assessing attitudes, experiences, and contextual influences from a biopsychosocial perspective remain limited. This study aimed to develop the Comprehensive Questionnaire on Attitudes, Experiences, and Contexts of Adolescent Sexuality (CIAECSA) and examine its content validity, comprehensibility, feasibility, internal consistency, and exploratory internal structure. Methods: A cross-sectional methodological study comprised three phases: theoretical delimitation and generation of 30 initial items; content evaluation by nine experts and semantic validation with 26 adolescents; and pilot administration to 51 adolescents from educational settings in Toledo, Spain. The pilot sample included 35 females (68.6%), 15 males (29.4%), and one gender-fluid participant (2.0%), aged 12–17 years (mean = 14.41; SD = 1.72). Content validity, perceived clarity, feasibility, Cronbach’s alpha, and principal component analysis with Varimax rotation were examined. Results: The final questionnaire comprised 18 items across three domains: sexuality/gender/anatomy, emotional/physical pain, and self-care/environment. The scale-level Content Validity Index (S-CVI/Ave) was 0.955, and mean perceived clarity was 4.53/5. The mean completion time was 5.52 min. Cronbach’s alpha was 0.800, 0.780, and 0.740 for the three domains and 0.715 for the total scale. The KMO was 0.659, Bartlett’s test was significant (p < 0.001), and an exploratory three-component solution, examined against the prespecified domains, explained 51.4% of the variance. Conclusions: The findings provide favorable evidence of content validity, comprehensibility, feasibility, and internal consistency. The CIAECSA may help identify educational needs and psychosocial factors related to adolescent sexuality, although its internal structure and additional measurement properties require examination in larger, balanced, and independent samples. Full article

Introduction: Tuberculosis [TB] and diabetes mellitus (DM) remain major public health concerns worldwide. TB negatively affects an individual’s glucose tolerance, increasing the risk of developing DM. Similarly, DM reduces the host’s ability to fight TB infection and increases the likelihood of developing TB and poor response to TB medication. This study analysed stigma and health-seeking behaviour in a sub-district of Accra Metropolis. Methods: We used a mixed-methods research approach involving a cross-sectional survey and in-depth interviews to explore community knowledge, stigma, and health-seeking behaviour related to TB and DM. A total of 437 individuals were selected for a survey using a simple random sampling technique, while 22 participants, including three TB patients, four nurses, one medical doctor, four students from a nursing and midwifery school, five students from a school of hygiene, and five community members, were involved in the study. Healthcare providers and patients were purposively selected, while students and community members were recruited through convenience sampling. Descriptive and logistic regression analyses were performed on the quantitative data using STATA, while the qualitative data were thematically analysed using the MAXQDA software. Results: Participants’ age, sex, and educational levels were significantly associated with their knowledge of TB and DM. Males were 0.600 times as likely as females to be knowledgeable about DM (95% CI: 0.386–0.934, p = 0.024). Social determinants of health, such as poverty, local beliefs, stigma, and negative attitudes from healthcare workers, may influence TB patients’ preference for traditional remedies over biomedical treatment. Conclusion: Therefore, we observed that addressing cultural barriers, stigma, and financial costs related to TB and diabetes care will help increase patients’ willingness for biomedical treatment. Full article

