This study explored sexual orientation and gender identity as predictors of health literacy among adolescents attending New York City (NYC) public high schools. Many studies have demonstrated disparities in sexual health among sexual and gender minority (SGM) adolescents. However, little is known about their health literacy. Health literacy, defined as the capacity to acquire, understand, appraise, and apply health information, especially in health decision-making, is a known predictor of health. Data came from a quantitative cross-sectional survey (N = 1,438) collected at 15 high schools in the Bronx, NYC. Four aspects of health literacy were explored: (1) knowledge of sexually transmitted infections (STIs), (2) knowledge of sexual health rights in New York State, (3) health access literacy and self-efficacy, and (4) health communication. Linear regression analysis was used to test predictors of health literacy. Contrary to our hypothesis, SGM adolescents did not score significantly lower on the health literacy variables compared with cisgender heterosexual adolescents. SGM adolescents scored significantly higher on knowledge of STIs and knowledge of health rights compared with cisgender heterosexual young men. Adolescents who were questioning their sexual identity scored significantly lower compared with both SGM and cisgender heterosexual adolescents on all four health literacy scales. Interventions are needed to ensure that in-school curricula are inclusive and address health literacy among questioning adolescents and cisgender heterosexual young men. Addressing the health needs of questioning adolescents is particularly important because adolescence is a critical time of decision-making around sexuality and health.

Background: It is evident that proper use of the insulin injection technique (IIT) is important for optimizing the efficacy of the therapy. Despite the readily available manufacturers' instructions, healthcare professionals (HCPs) play a major role in educating patients. This study aims to investigate the knowledge, practices, and challenges faced by insulin users regarding IIT, as well as the impact of healthcare professionals' education on it.

Methods: We conducted a questionnaire-based cross-sectional study using a validated online questionnaire to gather demographic and clinical data, as well as the participants' knowledge, practices, and challenges related to insulin therapy.

Results: The mean age of the participants was 38.25 ± 15.58 (mean ± SD) years, with a nearly equal distribution of genders. Thirty-six percent of the participants educated by the diabetes educators demonstrated an appropriate IIT, such as storage, priming the insulin pen (54%), skin folding (63%), injection hold time, and "use-by" date. Furthermore, the absence of diabetes education specialist training increases the likelihood of errors, potentially leading to a loss of glycemic control. Patients reported carrying insulin when traveling as one of the major challenges (27.9%), followed by timely injections (23.7%), priming (21.6%), and adjusting the insulin dose (16.8%). Forgetfulness (47.7%), traveling or altering the regular routine (15.5%), missing a meal (15.5%), and being overly busy (13.5%) were among the reasons for missing the insulin dose; all of which are easily manageable with proper education.

Conclusion: Consistent education and re-education are necessary for the insulin users to resolve the issues associated with suboptimal IIT. The inclusion of all stakeholders in insulin therapy, particularly the diabetes education specialists, is essential. Therefore, the Ministry of Health in Saudi Arabia should take the initiative to ensure that appropriately trained diabetes education specialists, pharmacists, nurses and other HCPs assess and follow up on patients.

Introduction: People with dementia and carers face challenges in understanding and managing medications at discharge. This study aimed to develop user-centered, co-designed medication management guidance tools to enhance medication management literacy post-hospitalization for these populations.

Methods: A four-phase, multi-methods study integrating experience-based co-design: (1) literature review, qualitative study, and survey; (2) expert advisory panels involving people with dementia; (3) focus groups with people with dementia, carers, and healthcare professionals; and (4) quantitative readability and suitability analysis.

Results: Two tools were developed: a simplified medication management guide for people with dementia and a carer-focused guide. Topics included shared decision-making, informed consent, and medications that can affect cognition. Participants valued the use of simple and active language, goal-of-care discussions, and the right to second opinion. Tools were acceptable for use from admission and during hospitalization.

Discussion: This study addresses gaps in medication related health literacy tools for dementia care, offering a framework for developing similar resources.

