Integrating health literacy into a theory-based drug-use prevention program: a quasi-experimental study among junior high students in Taiwan

Understanding aberrant driving intentions based on the Theory of Planned Behavior: Literature review and Meta-Analysis

INTRODUCTION

Despite deployed efforts to establish strict road safety standards, human factors is still the leading cause of road crashes. To identify determinants of driver's behavior, TPB (Theory of Planned Behavior) is widely used as a prominent theory of behavior change. However, the existence of different aberrant driving behaviors (decision errors, recognition errors, violations, and physical condition related errors) and several studies using TPB to understand driving behavior, makes it important to conduct a literature review and a meta-analysis of existing studies to use their results in effective driving behavior change interventions.

METHOD

The selection process provided 125 relevant studies that were published between 1991 and 2022, and that used TPB for the understanding of aberrant driving behavior. Five fundamental research questions were defined to identify information to be discovered from the literature review and from the meta-analysis.

RESULTS

In addition to the standard TPB constructs (attitudes, subjective norms, and perceived behavioral control), past behavior, moral norms, and descriptive norms were used in studies for a more comprehensive understanding of aberrant driving intention. This analysis demonstrated a significant correlation between aberrant driving intentions and past behavior. Also, moral norms construct was correlated with violations and recognition errors, whereas descriptive norms construct was correlated just with recognition errors.

CONCLUSIONS

The results of this study highlight the strength of TPB in the prediction of aberrant driving intention and its potential effectiveness to guide interventions aimed at changing aberrant driving behaviors. The study contributes to the comprehension of the relevant psychological factors influencing the engagement of drivers in each category of aberrant driving behaviors.

PRACTICAL APPLICATIONS

Researchers can use the results of this study to select the relevant psychological factors adapted to their interventions of driving behavior change. The results of the meta-analysis can also be used in the prediction of driver's intentions.

Teaching methods for critical thinking in health education of children up to high school: A scoping review

According to the World Health Organization, the improvement of people's health literacy is one of the fundamental public health challenges in the 21st century. The key issue in teaching health literacy is to develop critical thinking skills. As health literacy and critical thinking should be developed at school age, we reviewed teaching methods or educational interventions used in empirical studies focused on the development of critical thinking regarding health and implemented by teachers in preschools, primary schools, or secondary schools. We searched seven databases (Medline, Embase, Web of Science, ERIC, ProqQuest, PsycArticles, and CINAHL) from inception to 20 September 2023 for any type of empirical studies. Due to the heterogeneity in interventions and inadequate reporting of results, a descriptive synthesis of studies was performed in addition to quantitative analysis. Of the 15919 initial records, 115 studies were included in the review. Most of the educational interventions focused on lifestyle-related health issues such as substance use, sexual and reproductive health, and nutrition. The popularity of health issues changed over time and depended on the geographical context. Six dimensions that differentiated the teaching methods were identified: central teaching component, central educator, pupils' activity level, teaching context, educational materials, and significance of critical thinking. Many educational interventions did not address the development of critical thinking skills in a comprehensive manner, and the significance of critical thinking varied greatly. Interventions in which critical thinking had high and very high significance applied mainly problem-solving methods and involved pupils' activity. The evidence on the effectiveness of the teaching methods that develop critical thinking is limited because most articles failed to provide detailed information on the teaching methods or did not examine their effects. We recommend that a checklist is developed to facilitate a detailed description of health educational interventions and thus promoting their replicability. Study registration: The protocol of the review was registered in the OSF Registries on 13 January 2022 (doi: https://doi.org/10.17605/OSF.IO/46TEZ).

Health literacy as mediator between perception of illness and self-medication behaviour among outpatients in the Kingdom of Saudi Arabia: implication to primary healthcare nursing

INTRODUCTION

Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA).

METHODS

This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023.

RESULTS

The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001).

CONCLUSION

Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it.

User experience evaluation of a 3D virtual reality educational program for illegal drug use prevention among high school students: Applying the decomposed theory of planned behavior

Objective

To evaluate user acceptability of an immersive three-dimensional virtual reality program for preventing illegal drug use and identify factors associated with continuous usage intention of three-dimensional virtual reality learning among high school students based on the decomposed theory of planned behavior.

Methods

In this cross-sectional observational study, we developed five educational modules and serious games based on three-dimensional virtual reality technology. Ninety student-participants' experiences were assessed by a structured questionnaire based on the decomposed theory of planned behavior variables. We applied partial least squares structural equation modeling to examine the correlates of continuous usage intention.

Results

The proposed model demonstrated an acceptable fit to the observed data. Eight of the 11 hypotheses based on the decomposed theory of planned behavior were supported. Continuous usage intention was significantly associated with attitudes, subjective norms, and perceived behavioral control; these variables explained 55.4% of the variance in continuous usage intention. Perceived usefulness and compatibility were significant antecedents of attitude. The significant antecedent of subjective norms was support from school staff. Self-efficacy and resource-facilitating conditions were significant antecedents of perceived behavioral control.

Conclusions

Our findings support the applicability of the decomposed theory of planned behavior as a framework for evaluating a three-dimensional virtual reality program for illegal drug use. We recommend that the program be included as teaching material for illegal drug prevention education in senior high schools.

Impact of Two Types of Board Games on Drug-Use Prevention in Adolescents at Senior High Schools

Objective: A technology-assisted teaching tool with interactive features may improve the outcomes of illegal drug-use prevention strategies. This study explores augmented reality (AR) and paper board games incorporating a brief antidrug educational program for students without drug-use problems to increase their antidrug knowledge, attitude, life skills, subjective norms, perceived behavioral control, and intention to avoid using drugs. Materials and Methods: A total of 600 students were recruited, and 578 completed the intervention program and pre-and post-tests. The participants were randomly assigned to one of the following three groups: AR board game, paper board games, and comparison groups. The brief educational program consisted of two sessions. Generalized estimation equations were used to assess group differences in outcome variables. The paired t-tests were used to assess improvements in outcome variables of the two experimental groups. Results: The study found that the students who received the brief educational program featuring the AR board game was significantly different from the comparison group in outcome variables, including antidrug knowledge (P = 0.001), life skills (P = 0.004), subjective norms (P < 0.001), perceived behavioral control (P < 0.001), and intention (P = 0.02). The group with the paper board games also revealed similar findings as to the AR board game group in outcome variables, except for antidrug knowledge. There were no group differences in antidrug attitude between experimental and comparison groups. Conclusion: The results of this study support the efficacy of the two types of board games incorporated with a brief educational program. Results suggest that schools can adopt AR or paper board games as learning tools to assist in drug-use prevention programs and reduce the likelihood of students using illegal drugs.