Health Promotion International[JOURNAL]
Sun
200 papers
Assessing health literacy and digital health literacy: evidence from Brazil's Distrito Federal.
Tabak BM, Lima Moraes K, Oliveira Buta B … +2 more , Froner MB, Couto LCD
Health Promot Int · 2025 Oct · PMID 41429914 · Publisher ↗
Health literacy (HL) is essential for the population to be able to find, understand, and effectively use health information and services, which has an impact on adherence to treatments and preventive care. This study aim...
Health literacy (HL) is essential for the population to be able to find, understand, and effectively use health information and services, which has an impact on adherence to treatments and preventive care. This study aims to analyze the association between sociodemographic factors and the dimensions of the HL Questionnaire (HLQ), including digital HL. We surveyed 828 adults employing the HLQ and the eHL Scale (eHEALS). Using regression models, we evaluate the association of demographic variables and digital HL scores on each HLQ dimension. Our findings show significant associations between higher eHEALS scores, higher education levels, and better HL across most dimensions. Low income was associated with lower scores on several HLQ scales, particularly in dimensions related to understanding healthcare providers and navigating health systems. Older participants showed greater literacy in communication with providers and navigating healthcare, while younger respondents exhibited higher digital HL. Ethnic disparities were noted, especially among Black and Brown populations, who reported lower social support for health. The dimensions with lower scores were "Feeling understood and supported by healthcare providers" and "Navigating the healthcare system," showing low interactive HL levels.
The tobacco industry at the health-environment nexus: a framing analysis of the UK 'disposable' e-cigarette ban.
Lomngam P, Hiscock R, Evans-Reeves K … +1 more , Matthes BK
Health Promot Int · 2025 Oct · PMID 41429913 · Full text
The sharp rise in 'disposable', or single-use, e-cigarettes in the UK-especially among young people-has raised urgent public health and environmental concerns. Manufacturers, including transnational tobacco companies (TT...
The sharp rise in 'disposable', or single-use, e-cigarettes in the UK-especially among young people-has raised urgent public health and environmental concerns. Manufacturers, including transnational tobacco companies (TTCs), have faced criticism for designing and marketing products that appeal to youth and have a considerable environmental footprint. In response, a UK-wide ban on single-use e-cigarettes was implemented in June 2025. While industry resistance to health policy is well documented, this is the first study to examine how TTCs and TTC-linked actors responded to regulation framed around both health and environmental objectives. We analysed 21 submissions to three public consultations from four TTCs and 10 TTC-linked organizations. Drawing on a taxonomy of framing strategies from an evidence-based corporate political activity framework, we explored how these actors sought to shape policymakers' perceptions of the problem and its solutions. TTCs and TTC-linked organizations positioned themselves as responsible actors aligned with public health and environmental goals while opposing the ban. Youth use and environmental harms were reframed as problems of individual noncompliance and enforcement failure. The ban was portrayed as disproportionate, procedurally flawed, economically harmful, and likely to increase illicit trade and tobacco use. Industry-preferred alternatives included measures targeting individual behaviour and product innovation. These findings add to evidence of a disconnect between TTCs' claimed transformation and their continued resistance to regulation. Close collaboration between public health and environmental advocates is needed to pre-empt and counter industry framing and influence, and to advance regulation that promotes public and planetary health.
An analysis of framing mechanisms used in alcohol industry submissions to an Australian national parliamentary inquiry.
Cook M, Anderson-Luxford D, O'Brien P … +1 more , Gleeson D
Health Promot Int · 2025 Oct · PMID 41429912 · Full text
The aim of this study is to analyse alcohol industry submissions to an Australian national parliamentary inquiry to understand the industry arguments and their implications for alcohol policy-making, and to test, for the...