Highlights: Medication management guidance tools have not included people living with dementia or their carers in their development. This study is the first to describe the co-design of medication management guidance tools for people with dementia. Two tools were generated, one for people with dementia and one for carers to extend their agency. This co-design study can serve as a framework to inform the development of future tools for people with dementia and carers.

Aim: Laparoscopic salpingectomy has been widely used in the clinical treatment of benign tubal lesions. This study aims to explore the effects of interactive health education combined with evidence-based pain management nursing on disease cognition, postoperative pain and post-traumatic growth in patients undergoing laparoscopic salpingectomy, in order to provide new insights into clinical nursing for these patients.

Methods: In this retrospective study, 360 patients who underwent laparoscopic salpingectomy in our hospital from January 2022 to December 2023 were included. Patients receiving routine care were included in the control group (n = 213) and patients receiving interactive health education combined with evidence-based pain care were classified under the study group (n = 147). General data, disease cognition, postoperative pain and post-traumatic growth of the two groups were collected and compared.

Results: The awareness rate regarding pathogenesis, cardinal symptom, surgical and postoperative precautions, prevention of complications, medication management, diet management, sleep management, and review time and project in the study group were all significantly higher than those in the control group (p < 0.05). The numerical rating scale (NRS) scores of the study group were lower than those of the control group at 6 h, 12 h, 24 h and 48 h post-surgery (p < 0.001). Before discharge, all dimensions of the post-traumatic growth inventory (PTGI) scores like relating to others, new possibilities, personal strength, spiritual change, and appreciation of life of the study group patients were significantly higher than those of the control group (p < 0.05). The time to get out of bed, exhaust time, and hospitalization stay of the study group patients were significantly shorter than those of the control group (p < 0.05). The total incidence of complications in the study group was significantly lower than that in the control group (p < 0.05).

Conclusions: Interactive health education combined with evidence-based pain management nursing is conducive to improving disease cognition, reducing postoperative pain, enhancing post-traumatic growth, and promoting postoperative recovery in patients undergoing laparoscopic salpingectomy.

Background: There is limited research on mental health literacy (MHL) among Chinese older adults as well as their demand and willingness for mental health services (MHS). This study investigated the factors associated with them among Chinese older adults. Additionally, predictors of MHL as well as demand and willingness for MHS were compared between older adults living alone and those not living alone.

Methods: This study is a cross-sectional study conducted among 494 older adults in Guangzhou, China. Sociodemographic characteristics, frequency of participating in community-based activities, mental health status, MHL, and demand and willingness for MHS were assessed through self-reported questions. A series of logistic regression analyses were conducted to examine factors associated with the MHL and demand and willingness for MHS.

Results: The awareness rates for the three MHL-related questions were between 65.3% and 73.7%, and 62.0% and 69.6% of the participants indicated the demand and willingness, respectively, for MHS. Frequently participating in community-based activities increased the likelihood of awareness of the MHL-related questions (ORs = 2.92-4.18, CIs = [1.50,9.28]), as well as the demand and willingness for MHS (ORs = 2.16-2.24, CIs = [1.19,4.20]). Similar significant associations were found among the older adults who were not living alone but not among those living alone.

Conclusions: Based on the results of this study, policymakers and clinicians are advised to develop more targeted community-based activities for older adults and focus especially on those living alone to enhance their MHL and increase willingness for MHS.

Objective: To examine the accessibility of online information about cochlear implant (CI) services for Spanish speakers and evaluate organizational health literacy practices in CI programs in the United States (USA).

Method: From a list provided by Cochlear, CI programs working with at least two of three CI manufacturers were identified in eight states. Selected states had the highest and lowest Hispanic populations in each of the four US geographic regions. Online information access was evaluated based on whether programs' website links were a) listed on manufacturers' 'Find-a-Clinic' tabs, b) led directly to the CI program website, c) provided information about CIs in Spanish, and d) the readability level of such information. To examine language access, researchers determined if listed programs' phone numbers connected to the department providing CI services and the availability of Spanish speaking schedulers, audiologists, ENT surgeons, and professional interpreters (PIs).

