Health Promotion International[JOURNAL]
Sun
200 papers
Cervical cancer prevention behaviors and determinants among Indigenous women in rural Nepal.
Bhetwal B, Sharma V, Abbott A … +1 more , Schafer EJ
Health Promot Int · 2026 Mar · PMID 41966842 · Full text
Cervical cancer is the leading cause of cancer-related death among Nepali women, and most have not been screened. Little is known about cervical cancer prevention behaviors [e.g. screening and human papilloma virus (HPV)...
Cervical cancer is the leading cause of cancer-related death among Nepali women, and most have not been screened. Little is known about cervical cancer prevention behaviors [e.g. screening and human papilloma virus (HPV) vaccination] and behavioral determinants (e.g. knowledge and attitudes) among Nepal's minority groups, and no study to date has examined Tamang women exclusively. The objective of the study was to assess cervical cancer prevention behaviors and determinants in Tamang women. We utilized an in-person, one-on-one questionnaire, administered by a research-trained Nepali woman visiting women in their homes (n = 250) in three municipalities of Nuwakot, Nepal. Descriptive statistics and regression models were used to characterize participants and describe factors associated with cervical cancer prevention behaviors. On average, participants were 37 years old, had a low level of knowledge about cervical cancer and preventive behaviors (18% knew at least one prevention behavior), but most had positive attitudes toward screening (76.80%) and HPV immunization (81.60%). Participants who knew what cervical cancer is (OR = 3.27, 95% CI: 1.29-8.31) or knew at least one risk factor for cervical cancer (OR = 2.51, 95% CI: 1.27-4.96) had higher odds of intending to seek screening. Study results suggest health education programs and policies need to be culturally tailored for women living in rural areas, include local stakeholders, use local communication methods, and incorporate familial support.
Health promotion at the crossroads: putting civil society in the driver's seat.
Shiroya V, Bost T, Kadasia B … +1 more , Sozanski G
Health Promot Int · 2026 Mar · PMID 41966841 · Full text
Abstract loading — click title to view on PubMed.
Physical activity in urban green spaces: what do users value most in Casablanca, Morocco?
Abdala SA, Santos-Tapia C, Oliveira FC … +3 more , Arias S, Mouwafaq S, Khattabi A
Health Promot Int · 2026 Mar · PMID 41966840 · Full text
Urban green spaces (UGS) support physical activity and population health, yet their use depends on more than availability. In rapidly urbanizing cities, such as Casablanca (Morocco), understanding which UGS characteristi...
Urban green spaces (UGS) support physical activity and population health, yet their use depends on more than availability. In rapidly urbanizing cities, such as Casablanca (Morocco), understanding which UGS characteristics residents value is essential to inform equitable planning and health promotion. This study aimed to explore which characteristics of UGS users identify as motivating factors for engaging in physical activity and to analyze how these preferences vary across different sociodemographic groups in Casablanca. A cross-sectional survey was conducted in three UGS in Casablanca. A total of 468 participants completed structured questionnaires codeveloped through a participatory process under the Citizen Laboratory for Urban Health (CSU Lab). The survey assessed sociodemographic characteristics, physical activity behaviors, patterns of UGS use, and features valued for engaging in physical activity. Descriptive statistics, bivariate analyses, and multivariable logistic regression models were used. Proximity to home (69%), low pollution (43%), and safety (41%) were the top motivators. Functional aspects, such as facilities (36%), and environmental features, such as vegetation (33%), were also frequently cited. Preferences varied across population groups and contexts. After adjustment, proximity to home was more strongly valued by women, retired participants, and residents of specific districts, while younger adults were more likely to value facilities. Valuing safety was shaped primarily by place of residence, whereas valuing low pollution was less common among unemployed participants. This study demonstrates that urban planning and health promotion strategies must incorporate local user perspectives to effectively and equitably promote physical activity through UGS.
Quick response codes in the breakfast cereal aisle: prevalence, landing page, and product characteristics.
Bathie L, Chen MCL, Leahy A … +3 more , Sträuli B, Pettigrew S, Barrett EM
Health Promot Int · 2026 Mar · PMID 41941603 · Full text
Digital labelling technologies, including quick response (QR) codes, are increasingly used in the global packaged food supply to provide additional product information. While regulation in most jurisdictions requires ess...