The aim of this study is to analyse alcohol industry submissions to an Australian national parliamentary inquiry to understand the industry arguments and their implications for alcohol policy-making, and to test, for the first time, the applicability of Campbell and colleagues' typology of framing mechanisms to alcohol industry submissions. We undertook a directed content analysis to code policy positions and arguments made by industry actors in the ten industry submissions, followed by thematic analysis to examine coded data for patterned responses according to the framing mechanisms. We identified four framing mechanisms: 'equating', 'contesting', 'dichotomizing', and 'cropping', which alcohol industry submitters used to highlight their corporate social responsibility efforts, industry leadership, self-regulation and community partnerships, while undermining effective evidence-based public health policy action. Industry submitters consistently used the inquiry as an opportunity to make arguments that supported maintenance of the regulatory 'status quo' and the continued inclusion of commercial actors as partners in policy decision-making. We identified heightened and direct attacks on public health evidence not previously seen within the Australian context. While examinations of frames remain important, stepping back and examining the framing mechanisms and actions employed can also offer insights about how to critique the discursive strategies-not just the specific arguments-being utilized by industry. From this critique, it is possible to (i) understand how some frames and arguments have gained acceptance, and others have not, and (ii) to respond to dominant frames and arguments by exposing the flaws in the discursive techniques that underpin them.
A qualitative study on utilization of vulnerability assessment tool for heatwave-related health adaptation intervention in Australia.
Amoatey P, Arnot G, Endalamaw A … +3 more , Osborne NJ, Xu Z, Phung D
Health Promot Int · 2025 Oct · PMID 41416571 · Full text
Heatwave-health vulnerability index (HVI) map is an important tool for mitigating heatwave. However, the perspectives of heatwave-health management professionals (HMPs) about heatwave vulnerability have not been examined...
Heatwave-health vulnerability index (HVI) map is an important tool for mitigating heatwave. However, the perspectives of heatwave-health management professionals (HMPs) about heatwave vulnerability have not been examined. This study aims to understand HMP's perception and experiences of applying the HVI tool for heatwave-related health adaptation and mitigation. A semi-structured interview with HMPs was conducted between June and October 2024 across the Australian state agencies. We conducted an online interview, which lasted ∼31 minutes. Participants were asked to share their perspectives about the HVI tool, its policy applications, challenges, and recommendations. Twenty HMPs, the majority (75%) within 40-59 years old, 10 female (50%), and with a median (range) heat-health work experience of 6 (2-11) years participated in the study. The HMPs were from Health (50%), Climate/Environment (15%), Emergency Services (10%), Meteorology (10%), and City Councils (15%). The five themes identified were the following: (i) HMPs have moderate levels of awareness of heatwave vulnerability, particularly in the context of locating the hottest areas, (ii) HVI is considered an important tool for heatwave planning, public information, and urban design, (iii) adherence to traditional heat management strategies, low national awareness, and resourcing problems are perceived as key barriers to a national HVI, (iv) the current HVI is faced with methodological inconsistencies, limited understanding, and low confidence among policymakers, and (v) HMP are well positioned to evaluate HVI and encourage broader engagement of the index in Australia. This study offers critical insight for improving policy awareness and enhances the evaluation of the HVI through a multidisciplinary approach.
Strengthening health literacy research through consumer engagement: a qualitative analysis of building and maintaining partnership.
Ayre J, Ferguson E, Taba M … +11 more , Mac O, McFadden K, Tracy M, Edlund G, Ma ICK, Nadesan W, Yan J, Ng S, Slewa O, McCaffery KJ, Muscat DM
Health Promot Int · 2025 Oct · PMID 41414857 · Full text
Consumer engagement activities are variably implemented across research settings, and the 'science' of consumer engagement is still in its infancy. This study aimed to explore the experiences of community panel members w...
Consumer engagement activities are variably implemented across research settings, and the 'science' of consumer engagement is still in its infancy. This study aimed to explore the experiences of community panel members who supported a university-based health literacy research group that delivers experimental and applied health research across a wide variety of health topics. An independent researcher interviewed participants, asking them to reflect on their understanding of health literacy research, their experiences on the panel, and strategies to improve the panel. De-identified transcripts were analysed using Framework analysis. Ten of the 13 Sydney Health Literacy Lab Co-SHeLL community panel members were interviewed (four men; seven born in Australia, six spoke English at home). We generated four themes from the data. The first three emphasized foundational elements that supported deeper consumer engagement: diversity and belonging, trust and respect, and effective structures. The fourth theme described how the panel provided mutual benefits to researchers and consumers through increasing skills and capacities, and that this improved the quality of the research. Participants described this as a gradual process that progressed over the course of the year. This rigorous qualitative evaluation identified values that may be important for long-term partnerships with consumers, particularly for health research groups with a broad remit (e.g. health communication and health promotion) that does not focus on a single health condition. Further research could evaluate this kind of consumer engagement activity over the longer term.