Background: Restrictive dieting is a common behavior among young adults and may be associated with increased vulnerability to disordered eating. University students represent a population potentially exposed to multiple influences affecting eating behaviors, including academic stress, social pressures, and appearance-related standards promoted through digital media. This study aimed to analyze the relationship between restrictive dietary practices, eating behaviors, and indicators of vulnerability to disordered eating among university students in Poland. Materials and Methods: A cross-sectional study was conducted among 420 university students aged 19–34 years. Data were collected using an anonymous online questionnaire consisting of sociodemographic questions, the original Restrictive Diet Motivation Questionnaire (RDMQ), and the validated Three-Factor Eating Questionnaire-13 (TFEQ-13). Motivational factors were categorized into aesthetic, social, health-related, eating control, and self-discipline, and personal beliefs regarding restrictive dieting. Statistical analyses included the Gamma correlation coefficient, chi-square test, and ordinal logistic regression, with statistical significance set at p < 0.05. Results: Restrictive dieting was reported by a substantial proportion of participants, with women reporting this behavior more frequently than men. The most prominent motivations were related to appearance, weight control, social influences, and personal beliefs regarding restrictive diets. Participants who followed restrictive diets demonstrated higher levels of cognitive restraint compared with those who did not engage in restrictive dieting. Strong associations were observed between cognitive restraint and aesthetic motivations, personal beliefs regarding restrictive dieting, social motivations, eating control and self-discipline, and health-related motivations. Multivariable analysis confirmed that aesthetic motivation, personal beliefs, previous restrictive dieting, and female sex were independent predictors of higher cognitive restraint. Conclusions: Restrictive dieting among university students is strongly associated with appearance-related motives, dieting-related beliefs, and increased cognitive restraint. In this study, eating disorder risk was inferred from behavioral indicators, particularly cognitive restraint, rather than from clinical diagnostic criteria. These findings highlight the need for preventive strategies promoting evidence-based nutrition knowledge, healthy eating behaviors, and a positive body image among young adults. Full article

Background/Objectives: Virtual home health care (VHHC) is increasingly used to support chronic disease management, yet patient satisfaction is often examined through a linear barrier-focused lens, in which more barriers are assumed to produce lower satisfaction. This study introduced a satisfaction resilience framework to identify factors associated with preserved satisfaction among barrier-exposed VHHC users. Methods: This cross-sectional analysis included 517 adults with chronic diseases who had used VHHC services and were recruited across five regions of Saudi Arabia. Patients were classified by barrier load and overall satisfaction into four groups: Resilient, Vulnerable, Comfortable, and Disengaged. Group differences were examined using one-way ANOVA, chi-square tests with Cramér’s V, point-biserial correlations, and a linear probability model restricted to high-barrier patients. Results: Overall, 167 patients (32.3%) reported high barrier exposure. Among them, 109 (65.3%) were classified as Resilient and 58 (34.7%) as Vulnerable, despite statistically equivalent barrier counts. Resilient patients reported higher motivation count, provider trust, perceived effectiveness, and functional equivalence with in-person care. Lifestyle-integration motivations, particularly avoiding work absence and waiting rooms, differentiated Resilient from Vulnerable patients, whereas access-related motivations did not. Perceived functional equivalence showed the largest between-group effect. In the high-barrier subsample, motivation count and provider trust were independently associated with Resilient status, while demographic variables were not significantly associated with it. Conclusions: Satisfaction with VHHC among chronic disease patients is not determined by barrier exposure alone. Service-design and communication strategies that strengthen lifestyle integration, functional equivalence beliefs, and provider trust may help healthcare teams support satisfaction resilience among patients who experience barriers to virtual care. Full article

Background/Objectives: Age-related hearing loss (ARHL) is a major and growing public health concern, yet awareness of its nature, consequences, and management options remains inadequately studied in the Middle Eastern context. In Saudi Arabia, cochlear implantation is provided free of charge through the public healthcare system; however, adult uptake remains critically low, suggesting that awareness—rather than access—constitutes the primary barrier to timely intervention. In collective healthcare cultures, family members play a central role in healthcare decision-making for older individuals, making family-level awareness a critical determinant of early identification and treatment. This study aimed to assess public awareness, beliefs, and attitudes toward ARHL and its management options among adults in Saudi Arabia, applying the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional descriptive study was conducted using a structured questionnaire adapted from a previously validated survey, with cultural modifications for the Saudi context. The questionnaire was distributed electronically to adults aged 18 years and above across Saudi Arabia. A total of 506 consenting responses were included in the final analysis. Descriptive statistics were used to analyse frequencies, percentages, means, and standard deviations. Results: The majority of participants correctly identified hearing loss as a reduction in the ability to hear (84.6%), and 95.3% regarded good hearing as personally important. However, significant knowledge gaps were observed, with 53.8% believing hearing loss can be cured and 50.4% believing it can be halted. Notably, 34.2% believed cochlear implants benefit children exclusively. Doctors and the internet were the primary sources of medical information, yet 39.3% reported no preventive healthcare visits and 23.9% did not seek any information about hearing problems. When faced with a hypothetical hearing loss, 75.3% indicated they would consult an ENT specialist. Conclusions: Adults in Saudi Arabia demonstrate good awareness of the signs and consequences of hearing loss but exhibit significant knowledge gaps regarding its clinical course and available management options, most notably the belief that cochlear implantation is exclusively a pediatric intervention. These findings highlight the urgent need for culturally adapted awareness campaigns targeting family members of older adults, and support the development of community-based hearing health promotion strategies in Saudi Arabia and comparable collective healthcare societies. Full article