Digital labelling technologies, including quick response (QR) codes, are increasingly used in the global packaged food supply to provide additional product information. While regulation in most jurisdictions requires essential nutrition and ingredient information to be displayed directly on the physical label, concerns exist among researchers and consumer groups that QR codes may come to replace these key details, limiting access to essential information required for informed decision-making. This study aimed to assess the prevalence of QR codes on breakfast cereals in Australia, the types of information the codes provide and the healthfulness (measured by Health Star Rating and Nova systems) of products that feature them. In a sample of 483 breakfast cereals, 16% displayed QR codes, most frequently located on the back of the pack (72%). There were no significant differences between products with or without QR codes in median Health Star Rating (4.0 vs. 4.0; P = .832) or the proportion of ultra-processed products (83% vs. 76%; P = .136). QR codes were primarily linked to websites promoting the product (e.g. 80% featured product recipes), with none providing nutrition information besides claims. Our study provides evidence that, although QR codes are not yet widespread on breakfast cereals in Australia, they are currently being used mostly as additional marketing space rather than to provide key nutrition information to consumers. Their prevalence may increase as digital labelling technologies gain momentum globally. Regulatory oversight that prioritizes access to key nutrition information is important to ensure consumers can easily access the information required to make informed decisions.
Acceptability of HIV self-testing among sexual health service providers and Two-Spirit, gay, bisexual, and queer men in Ontario, Canada.
Ryu H, Stewart M, Dulai J … +4 more , Gómez-Ramírez O, Worthington C, Gilbert M, Grace D
Health Promot Int · 2026 Mar · PMID 41924929 · Full text
In 2020, Health Canada approved the INSTI human immunodeficiency virus (HIV) self-test. Adoption and distribution of alternative HIV testing interventions, like self-testing, are essential in meeting the United Nations 9...
In 2020, Health Canada approved the INSTI human immunodeficiency virus (HIV) self-test. Adoption and distribution of alternative HIV testing interventions, like self-testing, are essential in meeting the United Nations 95-95-95 goals. We explored the acceptability of HIV self-testing among sexual health service providers and Two-Spirit, gay, bisexual, and queer men (2SGBQM). Between 2020 and 2021, peer researchers conducted virtual focus groups (13) and interviews (18) with providers (n = 18) and 2SGBQM (n = 38) across Ontario, Canada, and analysed data using community-based participatory research approach and reflexive thematic analysis. HIV self-testing was highly acceptable among both providers and 2SGBQM. Both groups identified 'increased access to HIV testing' as a benefit. Providers identified 'client empowerment' and 'reduced workload for providers' as other perceived benefits. 2SGBQM highlighted 'convenience' as a key benefit and rationale for self-testing, though some expressed concerns and hesitance due to 'fear of needles/blood' and 'perceptions of lower accuracy and reliability' of self-test results. Providers and 2SGBQM referred to the 'potential for missed connections to care', and 'self-harm' with positive test results as additional concerns for self-testing. Both groups suggested that first-time or inexperienced testers should be tested in-clinic, compared with experienced or regular testers who may benefit from self-testing. Participants expressed that HIV self-testing should be widely available for free, or a modest fee up to $20 CAD. Providers and 2SGBQM both found HIV self-testing highly acceptable, particularly when self-administered by experienced testers. Clinic-based testing remains important, especially for first-time testers and 2SGBQM who have concerns or hesitance regarding self-testing.
Cultural and linguistic appropriateness of the HLS19-Q12 health literacy scale items among people in Norway with a Somali background.
Østbøll KK, Guttersrud Ø, Alasoow F … +3 more , Le C, Wångdahl J, Finbråten HS
Health Promot Int · 2026 Mar · PMID 41885198 · Full text
Although health literacy (HL) is essential for achieving health equity, limited knowledge exists about HL among migrant populations. The cultural and linguistic appropriateness of existing HL measurement scales is scarce...
