Health literacy and its determinants among school-going children: a school-based cross-sectional study in Nepal.

Limited health literacy is linked to unhealthy behaviors, adverse health outcomes, poor quality of life and financial burdens on society. However, little is known about the level of health literacy, especially among school-going children. This cross-sectional study assesses health literacy levels and their determinants in 354 school children from Kathmandu Metropolitan City, utilizing a multi-stage cluster sampling method. The 10-item Health Literacy for School-Aged Children was used to measure the student's literacy levels. Bivariate analysis and multivariable logistic regression at the significance level of 0.05 were performed to determine factors associated with limited health literacy. The majority of participants (76.6%) had moderate health literacy, while 13.8% had a high level and 9.6% had a low level of health literacy. Students from nuclear families had lower odds [adjusted odds ratio (aOR): 0.4; 95% CI: 0.2-0.8] of having limited health literacy. Students whose mother education was up to secondary school (aOR: 10.1; 95% CI: 1.3-78.9), students with pre-existing mental health conditions (aOR: 3.7; 95% CI: 1.4-9.6) and students with unsatisfactory health status (aOR: 3.9; 95% CI: 1.5-10.5) had higher odds to have limited health literacy. These results suggest the importance of prioritizing school health promotion and education activities for students with pre-existing mental health conditions and mothers with low educational attainment. Implementing peer support group programs for children with mental illnesses, mobilizing school health professionals and introducing interventions such as vocational training of mothers can collectively improve health literacy among school-going children.

Educational WhatsApp-delivered intervention based on social cognitive theory to promote leishmaniosis preventive behavior of health ambassadors: a randomized controlled trial.

BACKGROUND: Multidimensional strategies can promote preventive behaviors to prevent cutaneous leishmaniosis. WhatsApp, the popular messenger of Iranians, can be used as a platform to provide health education interventions. This study aimed to investigate the effect of using an educational intervention in WhatsApp based on social cognitive theory (SCT) on the preventive behaviors of health ambassadors. METHODS: A randomized clinical trial was conducted from September 2020 to April 2021 on 220 people living in endemic areas of leishmaniosis in Mashhad Province, Iran. By the cluster method sampling, the samples were randomly divided into two intervention and control groups. The intervention was performed for the intervention group over two weeks. Data were collected using a researcher-made questionnaire based on the constructs of SCT before and after the intervention. SPSS 16 was implemented to test multiple statistical analyses. RESULTS: Findings from the intervention group compared with the control group showed that the scores of SCT constructs and preventive behaviors were significantly changed (P < 0.001) across time during baseline through follow-up. These changes were not significant in the control group. CONCLUSIONS: The educational intervention based on the SCT model to promote leishmaniosis preventive behaviors is effective. This intervention module can be tested in other targeted populations in endemic areas to prevent and control leishmaniosis. TRIAL REGISTRATION: Iranian Registry of Clinical Trials Registry IRCT20200615047784N1, registered 02/09/2020.

Convenience behavior in German university students is associated with sociodemographic, study- and health-related factors.

Background: The transition from school to university is often accompanied by a change in students' lifestyles. So far little is known whether convenience behavior is an essential factor affecting students' health and social interaction. In a heterogeneous population regard to sociodemographic and anthropometric characteristics the Convenience Behavior Questionnaire (CBQ) showed a better relationship between convenience-related behavior with overweight and obesity than established questionnaires. Here we assessed convenience behavior in a large well characterized cohort of university students and its association with health-related (mainly sedentary behavior and physical activity), study-related and sociodemographic factors with the Convenience Behavior Questionnaire (CBQ). Methods: A total of 4,351 students participated in an online survey, of which 3,983 (23.6 ± 5.3 years old, 71.3% females) answered the questions concerning convenience behavior. A low value in the CBQ indicates more convenience behavior [Convenience Behavior Index (CBI) range: 3-15]. Differences with regard to sociodemographic (age, gender, body mass index), study-related (semester, degree, field of study) and health-related (physical activity, sedentary behavior) variables were examined with Mann-Whitney-U test or Kruskal-Wallis test and post-hoc tests (Bonferroni). Results: The CBI of men and women differed significantly (z = -6.847, p < 0.001, r = 0.11). First-year students and students beyond their first year showed significant differences (z = -2.355, p ≤ 0.05, r = 0.04). Differences were also found in the field of study (Chi2 (6) = 147.830, p < 0.001) and the targeted degree (Chi2 (7) = 79.985, p < 0.001). Furthermore, differences were found in the body mass index (Chi2 (5) = 70.678, p < 0.001), physical activity (Chi2 (2) = 279.040, p < 0.001) and sedentary behavior (z = -4.660, p < 0.001, r = 0.07). Conclusion: The results showed risk groups of convenience behavior among students [men, first-year, students enrolled in "Science, Technology, Engineering and Mathematics (STEM)," bachelor]. Our results confirm for the first time in a very homogeneous population a gender difference and an association between CBI and health-related factors. Further studies are needed to analyze the health behavior of students in more detail, especially their convenience behavior.

Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities-A cross-sectional study.

BACKGROUND: Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives. AIM: To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs). DESIGN: This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis. RESULTS: Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%). CONCLUSION: This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.

Aiming for transformations in power: lessons from intersectoral CBPR with public housing tenants (Québec, Canada).

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF-LPF frameworks and suggestions to increase the transformative power of future studies.

TV medical dramas: assessing the portrayal of public health in primetime.

Introduction: The influence of medical dramas could extend beyond the realm of entertainment and potentially strengthen/orient the knowledge, attitudes and hopefully practice of health professionals and the public, despite often depicting unrealistic medical outcomes and scenarios. Methods: This study examined the portrayal of public health issues in two popular international medical series, "Grey's Anatomy" and "House, MD," selected for their awards and viewership ratings. Individual episodes were double-rated by clinicians for patient characteristics, public health issues, and infection risk management. Results: 94 episodes with 286 clinical cases were analyzed. A wide range of conditions and pathologies were depicted, with a focus on acute clinical events, trauma and mental disorders, which contrasts with real-life causes of hospitalization and highlight the dramatization in these series. Public health issues such as organ donation and substance abuse were frequently addressed, but prevention and health promotion received little attention. Proper use of personal protective equipment was mostly observed, although hand hygiene was underrepresented. Conclusion: The study highlights the dual role of medical dramas as an entertainment medium and a potential educational tool. While they can raise awareness and encourage healthier behavior, their portrayal of medical practices and patient care often deviates from reality and can create unrealistic expectations. The influence of these dramas also extends to viewers' perceptions of healthcare and medical professionals, underscoring the need for accurate and responsible portrayal of health issues in the media.

A public health campaign to increase awareness of the risk of dog bites in South Australia.

Dog bites are a serious public health problem. A campaign by the Dog and Cat Management Board of South Australia was launched to increase awareness that any dog can bite as a first step in reducing the incidence of dog bites. The aims of this study were to 1) evaluate changes in attitudes to dog bites following the media campaign, and 2) provide baseline data on dog bites and attitudes to interactions with dogs to help target future campaigns. The media campaign 'Good Dogs Have Bad Days' was run from July to October, 2023, using TV, radio, billboards and social media. A cross-sectional survey was conducted pre- and post-campaign, including demographics and questions relating to interactions and attitudes to dogs. A total of n = 402 to the pre- and n = 404 responses to the post-campaign surveys were received, with most having owned a dog, living in metropolitan areas, and an equal split of males and females. Over one third (36-37 %) of dog owners and 25-29 % of non-dog owners had been previously bitten by a dog, although most did not require medical attention. Respondents were more likely to agree that any dog can bite if they recalled seeing the campaign, and less likely if they were male and had poor knowledge of the scenarios in which a dog might bite. Older respondents and those from lower socioeconomic areas believed dog bites were a more serious community issue than younger respondents from higher socioeconomic areas. Approximately 70 % of dog owners believed it was safe for strangers to approach their dog, 34-37 % allowed children or other people to pat their dog without permission and less than half separated their dog from visitors or delivery people. In contrast few of the non-dog owners allowed their children to pat a dog without the owner's permission and only 2 % allowed them to play with dogs without supervision. The results demonstrate a relatively short campaign was associated with increased agreement any dog can bite. The proportion of respondents who had been bitten by a dog affirms the importance of public health campaigns targeting dog attacks. Some behaviours, such as supervising dogs around children and keeping dogs separate from delivery people, had relatively low agreement from dog owners and may be targeted in future campaigns. Public awareness campaigns and ongoing education will help to increase safer interactions with dogs, but it will take time and commitment to achieve a result.

