The scale of the problem the researchers set out to address is difficult to overstate. Prior research indicates that more than 80 percent of U.S. adults report at least one eating, activity, or weight-related concern, ranging from poor diet quality and physical inactivity to disordered eating and body dissatisfaction. Because lifestyle is a primary determinant of non-communicable diseases such as cardiovascular disease and type 2 diabetes, these widespread difficulties translate directly into population-level disease burden. National prevention programs, including the well-known Diabetes Prevention Program, typically target weight loss, calorie reduction, self-monitoring, and structured exercise. While such programs have produced some benefits—a 27 percent reduction in type 2 diabetes incidence at 15-year follow-up in one analysis—their effects often attenuate or rebound over time, and adherence remains a persistent, stubborn challenge.

Crucially, the people most likely to benefit from prevention programs are the least likely to stay in them. Younger participants, people of lower socioeconomic status, and those from minoritized racial and ethnic groups show the lowest retention rates. Commonly cited barriers include the difficulty of sustaining rigid dietary and exercise guidelines, an emphasis on weight loss rather than health improvement, logistical obstacles such as transportation, and the fact that many programs fail to address binge eating, mood, and body image concerns. Intuitive eating, the researchers argue, offers a fundamentally different architecture. Rather than prescribing fixed external rules, it cultivates interoceptive awareness—the ability to perceive and respond to internal signals like hunger and satiety—and addresses psychosocial factors such as body dissatisfaction and emotion regulation that conventional programs often overlook.

To test whether this philosophy corresponds to tangible physical health advantages, the team recruited 1,057 U.S. adults aged 18 and older through CloudResearch’s Connect platform, an online data collection service designed to improve data quality. The sample was deliberately constructed to approximate the demographic diversity of the country: 52 percent female, with 13 percent Asian, Hawaiian, or Pacific Islander, 21 percent Black, 18 percent Latine, and 58 percent White participants, and roughly 30 percent reporting food insecurity. Participants completed a cross-sectional online survey lasting 20 to 30 minutes, with rigorous bot and fraud screening applied. The researchers measured intuitive eating using the recently revised Intuitive Eating Scale-3, and aligned their outcome measures with the American Heart Association’s Life’s Essential 8, the key variables associated with maintaining cardiometabolic health. All regression models adjusted for age, sex, and race/ethnicity.

The results were notable both for what was significant and what was not. Every one-unit increase in intuitive eating scores was associated with 47 percent lower odds of current or previous hypertension, 50 percent lower odds of hyperlipidemia, and 43 percent lower odds of type 2 diabetes—small to moderate effects that held consistently across the sample. Higher intuitive eating was also linked to greater physical activity, more weeknight sleep of at least seven hours, better self-rated health, and lower self-reported stress. Yet intuitive eating showed no significant association with consuming five or more daily servings of fruits and vegetables, nor with the use of tobacco, marijuana, or alcohol over the prior 30 days. The pattern, the authors suggest, indicates that intuitive eating may be most relevant for behaviors rooted in interoceptive awareness and emotion regulation—stress, sleep, movement—rather than for specific dietary composition or substance use.

The stress findings deserve particular attention. Chronic stress contributes to a biobehavioral cascade with downstream consequences for nearly every organ system, and is considered a risk factor in up to 90 percent of non-communicable diseases. Although a previous meta-analysis found no statistically significant association between intuitive eating and stress, that conclusion rested on only four studies with varied measures and predominantly female samples. In this larger, more diverse cohort, the association was clear, and an exploratory moderation analysis revealed that intuitive eating was more strongly related to lower stress among women than men. The authors propose a possible biological explanation: women appear to experience less acute stress-induced hunger suppression than men, making them more vulnerable to emotional eating and making intuitive eating simultaneously more challenging and, perhaps, more consequential when achieved.

The study also breaks new ground on physical activity. Previous research had linked intuitive eating to adaptive motivations for exercise—moving for pleasure and health rather than appearance—but not to the quantity of activity itself. Using the International Physical Activity Questionnaire Short-Form, which captures total walking and moderate-to-vigorous activity across a full week, this study found the first positive connection between intuitive eating and the amount of movement people actually perform. The authors speculate that the questionnaire’s broad scope, which includes everyday walking rather than only structured, high-intensity exercise, may have detected an association that narrower instruments missed. This aligns with intuitive eating’s own philosophy of mindful movement that serves psychological and physical needs without prescribing specific intensity or duration.

Equally instructive are the null results. The absence of an association with fruit and vegetable intake may reflect measurement challenges—dietary self-report is notoriously prone to recall bias, and the study’s dichotomization of intake at five daily servings may have masked subtler differences. It may also reflect the philosophy itself: intuitive eating does not prescribe specific foods or servings, instead encouraging people to eat foods that promote energy and well-being when hungry and stop when full. Intuitive eaters may therefore gravitate toward widely varying dietary patterns. Similarly, the lack of association with substance use is unsurprising given that intuitive eating does not explicitly target substances, though the authors note that harmful patterns such as binge drinking remain unexamined and represent a promising direction for future work.

The authors are careful about what these cross-sectional data can and cannot show. Because everything was measured at a single point in time, directionality remains unknown. It is plausible that eating intuitively lowers chronic disease risk through reduced stress, better sleep, and greater physical activity; it is equally plausible that a health-promoting lifestyle makes intuitive eating more feasible in the first place. The associations are likely complex and reciprocal. The study also relied on self-reported diagnoses, which are vulnerable to recall and social desirability bias, and the sample contained relatively fewer older adults, who bear the greatest burden of the conditions examined. Notably, with nearly a third of participants reporting food insecurity, the authors caution that intuitive eating may be less accessible for resource-constrained individuals, underscoring the need to study socioeconomic context as a moderator.

Even with those caveats, the implications are significant. If intuitive eating’s benefits prove durable in longitudinal and intervention studies, it could offer a more sustainable and inclusive alternative to rigid prevention programs that struggle with retention precisely among the highest-risk groups. Strategies centered on tuning into the body’s signals may be more approachable and realistic than strict meal plans, especially for people lacking access to fresh foods or time for preparation. Preliminary intervention data already suggest intuitive eating approaches are acceptable and durable over short-term follow-up. What this study adds is the tantalizing possibility that the approach matters not just for how people feel, but for the diseases they develop—suggesting that the path to a healthier heart may begin not with a rule, but with a signal from within.

Subject of Research: Associations between intuitive eating and health behaviors and cardiometabolic health in U.S. adults

Article Title: Associations between intuitive eating and health behaviors and physical health in U.S. adults

Article References: Burnette, C. B., Tessier, K. M., Launius, K. N., Crumby, E., Barnhart, W. R., & Hahn, S. L. (2026). Associations between intuitive eating and health behaviors and physical health in U.S. adults. Journal of Behavioral Medicine. https://doi.org/10.1007/s10865-026-00712-z

Image Credits: AI Generated

DOI: 10.1007/s10865-026-00712-z

Keywords: intuitive eating, health behaviors, cardiometabolic risk, chronic disease prevention, hypertension, type 2 diabetes, hyperlipidemia, stress, sleep, physical activity, health promotion, health psychology

The cornerstone of the collection is a paper titled “The arts as a global health resource: key priorities for future research,” which synthesises a broad body of evidence showing that engagement with cultural activities can contribute to health across the entire life course. The synthesis spans the role of the arts in promoting wellbeing and preventing illness, as well as their contribution to the management and treatment of disease once it occurs. The authors argue that decades of studies, conducted across diverse populations and health contexts, have brought the field to a critical stage. What is now required, they contend, is not simply more isolated studies but strategic, systems-level integration in which arts engagement is embedded within the structures of health policy, public health programming and medical practice.

Among the international group of co-authors is Professor Agustín Ibáñez of the Global Brain Health Institute at Trinity College Dublin, who contributed to both cornerstone papers in the collection. “This is a historic moment for medicine,” said Professor Ibáñez. “For the first time, arts and cultural engagement are being brought together within a global medical framework spanning health promotion, prevention, treatment and care.” His words capture the ambition of the project: to move the conversation about arts and health out of specialist circles and into the mainstream of global health policy, where decisions about funding, service design and prevention strategies are made.

