Investigating the interrelationships among food habits, sports nutrition knowledge, and perceived barriers to healthy eating: a study of adolescent swimmers

This cross-sectional study aims to explore the relationships between food habits, perceived barriers to healthy eating, and sports nutrition knowledge among adolescent swimmers. The study focuses on understanding how these factors interact and influence dietary choices in young athletes. A cohort of 52 adolescent swimmers aged 12-18 from Al Hussein Youth Club in Al-Hussein Sport City participated in the study. Data were collected through surveys assessing food habits, perceived barriers to healthy eating, and sports nutrition knowledge. Pearson Correlation analysis was employed to examine associations between variables, and stepwise regression analysis was used to identify predictors of food habits. The analysis revealed a significant positive association between food habits and sports nutrition knowledge (r = 0.393, p = 0.004). Knowledge emerged as a significant positive predictor of food habits (β = 0.393, p = 0.004), highlighting the influential role of sports nutrition knowledge in shaping the dietary choices of adolescent swimmers. However, the introduction of Barriers lacked significance, and individual predictors did not reach statistical significance. These findings underscore the importance of targeted interventions aimed at enhancing nutritional education among adolescent swimmers. Understanding the interplay between knowledge, barriers, and food habits provides valuable insights into the complex dynamics that influence the dietary choices of young athletes. Addressing these factors through tailored educational programs can promote healthier eating habits and optimize performance among adolescent swimmers. This study highlights the critical role of sports nutrition knowledge in shaping the dietary behaviors of adolescent swimmers. By addressing knowledge gaps and overcoming perceived barriers, targeted interventions can help improve food habits and enhance the overall health and performance of young athletes.

Individual and social system factors influencing evidence-based practices among nurses in general hospitals: A cross-sectional multi-institutional study

AIMS AND OBJECTIVES

To investigate evidence-based practices and examine the influence of individual and social system factors on evidence-based practices among nurses in general hospitals.

BACKGROUND

Evidence-based practice is essential for improving healthcare quality. However, a challenge for nursing worldwide is nurses' limited use of evidence-based practices. It is crucial to determine the individual and social system factors affecting nurses' use of evidence-based practices.

DESIGN

This study employs a multi-institutional cross-sectional design.

METHODS

With a multistage random sampling method, 336 registered nurses were recruited from 17 general hospitals in the Republic of the Union of Myanmar. Data were collected through a seven-part questionnaire, including the Evidence-Based Practice Implementation Scale and individual and social system factors. Data were analyzed using descriptive statistics and multiple linear regression.

RESULTS

Nurses in general hospitals perceived low levels of evidence-based practices. Individual factors, such as perceived barriers (p < .001), knowledge (p < .001) and attitudes (p = .001), were related to EBP as well as social system factors, including the work environment (p < .001) which influence nurses' practice, explaining 34% variance among nurses.

CONCLUSION

Nurses perceived the work environment as the most influencing factor related to evidence-based practices. Individual characteristics, including perceived knowledge, attitudes and barriers, were critical factors in performing evidence-based practices in Myanmar.

RELEVANCE TO CLINICAL PRACTICE

Nurse administrators and policymakers can develop strategies and interventions for improving knowledge, attitudes and work environment towards evidence-based practice. Minimizing the barriers to evidence-based practice will promote evidence-based practices in Myanmar general hospitals.

IMPACT

In addressing the individual and social system factors influencing the evidence-based practices of nurses, this study contributes to enhancing healthcare quality and outcomes.

REPORTING METHOD

This study adhered to the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

The Predictors of Perceived Barriers and Facilitators of Applying Sepsis Six Guidelines Among Critical Care Nurses

BACKGROUND

Sepsis is a life-threatening condition that demands quick and cautious interventions from nurses, as they are the frontline caregivers, so they are essential in recognizing early signs of sepsis, initiating prompt healthcare interventions, and providing comprehensive care to improve patient outcomes. This study aimed to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses.

METHODS

This cross-sectional descriptive study was conducted on a convenience sample of 180 nurses working in critical care settings (ICU, critical care unit, ED, burning unit, dialysis unit) at a university hospital. A valid and reliable questionnaire was used to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses.

RESULTS

This study revealed that the main barriers faced by critical care nurses are lack of sepsis recognition during observational rounds and delay in sepsis diagnosis by medical staff. For the most common facilitators of applying Sepsis Six guidelines, the participating nurses reported the presence of a written tool/protocol for sepsis identification and management.