Enhancing children's health literacy: a scoping review of resources for 'Curriculum for Wales' health and well-being design, implementation, and assessment.
Hughes L, James M, Lewis H … +3 more , Tur Porres G, Yu H, Marchant E
Health Promot Int · 2025 Oct · PMID 41414856 · Full text
Health literacy (HL) plays an important role in developing the skills and capacities to make health-enhancing decisions, impacting health and well-being. Primary schools are key settings for developing HL through the ref...
Health literacy (HL) plays an important role in developing the skills and capacities to make health-enhancing decisions, impacting health and well-being. Primary schools are key settings for developing HL through the reformed 'Curriculum for Wales' (CfW) and its 'Health and Well-being Area of Learning and Experience' (H&WB AoLE). With school-level autonomy offered in CfW design, resources are fundamental for curriculum design, implementation, and assessment. As the CfW is in its infancy, the visibility and quality of resources available to schools is unclear. This scoping review aimed to identify resources publicly available to primary schools to enable the design, implementation and assessment of the H&WB AoLE. A search was conducted across academic databases and sources of grey literature. Twelve sources (grey literature: n = 7, peer-reviewed research: n = 5) were selected for inclusion and discussed as a descriptive overview. The identified resources highlight a gap between policy intentions of the CfW framework and how this is implemented in practice. However, there is potential to address these concerns through self-assessment tools, collaborative improvement, planning, and evidence-informed practice. The broad nature of the CfW framework and variation in the availability and quality of health-related resources informing CfW design may result in variability in learning opportunities, influencing how children's HL is developed. Prioritizing HL as a core CfW learning outcome could streamline the translation of broad CfW guidance into impactful design, implementation and assessment of the H&WB AoLE.
Enabling sustainability through co-adaptation: a process evaluation of a school-based physical activity program.
Bachouri-Muniesa H, Verloigne M, Zaragoza J … +4 more , Lhuisset L, Julián-Clemente JA, Bois J, Asún-Dieste S
Health Promot Int · 2025 Oct · PMID 41410653 · Publisher ↗
Schools represent strategic settings for adolescent health promotion across multiple domains, including physical activity (PA). Despite the development of numerous effective programs, sustaining their impact within the s...
Schools represent strategic settings for adolescent health promotion across multiple domains, including physical activity (PA). Despite the development of numerous effective programs, sustaining their impact within the school context remains a key challenge. This process evaluation explores how mechanisms, participant experiences, and contextual factors shaped the design, implementation and potential sustainability of the replicated Sigue la Huella (SLH) program (originally designed to increase PA and reduce sedentary time) in a new secondary school in Spain. Grounded in the Replicating Effective Programs framework and co-creation principles, the intervention was co-adapted and implemented over a three-year period through an iterative, collaborative process. The approach emphasized contextual relevance, gradual transfer of responsibility, and long-term sustainability. Participants (ntotal = 43) included teachers (i.e. school implementers), the school principal, students, parents, and policymakers. Data were collected through field notes, focus groups, and interviews. Using the Framework Analysis, findings were organized into thematic matrices capturing stakeholder perspectives across co-adaptation and three implementation phases. While the core structure of SLH was retained, delivery strategies were adapted to reflect school priorities and constraints. Key enablers of sustainability included strategic planning, flexible implementation, stakeholder empowerment, and institutionalization. However, challenges such as training needs, coordination gaps, and competing initiatives persisted. In essence, the processes of co-adaptation, accompanied by a staged withdrawal of research implementation support, have been found to foster school ownership, high-fidelity delivery, and institutionalization creating optimal conditions for autonomous sustainability while recognizing context-dependent challenges.