The second cornerstone paper, “Developing roadmaps for advancing practice, research, and policy in the arts and health,” shifts the emphasis from evidence to action. It sets out a practical agenda built around several interlocking priorities. The authors call for equitable access to arts engagement so that the health benefits of cultural participation are not confined to privileged communities. They argue for the inclusion of arts engagement in population-level prevention strategies, meaning that cultural activities could be promoted alongside established preventive measures. The roadmap also emphasises stronger community pathways that connect people to arts-based programmes outside hospital walls, and evidence-based arts interventions within clinical care itself, where structured cultural activities could complement conventional treatment. Finally, the paper stresses the need for sustained cross-sector investment and research, acknowledging that lasting integration will require collaboration between health ministries, cultural institutions, philanthropic funders and academic researchers.

Perhaps the most striking conceptual move in the collection is its proposal that arts engagement should be formally recognised as a health-enhancing behaviour, comparable in importance to physical activity, diet and sleep. This framing carries significant implications. Behaviours such as exercise and healthy eating sit at the heart of public health messaging, screening conversations and lifestyle guidance precisely because they are understood to shape health outcomes at scale. Placing cultural engagement in the same category would mean that clinicians, public health agencies and policymakers could legitimately consider whether a person has access to music, art, theatre or dance as part of assessing and supporting their health. The authors are careful to note, however, that implementation must be culturally grounded and locally adapted: what counts as meaningful arts engagement varies across societies, and programmes imposed without regard to local culture are unlikely to succeed or to be equitable.

“We are moving from seeing the arts as an optional complement to health towards recognising cultural engagement as part of how we understand, protect and improve human health,” said Professor Ibáñez. This reframing is significant for how the medical community conceptualises the determinants of health. For much of modern history, health systems have been organised around biological and, more recently, psychological and social models of illness. The Lancet collection argues that cultural environments belong alongside these dimensions as genuine contributors to health, shaping everything from stress regulation and social connection to identity, resilience and community cohesion.

For brain health in particular, the implications may be profound. “For global brain health, this is particularly important,” added Professor Ibáñez. “Health emerges from the interaction of biological, psychological, social and cultural environments. Arts and culture are part of those processes. The challenge now is to build the evidence, policies and health systems that recognise this.” His institute, which trains future leaders in brain health, sits at the intersection of neuroscience, clinical care and global policy, and his involvement signals that the arts-and-health agenda is being taken seriously within mainstream academic medicine. Brain health offers a natural proving ground for this framework: conditions such as dementia, depression and stroke recovery involve cognitive, emotional and social dimensions where culturally embedded activities, from music-making to group dance, have shown promise in supporting cognition, mood and social participation.

The global launch of the collection underscores the political ambition behind the science. The research will be presented in New York during Healing Arts at UNGA, NYC 2026, a week of events held alongside the United Nations General Assembly. The research symposium, “The Jameel Arts & Health Lab–Lancet Global Collection on Arts and Health,” will take place on Tuesday 22 September 2026, from 1:30 to 5:30 PM US Eastern time, at the Skirball Center for the Performing Arts at 566 LaGuardia Place, New York, with Professor Ibáñez among the featured speakers. The event forms part of Healing Arts at UNGA, NYC, running from 19 to 26 September 2026, which brings together researchers, artists, health leaders and policymakers to explore the role of creativity and culture in building healthier societies. Scheduling the launch beside the UN General Assembly is a deliberate signal: the organisers intend the collection to be read not only by clinicians and academics but by governments and international agencies with the power to embed arts engagement in national health strategies.

The timing reflects a broader shift in how international health bodies think about wellbeing. In recent years, global health discourse has increasingly acknowledged that social connection, community participation and cultural identity influence health outcomes, yet concrete mechanisms for acting on these insights have remained scarce. The Lancet collection attempts to fill that gap with a roadmap that is specific enough to guide policy: establishing equitable access, embedding cultural engagement in prevention, building community referral pathways, commissioning evidence-based clinical interventions and committing to long-term cross-sector funding. Each element is designed to translate the accumulated evidence base into institutional change rather than leaving arts-on-prescription schemes to depend on the enthusiasm of individual practitioners.

The collection does not claim that the arts will replace medicine, and its authors are explicit that the field must continue to build rigorous evidence, including studies that clarify which forms of engagement work best, for which populations and under what conditions. But the direction of travel is unmistakable. With The Lancet, one of the most widely cited medical journals in the world, providing a global platform, and with the Jameel Arts & Health Lab marshalling the research infrastructure to advance the agenda, arts and cultural engagement has moved from the periphery of health debate to its centre. What the researchers describe as a historic moment may ultimately be judged by whether health systems follow through: whether cultural participation becomes, in practice, a recognised part of how societies promote wellbeing, prevent illness and care for the sick. The roadmap now exists; the task of implementation begins.

Subject of Research: A global framework for integrating arts and cultural engagement into health promotion, prevention and clinical care.

Article Title: Landmark Lancet series brings arts and cultural engagement into mainstream global health

Article References: Landmark Lancet series brings arts and cultural engagement into mainstream global health. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: arts and health, The Lancet, global health, Jameel Arts & Health Lab, cultural engagement, health promotion, disease prevention, clinical care, brain health, Trinity College Dublin, public health policy, health-enhancing behaviour

The review, led by Nanik Setiyawati with Sri Sulistyowati and Heru Priyanto, analysed twenty-one original intervention and implementation studies spanning Argentina, Nepal, India, the United States, Kenya, Nigeria, Uganda, Tanzania, Ethiopia, Iran, Malaysia and Hong Kong. Rather than pooling effect sizes, the researchers charted who delivered each intervention, where screening access was created, how cultural barriers were addressed and whether participants were connected to follow-up care. This implementation-focused lens matters because a programme labelled a “home visit” can mean radically different things: one visit may merely encourage clinic attendance, while another offers HPV self-collection on the spot, transports the specimen and arranges follow-up for abnormal results.

From the evidence map, six recurring strategy families emerged: lay or peer workforce models, culturally tailored education, navigation and barrier reduction, HPV self-sampling, mobile health reminders and integrated community outreach. The most successful programmes combined several of these functions. In Argentina’s EMA cluster-randomised trial, community health workers offering HPV self-collection during home visits achieved an HPV testing rate of 86 percent compared with 20 percent in the control arm, a risk ratio of 4.02. In Hong Kong, a community health worker-led programme combining education, monthly phone calls and navigation for South Asian women reached 97.9 percent screening uptake at three months versus 52.6 percent among controls.

The numbers from low- and middle-income settings are equally compelling. In Nepal, female community health volunteers who provided home education, referral and follow-up raised screening uptake by 48 percent relative to control. In rural India, a nurse-led multicomponent intervention lifted Pap testing from 4.1 percent at baseline to 71.5 percent within six months. In Nigeria, women offered HPV self-collection in their community achieved 93 percent screening completion compared with 56 percent for hospital-based collection, and nearly all returned specimens were adequate for testing. In the United States, mailed HPV self-collection kits plus scheduling assistance more than doubled uptake among under-screened low-income women, reaching 72 percent versus 37 percent.

Digital tools added measurable value when they addressed concrete barriers. In Tanzania, a randomised double-blind trial found that behaviour-change text messages tripled attendance compared with a single informational message, and adding a transport eVoucher nearly doubled the effect again, pushing the odds ratio to 4.7. That combination worked because it tackled both the behavioural hesitation and the financial cost of reaching a clinic. Yet the review is careful to note that SMS strategies depend on phone access, privacy, literacy and local service capacity, which is why eligibility for the Tanzanian trial itself required mobile-phone ownership.

