Senses and meanings of primary health care academic visions in nursing / Sentidos y significados de las visiones académicas de la atención/cuidado primaria de salud en enfermería / Sentidos e significados das visões acadêmicas da atenção básica/cuidado em enfermagem

Introduction: Primary Health Care (PHC) has acquired different meanings for different people, at specific times and places, which poses important challenges for its understanding. Objective: To analyze the meaning(s) and sense(s) of Primary/Basic Health Care in the academic views on Nursing/Health in the context of undergraduate Nursing courses offered at two public Higher Education Institutions. Materials and methods: Qualitative study with an exploratory approach. Semi-structured interviews and documentary analysis were used as data collection techniques. Results: The senses/meanings of Primary Health Care converge with the population's gateway to the health system at the first care level and with the first contact of a person with the health service. However, it is still considered as a less important service within the care network. Conclusion: Primary Health Care means a relevant possibility for Nursing/Health care through health promotion and disease prevention actions, with a commitment to respond to most of the population's health needs.

Introducción: La Atención Primaria de Salud ha adquirido diferentes significados para diversas personas, en momentos y lugares específicos, lo cual plantea importantes retos para su entendimiento. Objetivo: Analizar los significados y sentidos de la Atención Primaria de Salud desde una visión académica en Enfermería y en el contexto de cursos de pregrado en Enfermería ofrecidos en dos Instituciones Públicas de Educación Superior. Materiales y métodos: Estudio cualitativo con un enfoque exploratorio, para la recolección de datos se emplearon entrevistas semiestructuradas y análisis documental de contenidos. Resultados: Los sentidos/significados de la Atención Primaria de la Salud convergen con el ingreso de la población al sistema de salud en el primer nivel de atención y la primera experiencia de la persona con el servicio de salud. Sin embargo, dicha Atención Primaria todavía se considera un servicio de baja importancia dentro de la red asistencial. Conclusión: La Atención Primaria de Salud representa una posibilidad relevante para el cuidado de Enfermería a través de acciones de promoción de la salud y prevención de enfermedades, que debe fortalecerse para responder la mayoría de las necesidades de salud de la población.

Introdução: A Atenção Primária à Saúde tem adquirido diferentes significados para diferentes pessoas, em momentos e locais específicos, o que coloca desafios importantes para a sua compreensão. Objetivo: Analisar os sentidos e significados da Atenção Primária à Saúde na perspectiva acadêmica em Enfermagem e no contexto dos cursos de graduação em Enfermagem oferecidos em duas Instituições de Ensino Superior Públicas. Materiais e métodos: Estudo qualitativo com abordagem exploratória, utilizou-se entrevistas semiestruturadas para coleta de dados e análise de conteúdo documental. Resultados: Os sentidos/significados da Atenção Primária à Saúde convergem com a entrada da população no sistema de saúde no primeiro nível de atenção e a primeira experiência da pessoa com o serviço de saúde. Contudo, a referida Atenção Básica ainda é considerada um serviço de baixa importância dentro da rede de saúde. Conclusão: A Atenção Primária à Saúde representa uma possibilidade relevante para o cuidado de Enfermagem por meio de ações de promoção da saúde e prevenção de doenças, que devem ser fortalecidas para responder à maioria das necessidades de saúde da população.

Combined Social Frailty and Life-Space Activities Associated with Risk of Disability: A Prospective Cohort Study.

OBJECTIVES: To examine the association between social frailty and life-space activities, and determine whether a combined status of life-space activities and social frailty is associated with risk of disability among older adults. DESIGN: A prospective cohort study. SETTING AND PARTICIPANTS: The participants were 8,301 older adults (mean age 72.9 ± 5.6 years, women [53.3%]) from a community setting. METHODS: Life-space activities were evaluated using the Active Mobility Index (AMI) to assess activities in each life-space (distance from the respondent's home: up to 1 km, 1-10 km, or greater than 10 km) during the past 1 month. Activities were also assessed according to physical or social activity. Social frailty and characteristics were measured at the baseline. Incident disability was assessed according to long term care insurance. RESULTS: The lowest scoring group was based on the quartile in each of the AMI scores (Q1), with reference to the highest scoring group, which had a higher odds ratios for social frailty (AMI total score Q1: OR 4.32, 95% CI 3.43-5.45, AMI physical score Q1: 2.19, 95% CI 1.79-2.69, AMI social score Q1: 5.04, 95% CI 3.94-6.44). During the follow-up (mean 23.5 months), 330 participants had incident disability. Incident disability was associated with social frailty. Combined status of social frailty and low AMI increased the risk of disability (HR 2.15, 95% CI 1.52-3.03), with reference to non-frailty and higher AMI scores. CONCLUSIONS AND IMPLICATIONS: Social frailty or reduced activity in life-space assessment were identified as risk factors for incident disability. To decrease the risk of disability, the development of an intervention program to enhance activities and cope with social frailty is required.