Factors Associated With Leisure-Time Bicycling Among Adults in the United States: An Urban-Rural Comparison.

BACKGROUND: Bicycling is a healthy form of physical activity that can be performed by most adults as part of leisure-time (LT) activity. However, little is known about LT bicycling behaviors, especially in the rural areas of the United States. This study sought to contrast the prevalence and factors associated with LT bicycling in populations living in urban settings with those living in rural settings. METHODS: The 2019 Behavior Risk Factor Survey, which contains information regarding LT physical activity behaviors among adults (N = 396,261) in the United States, was used to determine the prevalence, demographic profile, and likelihood of meeting the physical activity guidelines of LT bicyclists. The 2013 National Center for Health Statistics Urban/Rural Classification Scheme was used to classify respondents living in rural and urban settings. RESULTS: Among US adults, 3.8% (95% CI, 3.7-3.9) reported LT bicycling activity, the sixth most common physical activity. Adults living in urban counties compared with rural counties had a greater prevalence of LT bicycling (3.9% vs 2.3%, respectively), with adults living in rural counties having a 34% lower probability of LT bicycling. Rural bicycling prevalence rates were lower across all demographics. Urban bicyclists, compared with rural bicyclists, cycled more months of the year. Overall, 85.5% of all bicyclists met the aerobic physical guidelines, with no differences between urban and rural bicyclists. CONCLUSIONS: Bicycling remains an important LT physical activity among adults in the United States. However, a rural-urban difference in the prevalence does exist for LT bicycling. The reasons for this disparity warrant further investigation.

The role of intermediaries in connecting individuals to local physical activity - protocol for a pilot feasibility trial.

Background: Intermediaries are health-related workers who facilitate connections to local physical activities. Intermediaries deliver interventions by receiving referrals, conducting assessments, connecting referred individuals to activities and/or services in the community, and following up with them over time. However, it is unclear whether individuals who are referred to physical activities by an intermediary improve their physical activity levels, and what their perspectives and experiences are of participating in this intervention. To date there has been a lack of studies investigating the effect of this intervention on physical activity using appropriate outcome measures. Methods: This will be a mixed methods pilot feasibility study. Participants will be individuals referred or self-referred to an intermediary and connected to local physical activities. Participants will be recruited through two types of intermediary services in Ireland; social prescribing and local sports partnerships. A total of 30 participants will be recruited (15 per service). Baseline demographic information will be taken upon enrolment to the study and three questionnaires will be completed: the International Physical Activity Questionnaire - Short Form, Self-Efficacy for Exercise Scale and Short Warwick Edinburgh Mental Well-being Scale. The questionnaires will be repeated after 12 weeks and in addition semi-structured interviews will be carried out to explore intervention content and delivery, as well as acceptability of the intervention and evaluation design. Discussion: This overall aim of this proposed study is to investigate the feasibility of an intervention delivered by an intermediary to improve physical activity and health-related outcomes of community-dwelling individuals. Registration: ClinicalTrials.gov (NCT06260995).

Anti-inflammatory properties of polysaccharides from edible fungi on health-promotion: a review.

Edible fungus polysaccharides have garnered significant attention from scholars due to their safety and potential anti-inflammatory activity. However, comprehensive summaries of their anti-inflammatory properties are still rare. This paper provides a detailed overview of the anti-inflammatory effects and mechanisms of these polysaccharides, as well as their impact on inflammation-related diseases. Additionally, the relationship between their structure and anti-inflammatory activity is discussed. It is believed that this review will greatly enhance the understanding of the application of edible fungus polysaccharides in anti-inflammatory treatments, thereby significantly promoting the development and utilization of edible fungi.