CONCLUSIONS

The study emphasized the importance of the presence of evidence-based protocols for sepsis assessment and management and nurses' compliance with guidelines. Ongoing education training for nurses and providing step-by-step written checklists are a cornerstone to improving nurses' knowledge and the practical skills of early identification and management of sepsis.

Exploring Public Knowledge, Attitudes, and Barriers to Using Genetic Services in Damanhur City and Beni-Suef City, Egypt: A Cross-Sectional Study

BACKGROUND

Advancements in genetic disorder management mark a transformative era in healthcare. This study aimed to assess knowledge, attitudes, and barriers to using genetic services among the Egyptian population.

METHODS

A cross-sectional study was used to achieve the aim of the study. A convenient sample was used to involve 385 residents of Damanhur City and Beni-Suef City to represent Upper and Lower Egypt. A validated questionnaire covering socio-demographic details, genetic knowledge, attitudes, and perceived barriers to using genetic services was used.

RESULTS

Regarding genetic knowledge, 70.9% of the participants reported an unsatisfactory level of knowledge about genetics. Furthermore, 67.6% expressed a negative attitude toward genetic services. Concerns about whether the test result is positive were the most common obstacle, cited by 64.94% of participants, followed by cost, which 60.78% of people found to be a major barrier. Significant associations emerge between socio-demographic factors and awareness levels.

CONCLUSION

The findings illuminate significant gaps in knowledge and attitude levels where less than a third of the participants had a satisfactory level of knowledge and about one-third had a positive attitude regarding genetic testing. Barriers such as concerns about treatment strategies, financial constraints, and conflict with personal beliefs emerge as critical obstacles. The identified associations between socio-demographic factors and awareness levels underscore the need for targeted interventions tailored to specific demographic groups.

RECOMMENDATIONS

This study recommends developing and implementing culturally sensitive awareness campaigns about genetics tailored to the specific demographic characteristics of the Egyptian population.

Knowledge, Attitude, Practice, and Perceived Barriers Regarding Colorectal Cancer Screening Practices Among Healthcare Practitioners: A Systematic Review

The recommendations of medical professionals play a significant role in colorectal cancer (CRC) screening. This study aims to systematically review knowledge, attitude, practice, and perceived barriers regarding CRC screening practices among healthcare practitioners (HCPs). From January 2023 to December 2023, a comprehensive literature search was conducted using online databases, including Web of Science, PubMed, Scopus, and Research Gate, by using the following keywords in combination: "knowledge," "attitude," "practice," "perceived barriers," "colorectal cancer," and "health practitioners." The researchers screened and examined the retrieved literature. A total of 21 studies were considered relevant for the current review. Among these studies, eight assessed the level of knowledge, attitude, practices, and perceived barriers toward CRC screening among various health practitioners. Three studies assessed knowledge and attitudes toward CRC screening among health practitioners. The remaining ten studies assessed awareness, perceived barriers, or only knowledge of CRC screening among HCPs. In addition, all the included studies employed a cross-sectional design. The review shows that many healthcare providers need more fundamental knowledge of CRC screening. Healthcare procedures must be improved to enhance the knowledge, attitudes, and practices of healthcare professionals regarding CRC screening and their understanding of the associated barriers.

Barriers in Opting for Emergency Medicine as a Career in Pakistan: A Cross-Sectional Survey Study

BACKGROUND

Medical professionals' low level of apprehension and insights may result in the undervaluing of emergency medicine (EM) as a speciality to pursue in the future, which is a vital component in the everyday management of hundreds of patients.

AIM

The aim of this study is to assess medical professionals' perception of the barriers in opting for EM as a career option in Pakistan.

METHOD

This was an online survey study that examined doctors'/medical students' perception of hurdles in EM in Pakistan between November and December 2023. This study was conducted at Rawalpindi Medical University, Rawalpindi, Pakistan. Social media platforms were used to recruit the participants to carry out this survey. The questionnaire proforma comprised three sections: a demographic characteristics section (six questions), a perception section (11 questions), and the last section, where participants were asked to give their opinion to improve EM for a future speciality.

RESULTS

An online Google survey form was used for the acquisition of data. Percentage and frequency distribution analysis was used. A total of 144 individuals (N = 144) participated in this study. Around 33.3% (N = 48) of the participants expressed that they had not considered a career in EM. Around 43% (N = 62) of them reported not having done a clinical placement in this speciality. A majority of the participants said that either they or their close friends/family members had faced a medical emergency. Leading barriers that proved a hindrance in pursuing this field were high levels of burnout, poor work-life balance, loss of patient follow-up, inability to work independently, more hostile environment, increased mortalities, and lack of exposure. Interestingly, family pressure had been reported by some participants as a limiting factor in pursuing EM.