Perhaps the review’s most important contribution is its insistence on framing screening promotion as a prevention cascade: engagement, communication, access, screening completion, result delivery, triage and treatment linkage. When the authors traced participants beyond the first test, troubling gaps appeared. In rural Kenya, community health campaigns raised population-level screening uptake to 60 percent versus 37 percent for facility-based delivery, but treatment acquisition among HPV-positive women remained low in both arms, at roughly 39 percent and 31 percent with no statistically significant difference. In Uganda, a community self-sampling programme achieved 82 percent participation, yet only 35 percent of women who tested positive for high-risk HPV and received SMS instructions actually attended follow-up, with transport costs, disbelief, childcare burdens and the absence of symptoms all cited as barriers.

These downstream failures carry a hard lesson for policymakers: a first screening test is an intermediate milestone, not the finish line. The review argues that programmes should begin with the least-screened population and specify a complete pathway from trust to treatment linkage, identifying who delivers the message, how cultural and language barriers are addressed, which screening route is offered, how results are communicated and how positive findings are followed up. Education alone, the evidence shows, is often insufficient. Two included trials, one in Hong Kong and one in Kenya, improved knowledge or beliefs without producing a clear screening uptake advantage, underscoring the distinction between changing minds and changing access.

The review also exposes persistent reporting deficiencies that limit how transferable these models are. Uptake was commonly reported, but fidelity to the intervention design, cost, workforce training, equity reach, participant burden, result notification, triage and long-term sustainability were inconsistently documented. Although many studies intentionally recruited rural, low-income, ethnic-minority or safety-net populations, few reported stratified data on who actually completed screening, received results or reached follow-up care across intersecting barriers. A Ugandan cost-effectiveness analysis built on the ASPIRE trial suggested that HPV screen-and-treat could reduce lifetime cervical cancer risk from 4.2 percent to as low as 2.4 percent with repeated screening, at incremental costs of roughly US$130 to US$470 per year of life saved, but those estimates hinge on test costs, treatment linkage and modelled assumptions.

The practical prescription that emerges is to match the intervention to the documented barrier profile of a community. Where mistrust or language barriers dominate, culturally concordant messengers such as community health workers, promotoras and lay health advisors supply relational trust and local legitimacy. Where access barriers dominate, self-sampling, local campaigns, worksite programmes and navigation can physically move the screening opportunity closer to the people who need it. Where downstream retention is weak, result-delivery systems and treatment navigation become the priority investment. The authors acknowledge limitations, including reliance on open bibliographic records, incomplete exclusion-reason logging and heterogeneous study designs that preclude meta-analysis, but the pattern across twenty-one studies is consistent enough to guide programme design today.

As the world pursues the World Health Organization’s cervical cancer elimination targets, this evidence map reframes what success looks like. Getting a woman to complete a screening test matters enormously, but the true measure of a community-based programme is whether she then receives her result, attends follow-up if the test is abnormal and obtains treatment when needed. Programmes that connect trusted community interfaces with feasible screening routes and reliable aftercare, the review concludes, are the ones positioned to convert screening activity into genuine cancer prevention, and future evaluations should report cascade completion and implementation conditions rather than celebrating uptake numbers alone.

Subject of Research: Community-based health promotion strategies to increase uptake of cervical cancer screening

Article Title: Mapping community-based health promotion strategies for cervical cancer screening uptake: A scoping review of intervention components, delivery models and implementation gaps

Article References: Setiyawati, N., Sulistyowati, S., & Priyanto, H. (2026). Mapping community-based health promotion strategies for cervical cancer screening uptake: A scoping review of intervention components, delivery models and implementation gaps. Public Health in Practice, 12, Article 100857. https://doi.org/10.1016/j.puhip.2026.100857

Image Credits: AI Generated

DOI: 10.1016/j.puhip.2026.100857

Keywords: cervical cancer screening, HPV self-sampling, community health workers, health promotion, prevention cascade, patient navigation, SMS reminders, scoping review, global health equity, cancer elimination, public health in practice, screening uptake

The context for the study is a demographic and policy pressure cooker. Societies and healthcare systems worldwide are confronting the demands of an aging population, and the European Commission has emphasized cross-sector collaboration to build sustainable, health-promoting solutions that support active and healthy ageing. In Sweden, healthcare is undergoing a deliberate transition toward person-centered and integrated care, with proactive, health-promoting approaches and digital solutions intended to deliver more equal, efficient, and accessible services. Municipal healthcare, provided in people’s homes or in specialized housing, serves a population in which up to 83 percent of recipients in 2023 were aged 65 or older, and many of these individuals also receive municipal social services such as home care. Staff in these services frequently perform delegated healthcare tasks, blurring the boundaries between sectors and making shared, collaborative perspectives essential to any preventive shift.

The scientific rationale is compelling. Cohort studies suggest that today’s older adults generally show higher levels of physical and mental functioning than previous generations, and Swedish data report improvements in health, longevity, and activity performance among people up to 80 years of age. Health promotion, defined as the process of enabling people to increase control over the determinants of their health, offers a way to consolidate those gains. Interventions that target key health determinants among community-dwelling older adults before they enter municipal care could help maintain health, delay the onset of care needs, and reduce future demand on strained health and social care systems. Within occupational therapy, engagement in meaningful everyday activities is considered a key determinant of health, and prior evidence supports both group-based formats and digital delivery, suggesting that combining the two could offer promising, resource-efficient routes to supporting healthy ageing.

To understand the organizational ground truth before any large-scale implementation, the researchers turned to the people who run and staff municipal services. Using a qualitative focus group design, they recruited 22 participants from seven municipalities in northern Sweden, including occupational therapists, development managers, area managers, operations managers, and case managers. The participants were purposively sampled across professional roles and organizational levels, and grouped with others in similar positions to reduce the distorting effects of hierarchy on candid discussion. Five focus groups were held over five months, three digitally because of the long distances between workplaces and two in person. To anchor the conversation, the researchers presented a shared case: a web-based, group-delivered occupational therapy intervention called Health Web, which their team had previously developed and piloted. The case was not being evaluated; it served as a concrete stimulus for broader reflection on what health-promoting work would demand of the organization. Discussions, lasting between 56 minutes and one hour and 50 minutes, were audio recorded, verbatim transcribed, and analyzed inductively using a structured focus group analysis approach.

The analysis converged on a single overarching theme: creating organizational readiness for health-promoting interventions. This theme was supported by three interrelated subthemes: supportive structures for health-promoting work are needed within the organization; a shared health-promoting focus and new collaborations are required; and new working methods are necessary to facilitate health promotion. The researchers found that these subthemes do not operate as isolated barriers or facilitators but interact dynamically in everyday practice, collectively shaping whether preventive ambitions can actually be realized. Every focus group judged current readiness to be insufficient, yet participants also expressed a clear sense that health-promoting interventions are essential as the organization aligns with person-centered and integrated care.

The first subtheme exposed a structural paradox. Participants described legal agreements, frameworks, and priority orders that govern municipal work as failing to stipulate health-promoting activity. Development managers explained that the home care agreement, for example, directs effort almost entirely toward technical aids and reactive, treatment-focused care, leaving professionals who are trained to work preventively feeling actively hindered. In their words, staff are left to put out fires without ever being able to prevent the fires from starting. The absence of supportive structures led to a shared perception of health promotion as optional work, something to be attempted only when time and resources allowed. Participants called for revised agreements, clearer interpretation of the new social services act, explicit direction on resource allocation and competence use, and political and managerial leadership to initiate the change, emphasizing that long-term sustainability requires extra resources during a transition period rather than short-term projects vulnerable to annual budget cuts.

The second subtheme revealed a cultural trap: daily practice is dominated by reactive, compensatory interventions. Occupational therapists are mainly contacted for acute needs following hospital discharge and are often perceived as an overburdened group with few staff, so managers hesitate to add anything beyond ordinary tasks. Interventions in older adults’ daily activities are frequently delegated to home care staff who lack formal competence and face language barriers, leading to deprioritization in favor of basic care. Collaboration between health and social care typically emerges only late, when complex needs have already arisen, and is further restricted by secrecy regulations. Participants proposed earlier, closer collaboration, tools such as life story forms used proactively to map health determinants, and outreach into society, including associations, libraries, and digital platforms, to reach resourceful older adults whose changing life circumstances make them ideal candidates for preventive intervention before poor health takes hold.