Although health literacy (HL) is essential for achieving health equity, limited knowledge exists about HL among migrant populations. The cultural and linguistic appropriateness of existing HL measurement scales is scarce. Hence, the aim of this study was to explore the cultural and linguistic appropriateness of HLS19-Q12 scale items among individuals of Somali background living in Norway. The HLS19-Q12 measure general HL and is a short version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). By using a sequential mixed methods approach, we present results from quantitative, qualitative and mixed methods meta-inferences perspective. We used data from the Somali diaspora in the Norwegian part of the Health Literacy Survey 2019 (HLS19) and tested the data against the partial credit Rasch model. Cross-cultural cognitive interviews (CCCI) were then conducted, in which data were analysed using reflexive thematic analysis. The mixed methods approach gave us a comprehensive understanding. The CCCIs provided detailed insights into deviating items identified by the Rasch modelling, and the CCCIs revealed that more items were problematic than those flagged by Rasch modelling. A large body of literature examine psychometric properties of different scales. While this is important, this article also shows the challenges and implications in HL surveys regarding developing health equity policies for all. Hence, exploring the cultural and linguistically validation of scale items should be a standard. The Somali version of the HLS19-Q12 scale items could not be considered culturally or linguistically appropriate for people with a Somali background living in Norway.
Unpacking the early implementation of social prescribing in Swedish primary care: a theory-informed process evaluation.
Jonsson F, Viklund EWE, Degerstedt F … +2 more , Lundgren AS, Nilsson I
Health Promot Int · 2026 Mar · PMID 41859853 · Full text
Social prescribing has gained attention internationally as a health-promoting way to address patients' nonmedical needs, yet research in the Nordic healthcare context remains limited. This theory-informed process evaluat...
Social prescribing has gained attention internationally as a health-promoting way to address patients' nonmedical needs, yet research in the Nordic healthcare context remains limited. This theory-informed process evaluation set out to unpack the early implementation of a social prescribing model in Swedish primary care, developed to reduce loneliness and promote health among older adults. Guided by Normalization Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR), this study assessed how and under what conditions the model was implemented across 10 primary care centres between May 2023 and December 2024. Data were triangulated from interviews with prescribers and patients, alongside prescribing and follow-up materials. Thematic analysis indicated that while the approach was perceived as relevant and timely, implementation was hindered by a selective use of the routine screening question and lack of person-centredness in the prescribing process, reflecting poor fidelity to core principles. Leadership engagement and managerial support that appeared symbolic rather than active further constrained implementation by limiting integration into organizational workflows, rendering the approach peripheral or optional to other clinical and statutory tasks. The model's operationalization also lacked alignment with community resources and bridging structures, limiting implementation by failing to meet patients' needs and expectations. While the Swedish social prescribing approach aligns with national policy discourse and prescribers' values, its scale-up will require clearer guidance on components needing high-fidelity delivery, necessary organizational structures, accessible local resources, and mechanisms linking primary care with the wider community. These findings contribute to the international evidence base on social prescribing and inform refinements of the Swedish model.
Creating health-promoting spaces for change within the economy: the role of food co-operatives in England.
Barnes A, Power M, Kennedy K
Health Promot Int · 2026 Mar · PMID 41853936 · Full text
Public health is in crisis, with health inequalities and environmental degradation reflecting failures and uneven power in our economy. There is interest in the potential of co-ops to address these issues. However, limit...
Public health is in crisis, with health inequalities and environmental degradation reflecting failures and uneven power in our economy. There is interest in the potential of co-ops to address these issues. However, limited research explores if or how co-ops could reshape power dynamics towards health promotion within our current economy or wider transformation of it. Drawing on an understanding of health as the 'capabilities for everyday living' and power to live a life you value, as well as the concept of 'space', this article explores power dynamics in and around co-ops and how these shape co-ops' role in promoting health. While focusing on food co-ops and the economy in England, the findings offer broader learning. Based on a mixed qualitative methods study (March-July 2024), we show how three types of co-ops (established-scaled worker co-ops, 'emanant' worker co-ops, and community organizing co-ops) all act as enabling spaces for distributing power within the current economy; specifically, creating conditions for members to exert control in their lives (at work, in food systems and local areas), including through meaningful participation, access to affordable food and a more equal income. Co-ops also create other opportunities for meaningful connection and purpose which co-op members value as important for their wellbeing. However, the capacity of co-ops to exert wider transformation is constrained by their wider political, economic and social context, including the relative isolation in which they operate. Without broader collective mobilization to scale out, their full public health potential is unlikely to be realized.