Effect of the health and wellness Kneipp concept on health promotion and reduction of sick days for kindergarten children: a cluster randomized controlled trial protocol.

Background: The holistic health and wellness Kneipp concept, has a long tradition in Europe with demonstrated health benefits. Based on the five elements of the Kneipp concept, kindergartens in and around Germany are used to certify "Kneipp Kindergartens" that practice regular Kneipp applications and activities: cold water applications, exercise, nutrition, herbs and mind-body interventions. Little is known about the potential health benefits for children, however. This study protocol describes our study design and intervention of the Kita Kneipp Study to investigate the effect of the Kneipp concept on kindergarten children aged 2-6 years. Methods and design: The Kita Kneipp Study, registered with the German Clinical Trial Register (DRKS-ID: DRKS00029275), is a confirmatory, mixed-method, two-armed, waitlist, clinical, cluster randomized controlled trial (RCT). Kindergartens in Berlin, Germany that would like to implement the Kneipp concept into their facility will be recruited and randomized to the intervention or control group. Changes in the number of kindergarten sick days will be the primary outcome measure. Kindergarten attendance and reason for absence including illness will be collected on a weekly basis at two time points for 6 weeks from the parents and kindergarten directors: baseline and 1 year after baseline. Secondary outcomes will measure cold symptoms through the Common Cold Questionnaire (CCQ) and National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) Scales describing gastroenterological-based symptoms Kindergarten educator sick days will be aggregately reported for the same time period. Kneipp concept activities will be recorded on a weekly basis over the one-year intervention period. To understand the experience of Kneipp concept implementation and possible changes in the kindergarten, expert interviews will be conducted with intervention kindergarten educators and focused ethnographies will be planned to observe and analyze the intervention activities. Discussion: This mixed method study design has potential to help identify if the Kneipp concept can be used for salutogenic purposes among young children and provide insights and experience of the implementation and practicing a holistic health and wellness concept in a kindergarten setting.

Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9-17 years in China: a cross-sectional study.

BACKGROUND: Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. METHODS: From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9-17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. RESULTS: Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02-1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. CONCLUSIONS: These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.

Effectiveness of engaging religious leaders in maternal health education for improving maternal health service utilization in Ethiopia: cluster randomized controlled trial.

Introduction: High mortality rates for pregnant women and their new-borns are one of Africa's most intractable public health issues today, and Ethiopia is one of the countries most afflicted. Behavioral interventions are needed to increase maternal health service utilizations to improve outcomes. Hence, this trial aimed to evaluate effectiveness of trained religious leaders' engagement in maternal health education on maternal health service utilization. Methods: The study employed a cluster-randomized controlled community trial that included baseline and end-line measurements. Data on end points were gathered from 593 pregnant mothers, comprising 292 and 301 individuals in the intervention and control groups, respectively. In the intervention group, the trained religious leaders delivered the behavioral change education on maternal health based on intervention protocol. Unlike the other group, the control group only received regular maternal health information and no additional training from religious leaders. Binary generalized estimating equation regression analysis adjusted for baseline factors were used to test effects of the intervention on maternal health service utilization. Results: Following the trial's implementation, the proportion of optimal antenatal care in the intervention arm increased by 21.4% from the baseline (50.90 vs. 72.3, p ≤ 0.001) and the proportion of institutional delivery in the intervention group increased by 20% from the baseline (46.1% vs. 66.1%, p ≤ 0.001). Pregnant mothers in the intervention group significantly showed an increase of proportion of PNC by 22.3% from baseline (26% vs. 48.3%, p ≤ 0.001). A statistically significant difference was observed between in ANC4 (AOR = 2.09, 95% CI: 1.69, 2.57), institutional delivery (AOR = 2.36, 95% CI: 1.94, 2.87) and postnatal care service utilization (AOR = 2.26, 95% CI: 1.79, 2.85) between the intervention and control groups. Conclusion: This research indicated that involving religious leaders who have received training in maternal health education led to positive outcomes in enhancing the utilization of maternal health services. Leveraging the influential position of these religious leaders could be an effective strategy for improving maternal health service utilization. Consequently, promoting maternal health education through religious leaders is advisable to enhance maternal health service utilization.Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT05716178].

