Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Protecting Protectors:Smartphone-Based Cognitive Behavioral Therapy for Mental Health in the Chinese Police

Background:The mental health challenges faced by police officers due to high-stress work environments necessitate effective interventions.Cognitive-behavioral therapy(CBT)has shown promise in addressing mental health issues,and this study aims to evaluate the efficacy of smartphone-based cognitive-behavioral therapy(SCBT)in improving mental health outcomes among police officers.This intervention could provide a reference for enhancing mental health literacy and resilience in this population.Methods:A randomized controlled trial(RCT)design was employed,involving 291 police officers who were randomly assigned to either the SCBT intervention group(n=145)or the control group(n=146).Participants completed pre-and post-intervention assessments using the Symptom Checklist-90(SCL-90),which measures multiple psychological symptoms including somatization,obsessive-compulsiveness,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,and psychoticism.Statistical analyses were conducted to examine group differences in symptom severity and effect sizes.Results:Post-intervention results indicated significant reductions in somatization,obsessivecompulsiveness,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,and psychoticism,with large effect sizes observed in the intervention group.Notably,the intervention group showed significantly greater improvements compared to the control group,particularly in overall psychological distress as measured by the total SCL-90 score.However,significant reductions in interpersonal sensitivity and paranoid ideation were also observed in the control group,suggesting external factors may have influenced these dimensions.Conclusion:SCBT demonstrated efficacy in reducing psychological distress among police officers,offering a flexible and accessible mental health intervention.However,challenges such as high dropout rates and the complex,dynamic nature of mental health warrant further investigation.Future studies should explore targeted interventions for specific behavioral issues and consider SCBT as a supplementary tool alongside traditional psychotherapy.

Health awareness and lifestyle toward healthcare-seeking behavior among students in Universitas Advent Indonesia

Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.

Health behaviors of Korean adults with hepatitis B:Findings of the 2016 Korean National Health and Nutrition Examination Survey

AIM To assess the frequencies of five health-related behaviors(smoking, alcohol consumption, body weight, sleep dura-tion, and physical activity) in Korean adults with chronic hepatitis B.METHODS Data were obtained from the 2016 Korean National Health and Nutrition Examination Survey. In total, 5887 subjects(2568 males, 3319 females) over 19 years old were enrolled in this study. Interviews were performed to obtain information on demographic characteristics and medical conditions. A self-administered questionnaire and medical examination were used to assess the smoking history, alcohol use, physical activity, sleep duration, and body weight of the subjects. Chronic hepatitis B was diagnosed based on detection of hepatitis B surface antigen(HBs Ag). The subjects were categorized into HBs Ag positive and negative groups, and a complex sampling analysis was conducted to compare the health behaviors between these groups.RESULTS Among males, the current smoking rate in the HBs Ag positive group was higher than that in the negative group(45.5% vs 38.5%). In the positive group, the rates of monthly and high-risk alcohol use were 70.4% and 17.6% in males and 45.9% and 3.8% in females, respectively. The rate of alcohol use was similar between the two groups [P = 0.455(males) and P = 0.476(females)]. In the HBs Ag positive group, 32.3% and 49.9% of males and 26.5% and 49.6% of females were overweight and physically inactive, respectively. High-risk alcohol consumption and physical inactivity were significantly associated with self-perceived health status.CONCLUSION Our data demonstrate that a large proportion of Korean adults with chronic hepatitis B have poor health behaviors. Further studies are needed to confirm our results.