Positionality refers to a researcher’s stance within the social context of their research study. It can include information such as gender, race and class, and other characteristics like location. In addition, positionality statements can also include researchers’ personal traits, such as their thoughts, feelings and behaviors. They convey a researcher’s position and are incorporated within research articles to make readers aware of the beliefs and assumptions that a scholar may be bringing into the study. Describing one’s positionality can be particularly beneficial within health professions education (HPE) research, where complex power dynamics often exist between the researcher and participants. However, there is currently limited literature on how positionality statements should be written for HPE research. This paper aims to present an introductory guide on how a novice researcher can write a positionality statement within HPE research, including elements such as reflexivity, location and context, power dynamics, and insider–outsider positioning, as well as the potential risks tied to positionality statements. Additionally, this paper provides readers with a practical step-by-step guide and a real-life example to follow when developing their own positionality statement. By practicing reflexivity and considering how their location and presence impact the research process and participants, a scholar can articulate how their identity and context shape their research approach. Consequently, adding a positionality statement can increase trustworthiness and enhance transparency of a study when they are reflexive, context-specific, ethically constructed and integrated into the research process. Full article

Background/Objectives: Members of the LGBTQ+ community often have poorer health outcomes and less access to health services than cisgender and heterosexual populations, and many healthcare professionals remain insufficiently aware of the barriers faced by these patients. Community nurses, given their skills and competencies, can help patients overcome barriers and achieve greater inclusion. The aim of this project is to identify the barriers and facilitators detected by the primary care nursing team of the Málaga-Valle del Guadalhorce Health District (MVGHD) when providing holistic care to LGBTQ+ individuals. Methods: A sequential explanatory mixed-methods design (DEXPLIS) will be employed to robustly combine a quantitative baseline of professional attitudes with an in-depth qualitative exploration of institutional discourses. Phase I consists of a pilot cross-sectional study with cluster allocation of questionnaire versions in which primary healthcare nursing staff in the MVGHD will complete the validated Sexuality Attitudes and Beliefs Survey (SABS) with one group completing a version framed around LGBTQ+ patients and the other around the general population. Phase II consists of a qualitative descriptive study based on discourse analysis (DA) using in-depth semi-structured interviews, analyzed with ATLAS.ti 23. Conclusions: This study protocol is expected to provide an empirical framework to identify potential institutional barriers and attitudinal biases in nursing care, highlighting the potential need for targeted training programmes in sexual and reproductive health. The resulting protocol aims to contribute to health equity by offering practical resources to optimize ongoing clinical education in primary care settings. Full article