Mpox Discourse on Twitter by Sexual Minority Men and Gender-Diverse Individuals: Infodemiological Study Using BERTopic.

BACKGROUND: The mpox outbreak resulted in 32,063 cases and 58 deaths in the United States and 95,912 cases worldwide from May 2022 to March 2024 according to the US Centers for Disease Control and Prevention (CDC). Like other disease outbreaks (eg, HIV) with perceived community associations, mpox can create the risk of stigma, exacerbate homophobia, and potentially hinder health care access and social equity. However, the existing literature on mpox has limited representation of the perspective of sexual minority men and gender-diverse (SMMGD) individuals. OBJECTIVE: To fill this gap, this study aimed to synthesize themes of discussions among SMMGD individuals and listen to SMMGD voices for identifying problems in current public health communication surrounding mpox to improve inclusivity, equity, and justice. METHODS: We analyzed mpox-related posts (N=8688) posted between October 2020 and September 2022 by 2326 users who self-identified on Twitter/X as SMMGD and were geolocated in the United States. We applied BERTopic (a topic-modeling technique) on the tweets, validated the machine-generated topics through human labeling and annotations, and conducted content analysis of the tweets in each topic. Geographic analysis was performed on the size of the most prominent topic across US states in relation to the University of California, Los Angeles (UCLA) lesbian, gay, and bisexual (LGB) social climate index. RESULTS: BERTopic identified 11 topics, which annotators labeled as mpox health activism (n=2590, 29.81%), mpox vaccination (n=2242, 25.81%), and adverse events (n=85, 0.98%); sarcasm, jokes, and emotional expressions (n=1220, 14.04%); COVID-19 and mpox (n=636, 7.32%); government or public health response (n=532, 6.12%); mpox symptoms (n=238, 2.74%); case reports (n=192, 2.21%); puns on the naming of the virus (ie, mpox; n=75, 0.86%); media publicity (n=59, 0.68%); and mpox in children (n=58, 0.67%). Spearman rank correlation indicated significant negative correlation (ρ=-0.322, P=.03) between the topic size of health activism and the UCLA LGB social climate index at the US state level. CONCLUSIONS: Discussions among SMMGD individuals on mpox encompass both utilitarian (eg, vaccine access, case reports, and mpox symptoms) and emotionally charged (ie, promoting awareness, advocating against homophobia, misinformation/disinformation, and health stigma) themes. Mpox health activism is more prevalent in US states with lower LGB social acceptance, suggesting a resilient communicative pattern among SMMGD individuals in the face of public health oppression. Our method for social listening could facilitate future public health efforts, providing a cost-effective way to capture the perspective of impacted populations. This study illuminates SMMGD engagement with the mpox discourse, underscoring the need for more inclusive public health programming. Findings also highlight the social impact of mpox: health stigma. Our findings could inform interventions to optimize the delivery of informational and tangible health resources leveraging computational mixed-method analyses (eg, BERTopic) and big data.

Methodology for evaluation of complex school-based health promotion interventions.

There is a need for careful examination of large volumes of collected (structured and unstructured) information related to school-based evaluation. There is also no published, comprehensive framework/s for evaluating complex interventions in Irish primary schools. The aim of this paper is to outline a methodology for process evaluation of an Irish primary school-based physical activity (PA) and nutrition intervention. Evaluation followed the three themes outlined by the British Medical Research Council: implementation, context, and mechanism of impact that we further divided into six dimensions. Methodological tools included questionnaires, PA logs, reflective journals, write and draw, and semi-structured interviews. We triangulated findings across these multiple tools to assess each dimension. We designed a unique framework to enable comparisons and offer researchers a template for evaluating complex health promotion interventions in primary schools. We present a methodology for evaluating a complex school-based health promotion intervention. The framework we propose integrates process and outcome data. It aims to enhance future result interpretation and facilitate informed comparisons among intervention schools.

Preventing Cognitive Decline in Older Latino Adults With HIV Through a Culturally Tailored Health Promotion Intervention: Protocol for a Single-Arm Pilot Trial.