Developing a Multiprofessional Mobile App to Enhance Health Habits in Older Adults: User-Centered Approach.

BACKGROUND: Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older. Sustaining a healthy life over time poses a motivational challenge. Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline. However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies. OBJECTIVE: We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design. The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app. METHODS: This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection. The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo. The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants. RESULTS: A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years. Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70). Overall, 90% (18/20) of the participants owned smartphones. However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches. The focus groups assessed app usability and satisfaction. Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14). Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support. CONCLUSIONS: This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs. It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults.

How would you describe a mentally healthy college student based on Chinese culture? A qualitative research from the perspective of college students.

BACKGROUND: Promoting college students' mental health remains a significant concern, necessitating a clear understanding of what constitutes good mental health. Variations in the conceptualizations of mental health across cultures, typically derived from academic and authoritative perspectives, have overlooked insights from laypeople. This study aims to investigate the characteristics of mentally healthy college students within Chinese cultural contexts, emphasizing perspectives provided by college students themselves. METHODS: Undergraduates with self-reported mental health scores ≥ 7 were randomly selected for in-depth interviews. The sample (N = 17, 59% female) had a mean age of 20.82 ± 1.33 years and represented diverse regions, backgrounds, and academic fields. Thematic analysis was used in the analysis of the qualitative data, involving initial coding to identify 168 manifestations of mental health among college students, followed by categorizing them into 18 characteristics through focused coding. These characteristics were then organized into five themes via core coding. The Delphi method was utilized to validate the themes with 3 experts, ensuring the trustworthiness of the final findings. RESULTS: Eighteen characteristics of mentally healthy college students emerged from the interviews, categorized into 5 themes: (1)Value Pursuit (i.e. Having a sense of responsibility and mission and being willing to dedicate oneself to the country at any time.); (2)Life Attitude (i.e. Staying positive and having the ability and quality to cope with hardships.); (3)Interpersonal Ideals (i.e., Showing filial respect to parents appropriately.); (4)Behavior Ability(i.e., Studying diligently and learning well.); and (5)Self-cultivation (i.e., Possessing good qualities advocated by Confucianism, Buddhism, and Taoism coexist harmoniously.). Most of these characteristics directly reflect traditional Chinese culture or culture that has changed with the times. At the same time, some are a reflection of modern Chinese new culture. CONCLUSIONS: On the whole, the characteristics of mentally healthy college students are diverse and with rich connotations, focusing on the individual's relationship with the country, family, and others, and are good expressions of Chinese cultural features, such as the balance of Yin and Yang, the coexistence of Confucianism, Buddhism, and Taoism, and highlight moral attributes. In essence, these traits hold profound importance in advancing the mental health of Chinese college students.

Pandemic treaty as an instrument to strengthen global health security: Global health diplomacy at its crux.

Background: The World Health Assembly (WHA), on 1st December 2021, unanimously agreed to launch a global process to draft and negotiate a convention, agreement, or other international instrument under the World Health Organization's (WHO's) constitution to strengthen pandemic prevention, preparedness, and response. We aimed to explore the role of global health diplomacy (GHD) in pandemic treaty negotiations by providing deep insight into the ongoing drafting process under the WHO leadership. Methods: We conducted a narrative review by searching Scopus, Web of Sciences, PubMed, MEDLINE, and Google Scholar search engine using the keywords "Pandemic Treaty," OR "International Health Regulations," OR "International conventions," OR "International treaties" in the context of recent COVID-19 pandemic. Besides, we included articles recommending the need for GHD, leadership and governance mechanisms for this international treaty drafting approved by the WHA. Results: Amid the COVID-19 pandemic, the concept of GHD bolstered the international system and remained high on the agendas of many national, regional and global platforms. As per Article 19 of the WHO constitution, the Assembly established an intergovernmental negotiating body (INB) to draft and negotiate this convention/ agreement to protect the world from disease outbreaks of pandemic potential. Since GHD has helped to strengthen international cooperation in health systems and address inequities in achieving health-related global targets, there is a great scope for the successful drafting of this pandemic treaty. Conclusion: The pandemic treaty is a defining moment in global health governance, particularly the pandemic governance reforms. However, the treaty's purpose will only be served if the equity considerations are optimized, accountability mechanisms are established, and a sense of shared responsibility is embraced. While fulfilling treaty commitments might be complex and challenging, it provides an opportunity to rethink and build resilient systems for pandemic preparedness and response in the future.