The third subtheme highlighted new working methods, particularly digital and group-based formats. Participants viewed digital solutions as a way to reach older adults who have difficulty leaving home, including informal caregivers and those with limited energy or mobility, and to build digital competence, itself a health-promoting skill in modern society. Yet current municipal digital use is largely one-way, covering security alarms and camera surveillance rather than mutual communication. Group formats were judged inherently health-promoting: shared activities foster mutual encouragement, social learning, empowerment, cognitive and physical stimulation, and a sense of purpose, right down to the motivation to look presentable for a meeting. Flexible design was seen as important, since combining an initial physical meeting with later digital sessions could lower the threshold for isolated older adults, while for others a screen feels safer as a first step out of isolation.

Interpreted through Weiner’s theory of organizational readiness for change and the Consolidated Framework for Implementation Research, the findings suggest low change efficacy and fragmented change commitment among staff, but also extend those frameworks by showing that readiness is continuously negotiated through structural conditions, shared views, and everyday collaborative practices rather than being a static psychological state. The authors argue that the study provides a foundation for structured dialogue between policymakers, managers, and professionals, ideally within collaborative co-creation processes, and call on the occupational therapy profession to engage across organizational levels in deciding how its competencies can shift from reactive, compensatory roles toward proactive, health-promoting practice. For a system facing an ever-growing older population, the message is stark but constructive: the potential for prevention already exists within municipal organizations, but it must be deliberately built, resourced, and led from the top if health promotion is ever to move from aspiration to everyday routine.

Subject of Research: A qualitative focus group study exploring organizational opportunities and challenges for delivering health-promoting interventions to older adults within municipal health and social care in Sweden.

Article Title: Opportunities and Challenges for Health-Promoting Interventions for Older Adults: A Focus Group Study with Professionals in Municipal Health and Social Care

Article References: Körlof, L., Nyman, A., Larsson, E., & Isaksson, G. (2026). Opportunities and Challenges for Health-Promoting Interventions for Older Adults: A Focus Group Study with Professionals in Municipal Health and Social Care. Scandinavian Journal of Occupational Therapy, 33(1), Article 6. https://doi.org/10.1007/s44474-026-00008-0

Image Credits: AI Generated

DOI: 10.1007/s44474-026-00008-0

Keywords: health promotion, older adults, occupational therapy, organizational readiness, municipal health care, social care, person-centered care, integrated care, digital interventions, group-based interventions, healthy ageing, qualitative research

The study was led by Saeed M. Alghamdi of Umm Al-Qura University, together with collaborators spanning respiratory care programs across Saudi Arabia and the National Heart and Lung Institute at Imperial College London. The team set out to explore perceptions regarding the use of traditional Saudi singing and dancing as a method to promote general and respiratory health. Their rationale rests on a simple physiological observation: singing, like breathing, demands precise breath control and recruits many of the same anatomical structures that respiratory therapists target in pulmonary rehabilitation, including the diaphragm, intercostal muscles, and the muscles of the upper airway.

Singing is, at its core, the production of musical tones with the voice, and it requires the coordinated regulation of inhalation, phonation, and controlled exhalation. When people sing sustained phrases, they typically deepen their tidal volume, slow their respiratory rate, and increase minute ventilation efficiency, mirroring techniques used in formal breathing retraining. Dancing adds an aerobic dimension, elevating heart rate and ventilatory demand while building endurance in the muscles of respiration. The concept of Singing for Lung Health, often abbreviated SLH in the respiratory therapy literature, has gained traction in recent years as a structured intervention for people with chronic obstructive pulmonary disease and asthma, and previous research suggests that singing and dancing can improve multiple aspects of health in both healthy individuals and those with respiratory conditions.

To test whether these ideas resonate within a Saudi cultural context, the researchers conducted an observational, cross-sectional survey in the Makkah region. The questionnaire combined closed-ended questions, which yielded quantitative data summarized as frequencies and percentages, with open-ended questions designed to surface the key barriers that might prevent people from engaging in traditional performance practices. Ethical approval was obtained from Umm Al-Qura University in Makkah, and the study was conducted in compliance with the Declaration of Helsinki, with all participants providing informed consent before completing the survey.

The results paint a picture of a population already deeply engaged with these traditions and broadly optimistic about their health value. Of the 273 participants, 153, or 56.0 percent, were female, the majority were aged 21 to 41 years, and 88 participants, representing 32.2 percent, reported having chronic respiratory diseases. Among all respondents, 203 people, or 74.4 percent, reported engaging in Saudi traditional singing and dancing. Within this engaged group, 120 participants, or 59.1 percent, believed that traditional singing and dancing had a positive impact on general health, while 93, or 45.8 percent, agreed that these practices are potentially improving lung health.

One of the most compelling findings was the relationship between active participation and perceived benefit. Participants who actively engaged in traditional singing and dancing were significantly more likely to perceive associated health benefits compared to those who did not, with differences reaching statistical significance at p less than 0.001. This pattern held even though the study could not establish causation; it nevertheless suggests that firsthand experience of the breath work and physical exertion involved in traditional performance may shape how people understand its health potential.

Age emerged as a significant factor in engagement. The association was statistically significant, with a chi-square value of 6.20, p equal to 0.045, and a Cramer’s V of 0.151, indicating a modest but measurable effect. Engagement was highest among participants aged 20 years and under, at 85.3 percent, followed by those aged over 41 years at 75.8 percent, and lowest among those aged 21 to 41 years at 69.8 percent. The authors suggest this pattern may reflect the central role of traditional performance in youth gatherings and older community celebrations, while working-age adults may face time constraints that limit participation.

Gender shaped the barrier landscape in a notable way. Female participants were significantly more likely than males to report a lack of community support as a barrier to practicing traditional singing and dancing, a difference that reached statistical significance at p equal to 0.004. No statistically significant gender differences were observed for other perceived barriers. This finding carries practical weight for any future health promotion program: interventions built around traditional performance would need to address social support structures, particularly for women, if they hope to achieve broad participation across the population.

The study’s authors are careful to frame their findings as perceptual rather than clinical. The survey measured what people in Makkah believe about the health effects of singing and dancing, not objective changes in lung function, exercise capacity, or quality of life. Nonetheless, the conclusion points clearly toward the next step: further research assessing the influence of singing and dancing on clinically relevant parameters would be useful. Such studies could measure forced expiratory volume, respiratory muscle strength, six-minute walk distance, and validated quality-of-life instruments before and after structured programs of traditional performance, providing the evidence base needed to move from cultural intuition to clinical recommendation.

If future trials confirm measurable respiratory benefits, the implications could extend well beyond Saudi Arabia. Culturally grounded interventions often outperform generic health messaging because they arrive wrapped in meaning, identity, and joy rather than obligation. Traditional Saudi singing and dancing, practiced for thousands of years in religious ceremonies, social gatherings, and artistic performances, may offer exactly that kind of vehicle: a form of pulmonary rehabilitation that people already love, passed down through generations, waiting to be recognized as medicine hiding in plain sight. The research was funded by Umm Al-Qura University under grant number 26UQU4340488GSSR02, and the study was registered with the Open Science Framework at 10.17605/OSF.IO/867ME.

Subject of Research: Perceptions of traditional Saudi singing and dancing as a means of promoting general and respiratory health in Makkah, Saudi Arabia.