CONCLUSION

In Pakistan, many doctors and medical students are not willing to pursue their careers in EM. Nationwide educational seminars should be conducted to increase awareness and interest among doctors in this field. Moreover, more and more clinical placement opportunities should be made available for junior doctors in EM. In the future, further research should be carried out to identify effective educational interventions to increase doctors'/medical students' awareness in this field of medicine.

Patient Attitudes and Perceived Barriers Toward Mental Health Treatment Options in a Rural Student-Run Clinic

Background While the prevalence of mental health conditions is similar in rural areas and non-rural areas, access to mental health care is more limited in rural areas. Patient attitudes toward specific mental health treatment options in rural populations have been understudied. Some previous studies indicate potential positive outcomes using osteopathic manipulative treatment (OMT) as an adjunct for mental health care. Physicians using OMT are more heavily represented in rural areas. Hence, understanding the mental health treatment needs and option preferences of the rural could inform policies that increase underserved population's access to various mental health treatment modalities including OMT. This study aims to characterize patient attitudes toward, beliefs regarding, and perceived barriers to treatment options for mental health treatment, access, and care in a rural, underserved clinical setting. Methods Adult patients attending a single outpatient rural clinic over a four-month period in 2022 were screened for participation. The survey consisted of Likert scale graded questions about mental health treatment options, access, knowledge, and perceived barriers including qualitative questions about OMTs. Versions of the survey were created in English and Spanish languages. Results Out of 46 respondents, 25 were English-speaking and 21 were Spanish-speaking. The most popular mental health treatments by respondents were indicated as therapy, spiritual guidance, and modifying diet and exercise. Considering barriers to care, 61% of respondents indicated cost of treatment as a logistical barrier. Finally, 80.5% of respondents did not have a good understanding of OMT. Conclusions The knowledge and understanding of patients' perceived attitudes and barriers toward mental health care, inclusive of OMT, can provide insight to clinicians to improve patient outcomes and guide efforts in overcoming barriers to increase and expand mental health treatment availability and utilization by patients.

Nutrition education has significant impact on perceived barriers to healthy diet among adults with and without COVID-19 history

Healthy diet is an important tool to lower the risk and severity of COVID-19 infection. Low diet quality is usually caused by perceived barriers that stop people to do certain behavior. Perceived barriers can be overcome by implementing proper method such as conducting nutrition education. This study aimed to analyze the impact of nutrition education on perceived barrier to healthy diet among adults with and without covid-19 history in Padang, Indonesia. This study was a pre-experimental study using pre and post-design. This study was conducted on 70 adults with or without COVID-19 infection history, residing in Padang, Indonesia. The intervention was given in the form of nutrition education. Difference test was conducted to assess the impact of nutrition education on respondents' nutrition knowledge and perceived barriers. The majority of the respondents both with and without COVID-19 history (71.4 and 80%) had medium level of nutritional knowledge before the intervention. After the intervention, there was a significant (P<0.05) improvement on respondents' nutritional knowledge for both groups (100%). The result also showed 40% of the respondents with COVID-19 history had medium level of perceived barriers, while 28.6% respondents without COVID-19 history (65.7%) had medium level of perceived barriers before the intervention. A significant improvement (P<0.05) also showed on respondents' perceived barriers after the intervention. On both groups more 90% of the respondents only had low level of perceived barriers. The result shows that nutrition education has significant impact both on respondents' nutritional knowledge and perceived barriers.

Parental Knowledge, Attitudes, and Perceptions Impacting Willingness to Vaccinate Against the Human Papillomavirus in Trinidad

