Background Evaluability assessment (EA), conducted independently or as part of a broader evaluation process, is performed to determine whether a program, policy, or intervention is ready and suitable ...

A recent study reveals that males bear a higher disease burden overall, while females experience a higher burden from seven specific conditions, emphasizing the need for tailored health interventions.

Background: An increasing number of multicomponent workplace interventions are being developed to reduce sedentary time and promote physical activity among office workers. The Physical Activity at Work (PAW) trial was one of these interventions, but it…

Researchers propose a tool to help policymakers address dietary inequalities by considering people's lived realities, including economic, social, and material factors. This tool aims to improve the ef...

Researchers propose a tool to help policymakers address dietary inequalities by considering people's lived realities, including economic, social, and material factors. This tool aims to improve the ef...

Background: Smoking after a #Cancer diagnosis has significant health consequences, and there are substantial benefits if #Cancer survivors can achieve cessation. However, there are few smoking cessation interventions for #Cancer survivors that have been effective, and they are highly resource intensive. Thus, novel low resource cessation interventions are needed. One such intervention modality that has not been tested among #Cancer survivors is using pre-recorded videos to deliver information about skills and resources to achieve smoking cessation. Objective: Assess barriers to smoking cessation, interest in a video-based smoking cessation intervention, and video content preferences (e.g. topic, video length, age and gender of video presenter, presenter type [peer, medical professional]) among individuals with #Cancer who smoke cigarettes. Methods: Participants were recruited from a #Cancer center in the southeast United States that houses an opt-out tobacco treatment program in which Tobacco Treatment Specialists proactively call all patients who have a current smoking status in their medical record. Patients were informed about the study, and their contact information was sent to the study team. Verbal consent was completed for those individuals who were #Cancer survivors, currently smoking, and agreed to participate and semi-structured qualitative interviews were conducted (N =10). Participants were asked questions about smoking history, previous quit attempts, barriers to quitting smoking, previous experience with and openness to watching videos about quitting smoking, and participant preferences related to video content and presentation. Interviews were transcribed and coded by two reviewers, and a codebook was developed. A thematic analysis was then conducted. Results: Results indicated that all participants had previously tried to quit smoking, but other substance use (50%), negative affect (e.g., depression [40%], anxiety [10%], stress [20%], loneliness [10%]), the social environment (e.g., being around others who smoke [20%], risky social situations [20%]), and habits surrounding smoking were significant barriers for cessation. All participants were open to watching smoking cessation videos and expressed a desire to see a peer with lived experience in the videos. Most participants did not have preferences related to the age or gender of video presenters. Many participants had difficulty articulating content preferences for the videos. Conclusions: #Cancer survivors who smoke may not be aware of their knowledge gaps related to smoking cessation, and videos may be an acceptable way to provide evidence-based information to fill knowledge gaps.

Background: Testimonials from credible sources are an evidence-based strategy for behavior change. Behavioral health interventions have used testimonials to promote health behaviors (e.g., physical activity, healthy eating). Integrating testimonials into eating disorder (ED) interventions poses a nuanced challenge because ED testimonials can promote ED behaviors. Testimonials in ED interventions must therefore be designed carefully. Some optimal design elements of testimonials are known, but questions remain about testimonial speakers, messaging, and delivery, especially for ED interventions. Objective: We sought to learn how to design and deliver testimonials focused on positive behavior change strategies within our multi-session digital binge eating intervention. Methods: We applied human-centered design methods to learn users’ preferences for testimonial speakers, messaging, and delivery (modalities, over time, and as “nudges” for selecting positive behavior change strategies they could practice). We recruited target users of our multi-session intervention to complete design sessions. Adults (N=22, 64% self-identified as female; 32% as non-Hispanic Black, 41% as non-Hispanic White, 27% as Hispanic) with recurrent binge eating and obesity completed individual interviews. Data were analyzed using methods from thematic analysis. Results: Most participants preferred designs with testimonials (versus without) for their motivation and validation of the intervention’s efficacy. A few distrusted testimonials for appearing too “commercial” or personally irrelevant. For speakers, participants preferred sociodemographically tailored testimonials and were willing to report personal data in the intervention to facilitate tailoring. For messaging, some preferred testimonials with “how-to” advice, whereas others preferred “big picture” success stories. For delivery interface, participants were interested in text, video, and multimedia testimonials. For delivery over time, participants preferred testimonials from new speakers to promote engagement. When the intervention allows users to choose between actions (e.g., behavioral strategies), participants preferred testimonials be available across all actions, but said that selectively delivering a testimonial with one action could “nudge” them to select it. Conclusions: Results indicated that intervention users were interested in testimonials. While participants preferred sociodemographically tailored testimonials, they said different characteristics mattered to them, indicating that interventions should assess users’ most pertinent identities and tailor testimonials accordingly. Likewise, users’ divided preferences for testimonial messaging (i.e., “big picture” versus “how-to”) suggest that optimal messaging may differ by user. To improve the credibility of testimonials, which some participants distrusted, interventions could invite current users to submit testimonials for future integration in the intervention. Aligned with nudge theory, our findings indicate testimonials could be used as “nudges” within interventions—a ripe area for further inquiry—though future work should test if delivering a testimonial only with the nudged choice improves its uptake. Further research is needed to validate these design ideas in practice, including evaluating their impact on behavior change toward improving ED behaviors.

