Health Education Journal

Providing basic health education to older adults with limited reading skills is increasingly important due to demographic change. Health literacy enables older adults to navigate healthcare more successfully and make informed decisions, but educators in adult basic education often struggle to find materials that are both relevant and suitable. This study explored two key aspects of this challenge. First, it investigated how adult educators from Germany perceived the relevance of health literacy for adults aged 65 years and above. Second, it examined the effectiveness of a language-adaptive search engine, KANSAS, in identifying linguistically appropriate health-related texts for this target group.

Mixed-methods design, combining a survey and an experimental comparison of perceptions and search results of two search engines.

Data were collected via an online platform used by adult educators working in basic education contexts.

A total of N = 58 adult educators participated in a between-subjects study in October 2022, comparing the KANSAS search engine with a similar looking search engine without linguistic functionalities. Participants were asked to evaluate retrieved health-related reading texts regarding their linguistic suitability. Texts were analysed for readability, word and syllable count, and targeted grammatical features.

Many educators considered health literacy for older adults important in their professional context, although some reported limited experience working with members of this learner group. Texts retrieved via KANSAS showed significantly better readability and lower linguistic complexity. Although the frequency of targeted grammatical constructions did not differ significantly, participants rated KANSAS as more suitable for educators in identifying relevant linguistic features.

KANSAS can support literacy educators by facilitating the selection of appropriate health texts. Combined with growing educator awareness of language-adaptive reading material, such tools may help integrate health literacy more effectively into various adult education contexts.

Mental fatigue resulting from prolonged cognitive activity leads to tiredness and decreased performance, particularly among university students. Active breaks (ABs) are short exercise sessions designed for use in the classroom, helping to alleviate stress and counteract the effects of prolonged sitting. This study aimed to evaluate the effectiveness of an AB programme on the psychological determinants of academic performance (motivation, attention, mood and mental fatigue) among university students.

A quasi-experimental design with pre- and post-repeated measurements was conducted with 96 undergraduate students (73.6% male, 26.4% female) in Mallorca, Spain. The intervention involved 3- to 5-minute ABs over 10 weeks, with two breaks per week. The order of conditions (AB/without AB) was counterbalanced. A visual analogue scale was used at the beginning, middle and end of the class to assess relevant psychological determinants.

All mid-class measurements were significantly better in the AB condition compared to the condition without ABs. The AB condition had higher mean scores than the non-AB condition for motivation (7.07 vs 5.91), attention (6.83 vs 5.90) and mood (7.19 vs 6.41). The AB condition also showed less mental fatigue (4.80 vs 5.38).

ABs are efficacious in improving attention, motivation and mood while reducing mental fatigue among university students. These beneficial effects seem to be immediate but temporary, suggesting that ABs should be integrated into classroom routines on an ongoing basis in order to maintain their impact on psychological performance.

This study aimed to evaluate university students’ attitudes and awareness towards Tai Chi and Qigong, and to explore their interrelationship as well as the influence of demographic variables.

A cross-sectional survey was conducted to gather quantitative data on students’ perceptions of Tai Chi and Qigong.

The study was implemented across five public universities located in eastern, central and western regions of China, representing diverse geographic and cultural contexts.

A cross-sectional survey design was adopted, using a bilingual questionnaire distributed online via Wenjuanxing. A total of 378 valid responses were analysed. The instrument assessed demographics, attitudes (via 10-point Likert-type scale) and awareness (via 10-item knowledge test) of Tai Chi and Qigong. Data were analysed using descriptive statistics, t tests, Pearson correlations and multivariate analysis of variance (MANOVA).

Students demonstrated generally positive attitudes, scoring 32.8 ± 8.80 for Tai Chi and 30.9 ± 9.81 for Qigong, with a statistically significant difference (p = .005). Awareness scores were moderate to low: 45.4 ± 16.1 for Tai Chi and 53.3 ± 18.9 for Qigong, also significantly different (p < .001). A positive correlation was found between attitudes and awareness for both Tai Chi (r = .43, p < .001) and Qigong (r = .39, p < .001). Demographic variables, particularly prior learning experience and source of exposure, significantly influenced both constructs.

Despite positive attitudes, students’ awareness of Tai Chi and Qigong remains limited. Educational initiatives should prioritise evidence-based integration and awareness-building strategies within university physical education programmes.

Organ donation is vital for sustaining the lives of individuals with organ failure, yet transplant rates remain low in Türkiye and globally. While nurses have a key role to play in public education and supporting donation decisions, limited research has explored nursing students’ metaphorical perceptions of organ donation – an approach that can reveal underlying values, beliefs and professional attitudes.