Results: 122 CI programs met the inclusion criteria. Only 4-9% of listed programs had a link connecting directly to the CI program's website, and only 11% had Spanish-language CI information. Spanish text averaged 10th grade readability (Flesch-Kincaid). Phone contacts showed 78% of numbers connected directly to the ENT/Audiology department, while only 27% offered an initial Spanish option. PIs were available in 68% of programs.

Conclusions: Results indicate reduced language access for Spanish speakers seeking CI services in the USA, exemplified by limited access to PIs and bilingual providers, insufficient availability of information about CIs on programs' websites, and low organization health literacy practices in CI programs.

Introduction: The navigational health literacy of higher education students is fundamental to effective health management and successful health navigation, thereby improving health outcomes and overall well-being. Assessing the general and navigational health literacy levels of these students is crucial for developing targeted interventions and facilitating informed decision-making on health-related issues. This study aimed to identify the levels of general and navigational health literacy, characterise access to and utilisation of healthcare services, and analyse the differences between the mean general and navigational health literacy indices and determinants among higher education students in the Alentejo region of southern Portugal.

Methodology: A descriptive and cross-sectional study was conducted between 25 May and 12 September 2023 with 1979 higher education students. An online structured questionnaire comprising the Portuguese version of the European Health Literacy Survey Questionnaire - 16 items (HLS-EU-PT-Q16) and the Navigational Health Literacy Scale (HLS19-NAV), both from the European Consortium, was used. Sociodemographic data, presence of chronic disease, perceived health status, perceived availability of money for expenses, and healthcare access and utilisation variables were included. The study data were analysed using independent samples t-test, one-way ANOVA, and post hoc Bonferroni test, followed by multiple linear regression analyses at a significance level of 0.05. Multiple linear regression analysis was performed to identify factors associated with both general and navigational health literacy. The study protocol was approved by the ethics committee of the University of Évora, and all participants provided written informed consent.

Results: Most students (86.8%) exhibited limited general health literacy, while 13.2% demonstrated adequate health literacy. Inadequate navigational health literacy was observed in 73.4% of students. Students with lower mean general and navigational health literacy were more likely to have utilised health services. Students with chronic conditions, recent use of urgent or emergency services, and difficulties in accessing healthcare had lower health literacy. Conversely, those enrolled in health-related courses, those with good financial resources and those who had not used health services during their course had higher health literacy. In addition, lower navigational health literacy was found among displaced students, those with chronic conditions and those who had recently consulted a doctor. Higher navigational health literacy was associated with enrolment in health-related courses and adequate general health literacy.

Conclusion: The findings highlight the significant influence of demographic and academic factors on general and navigational health literacy among higher education students. The prevalence of limited general and navigational health literacy underscores a significant challenge for students, institutions, and health policy makers. Effective health literacy interventions should take these factors into account. Future research should examine longitudinal changes in health literacy and evaluate the impact of targeted educational programmes.

Purpose: The prevalence of urinary stone disease is increasing due to climate change, dietary habits, and obesity. Percutaneous nephrolithotomy (PCNL) remains the preferred treatment for large kidney stones. The informed consent process is essential for patient understanding; however, conventional verbal and written methods may be inadequate. This study aimed to evaluate the effectiveness of video-assisted education in improving informed consent for PCNL.

Methods: This randomized controlled study was conducted from January to July 2023. Eighty patients scheduled for PCNL were randomly assigned to either a written-consent-only group or a video-assisted consent group that received both written consent and a seven-minute 3D-animated video. Comprehension was assessed using a 17-question knowledge assessment questionnaire before and after the consent process. Improvements in knowledge and differences in comprehension were compared.

Results: The video-assisted consent group showed significantly greater comprehension improvement than the written-only group, benefiting patients across all education levels. Multivariate analysis confirmed the strong association between video education and knowledge gain, though older age was linked to lower improvement. Despite its effectiveness, two patients withdrew due to increased anxiety, underscoring the need to balance understanding with emotional reassurance.

Conclusion: Video-assisted informed consent significantly improves comprehension in PCNL patients, particularly in those with lower education levels. However, an increased awareness of surgical risks may contribute to preoperative anxiety. Future research should refine video content, assess long-term outcomes, and explore strategies to balance comprehension with emotional reassurance.