Background: Smoking and physical inactivity compromise health, especially in combination. Interventions to promote smoking cessation and increased physical activity (PA) often lack impact, especially in the long term. Digital future-self interventions (FSIs), which prompt individuals to imagine who they do and do not want to become (ie, their desired and undesired future selves), show promise in encouraging sustainable changes in both behaviors. However, knowledge of user experiences with digital FSIs is limited. A deeper understanding of these experiences could help optimize FSIs, enhancing their efficacy in supporting smoking cessation and increased PA sustainably. Objective: This study examined behavioral, cognitive, and affective experiences with digital FSIs focused on smoking, PA, or both. Potential differences in user experiences based on behavior (smoking vs PA), polarity (desired vs undesired future self), and modality (verbal vs visual description of future selves) were explored. Methods: Secondary analyses of quantitative and qualitative survey data from 3 studies using digital FSIs as a means to encourage smoking cessation or increase PA were conducted. In study 1, participants (N=144) thought about how it would be to complete the FSI. In studies 2 (N=447) and 3 (N=87), they completed an FSI. Each study highlighted different aspects of user experiences with FSIs, namely, behavioral (eg, time spent), cognitive (eg, mental effort exerted), or affective (eg, emotions) experiences. Quantitative and qualitative findings were integrated for a comprehensive interpretation. Results: Regarding behavioral experiences, participants completed future-self tasks promptly (mean 6.64, SD 8.30 minutes), spent less time completing the desired- versus undesired-future-self (P

Using the Community Guide, the presenter located systematic-review findings recommending community health worker engagement for cervical cancer screening and highlighted the site's implementation notes and economic evidence tabs.

Our new global population datasets covering 15 years from 2015 to 2030 are now freely available to download on the Humanitarian Data Exchange website.

Global crises demand urgent financing for nutrition solutions for pregnant women and malnourished children.

Senator Duckworth emphasizes quick Narcan access as vital for overdose response in schools.

Background: #Digital #Health interventions (DHIs) using behavior change techniques (BCTs) show promise in addressing adolescent #Health behaviors, but evidence of their effectiveness across #Health behavior domains remains fragmented and poorly summarized. Objective: This systematic umbrella review synthesized evidence from existing systematic reviews on the effectiveness of BCTs within DHI targeting key adolescent #Health behavior domains: alcohol consumption, tobacco use, physical activity, dietary habits, and obesity management. Methods: We systematically searched PubMed, PsycInfo, Embase, and CINAHL in April 2024 for reviews of DHI for adolescents (10‐19 years old). We coded all identified BCTs using the Behavior Change Technique Taxonomy version 1 (BCTTv1). Data on BCT effectiveness, intervention characteristics, and review quality were extracted and narratively synthesized using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2). Results: A total of 20 reviews, comprising 224,135 participants, were included. These examined DHIs targeting physical activity (7 reviews), dietary habits (3 reviews), alcohol consumption (2 reviews), combined alcohol and nicotine use (1 review), and obesity management (1 review), with an additional 6 reviews covering multiple #Health behaviors. Across reviews, 65% (13/20) reported statistically significant positive effects on at least one #Health behavior outcome. “Social support (unspecified)” was the most consistently adopted and effective BCT, especially with parental/peer involvement. The combination of “self-monitoring,” “goal setting,” and “feedback” also commonly #Appeared in successful interventions. Intervention effectiveness #Appeared linked to strategic BCT selection and individualization rather than the total number of techniques. The methodological quality of included reviews was predominantly low, with only 2 rated high. Conclusions: This umbrella review identified “social support (unspecified)” as a consistently effective BCT across multiple adolescent #Health behavior domains, particularly with parental/peer involvement. Intervention success #Appears linked to targeted and individualized BCT use. Future research should prioritize clarifying the specific components and delivery methods of effective social support, rigorously evaluating BCT configurations in underexplored areas such as adolescent smoking cessation, and examining their long-term impact on behavior change.