Occupational experiences and their importance for young peoples' mental health.

BACKGROUND: Young peoples' mental health challenges have increased in recent years to become an urgent public health issue. Research is required to gain a better understanding of how occupations influence young peoples' everyday lives and support their mental health. AIM: How do young people experience engaging in various occupations in their daily lives, and how do these experiences shape their mental health? METHOD: Semi-structured interviews were conducted with 12 Norwegian young people aged 13-16 years. Verbatim transcriptions of the interviews were analysed using thematic analysis. RESULTS: Four core themes emerged: 'doing' for balance and stability; self-discovery through doing; intentional doing to recharge and feel free; and reflecting on the consequences of doing social media. CONCLUSIONS: Young peoples' occupational experiences shape their mental health in several ways: they serve as coping strategies, as a means to experience joy and accomplishment, and as a source of routines and opportunities for relaxation. We suggest that health-promoting initiatives for young people would strongly benefit from the inclusion of an occupational perspective.

Utilizing an Environmental Framework to Explore the Acceptability of a Health Promotion Program for Youth with Disabilities.

This study explored the acceptability of Children and Teens in Charge of their Health (CATCH), a program for children with spina bifida or cerebral palsy to enhance their physical activity and diet. Qualitative interviews were conducted with children (n = 6) and their parents (n = 6) who participated in CATCH. Analysis used an environmental systems framework. Microsystem factors impacting acceptability of the program were: Children's motivations for change, their age, and their physical health. Mesosystem factors were: Use of virtual coaching and the relationship between coach and child. Macrosystem factors (e.g. Covid-19), did not impact acceptability, but affected some goal attainment strategies. CATCH was broadly acceptable to children and parents and shows promise as a health promotion program tailored to children with disabilities. An environmental systems framework can potentially help other health promotion programs enhance their acceptability and success.

[Lights and shadows in the implementation of community action for health]. / Luces y sombras en la implementación de la acción comunitaria para la salud.

OBJECTIVE: To explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities. METHOD: Qualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach. RESULTS: The prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment. CONCLUSIONS: Participatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment.

The Role of Parental Adherence to the Mediterranean Diet and Family Time Together in Children's Weight Status: The BeE-School Project.

The family context has been associated with children's weight status. This study aims to investigate the association of parents' adherence to the Mediterranean diet and family time with the weight status of children. The research is part of BeE-school, a cluster-randomized trial implemented in primary schools located in socially vulnerable contexts. A total of 735 children (380 boys and 355 girls) aged 6 to 10 participated in the study. Anthropometrics were assessed during school time, and weight status was categorized, while parents self-reported sociodemographic variables, adherence to the Mediterranean diet (MEDAS questionnaire), and family time. Children from families with higher education levels whose parents have a high adherence to the Mediterranean diet have lower odds of overweight/obesity (odds ratio (OR) 0.301, 95% CI 0.143-0.634, p = 0.002). Also, children from families with lower education levels who have more time together with their family have lower odds of overweight/obesity (OR 0.731, 95% CI 0.573-0.934, p = 0.012). The family environment, mainly family time together and adherence to the Mediterranean diet, exerts a significant influence on children's weight status. Professionals working in children's health should consider the family when fostering health-promoting behaviors.

Health Promoting Behaviors among Adolescents at Selected Schools of Chitwan.

BACKGROUND: Health Promotion and maintenance are fundamental prerequisites to achieve optimum health in an individual and limit the illness. The objective of the study was to assess the health promoting behaviors among adolescents at selected schools. METHODS: A descriptive cross-sectional study was conducted among 238 adolescents age 14-18 years of age studying in three different government schools of Bharatpur-10 Chitwan. Probability simple random method was used for selecting the required respondent. Data were collected using Adolescents Health Promoting Scale questionnaire through self-administered technique. Obtained data were analyzed using descriptive and inferential statistics. RESULTS: The study revealed that 47.5% had high level of health promoting behaviors whereas 52.5% had low level of health promoting behavior. Regarding, the subscale, the highest score was obtained in the area of exercise (median percentage=72.5%) and lowest score was obtained in the area of stress management (median percentage=48%). Moreover, statistically significant variables for health promoting behavior were respondents age, availability of school health nurse, educational status of both the parents and and occupation of father (p<0.05). CONCLUSIONS: More than half of the adolescents in schools have low health promoting behavior, particularly in the area of stress management and nutrition. Adolescence is the period when most of the healthy and unhealthy habits are developed. Hence, it is necessary to focus on developing efficient health promotion and disease prevention strategies in collaboration with school teachers and school health nurse.