Background Cervical cancer remains a major cause of morbidity and mortality in young women in Trinidad and Tobago. This study aimed to determine the knowledge, attitudes, perceptions, and beliefs of Trinidadian parents toward human papillomavirus (HPV) vaccination. In addition, factors predictive of willingness to vaccinate were explored. Methodology In this cross-sectional study conducted between March and May 2019, a paper-based survey was self-administered to parents of children in the 5-12-year age group in seven geographically representative Trinidadian primary schools. Results Of the 420 questionnaires distributed, 160 were returned completed (38% response rate). General knowledge that HPV causes cervical cancer and genital warts and is spread by sexual contact was common among 81%, 71%, and 81% of parents, respectively. At least 40% of the respondents expressed uncertainty about the vaccine's long-lasting health problems and its effectiveness in preventing genital warts and cervical cancer. Half of the parents were unsure if the vaccine was harmful. The perceptions that vaccine safety data are fabricated, drug companies cover up the dangers of vaccines, vaccine efficacy data are often fabricated, people are deceived about vaccine efficacy and safety, and conspiracy beliefs were held by 15.5%, 26.1%, 13%, 21.7%, and 28.5% of parents, respectively. There was a negative correlation between knowledge and conspiracy belief scores (ρ = -0.30, p < 0.001). Overall, 45.3% of parents were willing to immunize their children against HPV. Being informed about HPV by a health professional (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.5-5.8), knowledge of the benefits (OR = 4.6, 95% CI = 2.2-9.6), and a health professional offering the option of vaccination (OR = 3.7, 95% CI = 1.7-8.0) were associated with significantly increased odds of parents willing to vaccinate their child. The agreement that vaccine safety data are often fabricated (OR = 0.31, 95% CI = 0.12-0.84), pharmaceutical companies cover up the dangers of vaccines (OR = 0.14, 95% CI = 0.06-0.37), waiting at the clinic being time-consuming (OR = 0.37, 95% CI = 0.15-0.89), and the beliefs that adolescents are too young to get a vaccine to prevent sexually transmitted disease (OR = 0.16, 95% CI = 0.11-0.83) were associated with a significantly decreased willingness to vaccinate. Conclusions While general knowledge about HPV was high, there remain several areas for parental education regarding the HPV vaccine. Misbeliefs need to be addressed and multilevel interventions are needed to improve HPV vaccine uptake in our setting.

Educating Substance Use Treatment Center Providers on Tobacco Use Treatments Is Associated with Increased Provision of Counseling and Medication to Patients Who Use Tobacco

Tobacco use is the leading preventable cause of death in America and is elevated among patients with non-tobacco substance use disorders. Substance use treatment centers (SUTCs) do not commonly address their patients' tobacco use. Lack of knowledge on treating tobacco use with counseling and medication may be a barrier that underlies this inaction. A multi-component tobacco-free workplace program implemented in Texas SUTCs educated providers on treating tobacco use with evidence-based medication (or referral) and counseling. This study examined how center-level changes in knowledge from pre- to post-implementation (i.e., over time) affected center-level behavioral changes in providers' provision of tobacco use treatment over time. Providers from 15 SUTCs completed pre- and post-implementation surveys (pre N = 259; post N = 194) assessing (1) perceived barriers to treating tobacco use, specifically, a lack of knowledge on treating tobacco use with counseling or medication; (2) receipt of past-year education on treating tobacco use with counseling or medication; and (3) their intervention practices, specifically, the self-reported regular use of (a) counseling or (b) medication intervention or referral with patients who use tobacco. Generalized linear mixed models explored associations between provider-reported knowledge barriers, education receipt, and intervention practices over time. Overall, recent counseling education receipt was endorsed by 32.00% versus 70.21% of providers from pre- to post-implementation; the regular use of counseling to treat tobacco use was endorsed by 19.31% versus 28.87% from pre- to post-implementation. Recent medication education receipt was endorsed by 20.46% versus 71.88% of providers from pre- to post-implementation; the regular use of medication to treat tobacco use was endorsed by 31.66% versus 55.15% from pre- to post-implementation. All changes were statistically significant (ps < 0.05). High versus low reductions in the provider-reported barrier of "lack of knowledge on pharmacotherapy treatment" over time were a significant moderator of effects, such that SUTCs with high reductions in this barrier were more likely to report greater increases in both medication education receipt and medication treatment/referral for patients who use tobacco over time. In conclusion, a tobacco-free workplace program implementation strategy that included SUTC provider education improved knowledge and resulted in increased delivery of evidence-based treatment of tobacco use at SUTCs; however, treatment provision rates-in particular, offering tobacco cessation counseling-remained less than desirable, suggesting that barriers beyond lack of knowledge may be important to address to improve tobacco use care in SUTCs. Moderation results suggest (1) differences in the mechanisms underlying uptake of counseling education versus medication education and (2) that the relative difficulty of providing counseling versus providing medication persists regardless of knowledge gains.

Exercise health belief model mediates the relationship between physical activity and peer support among Chinese college students: A cross-sectional survey