How participation in health promotion affects peer-experts and experts-by-experience from vulnerable neighborhoods: a case study from The Netherlands.
Elkhuizen S, van Aken B, Stulen E … +3 more , Niewold D, Wagemakers A, Thompson K
Health Promot Int · 2026 Mar · PMID 41847753 · Full text
Residents of vulnerable neighborhoods often experience economic hardship, poor health, and social exclusion. Health promotion in vulnerable neighborhoods is often unsuccessful due to residents' mistrust toward profession...
Residents of vulnerable neighborhoods often experience economic hardship, poor health, and social exclusion. Health promotion in vulnerable neighborhoods is often unsuccessful due to residents' mistrust toward professionals and governmental institutions and misaligned interventions. Engaging experts-by-experience and peer-experts, people drawing on lived experience to support others, offers a promising means to overcome these hurdles. While this approach is gaining ground in the social domain, little is known about its impact on the experts themselves. Therefore, this study addresses the question: "What is the impact of being an expert-by-experience or peer-expert within the social domain on the expert-by-experience and peer-experts themselves?" Using Participatory Action Research, we conducted seventeen participatory observations and nine semi-structured interviews with two peer-experts, one expert-by-experience, and nine professionals in a Dutch city. A reflexive thematic analysis identified four impacts of the expert-by-experience and peer-expert role: (1) feeling connected-through mutual recognition and community engagement; (2) feeling valued-by contributing meaningfully and being respected; (3) personal growth-gaining self-reflection, self-acceptance, and self-confidence; and (4) acquiring transferable skills and future prospects-such as language skills, boundary-setting, and employment opportunities. Challenges included balancing pressures associated with role identity, financial insecurity, and boundary-setting. We conclude that, working as an expert-by-experience and peer-expert offers personal benefits, but also presents risks without adequate support. Reciprocal learning between peer-experts, as well as supportive environments, and focus on financial security are needed to ensure sustainability. Ultimately, integrating experiential knowledge may help health promotion initiatives building trust, address health inequities, and achieve lasting impact in vulnerable neighborhoods.
Pai te moe, pai te ora: exploring the sociocultural practice of sleep in Aotearoa New Zealand through Māori media.
Haami D, Pullman Z, Gibson R … +1 more , Tassell-Matamua N
Health Promot Int · 2026 Mar · PMID 41841416 · Full text
Media has the potential to influence beliefs and social practices regarding sleep health. Sponsored articles, amateur guidance, and product advertising sit alongside Western scientific sleep research, which privileges bi...
Media has the potential to influence beliefs and social practices regarding sleep health. Sponsored articles, amateur guidance, and product advertising sit alongside Western scientific sleep research, which privileges biological and medicalized conceptualizations. Within this space, Indigenous knowledge and perspectives have largely been absent, creating a gap in culturally grounded understandings of sleep as a social practice. To begin the process of reclaiming and re-privileging Indigenous Māori sleep knowledge, 270 media texts concerning sleep were sourced from online media content predominantly created by and for Indigenous Māori in Aotearoa New Zealand (AoNZ). Texts were analysed thematically and organized in accordance with the Māori model of wellbeing Te Whare Tapa Whā (referring to the four-sided house, a holistic analogy of wellbeing). Five themes are presented: Te Taha Wairua, sleep as a spiritual experience; Te Taha Hinengaro, relationship between sleep and psychological wellbeing; Te Taha Tinana, relationship between sleep and physical wellbeing; Te Taha Whānau, sleep as a shared experience; and Te Taha Whenua, a place and space to sleep. Together, these illustrate key content concerning the understanding of sleep as a social and cultural practice for Māori in AoNZ. This research informs the reclamation and re-privileging of Indigenous sleep knowledge, aiding the development of future research and health promotion practices that are culturally responsive.
Youth washing as a corporate social responsibility tactic of health-harming industries.
Witchalls S, Pitt H, McCarthy S … +2 more , Freeman B, Thomas S
Health Promot Int · 2026 Mar · PMID 41830152 · Full text
The marketing tactics of health-harming industries are broader than advertising. Health-harming industries use a range of promotional and public relations strategies to increase corporate branding, promote their products...