This review aimed to investigate the role of large language models (LLMs) in clinical decision support, patient counseling, and patient education in the management of urolithiasis. Eleven eligible studies were assessed following a comprehensive search of the Scopus and Web of Science databases. In the realm of clinical decision support, large language models (LLMs), particularly ChatGPT-4, have shown efficacy in areas such as the diagnosis of urolithiasis and initial treatment planning. An evaluation of the models' adherence to the European Association of Urology guidelines revealed that ChatGPT and Perplexity outperformed Bard. For patient counseling, Bing AI exhibited a robust capacity to deliver resource-based information. The studies have yielded conflicting results regarding ChatGPT versions' ability to empathize. In the context of patient education, models such as Claude-3 and ChatGPT-4 have demonstrated the capability to provide accurate and comprehensible answers to patient questions. However, it was noted that the quality of information is occasionally conveyed using complex language. LLMs have considerable potential as assistive tools in the management of urolithiasis; however, their limitations necessitate expert supervision, especially in complex cases. In the future, it is anticipated that these limitations will be mitigated through improved training and integration of these models into clinical practice. Consequently, LLMs should be employed as auxiliary tools rather than primary instruments in clinical decision-making.

Care partners of hospitalized persons with dementia often experience significant burden at discharge. This study examined whether dementia care partner health literacy mediates the relationship between education and burden at hospital discharge. Data from 277 care partners in the Family-centered Function-focused Care (Fam-FFC) trial were analyzed using mediation analysis to assess indirect effects of education on burden (Short-Form Zarit Burden Interview [ZBI-12]) through health literacy (Rapid Estimate of Adult Literacy in Medicine-Short Form [REALM-SF]). Analyses were conducted using SPSS and AMOS. For medium education (B = -0.012; 95% CI = -0.019, -0.003), the indirect effect accounted for 18.5% of the total effect, while for high education (B = -0.018; 95% CI = -0.026, -0.006), it accounted for 21.4%, indicating partial mediation. Findings underscore the role of health literacy in reducing care partner burden and highlight the need to address education and literacy disparities to provide effective support at hospital discharge.

Primary care is responsible for diagnostics and follow-up of the majority of patients with asthma. The variable airway obstruction may contribute to difficulties in diagnosing asthma. The cornerstones of diagnostics are patient history and lung function measurements. Even patients with only sporadic symptoms should be treated with inhaled corticosteroids (Step 1 in the asthma treatment track). Patient education is essential for good asthma control. Optimal asthma control means normal lung function, absence of symptoms and absence of exacerbations. This must always be assessed at a patient consultation. In uncontrolled asthma, treatment barriers such as inadequate inhalation technique, insufficient adherence to treatment, exposure to asthma triggers, and possible influence of co-morbidity should be assessed.

Background: Epistaxis is a common otorhinolaryngology emergency, especially among the pediatric population. While prompt first aid is essential, there is limited data on parents' knowledge regarding its management in Saudi Arabia. This study assessed parental literacy in epistaxis first aid and its correlation with sociodemographic factors.

Methods: A cross-sectional online study was conducted from May to June 2023, targeting parents of children aged ≤12 years across Saudi Arabia. Using a structured questionnaire, data on demographic characteristics and epistaxis first aid knowledge were collected from 777 participants. Descriptive statistics and binary logistic regression were utilized for analysis.

Results: The majority of parents (79%) reported that their child had experienced epistaxis, and 72.7% considered it an emergency. However, knowledge gaps were evident: only 15.8% recognized posterior bleeds as life-threatening, and just 54.8% identified the correct position for managing epistaxis. Geographic disparities were noted, with parents in the South, East, and North showing lower literacy than those in the Western region. Additionally, male, non-Saudi, and postgraduate parents had reduced literacy regarding epistaxis prevention. A large proportion of parents relied on the internet for information, which may contribute to these gaps.