This study explored the influence of the exercise health belief model and peer support on university students' physical activity PA and clarified the related mechanism. Three hundred and thirty-six healthy university students (aged 19.4 ± 1.3 years, 166 male and 170 female) from Sichuan University of Arts and Science in China were evaluated by the peer support scale, the health belief model scale for exercise, and the physical activity scale (short volume). The results showed that the male students' exercise self-efficacy and PA were markedly higher than female university students. Peer support was positively correlated with perceived benefits, exercise self-efficacy, perceived severity, and cues to action, and was adversely associated with perceived objective and subjective barriers. PA was positively correlated with perceived benefits and exercise self-efficacy, and negatively correlated with perceived objective and subjective barriers. Among the components of the exercise health belief model, only exercise self-efficacy was suitable for constructing a structural equation model (SEM) with peer support and PA. The analysis showed that the predictive effect of exercise self-efficacy on PA was more significant than peer support, and exercise self-efficacy played a critical intermediary role. It is worth noting that, in the grouping model, the effect of male college students' exercise self-efficacy on PA was greater than that of female students, and the model fit of male peer support was better than that of female students. Although the impact of peer support on PA was less than that of exercise self-efficacy and the direct effect of peer support was less than the indirect effect, the impact of peer support on the PA of female university students was higher than that of male university students. This study revealed the impact of exercise self-efficacy and peer support on university students' PA and suggested that exercise self-efficacy is the main path to promoting university students' PA, followed by peer support. Peer support could affect university students' PA not only through direct effects but also through indirect effects. This study also suggested that female university students' peer support has a higher impact on PA than male students. Therefore, when formulating physical exercise courses in the future, it is necessary to give more peer support to female university students to compensate for their low exercise self-efficacy.

Perceived barriers to mobility in the intensive care units of Singapore: The Patient Mobilisation Attitudes and Beliefs Survey for the intensive care units

Purpose

Prolonged bed rest and immobility in the intensive care units (ICU) increase the risk of ICU-acquired weakness (ICUAW) and other complications. Mobilisation has been shown to improve patient outcomes but may be limited by the perceived barriers of healthcare professionals to mobilisation. The Patient Mobilisation Attitudes and Beliefs Survey for the ICU (PMABS-ICU) was adapted to assess perceived barriers to mobility in the Singapore context (PMABS-ICU-SG).

Methods

The 26-item PMABS-ICU-SG was disseminated to doctors, nurses, physiotherapists, and respiratory therapists working in ICU of various hospitals across Singapore. Overall and subscale (knowledge, attitude, and behaviour) scores were obtained and compared with the clinical roles, years of work experience, and type of ICU of the survey respondents.

Results

A total of 86 responses were received. Of these, 37.2% (32/86) were physiotherapists, 27.9% (24/86) were respiratory therapists, 24.4% (21/86) were nurses and 10.5% (9/86) were doctors. Physiotherapists had significantly lower mean barrier scores in overall and all subscales compared to nurses (p < 0.001), respiratory therapists (p < 0.001), and doctors (p = 0.001). A poor correlation (r = 0.079, p < 0.05) was found between years of experience and the overall barrier score. There was no statistically significant difference in the overall barriers score between types of ICU (χ2(2) = 4.720, p = 0.317).

Conclusion

In Singapore, physiotherapists had significantly lower perceived barriers to mobilisation compared to the other three professions. Years of experience and type of ICU had no significance in relation to barriers to mobilisation.

Perceived Barriers and Intentions to Receive COVID-19 Vaccines: Psychological Distress as a Moderator

A high vaccination uptake degree is crucial to achieve herd immunity to COVID-19 and restrict the spread of the COVID-19 pandemic. However, little is known about the antecedents that reduce or contribute to shaping the intention to receive COVID-19 vaccines, as well as how psychological distress-a mental health problem-can reinforce or dampen the translation from antecedents into intention to receive COVID-19 vaccines. The objective of this study was to explore the effects of perceived clinical and access barriers, self-efficacy, and attitudes towards COVID-19 vaccines on the intention to receive COVID-19 vaccines. Simultaneously, the moderation effects of psychological distress on this relationship were also examined. Using a sample of 2722 Vietnamese adults and structural equation modeling (SEM), this study illustrated that self-efficacy and attitudes towards COVID-19 vaccines were significantly interrelated with intention to receive COVID-19 vaccines. Self-efficacy, attitudes towards COVID-19 vaccines, and intention to receive COVID-19 vaccines were negatively influenced by perceived access barriers but were positively associated with perceived clinical barriers. Importantly, our study reported that when psychological distress was higher, the link between self-efficacy and intention to receive COVID-19 vaccines will become weaker, but the effect of perceived clinical barriers on intention to receive COVID-19 vaccines will be reinforced. Moreover, self-efficacy and attitudes towards COVID-19 vaccines served as mediators in the linkages between perceived barriers and intention to receive COVID-19 vaccines. Besides providing contributions to the extant COVID-19 vaccine literature, this study provides useful recommendations for practitioners and policymakers to foster adults' COVID-19 vaccine acceptance.