To explore nursing students’ perceptions of organ donation through metaphor analysis, providing insights for nursing education and public awareness strategies.

This descriptive qualitative study, grounded in Conceptual Metaphor Theory, was conducted with 205 undergraduate nursing students at a university in Ankara. Data were collected using an open-ended form in which participants completed the sentence: ‘Organ donation is like . . . because . . .’. Using purposive sampling, 63 invalid metaphors were excluded, leaving 142 valid responses. A five-stage thematic analysis was undertaken, involving metaphor identification, categorisation, thematic structuring, validation and reporting with illustrative quotations.

Analysis identified four main themes and eight subthemes: Life (‘giving life’, ‘being’); Hope and Future (‘a light in despair’, ‘expectation of a new beginning’); Altruism and Sacrifice (‘giving selflessly’, ‘responsibility to do good’) and Rebirth (‘a second chance’, ‘returning to life’). Common metaphors included ‘water’, ‘hope’, ‘rebirth’ and ‘sharing’.

Nursing students conceptualised organ donation as a holistic act encompassing emotional, ethical and humanistic dimensions, often linking it to continuity of life and hope, and second chances. These findings highlight the value of incorporating metaphor analysis into nursing curricula to foster ethical awareness, empathy and advocacy skills. Public awareness campaigns should also integrate values-based messages that emotionally engage target audiences.

Digital platforms, particularly YouTube, are increasingly used to deliver home dialysis education. However, the quality and reliability of these videos varies substantially, raising concerns regarding patient safety, treatment adherence and the continuing education of healthcare professionals. This study aimed to evaluate the educational value of YouTube dialysis training videos by assessing their accuracy, audiovisual quality, scientific consistency and instructional effectiveness.

A systematic search of YouTube was conducted between 22 October and 22 November 2025, using the keywords Dialysis Education, Peritoneal Dialysis and Hemodialysis. Videos lasting longer than one minute, with adequate audiovisual clarity and explicit educational purpose, were included. In total, 102 videos met the inclusion criteria. Three independent reviewers evaluated each video using DISCERN, JAMA benchmarks, the Global Quality Scale (GQS) and the Patient Education Materials Assessment Tool (PEMAT). Statistical analyses examined the associations between educational quality and video characteristics such as uploader type, country of origin, duration and presence of verbal narration.

Of the 102 videos analysed, 40.2% were uploaded by individuals and 59.8% by institutions. DISCERN classification revealed very low (13.7%), low (26.5%), moderate (30.4%), high (26.5%) and very high (2.9%) quality videos. Institutional uploads demonstrated significantly higher educational quality and reliability than individual uploads (p < .001). Videos uploaded in the USA scored higher across all metrics. Longer videos (>10 minutes) and those including verbal explanations were associated with significantly higher DISCERN, JAMA, GQS and PEMAT scores (p < .05). Popularity indicators, such as subscriber numbers and views, showed weak correlations with quality.

YouTube provides accessible dialysis education, yet content quality remains inconsistent. It was observed that institutional and US-uploaded videos generally were perceived as having higher educational quality, and that longer video duration supported by spoken/oral explanations were associated with greater instructional effectiveness. Ongoing evaluation of online materials is essential to ensure accuracy, reliability and pedagogical quality.

Whole-school approaches (WSAs) to mental health aim to promote collaborative, system-wide action by school communities to reduce stigma, raise awareness and embed mental health as ‘everyone’s business’. Although investment in such approaches has increased in England, implementation remains challenging due to variation in interpretation and the complexity of engaging diverse stakeholders.

The NHS Trailblazer programme introduced Mental Health Support Teams in schools to enhance support for children and young people’s mental health. This exploratory qualitative study examined stakeholder perspectives on the factors influencing the successful implementation of WSAs to mental health, using the Trailblazer programme as a real-world exemplar.

Interviews with senior practitioners (n = 19) and 12 focus groups with mental health practitioners, school staff, parents/carers and children and young people (n = 29) were conducted across four educational settings in three areas of the North East of England. Data were analysed thematically using the Framework Approach and mapped post hoc onto the COM-B (Capability, Opportunity, Motivation) model of behaviour and Theoretical Domains Framework (TDF) to inform policy and practice.

Using the COM-B model as the organising framework (with TDF domains mapped within each component): ‘Capability’ encompassed knowledge, skills and behaviour regulation; ‘Opportunity’ captured environmental context and resources and social influences and ‘Motivation’ included social/professional role and identity, beliefs about consequences, optimism/pessimism, emotions, goals, intentions and reinforcing behaviour.