Impact of interprofessional education training on health students' perceptions of youth: findings from the Health Service by Health Students Program in France.
Pereira V, Pudlo M, Belpois S … +8 more , Morgny C, Vuillemin X, Kubicki A, Girault M, Meurisse A, Bertrand X, Anxionnat R, Nerich V
Health Promot Int · 2025 Oct · PMID 41408792 · Publisher ↗
The Health Service by Health Students (HSHS) is a French interprofessional education program implemented in 2018 across all French regions by Health Universities. It aims to train health students (HS) in prevention throu...
The Health Service by Health Students (HSHS) is a French interprofessional education program implemented in 2018 across all French regions by Health Universities. It aims to train health students (HS) in prevention through primary health prevention actions (PHPA) targeting young populations. This study evaluated the impact of the HSHS program in Franche-Comté (HSHS-FC) on HS's representations of their target public during the 2022-23 academic year. A longitudinal, observational, prospective multicenter survey was conducted using a self-administered questionnaire before (T1) and after (T2) PHPA. The variation in responses between T1 and T2 (Δ) was analyzed for each target public. Among 755 HS included, 468 (62.0%) worked with young children, 240 (32.7%) with teenagers, and 40 (5.3%) with young adults. No significant differences in representations were found at T1 and T2 between groups regarding social background or health behavior factors. However, students working with young children and teenagers showed a statistically significant change in all items between T1 and T2. At T1, HS working with young children reported lower perceptions of their ability to receive, understand, and integrate information. Students focusing on young children reported the greatest shift in representations. HSHS-FC plays a role in reshaping HS's representations of young publics, especially children. The greater evolution in perception among HS working with young children highlights the value of initiating primary prevention early in life.
Policy implementation learnings from the introduction of a mandatory alcohol pregnancy warning label.
Pettigrew S, Davies T, Yusoff A … +9 more , Sträuli B, O'Brien P, Jongenelis MI, Stockwell T, Jones A, Stafford J, Brownbill A, Taylor F, Bowden J
Health Promot Int · 2025 Oct · PMID 41400970 · Full text
Policy makers lack guidance on effective ways to introduce alcohol warnings, making it important to document the experiences of early adopter countries. Aims of this study were to (i) assess uptake of a mandated pregnanc...
Policy makers lack guidance on effective ways to introduce alcohol warnings, making it important to document the experiences of early adopter countries. Aims of this study were to (i) assess uptake of a mandated pregnancy warning label in Australia, (ii) identify the placement of the warning on products (i.e. front, back, side, top, or bottom), and (iii) compare the results for (i) and (ii) between 2023 and 2024 to provide insights into industry willingness to engage with the policy. In-store visits and web-scraping were used to capture product images that were coded for presence and location of the mandatory pregnancy warning (2023: n = 5923; 2024: n = 6666). Four years after the initial introduction of the policy, corresponding to 1 year after the end of the implementation transition period, 22% of assessed products did not display the mandatory pregnancy warning. In both 2023 and 2024, prevalence was lowest in the spirits category and among single unit and imported products. In most instances, warnings were located on the back of products, although a substantial proportion of multi-packs displayed the warning on the underneath panel of the packaging. The Australian experience offers important insights for other jurisdictions introducing health warnings on alcohol products. Clearly specified compliance deadlines and requirements for warning location could overcome the identified implementation issues.
Examining the relationship between health literacy and eHealth literacy in adult populations: a systematic review and meta-analysis.
Edwards G, Dorstyn D, Oxlad M
Health Promot Int · 2025 Oct · PMID 41398315 · Full text
Despite their conceptual similarities and importance for effective health management, the relationship between health literacy and eHealth literacy remains poorly understood. This systematic review investigated the stati...