Patient concerns and physician strategies for addressing COVID-19 vaccine hesitancy.

OBJECTIVE: COVID-19 vaccination is critical for reducing serious illness and hospitalizations, yet many remain hesitant. We conducted a survey of frontline physicians to identify patient concerns and physician strategies to address COVID-19 vaccine-hesitancy. METHODS: A national random sample of physicians in frontline specialties selected from a comprehensive list of practicing physicians in the U.S. were emailed a survey in August 2021. Multiple choice and open-ended questions inquired about patient concerns related to the COVID-19 vaccines and strategies used by physicians to counter vaccine misinformation and encourage vaccine-hesitant patients. Weighting was applied to achieve representativeness and reduce non-response bias. Network analysis examined co-occurring patient concerns. Open-ended responses on communication strategies were coded via thematic analysis. Multi-variable logistic regression examined associations between physician and pandemic characteristics with patient concerns and use of communication strategies. RESULTS: 531 physicians responded: primary care (241); emergency medicine (142); critical care (84); hospitalists (34); and infectious disease (30). Weighted response balance statistics showed excellent balance between respondents and nonrespondents. On average, physicians reported four patient vaccine concerns. Safety, side effects, vaccine misinformation, and mistrust in government were most common, and often co-occurring. 297 physicians described communication strategies: 180 (61 %) provided vaccine education and 94 (32 %) created a safe space for vaccine discussion. Narrative responses from physicians provided compelling examples of both successes and communication challenges arising from misinformation. Compared with emergency medicine, critical care (OR 2.45, 95 % CI 1.14, 5.24), infectious disease (OR 2.45, 95 % CI 1.00, 6.02), and primary care physicians (OR 1.66, 95 % CI 1.02, 2.70) were more likely to provide communication strategies. CONCLUSIONS: Many physicians engage with vaccine hesitant patients using a variety of strategies. Dissemination of effective system and physician-level communication interventions could enhance physician success.

Actual and Virtual Parks Benefit Quality of Life and Physical Activity: A Cluster Trial.

Urban parks provide connectedness to nature as a health resilience environment for promoting health. Virtual reality can provide opportunities for urban citizens to be exposed to natural elements with health benefits. The purpose was to explore the effects of actual and virtual parks on the quality of life and physical activity of urban residents. The study design was a cluster trial. Participants were healthy adults aged 20-50 years, recruited from three college campuses, and randomly assigned to two experimental groups (n = 30, 32) and one control group (n = 30). The intervention with virtual or actual parks was conducted for 30 min a session once a week for 12 weeks. Outcomes were measured using self-reported questionnaires, including the World Health Organization Quality-of-Life Scale-BREF and International Physical Activity Questionnaire-Short Form. In total, 84 participants completed the interventions and post-intervention measures. Results showed that participants who experienced actual parks had significant increases in the social quality of life and light-intensity physical activity and had decreased body weight. Participants who experienced the virtual parks experienced a significant increase in their mental quality of life. Participants in the experimental groups of both kinds of parks had significant improvements in their self-rated health, physical and environmental quality of life, and sedentary time after the intervention. Urban parks are an important natural resource for citizens' health and physical activity promotion. Virtual parks can simulate actual parks and have similar health benefits and are thus are recommended for citizens who lack opportunities and motivation to go to actual parks.

Promoting children's health through community-led street interventions: analyzing sustained voluntarism in Canadian School Streets.