Article Title: The potential use of traditional singing and dancing for respiratory health promotion in Saudi Arabia: an observational study

Article References: Alghamdi, S. M., Kabrah, S. M., Alhawsawi, H. B., Almushayt, B. S., Bajudah, R. K., Abu Dark, R. M., Aldhahir, A. M., Alsulayyim, A. S., Alasimi, A. H., Philip, K. E., Alzahrani, H. A., Alhindi, A. O., Alhindi, A. O., Alasmari, A. M., Alahmadi, F. H., Alqarni, A. A., & Alqahtani, J. S. (2026). The potential use of traditional singing and dancing for respiratory health promotion in Saudi Arabia: an observational study. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05581-2

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05581-2

Keywords: Saudi Arabia, traditional singing, traditional dancing, respiratory health, health promotion, singing for lung health, respiratory therapy, cultural practices, quality of life, chronic respiratory disease, cross-sectional survey, dance movement therapy

The analysis identified four subgroups of eaters: unhealthy eaters, passive eaters, conscious eaters, and balanced eaters. The labels describe more than dietary preference; they capture entire orientations toward food, from deliberate attention to nutrition and food labels to habitual consumption of items high in fat, sugar, or sodium, often abbreviated as HFSS foods. The existence of these distinct classes matters because public health interventions tend to be designed for average populations, while actual behavior is patterned. A campaign that resonates with a conscious eater may fall flat with a passive eater, and the study’s statistical approach makes those differences visible in a way that simple averages cannot.

Latent class analysis works by modeling the probability that individuals share an underlying, unobserved categorical trait based on their observed responses. In this study, the researchers compared competing models with different numbers of classes using standard fit criteria, including the Akaike information criterion, the Bayesian information criterion, the consistent Akaike information criterion, and the sample size-adjusted Bayesian information criterion. These indices penalize model complexity while rewarding explanatory power, allowing the team to settle on the four-class solution as the best balance between parsimony and accuracy. Once the classes were established, binary logistic regression was used to estimate the odds of belonging to particular subgroups based on sociodemographic characteristics and indicators of health lifestyle.

The setting is significant. Universities concentrate diverse groups of students and working adults in one environment, making them natural laboratories for studying how place shapes eating behavior. Thai society is undergoing rapid changes in food consumption patterns, driven by urbanization, the proliferation of convenience foods, and shifting work and study schedules. At the same time, non-communicable diseases linked to diet have become a central public health concern in Thailand and across the region. Understanding how eating behavior is socially patterned within a university therefore has implications that extend well beyond campus boundaries, because the habits formed or reinforced during university years often persist into later adulthood.

Among the study’s most consistent findings is the role of age. Older participants showed higher awareness of healthy eating, suggesting that nutritional consciousness accumulates over the life course rather than arriving fully formed in youth. This pattern challenges the assumption that younger generations, often portrayed as more health-literate, are inherently better positioned to make sound dietary choices. In the Thai university context at least, the data indicate that younger members of the population are more likely to occupy the less healthful subgroups, while awareness of healthy eating rises as age increases. For health promotion planners, this implies that interventions targeting younger students should not assume baseline motivation but must instead build it.

Income adequacy emerged as another significant determinant of food choices. The finding underscores a material dimension of healthy eating that is easy to overlook in behavior-focused campaigns: the ability to afford nutritious food shapes what people actually eat, independent of knowledge or intention. When budgets are constrained, cheaper HFSS options become more attractive, and the study’s regression results indicate that perceived income adequacy significantly shifts the odds of membership in the healthier eating classes. This aligns with a broader literature on food insecurity and diet quality, and it suggests that university policies on food pricing, subsidized healthy options, and campus food environments may be as important as education in shifting population-level eating patterns.

Perhaps the most actionable findings concern knowledge and behavior. Knowledge of food labels was identified as a key determinant of healthy eating awareness, as was body satisfaction. Participation in health-promoting activities and regular exercise also predicted membership in the more healthful subgroups. Taken together, these factors sketch a coherent picture: people who engage actively with their health, whether by reading labels, exercising, or joining wellness programs, are also the people who eat consciously and in balance. The relationship is likely reciprocal, with healthy behaviors reinforcing one another, but the practical implication is clear. Programs that build food label literacy and create opportunities for physical activity and health participation may generate spillover effects into dietary behavior.

The study was conducted by Phoobade Wanitchanon, Saichol Panyachit, Cholvit Jearajit, Pychaniphat Wichaino, and Poramin Tangopasvilaisakul, all of the Department of Sociology in the Faculty of Social Sciences at Srinakharinwirot University, and was supported by the Thai Health Promotion Foundation. Ethical approval was obtained from the university’s Human Research Ethics Committee, and the research was conducted in accordance with the principles of the Declaration of Helsinki. The authors note that the work responds to a gap in research on recent eating behaviors in Thai universities, where the intersection of student life, employment, and Thailand’s evolving food culture had not previously been examined with this class-based statistical lens.

Methodologically, the paper demonstrates the value of person-centered approaches in nutrition and social science research. Variable-centered methods, such as ordinary regression on averaged outcomes, can obscure heterogeneity by estimating effects across a blended population. Latent class analysis instead treats the population as a mixture of types, which is often closer to how health promoters encounter the real world: not as an average eater, but as distinct audiences with different motivations, constraints, and knowledge. The four-class solution identified here, validated through information criteria and followed by logistic regression on class membership, offers a template that other institutions in Thailand and the wider ASEAN region could adapt, particularly within networks such as the ASEAN University Network-Health Promotion Network.

The broader significance of the work lies in its framing of healthy eating as a social pattern rather than a purely individual choice. By showing that class membership is predicted by age, income adequacy, food label knowledge, body satisfaction, exercise, and participation in health-promoting activities, the study situates diet within a web of social and lifestyle factors that institutions can influence. Universities, as dense environments where diverse populations eat, work, and study together, are well positioned to act on these findings, whether through campus food policy, nutrition education embedded in curricula, or structured wellness programming. As food consumption patterns in Thai society continue to change rapidly, research of this kind provides the evidence base needed to design interventions that meet distinct groups of eaters where they actually are, rather than where an average model assumes them to be.

Subject of Research: Social patterning of eating behavior among students and personnel in Thai universities identified through latent class analysis.

Article Title: Social patterning of eating behavior in a Thai university population using latent class analysis

Article References: Wanitchanon, P., Panyachit, S., Jearajit, C., Wichaino, P., & Tangopasvilaisakul, P. (2026). Social patterning of eating behavior in a Thai university population using latent class analysis. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00476-6

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00476-6

Keywords: eating behavior, latent class analysis, Thai university, healthy eating, food practices, non-communicable diseases, food labels, health promotion, sociodemographic factors, Thailand, university population, dietary patterns

The study focused on occupational therapists, physiotherapists, and registered nurses working in a large Swedish municipality of roughly 150,000 inhabitants. These professionals deliver the bulk of municipal primary healthcare, including home healthcare, residential care facilities, and services for adults needing special support. Under Swedish law and their professional codes of ethics, all three groups are obliged to use science and proven experience in their daily work. Yet the researchers found that few had completed advanced-level education, the uptake of new knowledge was low, and care was more often grounded in personal experience than in research-based knowledge, leaving patients potentially exposed to out-of-date assessments and treatments.

Methodologically, the study combined five audio-recorded dialogue meetings with a web-based survey sent to all 290 employed registered healthcare professionals in the municipality. The survey drew 102 valid responses, a response rate of 35 percent overall, with notably higher participation among occupational therapists at 54 percent and physiotherapists at 50 percent compared with 27 percent among nurses. The qualitative strand used inductive, latent thematic analysis following Braun and Clarke’s six-step procedure, while the quantitative strand applied single-item logistic regression analyses to identify which attitudes and conditions were statistically associated with basing work on research. Convergent design principles guided the integration of the two data streams in joint display tables.

The qualitative analysis yielded one overarching theme: a struggle between personal and organizational conditions to use research and work according to evidence-based practice. This struggle unfolded along two dimensions. The first captured clinicians being torn between personal ambitions and a lack of skills to use research. The second described how organizational conditions and limited access to support challenged any attempt to translate evidence into practice. Participants were acutely aware of their professional obligations to use science and proven experience, but when they could not fulfil those obligations because of missing resources, structures, and support, many resigned themselves to relying on experience-based knowledge.