BACKGROUND: Older Latino adults with HIV are at increased risk for mild cognitive impairment and earlier onset of aging-related cognitive decline. Improvements in cognitive functioning and cognitive outcomes are possible among people with HIV who adopt health promotion behaviors. However, health promotion interventions for older Latino adults with HIV have not been extensively used or widely recognized as viable treatment options. Happy Older Latinos are Active (HOLA) is a multicomponent, health promotion intervention that is uniquely tailored for older Latino adults with HIV. OBJECTIVE: This study aims to (1) determine the feasibility and acceptability of an adapted version of HOLA aimed at improving cognitive functioning among older Latino adults with HIV; (2) explore whether HOLA will produce changes in cognitive functioning; (3) explore whether HOLA will produce changes in activity, psychosocial functioning, or biomarkers of cognition; and (4) explore whether changes in activity, psychosocial functioning or cognitive biomarkers correlate with changes in cognition, while accounting for genetic risk for dementia. METHODS: A single-arm pilot trial with 30 Latino (aged 50 years and older) men and women with HIV was conducted to assess feasibility, acceptability, and preliminary effects on cognition. Participants were assessed at 2 time points (baseline and postintervention) on measures of neurocognitive and psychosocial functioning. In addition, blood samples were collected to determine biomarkers of cognition at baseline and postintervention. Successful recruitment was defined as meeting 100% of the targeted sample (N=30), with 20% (n=6) or less of eligible participants refusing to participate. Adequate retention was defined as 85% (n=25) or more of participants completing the postintervention assessment and acceptability was defined as 80% (n=38) or more of sessions attended by participants. RESULTS: Participant recruitment began on February 22, 2022, and was completed on August 15, 2022. The last study visit took place on February 20, 2023. Data analysis is currently ongoing. CONCLUSIONS: Encouraging findings from this exploratory study may provide a blueprint for scaling up the HOLA intervention to a larger cohort of older Latino adults with HIV who may be currently experiencing or are at risk for HIV-related cognitive challenges. TRIAL REGISTRATION: ClinicalTrials.gov NCT04791709; https://clinicaltrials.gov/study/NCT04791709. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55507.

Shape-shifting versions of class in Australia and the pursuit of equity in public health.

The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.

Self-Perceived Quality of Life (WHOQOL-Bref), and Self-Reported Health, Social and Environmental Factors Related to Its Improvement among Residents of Anil, Rio de Janeiro-Cross-Sectional Study.

This study aims to assess the self-perception of the QoL (WHOQOL-bref) in the Canal of Anil zone and its neighbor zone of the center of the District of Anil in Rio de Janeiro and to identify which factors are associated with the population self-perception of the need to "improve" their quality of life (QoL). A cross-sectional observational analytical study was carried out after approval by the competent ethics committee (CEP/CONEP) approval. A non-probabilistic sampling of residents of the Canal of Anil (n = 494) and the central district of Anil (n = 250) was used. A questionnaire was administered in person to collect data on self-reported sociodemographic characteristics, general health, sanitation, lifestyle in the residential area, and the WHOQOL-Bref. Although with a worse self-perceived water/sanitation participants in the Anil Canal community report fewer allergies, less medication, fewer skin diseases, less Zika virus, and less Chikungunya, among others. The self-perception of the need to improve the QoL in the Anil Canal community and the zone at the central District of Anil has proved to be influenced by several social and economic factors as well as residential practices and conditions. The multivariate analysis allowed us to identify both modifiable and non-modifiable risk factors for the need to improve physical QoL: taking medication, respiratory problems, skin disease diagnosed by a doctor, having a water tank at home or having filtered water at home, unpleasant odor of the water of the Anil Canal and the level of education, and age. Regarding the need to improve the environmental QoL, both areas are largely modifiable (e.g., having had ascariasis/roundworm; having a water tank in the house; not drinking bottled water; not having pavements in the street). Sociodemographic and environmental factors, in addition to health conditions, play a pivotal role in influencing individuals' perceptions of the necessity for enhanced physical and environmental well-being.