BACKGROUND: Active School Travel (AST) initiatives align with the Ottawa Charter for Health Promotion, which calls for 'creating supportive environments' and 'strengthening community action.' However, their reliance on volunteers poses sustainability challenges. The main objectives of this study were to document the motivations, satisfaction, and experiences of volunteers involved in sustaining two AST initiatives in Ontario for an entire school year. METHODS: Two volunteer-led School Street initiatives in Kingston, Ontario successfully operated during pick-up and drop-off times of each school day. The first initiative operated for the entire 2021-2022 school year, and the second operated for the entire 2022-2023 school year. These initiatives were the first of their kind in the province of Ontario, Canada. Volunteers from both sites (n = 56) participated in online surveys and their motivations, satisfaction, and experiences of their role were compared using the 2-sided Fisher's Exact Test. RESULTS: Over 80% of volunteers were highly motivated to promote safety and over 70% of volunteers were highly motivated to disrupt the status quo of unsupportive, car-centric urban environments by reimagining how streets can be used. By taking collective action to re-shape the environment around these public schools to support healthy, active living, our findings reveal that over 90% of volunteers were highly satisfied. Of the volunteers, 87% felt they contributed to child safety and 85% felt they had developed stronger community connections. They appreciated the short (i.e., 40 minute) time commitment of each shift, weekly email communications by the community organization leading the initiative, and the volunteer schedule. They also appreciated the positive social interactions during volunteer shifts, which they felt outweighed the minimal resistance they experienced. CONCLUSIONS: This research demonstrates the importance of logistical, motivational, and social factors in recruiting and retaining volunteers for community-led School Streets. Our findings support appealing to prospective volunteers' influence in achieving School Street objectives (e.g., improved safety) in recruitment efforts, as well as highlighting School Streets' innovative approach. Communicating with volunteers throughout School Street planning and implementation processes and limiting traffic in the closed street zone (i.e., by excluding the school staff parking lot and private driveways from the scope) are additional recommendations based on the findings of this study.

Influence of moderate-to-high intensity physical activity on depression levels: a study based on a health survey of Chinese university students.

OBJECTIVE: The study aims to examine how moderate-to-vigorous physical activity (MVPA) affects the severity of depression symptoms among Chinese college students. Additionally, it seeks to analyze the mediating mechanisms involving self-rated health and general self-efficacy. METHODS: The study utilized data from the 2023 Chinese College Health Tracking Survey and employed multiple linear regression and structural equation modeling techniques to investigate the impacts of MVPA on depression levels and its underlying mediating mechanisms among college students. The primary cohort comprised 49,717 enrolled college students from 106 universities in China. RESULTS: A total of 41,620 valid questionnaires were collected (response rate: 83.7%), with females accounting for 58.6%. In the past month, approximately 30.2% of college students engaged in MVPA. Self-rated health (B = - 0.282, P < 0.001) and general self-efficacy (B = - 0.133, P < 0.001) significantly influenced college students' depression scores. Even after controlling for other variables, participating in MVPA remained significantly associated with reduced depression scores (B = - 0.062, P = 0.002). The results of the structural equation model showed that MVPA not only directly decreased college students' depression scores but also indirectly reduced the likelihood of depression occurrence by improving their physical health status and general self-efficacy. CONCLUSION: The lack of physical activity among Chinese college students is evident. Engaging in MVPA can reduce the likelihood of depression among college students. MVPA achieves this reduction by enhancing college students' general self-efficacy and improving their physical health. The factors influencing depression levels among college students are multifaceted. For future interventions targeting college students' mental health, comprehensive approaches that incorporate behavioral and psychological factors should be emphasized.

Climate crisis risks to elderly health: strategies for effective promotion and response.

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.

Evaluation of Breast Health Promotion Intervention Among Catholic Nuns in Lake Zone 'Tanzania.

Objective: Despite facing unique barriers, Catholic nuns in Tanzania require accessible breast health promotion. This study explores interventions to empower nuns through knowledge, improved attitudes, and positive practices, ultimately promoting well-being and early detection for better breast cancer outcomes. Materials and Methods: A quasi-experimental design study guided by the Health Belief Model was conducted to monitor the implementation of a breast health intervention program aimed at increasing breast cancer screening knowledge among 385 Catholic nuns aged 20 to over 60 years old within Lake Zone, Tanzania. Data were collected at two-time points: pre-intervention (baseline) and implementation phase intervention (after three months). The intervention consisted of a 2-hour educational session. Participants had opportunities to ask questions and provide feedback. Results: The breast health promotion intervention was well-received by Catholic nuns, with 339 (88%) expressing strong motivation to learn and promote awareness. The training effectively increased knowledge and positive attitudes towards breast cancer screening. Researcher assistants successfully delivered the program, and 354 (92%) of participants expressed interest in continued education and support. The intervention addressed cultural barriers and empowered nuns to take charge of their health, though some challenges remain meanwhile 158 (41%) had limited prior knowledge, 81 (21%) hesitated to discuss breast health due to religious beliefs, and some faced difficulty applying the learnings. Conclusion: Overall, the breast health promotion intervention had a positive outcome on the Catholic nuns' awareness and knowledge of breast health. However, addressing the identified barriers and challenges is crucial to further enhance the intervention's effectiveness and sustainability.