Conclusion: There is a significant need for targeted educational programs to improve parental knowledge of epistaxis first aid, particularly among specific demographic groups. Enhancing access to first-aid training and credible resources could improve emergency responses to epistaxis, mitigating risks and promoting safer outcomes for children.

Background: Health literacy among college students majoring in kinesiology is higher than that among students in other majors. However, the structure of interactive health literacy is poorly understood, which may affect overall health literacy. Despite existing research on health literacy, studies targeting college students majoring in kinesiology are scarce, and a gap remains in translating study results into practical strategies. Therefore, this study constructed a theoretical model of interactive health literacy among college students majoring in kinesiology.

Methods: Qualitative data were collected from online posts, a literature review, and semi-structured interviews with 11 college students majoring in kinesiology, physical education teachers, and six physical fitness experts in China. Participants were selected using purposive sampling. Interview questions focused on participants' perceptions of the structure and characteristics of interactive health literacy among college students majoring in kinesiology. Data were analyzed based on the grounded theory.

Results: The analysis derived three categories with eight subcategories, 60 concepts, and 288 labels. The categories and subcategories were harnessing health information (comprising obtaining health information and comprehending health information), promoting health interactions (comprising perceiving health functions, shaping health awareness, and participating in health communication), and addressing health problems (comprising forming health motivation, making healthy decisions, and practicing healthy living).

Conclusions: College students majoring in kinesiology in China exhibited unique trends in interactive health literacy compared to students in other countries. Further large-scale surveys are required to revise and validate the initial exploration of perceptions and investigate the structural system of interactive health literacy in various groups.

In recent years, Artificial Intelligence (AI) is transforming healthcare systems globally and improved the efficiency of its delivery. Countries like Saudi Arabia are facing unique adoption challenges in their public healthcare, these challenges are specific to AI literacy, understanding and effective usage of AI technologies. In addition, cultural, regulatory and operational barriers increase the complication of integrating AI literacy into public healthcare operations. In spite of its critical contribution in enabling sustainable healthcare development, limited studies have addressed these adoption challenges. Our study explores the AI literacy adoption barriers in context to Saudi Arabian public healthcare sector, focusing on its relevance for advancing healthcare operations and achieving Sustainable Development Goals (SDGs). The research aims to identifying and addressing the adoption challenges of Artificial Intelligence literacy within the public healthcare in Saudi Arabia. The research aims to enhance the understanding of AI literacy, its necessity for enhancing healthcare operations, and the specific hurdles that impede its successful AI adoption in Saudi Arabia's public healthcare ecosystem. The research employs a qualitative analysis using the T-O-E framework to explore the adoption challenges of AI literacy. Additionally, the Best-Worse Method (BWM) is applied to evaluate the adoption challenges to AI literacy adoption across various operational levels within Saudi Arabia's public healthcare supply chain. The study uncovers substantial adoption challenges at operational, tactical, and strategic level, including institutional readiness, data privacy, and compliance with regulatory frameworks. These challenges complicate the adoption of AI literacy in the Saudi public healthcare supply chains. The research offers critical insights into the various issues affecting the promotion of AI literacy in Saudi Arabia's public healthcare sector. This evidence-based study provides essential commendations for healthcare professionals and policymakers to effectively address the identified challenges, nurturing an environment beneficial to the integration of AI literacy and advancing the goals of sustainable healthcare development.

Objectives: To explore the chain-mediating roles of negative emotions and caregiver readiness between self-efficacy and e-health literacy among caregivers of patients with lung cancer.

Background: With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.

Design: A cross-sectional survey.

Methods: A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples t-tests and a one-way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.

Reporting method: The STROBE checklist was used for this study.

Results: The total e-health literacy score of caregivers of patients with lung cancer was 29.65 ± 7.11, and there was a correlation between self-efficacy, negative emotions, caregiver readiness, and e-health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain-mediating roles between self-efficacy and e-health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.

Conclusions: Caregivers of patients with lung cancer exhibit moderate levels of e-health literacy. This research suggests that self-efficacy not only has a direct and positive influence on e-health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.

Relevance to clinical practice: Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.

Patient or public contribution: Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.

Aim: To assess Digital Health Literacy (DHL) levels among hypertensive patients.