A Cross-sectional Study of Health-related Behaviors in Rural Eastern China

Objective This study examined the status of health-related behaviors among rural residents and the factors influencing the practice of such behaviors. Methods One thousand and ninety subjects aged 15 years or over in a rural community, Anhui Province, China were surveyed. A questionnaire was used to collect information on the health knowledge, attitude and behavior of the subjects. Information on health behavior included smoking, drinking, dietary habits, regular exercises, sleeping pattern and oral health behavior. Results The prevalence of smoking and drinking in the male subjects was 46.5% and 46.9%, respectively. There was a positive significant association between smoking and drinking. Only 8.3% of all subjects ate three regular meals a day regularly. Among subjects who ate two meals a day, 89.7% did not have breakfast. Only 1.7% of subjects took part in regular exercise. About 85% of subjects slept 6 to 8 h per day. Only 38.4 % of the respondents had the habit of hand washing before eating and after using the lavatory. 79.3% of the subjects brushed their teeth every day, and among them, only 10.6 percent brushed their teeth twice a day Further analyses showed that 64.8% of subjects had 3-5 items of positive health behaviors out of 8 items and only 16.9% had six or more items. Logistical regression analyses suggested that better health behavior was affected by sex, age, years of education, income and health knowledge. Conclusion The status of health behaviors among rural residents was generally poor. It is thus urgent to reinforce health education in rural communities in China.

Levels and correlates of 24-hour movement behaviors among South Koreans:Results from the Korea National Health and Nutrition Examination Surveys,2014 and 2015

Purpose.This study aimed to examine the levels and correlates of 24-h movement behaviors(i.e.,physical activity,sedentary time,and sleep),and different patterns of these behaviors in a nationally representative sample of South Koreans aged 12 years and older.This study also aimed to examine the sociodemographic correlates of 24?h movement behaviors stratified by age groups.Methods.Self-reported,repeated cross-sectional data from 10,708 participants in the 2014 and 2015 Korea National Health and Nutrition Examination surveys were used.Key variables included moderate-to-vigorous intensity physical activity,muscular strengthening exercises,walking,active transportation,sedentary time,and sleep.Sociodemographic variables included age,sex,household income,area of residence,and education level.Descriptive statistics by sex and age as well as general linear models by age group were performed.Results.The proportions of individuals meeting the moderate-to-vigorous intensity physical activity,muscular strengthening exercises,and sleep guidelines were,respectively,21.6%,22.1%,and 32.5%in male youth;6.9%,4.5%,and 22.8%in female youth;55.5%,30.8%,and 54.0%in male adults;48.8%,14.4%,and 57.6%in female adults;44.0%,30.6%,and 45.5%in male older adults;and 29.5%,8.9%,and 37.3%in female older adults.The proportions of individuals showing the most ideal combinations of 24-h movement behaviors were only 3.2%in youth,0.4%in adults,and 0 in older adults.Universally,older age,female sex,or living in metro Seoul were associated with unfavorable patterns of 24-h movement behaviors across different age groups.However,the associations of income and education with movement behaviors were mixed across age groups.Conclusion.Overall,the proportion of South Koreans with a healthy 24-h movement behavior pattern is low.The sociodemographic correlates of different types of 24-h movement behaviors should be considered when designing targeted interventions for the promotion of healthy active living for South Koreans.

The effect of self-employment on health, access to care, and health behavior

The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Perceived ill-health and health seeking behavior in two communities in the nam theun 2 hydroelectric project area in Lao Peoples Democratic Republic

Objective:To compare perceived ill-health and health seeking behavior between two communities affected by the large Nam Theun 2 hydroelectric project in central Lao People’s Democratic Republic(PDR).Methods: Two different affected areas;Nakai plateaubeing remote,sparcely populated and mountainous,and Xe Bang Fai lowland plains,more densely populated and comparatively affluent were included.Data were obtained from two cross-sectional household-based health and socio-economic surveys.Results:We found pronounced differences in the frequency of self-reported fever,cough,headache and myalgia according to location.On the Nakai plateau,45.1%of the individuals with ill-health report(recall period;2 weeks) went to a local health volunteer compared to only 7.2%in the Xe Bang Fai area(P 【 0.001 ).In Nakai,there were disproportionately more illiterates seeking help from local health volunteers when compared to those who attended at least primary schooling(49.2%versus 17.5%,P 【0.01 ).Self-medication with antimalarials was more common in Xe Bang Fai than on Nakai(32.3%versus 7.0%,P 【 0.001).The mean amount of money spent per health consultation was US $ 1.7 in Nakai and US $ 7.2 in Xe Bang Fai.Conclusion:The observed differences in self-reported ill-health and health seeking behavior among these two Lao communities need to be considered when implementing setting-specific mitigation measures as part of the public health action plan of the Nam Theun 2 hydroelectric project.