A preliminary analysis of passport to practice: investigating development of core competencies in undergraduate health promotion students.

BACKGROUND: Equipping tertiary health promotion students with skills and knowledge to contribute meaningfully to the health promotion workforce begins with enhancing their health promotion competence via well-designed curriculum. This includes a focus on work-integrated learning, global citizenship, professional identity and competency mapping in line with the International Union for Health Promotion and Education Core Competencies and Professional Standards for Health Promotion. METHODS: In this paper we report baseline results for the Passport to Practice project, a mixed-methods prospective cohort study to track undergraduate health promotion student progress across their degree, to evaluate a new approach for assessing student achievement of the Competencies and Standards developed by the International Union for Health Promotion and Education. Baseline data were collected from first-year students via document analysis of student reflection papers (n = 40); and an online survey (n = 29) to measure self-reported health promotion competence, development of global citizenship and professional identity, and PebblePad usability. RESULTS: Findings suggest the Passport to Practice initiative positively contributed to professional identity and health promotion competence. Students appreciated work-integrated learning opportunities that enabled them to plan for future activities to address gaps in their competence; and students excelled in the social responsibility dimension of global citizenship but lagged in the political voice category of the global civic engagement dimension. CONCLUSION: Findings provide insights about strategies and concepts required to equip students with the skills and knowledge required for their role as health promotion practitioners to address complex public health challenges.

[Recommendations for Primary Health Care for transgender people]. / Recomendaciones para la atención de la salud en Atención Primaria de las personas transgénero.

The WHO defines Primary Health Care as essential health care, based on practical, scientifically founded and socially acceptable methods and technologies, made available to all individuals and families in the community, through their full participation, and at a cost that the community and the country can bear, at each and every stage of their development, in a spirit of self-responsibility and self-determination. With the intention of fulfilling the basic objective of caring for and promoting health in all the groups that make up our current society, the need arises to focus on certain groups in which the actions of Primary Care are currently consensual or poorly protocolised, as is the case with the health care of transgender people.

Appealing to Americans' altruism is not enough to nudge them to accept novel vaccines.

BACKGROUND: The role of altruism in the acceptance of novel preventive healthcare technologies like vaccines has not been thoroughly elucidated. METHODS: We 1:1 randomized n = 2004 Amazon Mechanical Turk (MTurk) participants residing in the USA into a control or treatment arm with vaccination decisions framed altruistically, to elicit their preferences for COVID-19 vaccination using web-based discrete choice experiments. We used conditional and mixed logit models to estimate the impact of framing decisions in terms of altruism on vaccination acceptance. RESULTS: Valid responses were provided by 1674 participants (control, n = 848; treatment, n = 826). Framing vaccination decisions altruistically had no significant effect on vaccination acceptance. Further, respondents' degree of altruism had no association with vaccination acceptance. LIMITATIONS: The MTurk sample may not be representative of the American population. We were unable to ascertain concordance between stated and revealed preferences. CONCLUSIONS AND IMPLICATIONS: Framing vaccination decisions in terms of altruism does not appear to significantly influence vaccination acceptance and may not be an effective nudging mechanism to increase the uptake of novel vaccines. Instead, a favorable vaccination profile appears to be the primary driver of uptake.

Cultivating Reciprocity Between People and Planet: Habit-Stacking Planetary Health Prescriptions Into Existing Nature RX Encounters During Integrative Health Visits.

The reported benefits of nature contact on human health and well-being have prompted the rise of nature prescriptions with health professionals recommending nature exposure. Due to the success of nature prescriptions and calls for greater reciprocity between people and the planet, this essay proposes to leverage health behavior promotion strategies to integrate planetary health prescriptions (Earth RX) into existing nature prescription frameworks with a vision to counsel patients on both the health and well-being benefits of nature contact as well as earth-sustaining behaviors, all of which fosters a compassionate interdependence between personal and planetary well-being. The essay emphasizes the importance of co-designed stakeholder collaboration for program success, addressing factors such as trust, perceived benefits, and accessibility. Finally, this essay concludes that integrating Earth RX in nature prescription programs strategically aligns with the principles of integrative health, acknowledging the reciprocal relationship between human health and well-being and planetary well-being.