Design: Cross-sectional study.

Methods: The study, conducted from March to August 2024 among hypertensive patients using convenience sampling, employed a 35-item questionnaire assessing: (I) sociodemographic; (II) physical activity, dietary habits, antihypertensive pharmacological treatment and medical history; (III) online health-related information knowledge and confidence; (IV) DHL, through the HLS₁₉-DIGI questionnaire with subscales on: (i) dealing with digital health information (HL-DIGI), (ii) interaction with digital resources (HL-DIGI-INT), (iii) frequency of digital device use for health (HL-DIGI-DD).

Results: Among 311 participants (mean age 63.9 years, SD = 14.8), 42.1% completed high school, 25.4% held a bachelor's degree and 22.8% were physically inactive. While 49.8% were aware of online health-related information, 28.9% were uncertain and 47.6% lacked confidence in using it for health decisions. On average, participants showed a problematic level of DHL in HL-DIGI, a sufficient level in HL-DIGI-INT, and used digital health devices just over once a week. Older age emerged as a predictor of higher online health-related knowledge and DHL, while higher education level predicted higher knowledge, confidence and DHL. Physical inactivity was associated with lower online health-related information knowledge and confidence.

Conclusions: These findings point to the need to design proactive strategies and implement targeted training and educational interventions to improve DHL in hypertensive patients.

Implications for the profession and/or patient care: Enhancing DHL levels through targeted interventions in patient care allows patients to effectively benefit from digital healthcare, achieve positive health outcomes and reduce disparities in care pathways.

Reporting method: This study adhered to the STROBE checklist for reporting.

Patient or public contribution: Patients were involved as the study population.

Protocol registration: Local Ethical Committee of the University Hospital Company of the Marche Region, Italy (protocol: 2023/279, date: 28/09/2023).

Background: Effective self-management behaviors offer a promising pathway to address the health challenges faced by patients with chronic diseases. As a key factor influencing self-management behaviors, multidimensional health literacy has yet to be systematically studied in relation to its impact on patients with chronic diseases across different socioeconomic statuses.

Objective: To systematically investigate the influence of functional, communicative, critical, and distributed health literacy on self-management behaviors among patients with chronic diseases from different socioeconomic statuses.

Methods: A modified multidimensional health literacy and self-management behavior questionnaire was used to assess the health literacy and self-management behaviors of patients with chronic diseases. A total of 590 valid samples were obtained, and participants were divided into high and low socioeconomic status groups based on their socioeconomic background. Correlation analysis and multiple linear regression were conducted to explore the influence of various dimensions of health literacy on self-management behaviors across different socioeconomic statuses.

Results: After controlling for confounding variables, the communicative (β = 0.262, P < 0.01) and distributed (β = 0.343, P < 0.01) health literacy dimensions showed a significant positive impact on self-management behaviors in the low socioeconomic status group. In the high socioeconomic status group, critical (β = 0.253, P < 0.05) and distributed (β = 0.267, P < 0.01) health literacy demonstrated a significant positive effect on self-management behaviors. No significant impact was observed for functional health literacy in either group.

Conclusions: The study comprehensively reveals the distinct effects of different dimensions of health literacy on self-management behaviors among patients with chronic diseases from varying socioeconomic statuses. These findings provide a theoretical basis for developing strategies aimed at improving self-management behaviors through health literacy enhancement, particularly tailored to patients from different socioeconomic backgrounds.

Background: Inhaled medication is the preferred route of administration for patients with chronic obstructive pulmonary disease (COPD). The compliance rate of inhaled medication in patients with COPD is <50%, which increases the risk of acute exacerbations. Considering the complex steps of inhaled medication, improving inhaled medication compliance not only requires consistent medication frequency and medical advice but also an evaluation of whether the patient has mastered the inhaler technique to achieve the correct dose.

Objective: This study aimed to explore the effectiveness of an inhaled medication education program (Inhaling-Health website) based on the Fogg Behavior Model and gamification design on inhaled medication compliance and other health-related outcomes in patients with COPD.