The marketing tactics of health-harming industries are broader than advertising. Health-harming industries use a range of promotional and public relations strategies to increase corporate branding, promote their products, and shape their image as socially responsible corporate citizens. Increasingly, this has included 'washing' strategies which companies use to enhance their legitimacy and deflect blame. There is growing research examining the use of youth-focused engagement in CSR strategies; however, there have been few attempts to document the range of 'youth washing' strategies that may be used by health-harming industries. This perspective piece explores some of the strategies that are used across a variety of health-harming industries, including the alcohol, gambling, ultra-processed food, tobacco, and fossil fuel industries, to align with youth activities and causes. We propose a definition of 'youth washing' and present some examples of youth washing strategies across five domains-youth education programs; youth employment and training programs; sports activities; youth events; and youth-focused philanthropy. Using this information, we constructed a proposed typology of strategies that will help guide future research and policy considerations of a range of public relations strategies that health-harming industries may use to align their business practices with youth. Academic and policy responses should apply youth-centred approaches to critically examine and counter such practices.
Evading regulation: young people's exposure to harmful commodity marketing in the social media feeds of their favourite influencers.
Lyons AC, Goodwin I, Young J … +1 more , Burton-Wood C
Health Promot Int · 2026 Mar · PMID 41830151 · Full text
Increasingly companies use social media influencers to market unhealthy products to young people, although we know little about the influencers young people follow and the content influencers post. This study aimed to id...
Increasingly companies use social media influencers to market unhealthy products to young people, although we know little about the influencers young people follow and the content influencers post. This study aimed to identify influencers young people follow, examine their exposure to harmful commodity content in influencer accounts, and examine the Instagram accounts of the most popular influencers for harmful commodity content and marketing. In Stage 1, 807 young people (aged 16-20 years, M = 17.1; 58% female, 33% male, 6% gender diverse, 3% did not say) completed a survey on social media use; recalled their exposure to alcohol, tobacco, and vape content and marketing within posts of influencers they follow; and named three favourite influencers. Among respondents who followed influencers (n = 665; 82.4%), 56% reported seeing influencer posts containing vapes (n = 347/620) and 23% vape marketing (n = 137/604); 47% reported seeing posts containing tobacco (n = 291/616) and 13% tobacco marketing (n = 78/604); and 76% reported seeing posts containing alcohol (n = 472/622) and 43% alcohol marketing (n = 260/602). Under-age respondents (16-17 years) reported seeing more tobacco marketing than older respondents (18-20 years). In Stage 2, researchers collected all Instagram posts of the 18 most frequently named influencers for 2 months and ephemeral 'stories' for 2 weeks. These posts/stories were analysed for harmful commodity content and marketing. Twelve influencers posted content with harmful commodities, primarily alcohol (117 posts, 6% of posts) but also vape and tobacco products (14 posts, 1% of posts). We need platform transparency and stronger policy to protect young people from harmful commodity marketing within influencers' accounts.
The value of health literacy for Global Health and One Health: nurturing the socioecological environment of schools.
Okan O, Winkler AS
Health Promot Int · 2026 Mar · PMID 41810887 · Full text
This perspective examines health literacy through a One Health lens, emphasizing its relevance for developing One Health-literate citizens, as advocated by the Lancet One Health Commission's recommendation on school heal...
This perspective examines health literacy through a One Health lens, emphasizing its relevance for developing One Health-literate citizens, as advocated by the Lancet One Health Commission's recommendation on school health literacy. It argues for a comprehensive understanding of health literacy across the socioecological continuum, integrating both individual agency and structural influences. Rather than viewing low health literacy as an individual deficiency, this perspective situates it within broader systemic and contextual factors, particularly pertinent to low- and middle-income countries and underserved populations. Building on this premise, the Health-Literate School (HeLit-School) framework offers a whole-of-school approach to advancing health literacy by embedding the concept of organizational health literacy within school systems. Drawing on socioecological and organizational development principles, HeLit-School fosters institutional transformation across all levels of school development, supporting the implementation of holistic, multi-level interventions to enhance health literacy in the school setting. It highlights the critical roles of principals and the importance of adequate resources as structural enablers of sustainable health promotion within educational settings. This perspective calls for integrating agency-based, behavioural approaches with structural, determinant-oriented strategies to strengthen both personal and organizational health literacy in schools. Aligning One Health principles with the HeLit-School framework helps bridge the behavioural and environmental determinants of health. The proposed adaptation of HeLit-Schools for One Health and its contextualization in low- and middle-income countries illustrate how upstream, setting-based interventions can support systemic capacity-building and the formation of health-literate students, educators, and policymakers in relation to One Health.