Despite their conceptual similarities and importance for effective health management, the relationship between health literacy and eHealth literacy remains poorly understood. This systematic review investigated the statistical association between health literacy and eHealth literacy in adults, along with study-level moderators and biopsychosocial correlates. CINAHL, Embase, Emcare, PubMed, ProQuest, PsycINFO, and Web of Science were searched until January 2025. Methodological reporting quality (QualSyst Checklist) was assessed and between-study heterogeneity explored using random and mixed-effects modeling. Twenty-three observational studies (N = 25 505 participants), all characterized by high methodological quality, were included. A weak positive relationship between overall health literacy and eHealth literacy was identified [r = 0.29, CI (0.21, 0.37)], with Category 2/comprehensive measures of health literacy correlating more strongly with eHealth literacy than Category 1/functional measures. Individual-level factors, including higher educational attainment, economic advantage, positive health behaviors, strong self-efficacy, and the ability to use digital resources were consistently linked to higher health literacy and eHealth literacy. The findings suggest that health literacy and eHealth literacy should continue to be researched in tandem to understand their impact on health outcomes in the digital age. Further research is also needed to understand how the surrounding environment, together with individual factors such as age and cultural background, influences the development of health literacy and eHealth literacy. Such studies are crucial for addressing disparities and enhancing access to health information and services.
The Taichung Statement on Health Literacy (2025): sustaining action on health literacy to promote health for all.
Chang P, Duong TV, Rachmani E … +4 more , Min-Che T, Van den Broucke S, Levin-Zamir D, Thomas S
Health Promot Int · 2025 Oct · PMID 41384730 · Publisher ↗
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An exploration of cultural grounding in Indigenous health promotion: perspectives from First Nations communities in Canada.
McBeath B, Lévesque MC, Lévesque L … +4 more , Périllat-Amédée S, Sahajpal R, Tremblay MC, Delormier T
Health Promot Int · 2025 Oct · PMID 41384729 · Full text
This article explores the evolving field of Indigenous health promotion, highlighting the use and endorsement of conventional health promotion models despite ongoing efforts toward decolonization. Although some Indigenou...
This article explores the evolving field of Indigenous health promotion, highlighting the use and endorsement of conventional health promotion models despite ongoing efforts toward decolonization. Although some Indigenous-led initiatives exist, such as the Kahnawà:ke Schools Diabetes Prevention Program (KSDPP), deeply entrenched funding models perpetuate dependency on colonial governments, marginalizing traditional knowledge and leadership within Indigenous community health systems. Drawing on community-engaged and participatory research, this study explored the potential of community mobilization to decolonize health promotion in Indigenous communities. The study, conducted during the delivery of KSDPP Community Mobilization Training sessions, explored diverse First Nations community member perspectives on culturally grounded health promotion: what it looks like and how it is implemented. Utilizing talking circles, the study identifies four core knowledge translation processes that illuminate both the nature and practical implementation of culturally grounded health promotion. These processes were grouped as experiential education, social-collaborative, adaptive, and personal cultural healing. The findings underscore the urgent need to recognize and support the ongoing shift toward Indigenous-led health promotion interventions grounded in culture and to challenge the continued reliance on Western health promotion frameworks in Indigenous settings.
Taking stock: understanding key processes in the public health programs-stages of research and evaluation framework.
Lee K, Phongsavan P, Wolfenden L … +2 more , Tabak R, Bauman A
Health Promot Int · 2025 Oct · PMID 41384728 · Full text
The complexity of research translation is well recognized. Efforts to accelerate the process have emerged through implementation science, scale-up, scalability, and sustainability. This area of research is now inundated...
The complexity of research translation is well recognized. Efforts to accelerate the process have emerged through implementation science, scale-up, scalability, and sustainability. This area of research is now inundated with a plethora of new concepts, creating overlap and confusion for those working in public health, implementation science, and scale-up as well as those seeking to understand it. This perspective examines the commonly used processes (scale-up, scalability, transferability, sustainability) and articulates their current definitions found in the literature. An explanation of the similarities and differences is also provided along with an illustration of where they may be applied in the public health programs: stages of research and evaluation framework. This perspective aims to clarify these processes, in order to provide guidance for seeking to engage in this area, how and when those processes might apply for those new to the field as well as those working within it.