The skills gap emerged as a strikingly consistent finding. Slightly more than half of survey respondents said they did not feel confident searching for and interpreting research results. Advanced-level education made a measurable difference: 63 percent of those with education beyond the bachelor’s level felt confident interpreting research findings, compared with only 37 percent of those with a bachelor’s degree or less. Clinicians described research as hard to understand and generalize, noting that studies are typically conducted at the group level while their patients present complex, individualized problems. One physiotherapist wrote that it can be difficult to judge how reliable a result is and how to apply group-level findings to a single patient.

Despite these struggles, the regression analyses revealed that several individual attitudes and conditions were significantly associated with actually basing work on research. Clinicians who believed that evidence-based work saves time were more than three and a half times as likely to base their work on research. Finding research interesting nearly quintupled the odds, active searching for work-relevant research increased them eightfold, and feeling confident in searching for, reviewing, and interpreting studies each roughly tripled the likelihood. Critically, holding an advanced-level education was itself significantly associated with evidence-based working, with an odds ratio of 3.7, echoing earlier findings among physiotherapists and occupational therapists in Sweden and internationally.

The organizational picture was bleaker. Only a minority of participants said evidence-based practice was highly valued in their workplace, with the smallest proportion among occupational therapists, at just 24 percent, compared with 53 percent of nurses and 41 percent of physiotherapists. Fewer than 15 percent experienced that their manager encouraged the use of research results, and a similarly small share reported any ongoing systematic implementation of evidence-based methods. A lack of allocated time emerged as the single most-cited barrier: 91 percent said they had no time to read research during working hours, and 88 percent lacked access to research at work. When clinicians did carve out time, they described it as coming directly at the expense of hands-on patient care, creating a culture of busyness in which reading research could induce guilt.

Organizational conditions that did support evidence-based working were statistically meaningful. Having access to research results at work increased the odds of basing work on research more than fourfold, having support to try new methods nearly tripled them, and perceiving that evidence-based work was valued at work nearly tripled them. Participants also pointed to structural confusion: unclear boundaries between municipal primary healthcare and county council-run health centres, underutilized professional competencies, and missing structures for multi-professional teamwork. Occupational therapists and physiotherapists described being unable to initiate health-promoting or preventive interventions they had identified, because responsibility fell to another provider under Sweden’s so-called threshold principle, which directs patients who can travel to local health centres instead.

The researchers situate these findings within the knowledge-to-action gap, the well-documented chasm between what research produces and what clinical practice adopts. They draw on prior scholarship describing organizational cultures oriented toward doing, focused on tasks and outcomes, rather than being, which allows reflective time for assessing, reading, and critiquing research. In such cultures, direct patient care is valorized and evidence work is sidelined. The study also notes a troubling ethical dimension: although clinicians were aware they were falling short, there was a consistent absence of reflection on their individual responsibility to fulfil professional codes of ethics, and on the potential consequences for patients of receiving care not grounded in current evidence.

The authors conclude that strengthening clinicians’ competence, particularly through advanced-level education, is essential, but insufficient on its own. Managerial support, education, clinical goals, allocated time, access to research, and clear strategies for implementing evidence-based practice are all needed to shift the organizational culture. Participants themselves called for planning and management that clarifies professional roles and responsibilities, and for structures that make teamwork and evidence-based development possible. As Sweden’s national reform toward local, integrated care moves advanced care out of hospitals and into municipalities, the stakes of closing this gap rise. Without deliberate action, the study warns, the very professionals expected to anchor the new model of care will continue to run, in one participant’s words, like hamsters in a wheel, well-intentioned but unable to move the system forward.

Subject of Research: Evidence-based practice and research usage among registered healthcare professionals in Swedish municipal primary healthcare

Article Title: Ambitions and obstacles for evidence-based municipal primary healthcare – a mixed- methods study

Article References: Gustafsson, M., Zingmark, M., Iwarsson, S., & Ekstam, L. (2025). Ambitions and obstacles for evidence-based municipal primary healthcare – a mixed- methods study. Scandinavian Journal of Occupational Therapy, 32(1), Article 2451265. https://doi.org/10.1080/11038128.2025.2451265

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2451265

Keywords: evidence-based practice, municipal primary healthcare, research usage, occupational therapy, physiotherapy, nursing, knowledge translation, organizational culture, integrated care, mixed methods, health promotion, advanced-level education

The study, led by Kristin Sofie Waldum-Grevbo and colleagues including Solveig Holen, Tore Wentzel-Larsen and Åse Sagatun, surveyed 1,425 thirteen-year-olds recruited from 48 lower secondary schools across 19 municipalities in Southeast and Central Norway. The sample deliberately spanned urban and rural communities ranging from villages of roughly 1,000 residents to cities of 700,000, and achieved a 71 percent response rate among invited students. Girls made up 50.3 percent of participants, and the vast majority reported Norwegian as their home language, lived with both parents, and perceived their family’s economic situation as ordinary. The data were drawn from the baseline of the GuideMe intervention study, collected in two waves during the 2022/23 and 2023/24 school years, making this one of the more robust population snapshots of early adolescence available in the Nordic region.

At the heart of the research is a concept known as health-related quality of life, or HRQoL — a measure that captures how health shapes physical, psychological and social functioning, and an explicit target of the United Nations’ Sustainable Development Goal 3. The researchers measured it using the Norwegian version of KIDSCREEN-27, a widely validated questionnaire covering five dimensions: physical well-being, psychological well-being, autonomy and parent relations, peer and social support, and school environment. Health literacy was assessed with the ten-item Health Literacy Among School-Aged Children instrument, which operationalizes the OECD-aligned definition — the knowledge, motivation and skills to access, understand, evaluate and apply health information — across five dimensions: theoretical knowledge, practical knowledge, critical thinking, self-awareness and citizenship. Self-efficacy was captured with the Norwegian five-item General Self-Efficacy Scale, rooted in Albert Bandura’s social-cognitive theory. All three instruments showed strong internal consistency, with Cronbach’s alpha values ranging from 0.81 to 0.90.

The descriptive results confirmed patterns that have haunted adolescent health research for years. Boys scored significantly higher than girls on health literacy, self-efficacy, and every single HRQoL subscale. Girls’ mean T-scores on KIDSCREEN ranged from 43.99 to 49.77, while boys’ ranged from 48.98 to 52.33, with the widest gaps in physical and psychological well-being. Compared with normative data spanning ages 8 to 18, the girls in this sample reported substantially lower physical and psychological well-being — a discrepancy the authors attribute in part to the narrow age range and in part to the timing of data collection shortly after the COVID-19 pandemic, whose documented toll on adolescent girls’ mental health may linger well beyond lockdowns.

But the study’s central question was not simply who scores higher. The researchers wanted to know whether self-efficacy mediates — statistically explains — the association between health literacy and quality of life. Using a causal mediation framework implemented in the R statistical environment, they modeled what would happen with a hypothetical 10 percentage-point increase in health literacy on a 0-to-100 scale, an increment grounded in reality: a recent European comparative study found health literacy levels vary by 13.5 percentage points across participating countries. The hypothetical bump produced significant increases across all five KIDSCREEN subscales for both sexes. The largest total effect appeared for school environment, with estimated T-score increases of 2.47 for girls and 1.86 for boys — roughly a quarter and a fifth of a standard deviation, respectively, which is notable for a modest, population-level shift in a single determinant.

The mediation results were striking. The proportion of the effect channeled through self-efficacy was significant for every subscale in both sexes, ranging from 30 percent for physical well-being among girls to 76 percent for peer and social support among boys — though the latter estimate came with a wide confidence interval and deserves caution. For psychological well-being, self-efficacy accounted for about 45 percent of the association in girls and 63 percent in boys. In other words, a substantial share of the benefit that comes with understanding health information appears to flow through the confidence to use it. The pattern fits neatly with Bandura’s theory: mastery experiences, social support and role models build self-efficacy, and self-efficacy determines whether knowledge and skills are actually translated into action and coping. An adolescent who believes she can successfully apply what she knows may be better equipped to engage in health-promoting behaviors and weather health-related challenges — and that, in turn, may be reflected in how well she feels and functions.