Valuing Australian parent preferences for community-based nutrition and physical activity initiatives: a discrete choice experiment.
Ward N, Thai T, Nichols M … +3 more , Moodie M, Robinson K, Brown V
Health Promot Int · 2026 Mar · PMID 41797371 · Full text
Parent engagement in community-based obesity prevention interventions (CBOPIs) enhances obesity prevention outcomes. Actions from CBOPIs may also have climate change-related impacts, but little is known about specific el...
Parent engagement in community-based obesity prevention interventions (CBOPIs) enhances obesity prevention outcomes. Actions from CBOPIs may also have climate change-related impacts, but little is known about specific elements of CBOPIs that promote parental engagement, and whether parents prefer CBOPIs that aim to address obesity alone or obesity and climate change warrants further investigation. An unlabelled 12-choice task discrete choice experiment (DCE) was undertaken, using a D-efficient design and incorporating two CBOPI alternatives plus an opt-out alternative. CBOPIs were described by six attributes: cost, aim, involvement, effectiveness, convenience, and social opportunities. Attributes were informed by a literature review of enablers and barriers to parent participation. The survey was electronically distributed to parents of primary-school-aged children in each Australian state and territory during April-May 2024. Data were analysed using conditional logit models, and willingness-to-pay for attributes was estimated. Parents (n = 438) preferred less costly CBOPIs (P < .001) that aim to address both healthy lifestyles and climate change (P = .086). Parents preferred short-term, manageable disruptions to family schedules to accommodate CBOPI participation (P = <.001) over no intervention. They were willing to pay an additional $3.97 per fortnight (∼$104.000 per year) for CBOPI participation to be convenient (standard error 1.380, P = .004). Our findings suggest that parents preferred CBOPIs that aim to address both healthy lifestyles and climate change. This suggests that incorporating climate change action into CBOPIs may increase parent support and consequently support CBOPI outcomes for both obesity prevention and climate change action.
Calling for a more coherent policy response to driving harm.
Gray K, Ennis G, Fell G
Health Promot Int · 2026 Mar · PMID 41784495 · Full text
High rates of population-level driving are associated with multiple adverse health outcomes arising from road crashes, air and noise pollution, physical inactivity, global warming, and social and economic isolation. Howe...
High rates of population-level driving are associated with multiple adverse health outcomes arising from road crashes, air and noise pollution, physical inactivity, global warming, and social and economic isolation. However, population-level driving is not widely treated as a public health issue, and efforts to reduce driving harms focus on lowering the prevalence of specific high-risk behaviours and exposures (e.g. speeding or drink-driving), not on reducing overall levels of population-driving itself. Silence on driving harms pervades because driving and cars have become deeply embedded in our surroundings, in our policies, and in our social fabric. Urban planning approaches prioritize mobility over access, and the ever-increasing road capacity, combined with underinvestment in walking and sustainable transport, has made society car dependent. Thanks to the influence of the road lobby, the harms of driving are underestimated and overlooked, while measures that make walking, cycling, and public transport the easiest option are viewed with suspicion. Policy responses to reducing population-level driving, as measured by vehicle kilometres travelled per capita and relative mode share, can create positive change. Efforts should focus on (i) improving population-level accessibility-by ensuring shops, schools, and public facilities are close to where people live and work; (ii) making walking and cycling possible and desirable; (iii) realigning incentives for transport so that walking, cycling, and public transport are cheaper and easier than driving; and (iv) communicating effectively and deliberately about transport, health, and happiness.
Parental food provisioning behaviours and perceptions in relation to environmentally sustainable diets for young children.
Samarathunga N, Spence AC, Grimes CA … +2 more , Russell CG, Lacy KE
Health Promot Int · 2026 Mar · PMID 41782177 · Full text
Promoting environmentally sustainable diets for children is crucial for human and planetary health now and for future generations. Much research has examined parents' roles in shaping children's dietary behaviours from a...