A qualitative exploration of Australian parental perspectives of commercial squeeze pouches for infants and children.
Smith B, Fleming CAK, Seivwright A … +2 more , Mistry Y, Kent K
Health Promot Int · 2025 Oct · PMID 41367256 · Full text
Foods in commercial squeeze pouches are a widely used feeding option for children, yet growing concerns exist about their nutritional quality and impacts on feeding development. There is limited evidence on how and why p...
Foods in commercial squeeze pouches are a widely used feeding option for children, yet growing concerns exist about their nutritional quality and impacts on feeding development. There is limited evidence on how and why parents use these products, leaving critical gaps in understanding how to design policy and food environments that support positive nutrition choices. This study aimed to explore Australian parents' experiences and motivations for providing commercial squeeze pouches to infants and children. An online survey was distributed nationally to parents, containing an open-ended question inviting them to describe the role of squeeze pouches in their child's diet and their reasons for use. Responses were inductively thematically analysed to understand motivations, perceptions, experiences, and feeding contexts. A total of 179 parents, mainly mothers (78.1%), participated, revealing five intersecting themes: societal and behavioural drivers, feeding supplement strategies, feeding confidence and nutritional perceptions, commercial food environment, and environmental impact considerations that influenced their use of squeeze pouches when feeding their child. Within the themes, parents frequently described how squeeze pouches are a practical solution to managing time pressures, fussy or neurodivergent eating behaviours, and feeding during illness or travel. However, many also expressed concerns about cost, packaging waste, and feeding skill development. Overall, a broader societal paradox emerged where convenience and modern parenting demands often outweighed nutritional or environmental ideals. The complex insights provided by parents demonstrate the need for policy and practice responses that address structural and commercial drivers of food choice, while supporting families with accessible, evidence-based feeding guidance.
Evaluating the Sustaining Play, Sustaining Health programme in Australian early childhood education and care services: a pilot randomized controlled trial.
Imad N, Hall A, Giles L … +7 more , Pearson N, Shoesmith A, Nathan N, Grady A, Renda A, Belski R, Yoong S
Health Promot Int · 2025 Oct · PMID 41367255 · Full text
Early childhood education and care (ECEC) services are a recommended setting to deliver interventions improving children's physical activity (PA). Indoor-outdoor free play, where children move freely between indoor-outdo...
Early childhood education and care (ECEC) services are a recommended setting to deliver interventions improving children's physical activity (PA). Indoor-outdoor free play, where children move freely between indoor-outdoor environments, can increase child PA. However, these programmes in ECECs are often not sustained. This study aims to assess the acceptability, feasibility, impact, adoption and cost of the Sustaining Play, Sustaining Health (SPSH) programme on sustainment of indoor-outdoor free play programmes in ECECs. A 6-month parallel-group pilot randomized controlled trial was conducted with 16 ECEC services across New South Wales, Australia, following removal of COronaVIrus Disease of 2019 (COVID-19) recommendations. Services implementing indoor-outdoor programmes were randomized to (i) SPSH programme (n = 8) or (ii) usual care control group (n = 8). The intervention included eight strategies to target identified barriers, informed by the Integrated Sustainability Framework. Primary outcomes at 6 months were acceptability, feasibility, adoption, cost, and barriers/facilitators. Potential impact (sustainment) was measured at 6 (primary) and 12 months using nonparametric analysis. Overall, 31.48% (17/54) of eligible services consented and 16 randomized. Statistically insignificant mean differences between groups in indoor-outdoor free play were 26.27 minutes at 6 months, and 2.87 minutes at 12 months, favouring the intervention group. The SPSH programme was considered acceptable and feasible and costed AUD $452.38 ($289.74 USD) to deliver per service. There were no changes in sustainability barriers/facilitators. This pilot found mean differences favouring the intervention group for sustaining indoor-outdoor free play programmes in ECECs, particularly at 12 months. Future fully powered trials should consider addressing broader barriers including staff turnover, motivation/attitudes, and fit within broader contexts to increase impact.
Improving health promotion at universities through student participation: cross-sectional analysis of who, why, and how.