Background/Objectives: Cervical cancer (CC), mainly caused by human papillomavirus (HPV), is one of the major cancers threatening women’s health in Algeria. However, despite the existence of a cost-effective vaccine, it has not yet been introduced into the national vaccination program. Recent information indicated that its introduction will be imminent. Thus, the current study was conducted to evaluate the level of awareness and knowledge about CC and HPV among the Algerian population as well as its attitudes toward HPV vaccination. Methods: A cross-sectional survey was carried out between 4 November 2022 and 8 May 2023 using a self-administered questionnaire that was diffused through social media platforms. Results: A total of 414 participants were included in our sample, with the dominance of those aged 18 to 30 years old (74.6%), those with university education (75.8%), and those with a medium financial level (77.5%). A high level of awareness was reported (76.3%), especially among healthcare workers (98.4%, OR: 17.099, 95% CI: 2.294–127.476, sig. = 0.06), participants aged more than 30 years (87.6%, OR: 2.78, 95% CI: 1.313–5.883, sig. = 0.008), and females (85.1%, OR: 2.02, 95% CI: 1.15–3.548, sig. = 0.014). However, the level of knowledge did not follow, since less than a third (32.1%) of the participants only were aware of HPV, and multiple gaps were reported regarding its epidemiology and its prevention. Moreover, while 30.8% of the participants were willing to get the HPV vaccine, 40.5% were hesitant, and 27.7% were resistant. The causes of rejection/hesitancy included mainly complacency, vaccine refusal, and the lack of confidence in the vaccine. In addition, hesitant and reluctant participants have shown a low level of knowledge and a high score of conspiracy beliefs. Conclusions: These results provide new insights into knowledge and attitudes towards CC and HPV vaccination. It reported that despite the high level of awareness about CC, gaps of knowledge remain and vaccination hesitancy/reluctance is persistent. These results suggest the need for raising awareness particularly about HPV which will consequently help to increase HPV vaccine acceptance. Full article

Background/Objectives: Previous research has linked religious involvement to increased rates of breastfeeding initiation and duration, as well as improved lactation-related health outcomes. However, affiliation with certain faith traditions may also constrain breastfeeding practices due to misconceptions, modesty norms, religiously informed cultural beliefs, or other contextual factors. Given Mississippi’s status as one of the most religious states in the United States, this study examines unique facets of the association between religion and breastfeeding, with special attention to the direct and indirect role of congregational support. Methods: This study uses data from men and women, primarily White and African American respondents, in Wave II of the Mississippi REACH Social Climate Survey. This survey features both established and novel measures of breastfeeding outcomes, enabling new insights into the linkages among religion, community perceptions, and breastfeeding prevalence in primary social networks. The REACH Social Climate Survey combines a general population sample with an oversample of African American residents from the Mississippi Gulf Coast, collected in 2023. The analysis focuses on the direct and indirect associations between congregational support for breastfeeding and the prevalence of breastfeeding within social networks. Results: The main findings reveal (1) a direct and positive association between congregational support and breastfeeding social network prevalence and (2) an indirect association between congregational support and breastfeeding social network prevalence through community support for breastfeeding. Conclusions: These results underscore the importance of examining the intersectional associations among religion, community context, and infant health outcomes. Full article

Introduction: Fitness short videos have become an increasingly popular form of digital health communication, yet the factors influencing users’ continued usage remain insufficiently understood. This study integrates the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), the Health Belief Model (HBM), and the Theory of Planned Behavior (TPB) to examine the determinants of users’ continuous intention and actual use of fitness short videos. Methods: A cross-sectional questionnaire survey was conducted using a convenience sampling approach among Chinese fitness short video users. A total of 550 valid questionnaires were collected. Structural equation modeling (SEM) and bootstrapping analysis were employed to examine the proposed research model and test the hypothesized relationships among constructs. Results: The results indicate that performance expectancy, hedonic motivation, habit, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived behavioral control, and behavioral intention significantly influenced users’ continued fitness short video usage. Habit exerted significant effects on both behavioral intention and actual use behavior. In contrast, attitude, subjective norm, and self-efficacy did not show significant direct effects. Conclusions: This study extends current understanding of continuous fitness short video usage by integrating technology acceptance, health belief, and planned behavior perspectives into a unified framework. The findings provide theoretical insights into digital health behavior and offer practical implications for the design of fitness short-video platforms and digital health intervention strategies. Full article