Promoting environmentally sustainable diets for children is crucial for human and planetary health now and for future generations. Much research has examined parents' roles in shaping children's dietary behaviours from a nutrition viewpoint, but there is little evidence regarding whether and how parents consider environmental sustainability in feeding their children. This study primarily aimed to understand parental perceptions, current practices, motivation, and self-efficacy regarding environmentally sustainable diets for children. A cross-sectional online survey was conducted among Australian parents of children aged 2-8 years (n = 316), recruited via social media and a university website. The survey included closed-ended and open-ended questions, with quantitative data analysed using descriptive statistics and chi-square tests, while thematic analysis was applied to open-ended responses. Australian parents' perceptions aligned with many aspects of environmentally sustainable diets, with the majority highlighting that providing local and seasonal foods aligns with such a diet. Most parents were already engaging in multiple sustainable food provisioning and purchasing behaviours (60%-90%), such as providing fruit and vegetables in season (95%) and avoiding buying food without knowing how it will be used (90%). Although fewer parents engaged in behaviours such as providing fruits and/or vegetables from a home or community garden (60%) and actively searching for products in degradable, compostable, or recyclable packaging (65%), there was high motivation and self-efficacy to adopt them. Understanding perceived enablers and barriers to parents providing children with sustainable diets is an important next step in designing interventions to support parents in providing healthy and sustainable diets for their children.
Why school tobacco bans fail: staff engagement in enforcement in Belgian schools.
Laloux P, Rimpelä A, Lorant V
Health Promot Int · 2026 Mar · PMID 41773333 · Full text
Tobacco control bans are only as effective as their enforcement, and schools are a critical though often overlooked frontline. School tobacco policies (STPs) frequently fail when staff hesitate to act. This study aimed t...
Tobacco control bans are only as effective as their enforcement, and schools are a critical though often overlooked frontline. School tobacco policies (STPs) frequently fail when staff hesitate to act. This study aimed to measure and explain staff engagement in STP enforcement using a newly developed scale. Staff members (n = 624) from 18 Belgian secondary schools took part in the ADHAirE study. Building on previous qualitative studies, we constructed a 10-item scale to assess staff willingness to enforce the STP. We used exploratory factor analysis (EFA) to identify key attitudinal dimensions underlying the scale and conducted multilevel analyses to assess factors that predict enforcement. Participants scored high on willingness to enforce the rules (2.89, range 1-4). EFA revealed two key attitudinal dimensions, each explaining 20% of the variance: the perception that enforcement is a professional role, which was widely endorsed, and sharedness of rules, for which there was less adherence: only half of the participants felt supported by parents, and 40% believed tobacco control was not a school priority. Notably, enforcement was predicted by the perception that rules are enforced by one's colleagues and the sense that the rules are justified. Bans are likely to be enforced if they are perceived as part of the staff's professional role and are shared among the school community. Effective enforcement of school smoking bans requires a shared commitment that integrates school staff, leadership, and parents. The validated scale offers a tool for school principals or health authorities to assess that alignment.
Testing the effects of nutrition-related claims on perceptions of and preferences for alcohol products among Australian consumers.
Yusoff A, Jones A, Sträuli B … +3 more , O'Brien P, Bowden JA, Pettigrew S
Health Promot Int · 2026 Mar · PMID 41769874 · Full text
To appeal to health-conscious consumers, alcohol companies are marketing some products with a variety of on-pack claims. The aims of this study were to assess (i) whether the presence of sugar, carbohydrate, or energy cl...