Social Determinants of Health Behaviors in Primary School Children：A Cross-sectional Study of both Migrant and Resident Children in Beijing,China

Childhood risky behaviors always result in adverse health outcomes. These behaviors are greatly affected by social environment and individual factors. However, few studies explored the social determinants of schoolchildren＇s health behaviors. In this cross-sectional study, the social determinants of health behaviors were examined among both migrant and resident students in Beijing, China. Data of 967 children from six urban and suburban primary schools were analyzed using multiple linear regression analysis. The results showed that less than 60% of children performed some healthy behaviors, although their health knowledge was generally good. Children＇s health behavior scores were greatly determined by school characteristics, health knowledge, demographic characteristics, and family context. Therefore, improving health education and conditions in primary schools is the priority to promote children＇s healthy behaviors, especially for disadvantaged children.

Self-care practices and health-seeking behavior among older persons in a developing country:Theories-based research

Purpose:The aim of this study was to examine the self-care practices and health-seeking behaviours of older adults in urban Indonesia.Methods:The cross-sectional study was performed from January to March 2014 in the Tammua sub-district of Indonesia.At the time of the study,273 older adults resided in Tammua,and half of them(51.2%)participated in this study.Data collection was carried out including self-care practices,health literacy,self-efficacy and basic conditioning factors.Results:It was found that most respondents(124;88.6%)always ate various protein sources daily.However,many participants never limited consumption of sugar(55;39.3%)or salt(40;28.6%),and more than half of respondents(96;68.6%)did not regularly visit MHCs.Health status(p<0.05),health maintenance(p<0.01)and salt limitation(p<0.05)were all significantly associated with salt limitation.It was found that respondents with higher selfefficacy,those who did not want to get information,and those of younger ages are less likely to visit MHCs regularly.Conclusion:An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries.High self-efficacy should be promoted along with adequate health literacy.Older persons should learn the importance of regular health examinations to promote health,prevent diseases,and slow the progress of chronic diseases.The number of respondents who never limit their sugar and salt intake was especially surprising.An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.

Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth

Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.

Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice

AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.

A Dataset on the Status Quo of Health and Health-Related Behaviors of Chinese Youth: A Longitudinal Large-Scale Survey in the Secondary School Students of Shandong Province

This data article describes data acquired from the Database of Youth Health(DYH)program.The DYH program consisted of a multi-wave survey conducted annually in the academic year 2015/2016,2016/2017,2017/2018,and 2020/2021 to investigate the status quo of health and health-related behaviors of Chinese junior and senior high school students.A total of 99,327 students from 186 secondary schools in 17 cities of Shandong province participated in the survey.The dataset is longitudinal and consists of rich parameters in aspects of individual information,social-economic status,social interaction,nutrition and diet,psychological cognition,mental health,school adaptation,quality of life,spare-time physical activity,risk behaviors,and physical fitness evaluation results based on the National Student Physical Fitness and Health 2014.It is the first open shared dataset about Chinese adolescents’health and health-related behaviors.It would be valuable and beneficial for policy makers,educational institutions,and other stakeholders to generate or adjust the existing strategies for improving Chinese adolescents’wellbeing.

Preventing Behavioral-Risks Incidence among School Children: The Role of School-Based Health Promotion Program

This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.