Background: The excessive use of dietary supplements is widespread, and their advertising is often misleading and suggests therapeutic properties. The aim of the study was to assess consumers’ perceptions of advertising, their expectations regarding the effects of dietary supplements, and their overall knowledge of these products. Methods: The study was conducted among 397 adults who were presented with the content of advertisements for four dietary supplements broadcast on Polish radio stations. Results: More than 67% of respondents had low or negligible knowledge of dietary supplements. Only 4.8% considered dietary supplements to be food products, whereas 40.3% believed them to be over-the-counter medicines. According to 45.7% of respondents, the advertisements created the impression that the efficacy of the products had been scientifically evaluated and proven. Furthermore, 74.1% believed that if the advertised dietary supplements did not have proven efficacy, such advertising was unfair and misleading. The largest proportion of respondents (41.1%) expressed moderate expectations regarding the efficacy of the advertised dietary supplements. Furthermore, the proportion of respondents expressing the highest level of scepticism increased with increasing knowledge of dietary supplements. Despite this, 60.6% of respondents declared that if they experienced the health problems referred to in the advertisement, they could be encouraged by it to start using such products. Factors that significantly increased the likelihood of dietary supplement use included high expectations regarding their efficacy (OR = 11.1), negligible knowledge about dietary supplements (OR = 2.9), the belief that their efficacy had been demonstrated in scientific studies (OR = 1.9), and residence in a rural area (OR = 1.9). Conclusions: Given forecasts of continued growth in the dietary supplement market, and the belief held by many consumers that the effects of such products have been proven, educational campaigns are needed to prevent them from being confused with medicines. Full article

Background/Objectives: Filipino Americans are one of the least likely Asian American subgroups to use formal mental health services, even when mental health needs are present. This study used the Capability–Opportunity–Motivation–Behavior (COM-B) framework to examine mental health symptomatology, perceived social support, help-seeking intentions, and perceived barriers to mental health treatment among Filipino American older adults residing in the United States. Methods: We used a cross-sectional descriptive correlational design. A sample of 100 Filipino American older adults completed the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, an 8-item subset of the Multidimensional Scale of Perceived Social Support, the Mental Health Seeking Intention Scale, and the Perceived Barriers to Psychological Treatment scale. We performed descriptive statistics and correlation analyses using Pearson’s and Spearman’s coefficients. Results: Participants experienced low levels of depressive symptoms (M = 2.73, SD = 4.80) and anxiety symptoms (M = 2.56, SD = 4.11), high perceived social support (M = 5.32, SD = 1.83), moderate help-seeking intentions (M = 4.90, SD = 2.18), low overall perceived barriers to care (M = 1.67, SD = 0.90), and nearly universal health insurance coverage. Of the barrier domains, stigma/interpersonal barriers had the highest mean scores. Greater depressive and anxiety symptom severity was associated with higher overall perceived barriers to mental health care (r = 0.45–0.47) and with higher structural, motivational, and stigma/interpersonal barriers (r = 0.41–0.46). Conclusions: Despite high healthcare access and strong perceived social support, Filipino American older adults expressed only moderate intentions to seek professional mental health care. Culturally mediated factors may shape mental health help-seeking beyond structural barriers to access. The COM-B framework offers a useful lens for understanding help-seeking behavior and guiding culturally responsive interventions with Filipino American older adults. Full article

Background: Mental health problems are common among people living with HIV (PLWH); however, the use of mental health services remains inadequate in many low- and middle-income countries. Objectives: This study aimed to explore the perspectives of health professionals on the provision of mental health services for PLWH presenting with mental health problems in primary health care in Lesotho. Methods: A qualitative descriptive approach was adopted, involving semi-structured interviews with 50 health professionals who were purposely selected, including nurses and medical officers, each with a minimum of 2 years’ primary health care experience in the Maseru district. Data were collected between December 2022 and January 2023, audio-recorded, and transcribed verbatim. Data collection continued until thematic saturation was achieved, and analysis was conducted using a thematic framework analysis. Results: The analysis revealed two main themes: (1) limited knowledge of mental health problems, encompassing an inadequate understanding of signs and symptoms, diagnosis, and management, and (2) barriers to the management of mental health problems. Key subthemes included the shortage of qualified mental health specialists and psychiatric medications, the absence of dedicated counselling services for the prevention of mental health problems, lack of a mental health department, time constraints within clinical practice, and limitations in clinical infrastructure. Cultural beliefs, stigma, and discrimination, both among health professionals and in the broader community, were also identified as significant impediments. Participants described a substantial treatment gap, driven by insufficient training and limited resources, which undermines the effective delivery of mental health services. Conclusions: The findings revealed that health professionals working in primary health care in Lesotho experience considerable knowledge gaps and systemic constraints that hinder the provision of adequate mental health services for PLWH who have mental health problems. These challenges can be mitigated through targeted capacity building, the integration of MHS into primary care, improved resource allocation, and strategies to reduce stigma, thereby enhancing health outcomes. Full article