Westbrock A, Bühler A
Health Promot Int · 2025 Oct · PMID 41367254 · Publisher ↗
Participation is defined as having a genuine influence on the decisions made and methods employed and is a key component of health promotion. This also applies to health promotion in the university setting. Yet while its...
Participation is defined as having a genuine influence on the decisions made and methods employed and is a key component of health promotion. This also applies to health promotion in the university setting. Yet while its advantages are clear, motivating students to participate is difficult, and there is limited information on 'how' universities can encourage participation. Accordingly, this article employed a cross-sectional survey at a German university to determine who is willing to participate in student health management (SHM), what motivates students to participate, and which organizational parameters are necessary. Additionally, it analyses the personal and study-related influencing factors of students' motives. Group comparisons Analysis of Variance (ANOVA) and linear regression found that female students are more inclined to participate than their male counterparts and that participation varied by major and study load. Students' motives for participating in SHM are significantly associated with gender, age, major, and year of study. The most important motives are 'career' and 'values'. Finally, participation was promoted by good overall organization, successful coordination, and appropriate communication and feedback. By thus revealing who is willing to participate and why, our study suggests ways of organizing student participation to encourage students to join in SHM. Our results will aid university stakeholders in ensuring suitable conditions for participation and in addressing specific motives to promote diversity and ensure equal opportunities, leading to higher participation rates and therefore increasing the chances of target group-specific, accepted, and effective interventions.
Putting ethics at the centre of health promotion practice: lessons from Australia.
Blackford K, Burns S, Taylor J … +3 more , Leaversuch F, Gamble T, Crawford G
Health Promot Int · 2025 Oct · PMID 41340538 · Full text
This article examines recent developments to strengthen ethical health promotion practice in Australia and their global relevance. Ethical health promotion practice requires a dual foundation: structured ethical oversigh...
This article examines recent developments to strengthen ethical health promotion practice in Australia and their global relevance. Ethical health promotion practice requires a dual foundation: structured ethical oversight combined with practitioners' ability to implement ethical values and principles in their decision-making processes, leading to evidence-informed health promotion practice. However, health promotion organizations and practitioners report barriers to ethical practice, including limited resources and access to human research ethics committees and formal ethical oversight. Growing global recognition of inadequacies of traditional procedural approaches to ethical practice in health promotion highlights the need for initiatives and frameworks emphasizing decolonizing methodologies, relational and reflexive ethics, participatory and community-led oversight, and social justice embedded as a core principle. In response to barriers faced by health promotion practitioners and organizations in Australia, the Australian Health Promotion Association developed the Health Promotion Ethics Project to support ethical practice of the Australian health promotion workforce. A comprehensive ethics framework was developed comprising: (i) specialized ethics training and tools for health promotion practitioners; (ii) an ethical oversight committee with relevant expertise; (iii) customized submission processes and templates tailored to health promotion practice contexts; and (iv) advice to guide practitioners through ethical challenges. A pilot project to evaluate the framework was undertaken in 2024 with five diverse health promotion organizations across Australia, with findings informing several key recommendations for the global context. Continued investment in workforce development and tailored ethical oversight systems is vital for advancing the health promotion discipline and strengthening the global health promotion workforce.
Early generational and partisan divides in vaccine acceptance in USA during the COVID-19 pandemic.
Alonso G, Kiesel S
Health Promot Int · 2025 Oct · PMID 41334594 · Full text
Partisanship is a factor behind COVID-19 vaccine hesitancy in USA. A growing body of research indicates that conservative Republicans demonstrate greater vaccine hesitancy than their liberal Democratic counterparts. Impo...