Research on the Model of Consumer Health Information Seeking Behavior via Social Media

Purpose: We aim to create a model of consumer health information seeking behavior via social media, then to have a better understand of it. After that further efforts should be made to provide targeted recommendations for media managers to promote health communication via social media. Methods: Our custom model was derived from literature review, empirical research was tested by the use of questionnaire investigation, and then the collected data were analyzed by structural equation model tool SmartPLS. Finally, the custom model was modified according to the experimental results of SmartPLS. Results: A total of 239 (66.39%) of the respondents were female and 121 (33.61%) were male. The maximum of two stages of age were 18 - 29 (70.56%), 30 - 39 (13.89%). Wechat (60.28%), QQ Zone (55.22%), Micro-blog (48.89%) were the most commonly used social media to obtain health information. About 44.72% of respondents used social media to obtain health information multiple times a day. The whole numerical values of AVE, cronbach’s alpha, CR and square roots of AVE were above the benchmarks of themselves and showed great reliability and validity. All the 11 hypotheses had obvious statistical significance, the P-value of eight path coefficients exhibited <0.001, one path coefficient exhibited <0.01 and two path coefficients exhibited <0.05. Conclusions: A suitable model of consumer health information seeking behavior via social media was created and some inner relationships were found. Namely, gratification of health information and its platform had a positive effect on attitudes toward health information seeking behavior. Health information literacy and health status were proved to have a significant influence on attitudes toward health information seeking behavior, subject norms and perceived behavioral control respectively. In addition, attitudes toward the health information seeking behavior, subject norms and perceived behavioral control were proved to positively associate with health information seeking behavior intention.

Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review

Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.

School health promotion:A cross-sectional study on Clean and Healthy Living Program Behavior(CHLB)among Islamic Boarding Schools in Indonesia

Objective:This study aims to identify the knowledge,attitude,and behavior of students using eight indicators of Clean and Healthy Living Behavior(CHLB)in relation to the health education and grade levels in Islamic Boarding Schools(IBS)in Jember regency,East Java Province,Indonesia.Methods:A cross-sectional school-based survey design was used.About 114 students(mean age of 13.17 years old)selected through a multi-stage random sampling completed a selfadministered questionnaire to measure the eight indicators of CHLB,such as washing hands with running water and soap,eating healthy snacks,using clean and healthy latrines,exercising regularly and measurably,eradicating mosquito larvae,not smoking at school,weighing and height measurement every 6 months,and disposing garbage properly.The data analyses included descriptive and comparative analyses of the difference in knowledge,attitude,and behavior toward CHLB by health education and grade level.Results:About 66.7% students received health education.Significant knowledge in CHLB in relation to health education and grade was observed(P<.05),including in-depth knowledge of exercises,measurable weight and height,smoking,and healthy latrines.Meanwhile,no significant difference was observed between the attitude toward CHLB and health education in different grade levels.Furthermore,CHLB was associated with health education,including habitual exercise and using of clean and healthy latrines.

Professional Behaviors of Nurses in Geriatric Health Services Facility in Japan

Background: The characteristics of geriatric health services facilities (GHSFs) in Japan include provision of care focused on the life of the residents, and there is a need for cooperation between care workers and physical therapists responsible for the care. Our goal is to create an organizational system that allows nurses to succeed professionally. To do this, we must first discuss the professional behavior of nurses in GHSFs. Objectives: The aim of the present study was to clarify the professional behavior of nurses in GHSFs using a questionnaire survey. Method: We used a descriptive, cross-sectional design. The study was conducted in 1000 GHSFs all over Japan. The instrument used for data collection was a questionnaire. The questionnaires consisted of 24 items for determining the professional behavior of nurses, the background information of respondents. The professional behavior of nurses was analyzed using principal factor analysis (Promax rotation). Results: A total of 1189 nurses participated. Of those, 91% (n = 1084) were women, and mean age was 48.2 years. Most participants were staff nurses (n = 791;66%). We extracted 16 items by factor analysis, which were classified into four factors (professional development, autonomy, positive assertiveness to colleagues, and advocating for patient). Conclusion: The professional behaviors as identified in this study are similar to those reported in previous studies of clinical nurses in hospital. However, some subscale results are specific to the characteristics of GHSFs. The ability to understand professional behaviors has significant implications in terms of affirming and identifying sources of quality of care and creating a professional practice environment within GHSFs.