Background: Older adults face increasing health risks associated with aging and chronic disease; yet, uptake of recommended clinical preventive services remains low. Digital health interventions have the potential to enhance access and engagement, but their effectiveness in older adult populations remains unclear. Objective: This systematic review aimed to examine the range and types of digital clinical preventive service interventions and assess their impact on preventive care uptake among older adults. Methods: We conducted a systematic review of peer-reviewed research literature published since 2014. Eligible studies included experimental and quasi-experimental designs evaluating digital interventions targeting community-dwelling adults aged 60 years and older. Interventions focused on high-priority preventive services, including cancer screening and adult immunizations. Data were extracted using a standardized form and synthesized narratively due to heterogeneity in study designs and outcomes. Results: In total, 24 studies involving over 1.3 million participants from 11 countries were included. Interventions used a range of digital tools, including telephone calls, SMS text messages, patient portals, and video-based education. While some digital and automated interventions demonstrated modest improvements in preventive services uptake, results were mixed. Interventions incorporating personalized elements (eg, tailored telephone counseling or in-person education) were generally more effective than generic, automated communications. Few studies reported on digital literacy support or intervention reach, and engagement with digital platforms was often low. Conclusions: Digital interventions can support modest improvements in preventive services uptake among older adults, particularly when personalized or combined with human interaction. However, assumptions of digital fluency and limited reporting on engagement constrain generalizability. Future research should prioritize inclusive design, detailed reporting, and strategies that address digital equity to better support older adult populations.

Background: Food Is Medicine (FIM) programs integrate interventions such as medically tailored meals or produce prescriptions into clinical care. However, there is limited evidence on how to design these programs to be responsive to the lived experiences of participants to optimize initiation, engagement, and long-term retention. Objective: The objective of the study was to develop interventions to promote initiation, engagement, and retention in FIM programs that are responsive to the lived experiences of participants. Methods: We used a human-centered design approach to engage current and former cardiac rehabilitation participants in the development of interventions to promote participation and engagement in a FIM program. We recruited participants through invitations sent via electronic health record messages. We interviewed participants about their experiences, preferences, and unmet needs related to healthy eating and program design. Additionally, we elicited participant feedback on draft versions of patient navigator scripts and text messages promoting healthy eating habits. Results: A total of six participants identified themes across Theory of Planned Behavior constructs and emergent themes, including the cost of healthy food, cultural appropriateness, clear and timely communication, transportation, local food access, scheduling flexibility, the ability to provide feedback to the program, and personalized support for navigating food resources. Participants described financial strain as a key barrier to healthy eating and noted that social influence often shaped eating behaviors. Feedback on navigator scripts led to revisions clarifying program logistics, addressing barriers such as language and cultural dietary restrictions, and tailoring positive endorsements to individual health goals. Based on participant feedback, text messages were made more concise, reframed positively (eg, humor and gratitude), and encouraged to be warmer, with respectful language that is easy to understand, while avoiding stigmatizing or overly clinical phrasing. Participants also suggested that messages should reflect empathy and offer actionable information to increase trust and engagement with the program. Trust in the health care system and a sense of dignity in receiving food support emerged as critical themes influencing overall satisfaction and retention. Participants emphasized that endorsement from their health care team and cardiologist was important for building trust in the program. Communication between health care navigators and FIM navigators could help reduce the burden placed on patients to navigate food resources. Conclusions: Using a human-centered design approach, we gained insights about participant-identified needs for navigation scripts and text messages that are culturally sensitive and personalized to promote optimal participation in a FIM program.