Methods: In a randomized, 2-arm, concurrent parallel design, we enrolled 102 patients with COPD from respiratory medicine clinics at 2 hospitals in Zhejiang Province, China, between April and May 2023. Participants were randomly assigned to either the control group (51/102, 50%) or the experimental group (51/102, 50%). All participants completed the intervention, with 94 participants completing 6 months of follow-up. Two independent-sample 2-tailed t tests and the Mann-Whitney U test were used to analyze group differences, and generalized estimating equations were used to analyze repeated measurements.

Results: After the intervention, all outcome measures improved compared to baseline. The generalized estimating equation showed that, compared to the control group, the Inhaling-Health website led to a gradual improvement in total adherence-to-inhaler scores starting from 2 months after the intervention (median 51.00, IQR 49.00-52.25 vs median 50.00, IQR 47.00-51.00; Z=-2.014; P=.04). It had a separate positive effect on inhaler technique. In addition, the website was more effective in reducing the modified Medical Research Council score than routine inhaled medication education, starting from 4 months after intervention (median 1.00, IQR 1.00-2.00 vs median 1.00, IQR 0.00-2.00; Z=-2.260; P=.02). The website was also more effective than the conventional intervention in improving Chronic Obstructive Pulmonary Disease Knowledge Questionnaire scores, beginning at the end of the intervention (mean 6.14, SD 1.83 vs mean 7.06, SD 1.82; t₁=-2.551; P=.01).

Conclusions: The gamified inhaled medication education program based on the Fogg Behavior Model can improve inhaled medication adherence, inhaler technique accuracy, health literacy, lung function, and health-related quality of life; help reduce the severity of dyspnea and COPD physical symptoms; and reduce the risk of acute exacerbations in patients with COPD. This study can provide a reference for inhaled medication education in patients with COPD.

Trial registration: China Clinical Trials Registry (ChiCTR) ChiCTR2300070213; https://www.chictr.org.cn/showprojEN.html?proj=194829.

Background: Adolescent mental illness contributes significantly to both the global and South African burden of mental health. Mental health literacy (MHL) promotes early recognition and intervention and consequently, determines mental health-promoting behaviours. We aimed to explore adolescent MHL and its intersection with help-seeking behaviour and gender in adolescents in the Western Cape.Method: The study instrument was a self-report survey/questionnaire. One hundred learners from public and independent schools in the Western Cape completed the survey.Results: There was a significant difference between first aid skills and help-seeking behaviours between the different genders. Specifically, girls were more prone to first aid skills and help-seeking behaviours than boys and other genders. Boys, on the other hand, were significantly more prone to using self-help strategies than girls and other genders. While gender differences were evident, these results are not sufficient to generalise to the larger population due to the limited sample.Conclusion: The results of this study are relevant to practitioners who wish to improve MHL and help-seeking behaviours among adolescents.

Dermatologic toxicities resulting from cancer treatments are common, debilitating, and can significantly impact a patient's quality of life. In some cases, these toxicities may require dose adjustments or even discontinuation of treatment. Timely management of dermatologic adverse events (DAEs) is crucial to improving patient outcomes, and educational resources are instrumental in empowering patients to recognize and manage these issues. This cross-sectional survey study aims to characterize patient utilization of and satisfaction with educational resources regarding dermatologic toxicities of cancer treatments. Findings indicate that while 77.5% (n = 110) of patients received information on managing dermatologic toxicities, a larger proportion (n = 123; 86.5%) experienced these side effects. Healthcare providers were the primary source of information (n = 102/110; 92.7%), followed by self-searching on the internet (n = 59/110; 53.6%), and social media (n = 43/110; 39.1%). Despite most patients receiving educational content, patients expressed low satisfaction with both the quality and quantity of information provided, with only 31.3% (n = 41) reporting satisfaction with the amount of information and 33.8% (n = 44) reporting satisfaction with its quality, highlighting a significant gap in resource effectiveness. Notably, patients reported the highest satisfaction with information provided by healthcare providers, suggesting that integrating comprehensive dermatologic education into oncologic care could improve patient satisfaction and outcomes.