While WSAs to promote mental health in schools show promise, their success depends on sustained investment, professional development and clarity around implementation roles and expectations. This study contributes to the literature by providing real-world insights into the implementation of such approaches, extending understanding of how national policies can translate into local school practices.

Rates of physical inactivity and obesity among children, including those in Israel, continue to rise. While childhood is recognised as a crucial stage for developing lifelong physical activity (PA) habits, the extent to which the school environment and individual pupil characteristics are associated with leisure-time physical activity (LTPA) is not yet well understood.

This study aimed to explore which characteristics of pupils and elementary schools in Israel were associated with the frequency of pupils’ LTPA.

This cross-sectional survey included 1,398 pupils (aged 10–12 years) and 134 parents across 29 schools. Fourteen of them were Health Promoting Schools (HPS), representing Jewish secular, Jewish religious and Arab populations across Israel. The survey questionnaire examined pupils’ LTPA and potential related factors, including school population group, school climate, school health policies, parental involvement and the integration of PA into school routines. Data were also collected on pupils’ socioeconomic background, gender and school’s recognition as an HPS.

LTPA was significantly associated with pupils’ engagement in school sports activities (p < .001) and a positive school climate (p < .001). Boys engaged in significantly more LTPA than girls (p < .001). However, socioeconomic status, school affiliation with the HPS initiative and population group were not significantly associated with LTPA.

Integrating sports activities into everyday school routines, fostering positive school climates and considering gender differences are essential factors for enhancing LTPA among elementary school pupils. Furthermore, being an HPS, having high socioeconomic status and implementing health-promotion policies in the school do not necessarily guarantee higher frequency of LTPA among pupils.

School-based health promotion interventions in resource-constrained settings must align with curriculum requirements and the local context to be sustainable and effective. In South Africa, there is a need to integrate support for nutrition, psychosocial well-being, and environmental sustainability within everyday teaching and learning.

This study explored the expectations of school communities regarding Wellness in Lifestyle, Intake, Fitness, and Environment (Win-LIFE), a school-based health promotion intervention designed for use in resource-constrained South African contexts.

A qualitative, multiple-case design was employed using Participatory Reflection and Action (PRA) methodology to co-develop and adapt the intervention with teachers, parents, learners, and institutional stakeholders. Data were generated through document reviews, semi-structured interviews, focus groups, workshops, and observations conducted in three primary schools. Reflexive thematic analysis was used to identify patterns in stakeholder expectations.

Five key expectations were evident across stakeholders: namely, that the intervention should be educational and practical; that it should be aligned with the South African Curriculum and Assessment Policy Statement for Grades 4–6; that it should be grounded in cooperative learning; that it should be engaging and enjoyable for learners; and that it should be inclusive of parental involvement.

The findings from this study highlight the importance of contextual alignment, meaningful stakeholder participation, and curriculum integration in the design of sustainable school-based health promotion interventions. The study demonstrates how schools can function as inclusive hubs for promoting health and well-being in marginalised communities.

This study aimed to assess high school adolescent female students’ knowledge about breast cancer and breast self-examination (BSE) and to determine the impact of a structured education programme on knowledge levels.

The study was conducted using a quasi-experimental, single-group pretest–posttest design. A total of 178 female adolescents studying in the city centre of Bartın were included in the study. A two-part form measuring the participants’ demographic characteristics and their knowledge levels about breast cancer and BSE was used as the data collection tool. The education programme consisted of two modules, the first focusing on breast cancer awareness and the second on promoting knowledge of BSE, and was implemented face-to-face in the school setting.

Of the 178 individuals who participated in the study, 50.6% were in the ninth grade. The mean age of the adolescents was 14.8 ± 0.6 years, and their mean age at menarche was 12.4 ± 1.1 years. Following the education, a substantial enhancement was evident in the students’ knowledge of breast cancer (4.2 ± 1.3→6.8 ± 0.9), their awareness of misconceptions (2.1 ± 1.1→4.5 ± 0.8), their cognisance of screening and early diagnosis (2.8 ± 1.0→5.6 ± 0.7), their practices regarding BSE (1.9 ± 0.9→4.9 ± 0.8), and their total score (11.0 ± 2.6→21.8 ± 2.1) (p < .001).

The education programme significantly increased adolescent female students’ knowledge of breast cancer and BSE and raised awareness of early diagnosis and preventive health behaviours.