Background: Emerging adulthood is a high-risk period during which many with type 1 diabetes (T1D) demonstrate suboptimal diabetes management and glycemic control. There is a need for effective and scalable interventions designed specifically for this population. Technology-based approaches are readily accessed by this age group. Further, interventions that are consistent with self-determination theory (SDT) – which posits the fulfillment of psychological needs for autonomy, self-efficacy, and relatedness promote intrinsic motivation for change – may resonate well with emerging adults’ (EAs) developmental needs for establishing independence, autonomy, and growing their social network. Objective: To gather patient feedback on three SDT-informed mHealth interventions for EAs with T1D: a Motivational Interviewing-based counseling intervention, one-way text message reminders to complete diabetes care, and a question prompt tool to empower EAs to actively participate during medical visits. Methods: In this qualitative formative study, 20 EAs reviewed and provided feedback on the newly developed interventions via individual interviews. Interviews were analyzed using Framework Matrix Analysis, an efficient approach to inductive thematic analysis. Results: EAs provided high ratings for intervention acceptability and helpfulness. EAs appreciated the technology-based approach and the tailoring to their demographic characteristics, illness experiences, and personal preferences. They also highlighted SDT-related intervention elements that aligned with SDT. Recommendations for intervention improvement included additional tailoring to personal preferences including the frequency and duration of intervention, intervention content, and personalizing reminders with the recipient’s name. Conclusions: EA feedback supports the acceptability and utility of this intervention and will be used to refine the interventions. The unique contribution of each intervention to improvements in glycemic control will be tested in a randomized controlled trial using the multiphase optimization strategy (MOST) to build the most efficacious multicomponent intervention. Clinical Trial: N/A

Background: Human-centered design (HCD) is vital for crafting impactful and successful health interventions. This approach has been effective in enhancing the uptake of health services, especially in rural areas. The Routine Immunization Buddy System (RIBS) is an HCD-driven intervention designed to support economically disadvantaged caregivers by empowering them to take greater responsibility for their own health and the immunization of their children. Objective: Through a community-based participatory approach (CBPA), this study seeks to understand the economic, social, and health lifestyles and the impact on the health-seeking attributes of the potential beneficiaries of the project. This ensures that the identified intervention and its strategy will be implemented in a way that is of utmost benefit to the users. Methods: Employing a three-step HCD process, including the Discovery, Ideation, and Formulation phases, the study conducted Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) for caregivers and stakeholders capable of influencing the woman's decision within a health setting. Semi-structured interviews facilitated an in-depth exploration of participants' experiences. Data collection utilized audio/video recordings, detailed notes, and observation sessions. Data analysis encompassed transcription, descriptive, and thematic analysis to inform evidence-based interventions. Results: Four key interconnected barriers to routine immunization were identified from the formative research: vaccine hesitancy which is driven by safety concerns and inconsistency in vaccine-related messaging; gender-based decision-making constraints, where male approval often influenced access to care; financial limitations affecting transport and medical costs; and unequal access to healthcare due to geographic disparities. Caregivers emphasized the need for economic empowerment and trusted community-based health education. These findings informed a critical redesign of the intervention from a two-arm to a three-arm model, with peer support groups, and financial empowerment components added to address both economic barriers and vaccine misinformation through culturally tailored approaches. Conclusions: The use of human-centered design (HCD)-informed formative research has helped identify tailored women’s empowerment strategies, such as economic support, community-led advocacy, and peer networks, that show promise in addressing health disparities among caregivers. These approaches are hoped to enhance caregivers’ ability to make informed health decisions, ultimately contributing to improved immunization uptake and broader community well-being. The insights from this research are actively informing the design of our upcoming cluster-randomized controlled trial (cRCT), which aims to strengthen women’s decision-making power around immunization services.