Why would the school environment subscale show the strongest total effect? The authors offer a plausible mechanism: health literacy overlaps conceptually with the competencies that drive learning. Students who can access, evaluate and apply information may engage more effectively with schoolwork and perceive their school environment more positively. Notably, the total effect estimates tended to be larger for girls than boys across all subscales, possibly because thirteen-year-old girls typically show higher emotional awareness and psychological distress and may be more receptive to health information. The confidence intervals for boys and girls overlapped, however, so the authors urge restraint in interpreting that pattern — it is a hypothesis generator, not a conclusion.

The team was careful about the limits of its design. Because the data are cross-sectional, the temporal assumptions underpinning causal mediation cannot be verified; the authors explicitly label the findings exploratory. Sensitivity analyses probed how much unmeasured confounding would be needed to overturn the results, and the direct effect estimates proved largely robust across subscales in both sexes, with one exception — peer and social support among boys — showing greater vulnerability. School-level clustering, measured by intra-class correlation coefficients between 0.003 and 0.03, was deemed negligible. All measures were self-reported, leaving room for social desirability bias, and item-level correlations between the health literacy and self-efficacy instruments (Spearman coefficients of 0.14 to 0.35) confirmed the two constructs, while related, are conceptually distinct.

The implications, if the associations hold causally, are considerable. Global health policy documents, European frameworks and Norway’s national strategy all emphasize strengthening population health literacy, and the education sector is the natural arena — it reaches nearly all children across socioeconomic backgrounds. Finland, whose children rank among Europe’s health literacy leaders, credits a standardized framework of health literacy learning objectives woven through the entire school program. Norway’s national guideline for school health services already mandates individual health-promoting consultations with all thirteen-year-olds, precisely to build health literacy, encourage positive behaviors and bolster self-efficacy, while identifying students who need follow-up. Evidence from German school nursing, where health literacy was measured before and after nurse-led health education, suggests schools and school health services jointly hold real potential to lift students’ literacy. Yet effectiveness studies of these strategies remain scarce.

What makes this study resonate beyond Norway is its population-level arithmetic. As Geoffrey Rose famously argued, even modest individual-level shifts in a health determinant can yield substantial benefits when applied across an entire population. If a ten-percentage-point improvement in adolescent health literacy is associated with measurable gains in physical, psychological and social well-being — with self-efficacy carrying a third to three-quarters of that association — then school-based literacy interventions become not just educational policy but mental and physical health infrastructure. The authors conclude that longitudinal studies are now needed to pin down the temporal ordering and causal nature of these relationships. Until then, the message for educators, school nurses and policymakers is tantalizingly concrete: teaching teenagers to understand health information may matter most when it also teaches them to believe they can act on it.

Subject of Research: The mediating role of self-efficacy in the association between adolescent health literacy and health-related quality of life.

Article Title: Adolescents’ health literacy and health-related quality of life: The mediating role of self-efficacy

Article References: Waldum-Grevbo, K. S., Holen, S., Wentzel-Larsen, T., & Sagatun, Å. (2026). Adolescents’ health literacy and health-related quality of life: The mediating role of self-efficacy. Public Health in Practice, 12, Article 100849. https://doi.org/10.1016/j.puhip.2026.100849

Image Credits: AI Generated

DOI: 10.1016/j.puhip.2026.100849

Keywords: adolescent health, health literacy, self-efficacy, health-related quality of life, KIDSCREEN, school health services, public health, Norway, mediation analysis, well-being, social-cognitive theory, health promotion

The 24-Hour Movement Guidelines for the Early Years represent an integrated approach to healthy development in early childhood, recognizing that sleep, physical activity, and sedentary behavior are not isolated habits but interlocking components of a single 24-hour cycle. For children aged 3 to 4 years, the guidelines recommend between 10 and 13 hours of good-quality sleep per day, at least 180 minutes of total physical activity spread across the day, of which at least 60 minutes should be moderate-to-vigorous intensity, no more than one hour of screen time, and no more than one hour of restrained sitting, such as being confined in a stroller, high chair, or car seat for extended periods. Meeting the recommendations individually is one matter; achieving all of them simultaneously on a consistent basis is substantially harder, and that is precisely where the new study focused its attention.

Measurement rigor distinguishes this surveillance effort from earlier surveys that relied largely on parental questionnaires. The research team, led by Sabrina Buchanan and Mark S. Tremblay of the Children’s Hospital of Eastern Ontario Research Institute, together with collaborators from institutions including Western University, Dalhousie University, the University of Alberta, the University of British Columbia, the University of Montreal, Acadia University, and the University of Wollongong, fitted each child with a waist-worn ActiGraph wGT3X+ accelerometer for seven consecutive days and nights. These devices captured objective data on movement intensity and sleep duration, while parents reported on their children’s screen time and time spent restrained in seats and strollers. The study formed part of the SUNRISE International Study of Movement Behaviours in the Early Years and was funded by the Canadian Institutes of Health Research.

Within the final analytic sample of 631 children, 29.0 percent met the overall movement guidelines when accelerometer-estimated measures were prioritized. That headline figure conceals a striking asymmetry in how children performed on each individual behavior. On the positive side, physical activity proved to be a genuine strength of this cohort: every child in the sample accumulated the recommended 180 minutes of total daily physical activity, and 92.4 percent achieved the more demanding threshold of at least 60 minutes of moderate-to-vigorous physical activity per day. Sleep was also largely on target, with between 74.6 percent and 92.0 percent of children meeting the sleep recommendation, depending on whether accelerometer estimates or parent reports were used.

The weak link in the 24-hour equation was sedentary behavior. Only 40.7 percent of children met the sedentary behavior recommendations overall, and the two components told divergent stories. Screen time was the more problematic of the pair, with just 57.1 percent of children staying within the one-hour daily limit, while 71.8 percent met the recommendation for restrained sedentary time. In an era when tablets, smartphones, and televisions are woven into daily family life, the finding that more than four in ten preschoolers exceed recommended screen limits will resonate with pediatricians and early childhood educators who have warned that early excessive screen exposure can displace active play, conversation, and sleep, all of which are critical to brain development during these years.

Beyond the headline prevalence figures, the study uncovered meaningful demographic patterns in who was meeting which guidelines. Girls were significantly less likely than boys to meet the moderate-to-vigorous physical activity recommendation, with an adjusted odds ratio of 0.37, meaning their odds were less than half those of boys. This gender gap, emerging as early as ages 3 and 4, suggests that differences in physical activity participation between males and females are established well before formal schooling begins, reinforcing calls from the study’s authors for targeted strategies to support young girls’ physical activity participation, including inclusive play environments and deliberate encouragement from parents and early childhood educators.

Geography also mattered, though in an unexpected direction. Children living in urban areas were more likely to meet sedentary behavior recommendations than their rural counterparts, with an adjusted odds ratio of 1.51. The authors note that systematic monitoring of preschool movement behaviors has often overlooked subgroups such as males versus females and urban versus rural residents, making these comparisons an important contribution. The rural disadvantage in sedentary time may reflect longer durations spent restrained in car seats during travel to childcare, services, and activities, though the study’s cross-sectional design cannot definitively establish the underlying causes.

Perhaps most intriguing were the age-related findings. Older children within the sample were less likely to meet the overall guidelines, with an adjusted odds ratio of 0.49 per unit increase in age, and less likely to meet sleep recommendations, with an odds ratio of 0.96. Yet the same older children were more likely to meet the moderate-to-vigorous physical activity recommendation, with an odds ratio of 1.08. This pattern suggests that as children approach kindergarten age, their waking hours become more active, but their sleep appears to erode, possibly reflecting later bedtimes, earlier morning routines, or the creeping influence of evening screen use. The net effect is that the delicate balance of the full 24-hour day tips away from the healthy profile as children grow older within the preschool window.