Partisanship is a factor behind COVID-19 vaccine hesitancy in USA. A growing body of research indicates that conservative Republicans demonstrate greater vaccine hesitancy than their liberal Democratic counterparts. Importantly, older adults tend to be more conservative yet exhibit less vaccine hesitancy overall. Accordingly, this study investigates age as a moderating factor in early vaccine attitudes, addressing a gap in the current literature. Leveraging protection motivation theory and data from the Collaborative Multiracial Post-Election Survey (N = 15 000), our analysis suggests that the relationship between partisanship and COVID-19 vaccine hesitancy is conditioned by age, as measured both continuously and categorically through generational cohorts. Our primary contribution is the finding of no partisanship effect on the oldest cohort of Americans in the earliest days of COVID-19 vaccine implementation. For adults from the Silent Generation, partisanship has no systematic effect on COVID-19 vaccine hesitancy. Furthermore, for younger partisans, vaccination attitudes are more closely tied to political identity than previously known. Our findings uncover generational diversity and provide novel insight into vaccine hesitancy across age and partisanship. Examining age interactions is crucial since age is a major risk factor for many infectious diseases worldwide. Understanding this relationship is essential to ensure that vaccine campaigns are targeted in the most effective way. We present an important contribution that is intersectional in nature, furthering research in both health behavior and politics.
Factors influencing the mental health help-seeking behaviours of construction workers in Ireland: perspectives from managers.
Roche E, O'Donnell S, Richardson N
Health Promot Int · 2025 Oct · PMID 41334593 · Full text
Men in the construction industry are at a higher risk for suicidality when compared to the general male population. While industry-specific challenges such as excessive working hours and a pressurized work environment ar...
Men in the construction industry are at a higher risk for suicidality when compared to the general male population. While industry-specific challenges such as excessive working hours and a pressurized work environment are contributory factors, deeply embedded masculine norms within the industry can further exacerbate this risk by discouraging mental health disclosure and help-seeking. Against this backdrop, managers occupy a pivotal position to potentially transform this wider workplace culture. Their dual perspectives-both professionally as gatekeepers and personally as individuals with lived experience of key pressure points within the industry-can provide a nuanced, in-depth understanding of the sociocultural influences affecting construction workers' help-seeking behaviours for mental health challenges. Despite this, managers' perspectives are underexplored. Five focus groups were conducted with managers (n = 33) to explore their experiences of the broader cultural influences on help-seeking behaviour within the industry. Reflexive thematic analysis was used to analyse the data. Findings indicated three themes: (i) industry influences on help-seeking, (ii) navigating disclosure of mental health issues in a male-dominated industry, and (iii) negotiating support pathways. Findings highlight the interconnectedness of industry-specific and personal challenges that influence the disclosure of mental health issues and shape help-seeking behaviours among construction workers. Study findings have informed the development of a gender-responsive suicide prevention programme for the Irish construction industry.
Enhancing healthy eating and active play in the Australian early childhood education and care system.
Kuswara K, Laws R, Ganakas E … +2 more , Bell C, Love P
Health Promot Int · 2025 Oct · PMID 41328517 · Full text
Early childhood education and care (ECEC) settings are crucial for promoting healthy eating (HE) and physical activity (PA) among young children. However, the implementation of health promotion strategies in these settin...
Early childhood education and care (ECEC) settings are crucial for promoting healthy eating (HE) and physical activity (PA) among young children. However, the implementation of health promotion strategies in these settings is often inconsistent and suboptimal. This study applied a systems thinking approach to identify potential leverage points for improving HE and PA promotion in Australian ECEC settings. The study involved qualitative systems mapping through a desktop review and interviews with a purposive sample of stakeholders from the ECEC sector, to explore gaps, opportunities, and strategies, for strengthening HE and PA promotion. Interview data were analysed in NVivo 14 using reflexive thematic analysis within a constructivist paradigm. The desktop review showed that although ECEC quality is regulated in Australia, the standards for HE and PA promotion are vague and inconsistently assessed. Implementation support is provided at the state/territory level, but the availability and intensity of this support vary widely across jurisdictions, resulting in fragmented practices. Interviews with 16 participants, including ECEC providers (n = 4), quality assurance bodies (n = 2), and health promotion support organizations (n = 10) identified three key themes: (i) a mismatch in problem perception, (ii) the 'carrot or stick' approach, and (iii) the need to build sector capacity. From a systems thinking perspective, these findings highlight the need for a nationally coordinated approach to align quality standards, implementation support, and workforce development in the ECEC sector.
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