Background: Digital health interventions (DHIs) refers to the use of information and communication technologies to support or facilitate the achievement of health objectives. The Government of India has launched various DHIs at the primary healthcare level to improve health services and health-seeking behaviours. However, there is a paucity of evidence on the effectiveness of the implementation of these interventions and the user response from target end-users within the government health system setting Objective: To assess the implementation status of DHIs and the user response of target end-users i.e., general population and healthcare workers (HCWs) in Health and Wellness Centres (HWCs) in Chandigarh, Union Territory, India Methods: A cross-sectional study was conducted to assess the implementation status of nine DHIs: the Electronic Vaccine Intelligence Network (eVIN), Reproductive and Child Health (RCH), Health Management Information System (HMIS), HWC portal, Comprehensive Primary Healthcare – Non-Communicable Disease (CPHC-NCD), Family Planning Logistics Management Information System (FP_LIMS), eSanjeevani, Integrated Disease Surveillance Platform– Integrated Health Information Platform (IDSP-IHIP) portals, Aarogya Setu, and the #covid19 Vaccine Intelligence Network (CoWin) app. Data were collected from four purposively selected HWCs using a pretested data extraction form and observation checklist during June–September 2022. The implementation status of these DHIs was evaluated by categorizing indicators into input, process, and output components, and estimating cumulative percentage scores using a score-based logic model framework. Pretested interview schedules were used to assess awareness and user response of DHIs among 120 target end-users (clients visiting HWCs) and 120 HCWs (Auxiliary Nurse Midwife, Data Entry Operator, and Medical Officer). The prevalence of user response was then estimated. Results: The implementation status scores of the eVIN and RCH portals ranged from 70–90%. The HMIS portal, HWC portal, CPHC-NCD portal, and FP_LIMS scored between 25–50%, while eSanjeevani and the IDSP_IHIP portal scored between 51–70%. Community awareness of DHIs was poor, ranging from 1% to 22%, except for Aarogya Setu (78.3%) and the CoWIN app (35.8%), despite 87% of participants having access to a mobile phone. Low awareness of DHIs was significantly associated with lower socio-economic status and lower education levels (p-value < 0.05). Sixty-six percent of HCWs reported that working with DHIs was easy; however, 88% stated that dual data entry increased their workload. Frequent technical glitches were most commonly reported for the ANMOL app (92%) by HCWs. Helpdesk or feedback options in DHIs were rarely used by ANMs/MPWs (0–3.8%). Conclusions: The RCH and eVIN portals were effectively implemented; eSanjeevani was moderately implemented, while the HMIS, HWC portal, CPHC, and FP_LIMS were poorly implemented. Community awareness of DHIs was low, except for the Aarogya Setu and CoWIN apps. Although HCWs found DHIs easy to use, increased workload due to dual data entry and frequent technical issues were key concerns Clinical Trial: Not applicable

Background: Young adults take their asthma maintenance medication 67% of the time or less. Understanding the specific needs and behaviors of young adults with asthma is essential for developing targeted interventions to improve disease self-management. artificial intelligence (#AI) has demonstrated its utility in summarizing and identifying patterns in qualitative research and may support or augment human coding efforts. However, there is pause literature to support this assertion. Objective: The objective of this study is to begin to explore the medication management related needs of young adults with asthma via a pilot #feasibility study. We aim to understand how to best assist young adults with asthma self-management and to identify potential areas where digital health interventions can provide support. We further aimed to understand the comparative outcome of human versus multiple Ai platforms in performing thematic analysis. Methods: This study purposefully sampled young adults between the ages of 18 and 29 years old who had a prescription for an inhaled corticosteroid and were either students or staff of a large metropolitan University in northeastern USA. Semi-structured interviews lasting 40 minutes on average were conducted with four participants via a teleconferencing application to elicit young adults’ opinions on the topic. Interviews were recorded and transcribed verbatim using Otter.ai. Investigators listened to the recording to confirm the accuracy of transcriptions and to make corrections when necessary. After performing a second round of line-by-line coding, the codes were reviewed by investigators and grouped into broader, overarching themes. All investigators reviewed and discussed the final codes. Human qualitative data-analyses were performed using NVivo 14 software (QSR International). After completing human analyses, the investigators performed thematic analysis with multiple Ai platforms (Google Gemini, Microsoft Copilot, and ChatGPT) to compare the final themes with investigator derived themes. Results: Human analysis yielded four themes: Support from clinicians, social support, digital self-management support, and educational support. The Ai-based analysis also generated similar themes with different labels. The level of overlap on the underlying concept between humans, Gemini, Copilot, and ChatGPT was high, accounting for the fact that, although the specific labels differed, they referred to the same concept. Conclusions: Findings from our pilot exploratory study offer insights into the necessity for a holistic approach in supporting young adults with asthma. Based on the health belief model, if the identified multi-faceted needs are addressed, healthcare systems may support medication adherence and improve health outcomes for this understudied patient population. Our pilot study also offers preliminary findings that artificial intelligence (#AI) may be leveraged upon for successful thematic analysis of qualitative data with appropriate caution.

As dementia progresses, patients exhibit various psychological and behavioral symptoms, imposing a significant burden on families and society, including behavioral and psychological symptoms of dementia. However, caregivers lack professional care…

Wendy Palmer, director of health interventions at the YMCA of the Chesapeake, described 'Tandem,' an Alzheimer's and dementia support program that combines gentle exercise, collaborative art and caregiver respite; the program serves Easton and Centerville and is planned to expand to all 12 area Ys.