Prevalence of physical activity levels and perceived benefits of and barriers to physical activity among Jordanian patients with coronary heart disease: A cross-sectional study

Background

Many studies published in other countries have identified certain perceived benefits of and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease.

Objective

This study aimed to describe the prevalence of levels of physical activity, the benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity.

Methods

A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits of and barriers to physical activity and asked to what extent they disagreed or agreed with each.

Results

Jordanian patients with coronary heart disease perceived various benefits of and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = 0.7). The most substantial barriers to physical activity as perceived by the patients were "feeling anxiety," "not enough time," "lack of interest," "bad weather," and "feeling of being uncomfortable." Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behavior.

Conclusion

This study demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity and have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

Physical Activity Counseling in Saudi Arabia: A Systematic Review of Content, Outcomes, and Barriers

OBJECTIVES

This study aimed to map the characteristics and the predominant components of clinical physical activity (PA) counseling in Saudi Arabia for adult patients and outline evidence of outcomes and prevalent barriers to its implementation.

METHODS

We conducted a systematic literature search of four online databases: Web of Science, PubMed, ScienceDirect, and The Cochrane Library. Each study was assessed and evaluated using the Mixed Methods Appraisal Tool (MMAT) for methodological quality.

RESULTS

A total of 120 studies were screened, and 47 studies were sought for retrieval. In total, 25 articles were eligible and were subjected to extensive review. After a detailed evaluation, only nine studies met the inclusion criteria. All included were quantitative studies that compiled descriptive and numerical data on physical activity counseling. Four studies described PA counseling information in Saudi Arabia or prescription as lifestyle modification and program structure. The programs used various techniques to motivate patients to adhere to PA protocols. In general, practitioners indicated a high perceived competence in helping patients meet PA guidelines. The most frequently stated barrier was a lack of time for PA discussions with patients, followed by a lack of training in PA counseling, and a lack of patient compliance. Significant improvements in clinical parameters and smoking, food, and exercise habits were detected in experimental trials with respective intervention programs.

CONCLUSION

This review provides preliminary insights into the delivered intervention and standard care content, its outcomes, and clinicians' perceived competence and barriers regarding current PA counseling approaches in Saudi Arabia. Despite the small number of studies included, this review contributes to the limited understanding of current PA counseling practices in Saudi Arabia and serves as an informational source for clinicians and policymakers and a starting point for further research.

Facilitators and Barriers of Artificial Intelligence Applications in Rehabilitation: A Mixed-Method Approach

Artificial intelligence (AI) has been used in physical therapy diagnosis and management for various impairments. Physical therapists (PTs) need to be able to utilize the latest innovative treatment techniques to improve the quality of care. The study aimed to describe PTs' views on AI and investigate multiple factors as indicators of AI knowledge, attitude, and adoption among PTs. Moreover, the study aimed to identify the barriers to using AI in rehabilitation. Two hundred and thirty-six PTs participated voluntarily in the study. A concurrent mixed-method design was used to document PTs' opinions regarding AI deployment in rehabilitation. A self-administered survey consisting of several aspects, including demographic, knowledge, uses, advantages, impacts, and barriers limiting AI utilization in rehabilitation, was used. A total of 63.3% of PTs reported that they had not experienced any kind of AI applications at work. The major factors predicting a higher level of AI knowledge among PTs were being a non-academic worker (OR = 1.77 [95% CI; 1.01 to 3.12], p = 0.04), being a senior PT (OR = 2.44, [95%CI: 1.40 to 4.22], p = 0.002), and having a Master/Doctorate degree (OR = 1.97, [95%CI: 1.11 to 3.50], p = 0.02). However, the cost and resources of AI were the major reported barriers to adopting AI-based technologies. The study highlighted a remarkable dearth of AI knowledge among PTs. AI and advanced knowledge in technology need to be urgently transferred to PTs.

Pharmacists and Mental Health First Aid training: A comparative analysis of confidence, mental health assistance behaviours and perceived barriers

BACKGROUND

Pharmacists are aptly positioned to provide first aid-level assistance to patients experiencing a mental health problem or crisis, yet often lack confidence or perceive barriers to intervention. One potential solution is Mental Health First Aid (MHFA) training-an evidence-based psycho-educational programme. This study evaluates MHFA training within pharmacy by (1) assessing pharmacists' perceptions of the prevalence of patients experiencing a mental health-related problem or crisis, (2) investigating whether MHFA is associated with increased confidence, intervention and assistance quality and (3) examining perceived intervention barriers.

METHODS

Pharmacists working in Australia were surveyed. The survey included validated measures and research objectives were assessed using descriptives and ANOVAs.