Dengue and other arboviruses are a rising public health concern, worsened by climate change, globalization, and weak vector control. This study assessed the preparedness of local institutions and general practitioners (GPs)/paediatricians in ASL Roma 5 (Lazio, Italy) for potential arboviral outbreaks. A cross-sectional survey (April–May 2024) conducted 99 interviews: 57 with mayors and 42 with general GPs/paediatricians. A Health Belief Model (HBM)-based questionnaire assessed knowledge, attitudes, and practices regarding arbovirus transmission and management. Data were analyzed using descriptive statistics and chi-square tests. Dengue transmission awareness was low. Most mayors (85.96%) and GPs/paediatricians (88.1%) rated community knowledge as poor; 12.8% of mayors and 4.76% of GPs/paediatricians believed residents recognized local transmission risks. Environmental prevention programs were reported by 57.89% of mayors and 26.19% of GPs/paediatricians. Staff resource adequacy perceptions differed significantly (73.33% GPs/paediatricians vs. 21.82% mayors; p = 0.0005). In emergencies, 84.62% of GPs/paediatricians and 66.07% of mayors felt ready to act within 24 h. Local administrations face organizational and staffing limitations that hinder effective dengue prevention. While GPs/paediatricians showed greater confidence, they stressed the need for further training. Enhancing risk communication, environmental management, and intersectoral collaboration is crucial to improve preparedness for dengue and emerging arboviruses. Full article

Background/Objectives: Empowerment strategies promoting healthy behaviors are important for preventing chronic diseases and cancer, while individual health responsibility (IHR) plays a significant role. Although widely discussed in the literature, the concept of IHR does not have clearly defined domains or a validated instrument for assessment. Its overlap with locus of control theory, self-motivation, and personality type creates further difficulties. Meanwhile, perception of one’s own responsibility for health is an intuitive, simple item to answer, reflecting a person’s belief related to this topic. Moreover, for ethical reasons, this concept cannot be separated from personal beliefs and should not be adjusted according to strict scales and externally imposed definitions. Therefore, this study aimed to: (1) explore whether there is an association between self-perception of IHR and preventive/risk-taking behaviors; and (2) examine socio-demographic factors associated with the IHR score and three self-perceived characteristics, namely self-perceived locus of control, health literacy, and health status. Methods: A cross-sectional study with 968 healthcare workers was conducted in a large, multidisciplinary hospital covering several behaviors (smoking, alcohol consumption, diet, and participation in a screening program for hepatitis C). IHR was evaluated on a scale from 1 to 10, where 1 meant “to very little extent” and 10 meant “to a great extent”. Results: The average IHR score was 8.80 (SD = 1.88). In the univariate analysis, the IHR score was significantly related to gender, age, education, marital status, and all three personal characteristics. In the multivariate analysis, the socio-demographic associations lost statistical significance. IHR maintained its association with the healthy diet score in the multivariable model (B = 0.113, p = 0.036). In the unadjusted analyses, the distribution of IHR differed between participants who declared alcohol consumption and those who declared abstinence (χ² = 17.157, p = 0.002). However, this association was not retained in the multivariable model. Self-perceived internal locus of control was negatively associated with screening acceptance, but not with IHR. The OR of 0.927 refers to a one-point increase on the 1–10 scale. Across the full observed scale range, this corresponds to an OR of 0.51 (95% CI: 0.29–0.89), indicating lower odds of screening acceptance among participants with higher perceived internal control. Because this estimate assumes linearity across the entire scale, it should be interpreted cautiously. Conclusions: The gap between perceived responsibility and actual behavior suggests that IHR messaging alone is unlikely to be sufficient. Future research should consider social desirability and external locus of control when analyzing IHR and health behaviors. Full article