To appeal to health-conscious consumers, alcohol companies are marketing some products with a variety of on-pack claims. The aims of this study were to assess (i) whether the presence of sugar, carbohydrate, or energy claims on alcohol labels can influence perceived healthiness and product selection, (ii) whether any differences occurred by age and gender, and (iii) whether claim format influenced any observed effects. A total of 2034 Australian drinkers responded to an online survey where each participant was randomized to view products featuring either sugar (e.g. low sugar), carbohydrate (e.g. low carb), or energy claims (e.g. 86 cals). Participants viewed sets of three products from three different alcohol categories (out of a possible five: beer, cider, premix, spirits, wine) without any claims, and then viewed the same products, some with and some without claims from their assigned condition. For each set, participants selected a preferred product and rated all products on perceived healthiness. All products within each set contained identical alcohol content. The addition of a claim to product labels significantly increased mean perceived healthiness scores. The largest increase was observed for carbohydrate claims, followed by sugar and then energy claims. The presence of a claim did not uniformly influence product selection. The results of this experimental study indicate that displaying nutrient content and energy claims on alcohol labels has the potential to mislead consumers into perceiving such products as healthier options. Policymakers should restrict the use of claims to limit companies' ability to market alcoholic beverages as healthier alternatives.
See me and hear me: a Photovoice study of Hispanic adolescents' mental health conceptualization and priorities in the USA.
Vélez-Grau C, Romanelli M, Francis K … +4 more , Rios A, Lopez P, Hanks M, Pineros-Leano M
Health Promot Int · 2026 Jan · PMID 41755619 · Publisher ↗
Hispanic adolescents experience disproportionately high rates of mental health issues and face systemic barriers to accessing care, yet their perspectives remain underrepresented in research. Understanding how they defin...
Hispanic adolescents experience disproportionately high rates of mental health issues and face systemic barriers to accessing care, yet their perspectives remain underrepresented in research. Understanding how they define mental health is critical, as it shapes beliefs, priorities, and help-seeking behaviors. This study employed Photovoice, a community-based participatory research (CBPR) method, to explore Hispanic adolescents' conceptualizations of mental health and their priorities. Twelve adolescents (ages 13-17) from two youth centers in Greater Boston were divided into three groups. Each group participated in three meetings (a preparatory workshop, a focus group, and a feedback workshop) between June 2024 and February 2025. Participants took photographs reflecting their views on mental health, followed by reflective discussions using the SHOWeD technique. Reflexive thematic analysis was used to analyze data. Mental health was defined as the ability to feel, express, and manage emotions. Adolescents' mental health priorities were (i) self-expression and coping with distress; (ii) the role of immigrant families in adolescent mental health; (iii) the influence of peers, trusted adults, and safe community spaces in adolescent mental health; and (iv) mental health stigma. Participants emphasized creative outlets and open dialogue, while identifying cultural expectations and intergenerational silence as barriers to emotional well-being. Results underscore the need for culturally responsive mental health promotion that centers adolescent voices. Interventions should foster safe spaces for expression, validate lived experiences, and address stigma within immigrant families and communities. Intervention strategies must be multisystemic and multilayered-including family and community settings-to advance mental health equity and ensure sustainable support for Hispanic adolescents.
The social nature of parks: associations between social interactions and park visitation and physical activity among children and adolescents.
Rivera E, Deforche B, Loh VHY … +2 more , Timperio A, Veitch J
Health Promot Int · 2026 Jan · PMID 41736689 · Publisher ↗
Parks can support physical activity and socializing. While children and adolescents' use of these settings is largely socially driven, little is known about relationships between social factors and park visitation and ph...
Parks can support physical activity and socializing. While children and adolescents' use of these settings is largely socially driven, little is known about relationships between social factors and park visitation and physical activity. This study examined associations between social interactions in parks and park use behaviour among children and adolescents, respectively. Children (8-12 years, n = 213) and adolescents (13-18 years, n = 210) self-reported accompaniment, frequency of socializing during park visits, frequency of seeing known people in parks, park visitation (frequency, duration), park-based activity, and demographics. Logistic regression models, adjusting for age, sex, dog ownership, and school-level socio-economic status, examined associations of social interactions with park visitation (frequency, duration) and park-based physical activity. Children who socialized in parks most of the time and who visited with family or friends had higher odds of visiting parks ≥ once/week and engaging in physical activity compared to children who rarely socialized and only visited with family. Adolescents who more frequently socialized spent more time at the park, visited the park ≥ once per week, and were more likely to be active compared to those who rarely socialized. Adolescents who visited with family and friends visited parks for longer compared to those who visited alone. Given the link between social interactions and park use, understanding how park design and social activities (e.g. programming) can support social interaction is critical for increasing children and adolescents' park use. Future interventions may benefit from targeting both social and physical park environments. Further research should examine causal associations.
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