RESULTS

One hundred sixty-one pharmacists were included; 90 MHFA trained and 71 untrained. Overall, 86% of reported encountering at least one patient perceived to be experiencing a mental health problem or crisis in the last year. MHFA trained pharmacists reported being more confident, with notable differences in their confidence to recognize signs, approach and ask someone about suicide. Pharmacists did not intervene ~25% of the time in which a problem/ crisis was identified. When they did intervene, results suggest the assistance was similar in content. Intervention barriers were reported to impede MHFA trained pharmacists significantly less than untrained pharmacists.

CONCLUSION

Results suggest pharmacists frequently encounter patients experiencing a mental health problem or crisis and that MHFA training may support pharmacists in helping these patients. Future research can utilize experimental methods to provide causal evidence as to the utility of MHFA training for pharmacists and patients.

"Sports for All"-An Evaluation of a Community Based Physical Activity Program on the Access to Mainstream Sport for Children with Intellectual Disability

Access to club sports is still not a given for children with ID. Parents and children report numerous structural and social barriers to accessing mainstream sports. Sports clubs, on the other hand, want to include this group of people, but often do not know how to do it. Using a community-based approach, children with intellectual disabilities (8-15 years) and their parents were given the opportunity to participate in an 8-week sports program in four mainstream clubs organized by a self-help organization for people with intellectual disabilities. Focus groups were conducted with all participants (parents, children, and club representatives) before and after the program and evaluated by means of a thematic analysis. The children rated participation very positively and only very occasionally reported that they had been excluded. The parents confirmed this experience, but were nevertheless more critical in their assessment. Outside the research context of this study, the sports clubs hardly provided good support, which can also be deduced from previous negative experiences of the parents. The sports clubs themselves received valuable information about what their failings were: sufficiently available and qualified staff, better access to sports facilities, and a wider range of inclusive groups are needed. On the other hand, there was hardly any prejudice on the part of the non-disabled club members towards the new members with ID, which was evaluated extremely positively, albeit surprisingly, by the sports clubs.

Development of an Air Pollution Risk Perception Questionnaire for Running Race Runners Based on the Health Belief Model

An increasing number of individuals participate in running races worldwide; however, running in the presence of air pollution poses health risks to runners. Therefore, developing a valid and reliable instrument is imperative to assess runners' beliefs and perceptions regarding risks and health behaviors. This study developed a comprehensive questionnaire based on the health behavior model and relevant literature. The questionnaire was tested with 310 responses from individuals with running race experiences in Taiwan. Tests of the measurement model were conducted using reliability and confirmatory factor analysis. The results reveal that the questionnaire consists of eight constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues to action, health behavior intention, and awareness of air quality. The 31 items jointly accounted for 72.71% of the observed variance. All eight factors have good internal consistency, convergent, and discriminant validity with acceptable model fit indexes. Additionally, a valid translated English version of the questionnaire is provided for future research, sports agencies, or governments to explore factors that affect, or interact with, risk while running under air pollution conditions to develop management strategies.

Exploring perceived barriers to effective utilization of learner-centred teaching methods by tutors at Holy Family College of Nursing and Midwifery, Phalombe, Malawi

Introduction

Learner-centred teaching implies a paradigmatic shift in roles of a teacher from being a source of knowledge to that of a facilitator in the process of knowledge construction. Literature shows that perceptions which teachers hold about barriers to utilisation of learner-centred teaching methods influence how the teachers teach. Anecdotal records as well as observation of classroom teaching demonstrate that tutors at Holy Family College of Nursing and Midwifery dominantly use traditional teacher-centred teaching methods.

Research Design and Methods

This was a qualitative study based on the philosophical principle of constructivism.

Study population and sample

All tutors at Holy Family College of Nursing and Midwifery were the study population. Purposive sampling technique was used to select participants. In-depth interviews with 12 tutors were held using a semi-structured interview guide.

Data analysis

Data were analysed using the 6-step thematic method.

Findings

The participants suggested that effective utilization of learner-centred teaching methods is negatively affected by teacher-related as well as technical barriers.

Conclusion

Teachers clinging to power and need for more resources negatively affect utilisation of learner-centred teaching methods.

Maternal Kangaroo care education program in the neonatal intensive care unit improved mothers' perceptions, knowledge, perceived barriers and stress relates to premature infant

AIM

To assess the effectiveness of the maternal kangaroo care education programme over 1 month and 3 months on the mother's perception, knowledge, perceived barriers and stress.

DESIGN

A quasi-experimental and longitudinal study was conducted among mothers with premature infants.