The authors are careful to frame these results within the limitations of a cross-sectional design, which captures a snapshot rather than trajectories over time, and within a sample drawn from childcare settings across five provinces. Methodological choices also mattered: the proportion meeting overall guidelines shifted depending on whether accelerometer-derived sleep estimates or parental reports were prioritized, a reminder that measurement modality can materially alter surveillance conclusions. Even so, the direction of the evidence is consistent with broader international literature showing that very young children are moving enough and sleeping reasonably well but sitting too much in front of screens.

The study’s conclusions point toward a clear public health priority. Because most children in the sample already met sleep and physical activity recommendations, the greatest gains lie in limiting sedentary time, particularly screen time, across the entire preschool population. At the same time, the authors emphasize that continued encouragement of healthy sleep and physical activity remains essential, and that specific, tailored strategies should be developed to support young girls’ physical activity participation. As part of the SUNRISE international surveillance network, this Canadian dataset also provides a benchmark against which future policy interventions, such as screen time guidance, active play programming in early childhood education and care settings, and provincial health promotion campaigns, can be evaluated. With early childhood representing a uniquely plastic developmental window, the difference between 29 percent and a far higher proportion of children meeting all four movement targets may ultimately be measured not in odds ratios but in lifelong health trajectories.

The SUNRISE initiative, of which this Canadian dataset forms a part, was designed to fill a conspicuous gap in global surveillance. While movement behavior monitoring has become routine for school-aged children and adolescents in many countries, comparable data for the early years have been sparse, and the SUNRISE network has sought to harmonize protocols so that preschool findings can eventually be compared across nations with very different childcare systems, climates, and cultural norms around sleep and screen use. The Canadian contribution, spanning five provinces and drawing participants through childcare centres, therefore serves both a national policy purpose and an international comparative one.

The integrated nature of the guidelines themselves reflects a relatively recent shift in thinking among exercise science and pediatric sleep researchers. Earlier guidance treated physical activity, sedentary behavior, and sleep as separate domains with separate targets, but time is inherently finite within a day, so gains in one behavior necessarily displace another. Modeling the full 24 hours as a single continuum allows researchers and practitioners to see trade-offs explicitly, and it explains why the proportion meeting all recommendations simultaneously is so much lower than the proportion meeting any single recommendation in this sample.

The accelerometer protocol also merits attention. Seven consecutive days of waist-worn monitoring captures both weekday and weekend behavior, which matters because preschoolers’ routines often differ markedly between childcare days and home days. Prioritizing device-based estimates over parental report reduces the social desirability bias that plagues questionnaire measures of screen time and sleep, though the divergence between accelerometer-estimated and parent-reported sleep prevalence in this study illustrates that even objective devices rest on assumptions about what constitutes sleep onset and wake.

Finally, the childcare setting through which families were recruited is itself a promising intervention lever. Early childhood education and care environments shape much of preschoolers’ daily movement, and provincial licensing standards governing active outdoor play and screen exposure could translate these surveillance findings into practical policy change.

Subject of Research: Compliance of 3- and 4-year-old Canadian children with 24-hour movement guidelines for sleep, physical activity, and sedentary behavior

Article Title: Proportion of 3- and 4-year-old children meeting individual and combinations of 24-hour movement guidelines across five Canadian provinces: a SUNRISE study

Article References: Buchanan, S., Bremer, E., Bruijns, B. A., Caldwell, H. A. T., Carson, V., Chong, K. H., Faulkner, G., Harandian, K., Hawthorne, M., Kuzik, N., Martins, R., Ong, M., Pagani, L., Potter, M., Tucker, P., & Tremblay, M. S. (2026). Proportion of 3- and 4-year-old children meeting individual and combinations of 24-hour movement guidelines across five Canadian provinces: a SUNRISE study. Journal of Activity, Sedentary and Sleep Behaviors. https://doi.org/10.1186/s44167-026-00113-2

Image Credits: AI Generated

DOI: 10.1186/s44167-026-00113-2

Keywords: 24-hour movement guidelines, preschool children, physical activity, sedentary behavior, screen time, sleep, SUNRISE study, accelerometry, public health surveillance, Canada, early childhood, health promotion

The urgent need to tackle this public health dilemma has inspired numerous intervention studies aimed at increasing physical activity levels. These studies have attempted various strategies, targeting different aspects of motivation and behavior modification to inspire changes in physical activity patterns among adults aged 18-65. In an increasingly health-conscious society, understanding which strategies are most effective in promoting active lifestyles is crucial. A latest systematic review seeks to synthesize existent research and provide deeper insights into the effectiveness of these intervention components.

Published studies highlight a variety of promotional methods tailored to boost exercise and activity. These methods range from community-based programs to digital health apps, each employing unique approaches to energize individuals toward a more active lifestyle. The systematic review in focus meticulously analyzed 116 randomized controlled trials sourced from rigorous databases such as PubMed and Ichu-shi Web, providing a comprehensive overview of various physical activity interventions targeting healthy adults.

Through meta-analysis, the researchers denoted that the overall effectiveness of such interventions remains relatively minimal. Despite the multitude of strategies employed, the results suggest that many existing programs may not adequately cater to instigating substantial behavior change. Hence, it raises an essential question regarding the design and execution of health promotion campaigns aimed at increasing physical activity levels: how can these interventions be improved?

One of the most significant findings from the meta-regression analysis conducted in this study was the revelation that reviewing behavior goals is a particularly effective component. This insight emphasizes the need for personalization in health interventions, whereby participants not only set but continually assess and refine their activity goals as part of the program. Such dynamic adjustments could lead individuals to be more engaged in their health journeys, ultimately fostering a greater commitment to maintaining an active lifestyle.

Moreover, the research uncovered several components that could potentially inhibit the effectiveness of these interventions. While it is essential to identify what works in promoting physical activity, equally important is understanding the barriers that may deter individuals from engaging in exercise. Some existing components may apply pressure or expectation that inadvertently discourages participation, thus highlighting the need for more supportive, less intimidating interventions.

The synthesis of effective and inhibitory components presents an opportunity for researchers and health practitioners to collaborate in designing better intervention programs. By leveraging the identified behavior change techniques taxonomy, strategies can be refined and tailored to meet the unique needs of various population segments. This targeted approach marks a significant shift from generalized strategies, pushing towards more nuanced programs that acknowledge individual differences in motivation and behavior.

Ultimately, developing more effective intervention programs lies at the crossroads of behavioral psychology and public health. By engaging with theories surrounding human behavior and incorporating progressive techniques, health promotion campaigns could find renewed success in inspiring physical activity among adults. The implications of these efforts are far-reaching; by increasing activity levels among the working-age population, we could see a decline in various chronic health conditions that plague society.

In moving forward, it is vital for health organizations to embrace flexibility and adaptability in program design. Integrating findings from systematic reviews and meta-analyses into practical applications will help create interventions that resonate with individuals on a personal level. Investing in such health programs not only promotes a culture of movement but also potentially generates positive societal shifts toward wellness and longevity.

Simultaneously, ongoing research should be encouraged to continuously monitor the effectiveness of these interventions. Longitudinal studies can provide further clarity on sustaining behavior change over time, evaluating the lasting impacts of motivational techniques implemented in physical activity promotion.

Thus, as we demystify the intricacies of physical inactivity and the myriad factors influencing our behavior, a collective effort is essential in promoting a healthier, more active society. This alliance between research, public health policy, and community engagement will ultimately play a pivotal role in fostering a healthier generation not just today but for years to come.

Subject of Research: Effectiveness of physical activity promotion interventions
Article Title: Effectiveness and Components of Health Behavior Interventions on Increasing Physical Activity Among Healthy Young and Middle-Aged Adults: A Systematic Review with Meta-Analyses
News Publication Date: December 19, 2024
Web References: https://doi.org/10.3390/bs14121224
References: (not provided)
Image Credits: (not provided)

Keywords: Physical activity, public health, behavior change, interventions, health promotion, exercise.