METHODS

Forty-eight mother-infant dyads were enrolled per arm in the control and experimental groups. The control group received standard routine care, while the experimental group received a maternal kangaroo care education program. Data were collected through self-administered Kangaroo Care Questionnaires. Chi-square, the general linear model and repeated measures ANOVA were used to analyse data.

RESULTS

The demographics are a majority of Malay mothers with multipara, a caesarean delivery with prematurity. At 3 months post-intervention, the experimental group reported a significant reduction in stress, a positive perception and good knowledge towards kangaroo care implementation. The mothers' perceived barriers towards kangaroo care significantly decreased after 3 months in the experimental group.

Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment

Tobacco use, and thus tobacco-related morbidity, is elevated amongst patients with behavioral health treatment needs. Consequently, it is important that centers providing health care to this group mandate providers' use of tobacco screenings to inform the need for tobacco use disorder intervention. This study examined the prevalence of mandated tobacco screenings in 80 centers providing health care to Texans with behavioral health needs, examined key factors that could enhance screening conduct, and delineated providers' perceived barriers to tobacco use intervention provision. The results indicated that 80% of surveyed centers mandated tobacco use screenings; those that did were significantly more likely than those that did not to have a hard stop for tobacco use status in health records and were marginally more likely to make training on tobacco screening available to providers. The most widespread barriers to tobacco use disorder care provision were relative perceived importance of competing diagnoses, lack of community resources to refer patients, perceived lack of time, lack of provider knowledge or confidence, and belief that patients do not comply with cessation treatment. Overall, the results suggest that there are opportunities for centers providing care to Texans with behavioral health needs to bolster their tobacco screening and intervention capacity to better address tobacco-related health disparities in this group. Health care centers can support their providers to intervene in tobacco use by mandating screenings, streamlining clinical workflows with hard stops in patient records, and educating providers about the importance of treating tobacco with brief evidence-based intervention strategies while providing accurate information about patients' interest in quitting and providers' potential impacts on a successful quit attempt.

The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review

This study systematically analyzes the research that used the Health Belief Model (HBM) as a theoretical basis to examine the influence of HBM constructs on COVID-19 vaccine hesitancy. Following PRISMA guidelines, PubMed, Web of Science, Google Scholar, and Scopus were searched for quantitative studies. Sixteen studies with 30,242 participants met inclusion criteria. The prevalence of COVID-19 vaccine hesitancy was 33.23% (95% CI 24.71–41.39%). Perceived barriers and perceived benefits were the most common HBM constructs that were significantly associated with vaccine hesitancy. While perceived benefits was inversely associated, a positive association was found between perceived barriers and vaccine hesitancy. Other HBM constructs that were frequently examined and inversely associated were perceived susceptibility, cues to action, perceived severity, and self-efficacy. The most common HBM modifying factor that was directly associated with COVID-19 vaccine hesitancy was gender, followed by education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity; however, a few studies report inconsistent results. Other modifying variables that influenced vaccine hesitancy were knowledge of COVID-19, prior diagnosis of COVID-19, history of flu vaccination, religion, nationality, and political affiliation. The results show that HBM is useful in predicting COVID-19 vaccine hesitancy.

Factors influencing the consumption of fruits and vegetables in diabetic patients based on Pender's health promotion model

BACKGROUND

To control blood sugar and prevent complications related to diabetes, eating fruits and vegetables in standard amounts is recommended. The aim of this study was to investigate the factors affecting the consumption of fruits and vegetables in diabetic patients based on the Pender health promotion model.

MATERIALS AND METHODS

This cross-sectional study was conducted on 260 diabetic patients in Sirjan; one of the cities of Kerman in Iran in 2020. To collect data, a researcher-made questionnaire of Pender's Health Promotion Model and a standard Behavioral Risk Factor Surveillance System questionnaire were used to measure fruit and vegetable consumption. Data were analyzed using SPSS24 software. Data were analyzed using t-test, Pearson correlation coefficient, linear regression, and path analysis. Significance level <0.05 was considered.

RESULTS

The study showed that 71.5% of patients consumed fruits three or more times and 52.3% consumed vegetables per week. Employment, income, education, and gender were significantly associated with fruit and vegetable consumption (P < 0.05). Perceived barriers (P < 0.0001, β =0.23), self-efficacy (P < 0.0001, β =0.32), and commitment to action plan (P = 0.002, β =0.20) were the main predictors of fruit and vegetable consumption.

CONCLUSION

In this study, self-efficacy was the strongest predictor of fruit and vegetable consumption in diabetic patients. Therefore, it is necessary to consider health education as well as health promotion interventions based on these variables is considered to increase the consumption of fruits and vegetables for diabetic patients.